Annual Report - Independent Living Services For Older Individuals Who Are Blind

RSA-7-OB for Arizona Rehabilitation Services Administration - H177B110003 report through September 30, 2011

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year664,192
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year632,696
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2918,697
A2. Total other federal556,841
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement178,937
(c) Title XX - Social Security Act16,833
(d) Older Americans Act0
(e) Other361,071
A3. State (excluding in-kind)144,100
A4. Third party0
A5. In-kind0
A6. Total Matching Funds144,100
A7. Total All Funds Expended1,619,638
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs195,770
C. Total expenditures and encumbrances for direct program services1,423,868

Part II: Staffing

FTE (full time equivalent) is based upon a 40-hour workweek or 2080 hours per year.

A. Full-time Equivalent (FTE)

Program Staff a) Administrative and Support b) Direct Service c) Total
1. FTE State Agency 2.6000 3.2000 5.8000
2. FTE Contractors 7.7500 23.0000 30.7500
3. Total FTE 10.3500 26.2000 36.5500

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 24 12.9500
2. Employees with Blindness Age 55 and Older 1 0.5000
3. Employees who are Racial/Ethnic Minorities 13 5.4000
4. Employees who are Women 46 21.8000
5. Employees Age 55 and Older 10 4.5500

C. Volunteers

1.00

Part III: Data on Individuals Served

Provide data in each of the categories below related to the number of individuals for whom one or more services were provided during the reported fiscal year.

A. Individuals Served

1. Number of individuals who began receiving services in the previous FY and continued to receive services in the reported FY312
2. Number of individuals who began receiving services in the reported FY489
3. Total individuals served during the reported fiscal year (A1 + A2) 801

B. Age

1. 55-5970
2. 60-6460
3. 65-6972
4. 70-7468
5. 75-79108
6. 80-84145
7. 85-89152
8. 90-9492
9. 95-9930
10. 100 & over4
11. Total (must agree with A3)801

C. Gender

1. Female586
2. Male215
3. Total (must agree with A3)801

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race40
2. American Indian or Alaska Native13
3. Asian2
4. Black or African American20
5. Native Hawaiian or Other Pacific Islander0
6. White720
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)6
9. Total (must agree with A3)801

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)37
2. Legally Blind (excluding totally blind)422
3. Severe Visual Impairment342
4. Total (must agree with A3)801

F. Major Cause of Visual Impairment

1. Macular Degeneration444
2. Diabetic Retinopathy45
3. Glaucoma111
4. Cataracts32
5. Other169
6. Total (must agree with A3)801

G. Other Age-Related Impairments

1. Hearing Impairment143
2. Diabetes101
3. Cardiovascular Disease and Strokes203
4. Cancer31
5. Bone, Muscle, Skin, Joint, and Movement Disorders210
6. Alzheimer's Disease/Cognitive Impairment49
7. Depression/Mood Disorder23
8. Other Major Geriatric Concerns195

H. Type of Residence

1. Private residence (house or apartment)624
2. Senior Living/Retirement Community95
3. Assisted Living Facility70
4. Nursing Home/Long-term Care facility12
5. Homeless0
6. Total (must agree with A3)801

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)31
2. Physician/medical provider19
3. State VR agency43
4. Government or Social Service Agency48
5. Veterans Administration5
6. Senior Center17
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization1
10. Independent Living center47
11. Family member or friend134
12. Self-referral432
13. Other24
14. Total (must agree with A3)801

Part IV: Types of Services Provided and Resources Allocated

Provide data related to the number of older individuals who are blind receiving each type of service and resources committed to each type of service.

A. Clinical/functional vision assessments and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 0
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 0

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 276,546
1b. Total Cost from other funds 194,768
2. Provision of assistive technology devices and aids 212
3. Provision of assistive technology services 27

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 181,726
1b. Total Cost from other funds 206,422
2. Orientation and Mobility training 162
3. Communication skills 776
4. Daily living skills 776
5. Supportive services (reader services, transportation, personal 0
6. Advocacy training and support networks 0
7. Counseling (peer, individual and group) 0
8. Information, referral and community integration 693
. Other IL services 0

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Information and Referral 693
3. Community Awareness: Events/Activities 19 1,551

Part V: Comparison of Prior Year Activities to Current Reported Year

A. Activity

a) Prior Year b) Reported FY c) Change ( + / - )
1. Program Cost (all sources) 1,138,055 1,619,638 481,583
2. Number of Individuals Served 930 801 -129
3. Number of Minority Individuals Served 81 75 -6
4. Number of Community Awareness Activities 50 19 -31
5. Number of Collaborating agencies and organizations 71 71 0
6. Number of Sub-grantees 23 19

Part VI: Program Outcomes/Performance Measures

Provide the following data for each of the performance measures below. This will assist RSA in reporting results and outcomes related to the program.

Number of persons Percent of persons
A1. Number of individuals receiving AT (assistive technology) services and training 27 100.00%
A2. Number of individuals receiving AT (assistive technology) services and training who maintained or improved functional abilities that were previously lost or diminished as a result of vision loss. (closed/inactive cases only) 6 22.22%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 26 96.30%
B1. Number of individuals who received orientation and mobility (O & M) services 162 100.00%
B2. Of those receiving orientation and mobility (O & M) services, the number of individuals who experienced functional gains or maintained their ability to travel safely and independently in their residence and/or community environment as a result of services. (closed/inactive cases only) 30 18.52%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 44 27.16%
C1. Number of individuals who received communication skills training 776 100.00%
C2. Of those receiving communication skills training, the number of individuals who gained or maintained their functional abilities as a result of services they received. (Closed/inactive cases only) 279 35.95%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 129 16.62%
D1. Number of individuals who received daily living skills training 776 100.00%
D2. Number of individuals that experienced functional gains or successfully restored or maintained their functional ability to engage in their customary daily life activities as a result of services or training in personal management and daily living skills. (closed/inactive cases only) 279 35.95%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 129 16.62%
E1. Number of individuals served who reported feeling that they are in greater control and are more confident in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 662 n/a
E2. Number of individuals served who reported feeling that they have less control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 1 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 34 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 125 n/a
E5. Number of individuals served who died before achieving functional gain or experiencing changes in lifestyle as a result of services they received. (closed/inactive cases only) 3 n/a

Part VII: Narrative

A. Briefly describe the agency's method of implementation for the Title VII-Chapter 2 program (i.e. in-house, through sub-grantees/contractors, or a combination) incorporating outreach efforts to reach underserved and/or unserved populations. Please list all sub-grantees/contractors.

Rehabilitation Services’s Administration’s method of implementation for the Title VII-Chapter 2 program utilizes a combination of in-house staff who devote their time providing evaluation and direct instruction in a variety of adaptive skills in blindness areas. Additionally, 19 contractors provide services in facilities and on an itinerant basis. This combination allows AZRSA to provide the most effective and efficient services possible on a statewide basis. The goal is to provide specialized services for the blind that will allow older individuals to remain in their home and community to the extent possible within the existing resources. AZRSA maintains cooperative efforts with numerous community agencies. AZRSA staff and contractors have continued to increase the provision of assistive technology services, including the purchase of adaptive aides and devices.

AZRSA continues to provide services to older individuals who reside in rural Arizona. Rehabilitation Teachers provide community outreach through in-service presentations to local health fairs, senior centers, nursing homes, retirement communities, medical facilities, hospitals and the Hopi Native American event. The focus of these outreach efforts is to educate interested individuals regarding the needs of seniors who are blind or visually impaired, including how to access all RSA services and how to access senior related community services. Cumulatively, 1551 clients, their friends and family members, as well as, service providers have been provided information regarding vision related services available through 19 presentations given in both metropolitan and rural communities throughout Arizona. AZRSA, the Governor’s Council on Blindness and Visual Impairment and several community providers sponsored the 16th annual Vision Rehabilitation and Technology Expo (VRATE) Conference in November 2010, along with assistive technology providers from across the country. There were 1000 in attendance at the VRATE Conference, which focuses on the specific needs of the blind and visually impaired users, bringing together clients, professionals, agency staff, and the community. AZRSA has developed and maintained the AZ Directory of Services for Persons Who Are Blind & Visually Impaired. AZRSA continues to maintain a website, which provides information and links to additional resources and services.

CONTRACTORS:

Arizona Center f/t Blind & Visually Impaired (ACBVI) Institute for Human Development (NAU) Low Vision Plus Services Maximizing Independent Living & Empowerment (SMILE) Southern Arizona Association f/t Visually Impaired (SAAVI) Linda Adams Patty Arnold Kathy Carlise Julie Dockery Georgeann Hanna Kathy Morell Debra Macilroy Darian Morgan Sandra Perry Julie Rock Ethan Rutkoff Carrie Schaffer Jay Whipple Venu Vanguetty

B. Briefly describe any activities designed to expand or improve services including collaborative activities or community awareness; and efforts to incorporate new methods and approaches developed by the program into the State Plan for Independent Living (SPIL) under Section 704.

AZRSA Services for the Blind, Visually Impaired & Deaf (SBVID) has enhanced community awareness by presenting nineteen events or activities in FFY 2011. Some of the larger presentations and collaborations include: McDowell Village Senior Center Chandler Senior Expo Sun Lakes Support Groups East Valley Adult Resources Catholic Community Outreach Low Vision Support Group Verde Valley Manner Hopi Office of Special Needs/Aging and Adult Services/Village Elder Coordinators Ponderosa Pines Assist to Independence White Cane Day at the Arizona VA Hospital VRATE Community Action Network Lost Peepers Meetings (SMILE Outreach Coordinator presents group information on various topics) Hopi Disability Awareness Day These activities combined with the smaller gatherings that occurred during this FFY provided outreach to 1,551 participants.

C. Briefly summarize results from any of the most recent evaluations or satisfaction surveys conducted for your program and attach a copy of applicable reports.

A survey containing eleven specific questions on changes in client’s lives as a result of their participation in the rehabilitation program for independent living was mailed to clients after they had completed their participation in the program. Postage-free return envelopes were provided. Of the 649 surveys that were mailed: 287 or 44% of the surveys were received with one or more response(s); 13 or 2% surveys were returned as undeliverable; 349 or 54% of the surveys were not returned.

The Independent Living Older Blind Program Survey yielded both quantitative and qualitative information on whether and how the program had benefited clients. There were four questions that were scored on a 4-point scale, from strongly agree to strongly disagree and there were six questions that best described the client’s current functioning on independent living tasks. The final item asked clients to answer, in their own words, how the program had made a difference in their lives. There were 14 questions to obtain specific client background data. Please note that the calculation for the satisfaction rate does not include the no response category and percentages of less than 1 were reported as 0% in this section.

1. Services were provided in a timely matter. Of the 287 returned surveys: 195 or 68% strongly agreed 59 or 21% agreed 2 or 0% disagreed 0 or 0% strongly disagreed 14 or 11% no response This represents a satisfaction rate of 89%. Comments: Pam was a great help in all ways. I really appreciate her. Deborah was so helpful in so many ways to help me in suggesting ways to help me in everyday living tasks. She is a very caring person. I really appreciated her suggestions. I am very grateful the things that you provided for me, they helped me so much! Thank you! Georgeanne and your organization have done a wonderful job. Georgeanne was very helpful and very pleased to know we have your organization. I cannot thank Pam enough for her help and understanding of my problem. She was made everyday life easier for me. Pam is an outstanding special person. I was very pleased with the services. The instructor Nancy Lacock was well versed on the subject she was teaching and quite patient and understanding with the students. She was absolutely great! Mr. Perry was exceptional in every way, he explained about anything I needed to know; was clean, polite and very helpful. 2. The instructor was attentive and interested in my well-being. Of the 287 returned surveys: 224 or 78% strongly agreed 32 or 11% agreed 1 or 0% disagreed 0 or 0% strongly disagreed 30 or 11% no response This represents a satisfaction rate of 89% Comments: Kathy is a great asset to your department. She is genuine in her interest and wants to help I cannot speak highly enough about Kathy. Sandy Perry is the sweetest most helpful person I have ever met. You are lucky to have her. Thank you for sending me Venu, he was very kind, understanding and helpful. Mimi Marsh is quite an exceptional and extraordinary person 3. The instructor was familiar with techniques and aids used by blind and visually impaired individuals. Of the 287 returned surveys: 217 or 76% strongly agreed 36 or 13% agreed 1 or 0% disagreed 1 or 0% strongly disagreed 32 or 11% no response This represents a satisfaction rate of 88% Comments: Person who helped knew her information. You should let the instructor have some of the devices to use at home so they are thoroughly familiar with all aspects of use especially the Victor Reader and Zoom Text. Very patient in explaining. River was very helpful but we need services that address the psychology of going blind later in life. River was wonderful but this is an area you might look at for people blinded later in life.

4. I was satisfied with the quality of services provided by the program. Of the 287 returned surveys: 211 or 74% strongly agreed 38 or 13% agreed 5 or 2% disagreed 0 or 0% strongly disagreed 33 or 11% no response This represents a satisfaction rate of 87% Comments: Pam has been a big help. I will be moving to Casa Grande, to go to an assisted living facility. Georgeann Hanna was caring and helpful in every way. The tools I have been given have helped me to have a better quality and understanding of my disability. I can’t begin to tell you how much the talking book magnifiers and various gadgets have helped me.

5. Travel Responses Of the 287 returned surveys: 128 or 45% are now better able to travel safely and independently in my home and/or community. 49 or 17% - report no change in my ability to travel safely and independently. 3 or 1% - are now less able to travel safely and independently 49 or 17% - did not receive services that would help me travel safely and independently in my home and/or community. 7 or 2% - were not aware or offered these services. 51 or 18%- no response Comments: I do drive but I am not sure that my license will be renewed because of my eyesight. My eyes have worsened and I have become more fearful of traveling alone. I now use my walker in my home, as my legs are very unsteady. Friends help me to sit at a table in the dining area and help me to pick my food from the menu as my sight is slowly getting worse. I did have laser surgery since I’ve been in the program which didn’t help any, but that has been alone the very best as can be. I am so very thankful for everything, I use cab service for some things and company transportation. Currently I am just using the mail service for audio books. I am very independent in my travel and do not need help yet. I was given a cane to get around with. Darian was a wonderful teacher and so patient. River Forest gave me a human ware trekker breeze gaps which provides the street names as you travel around my neighborhood. I am confident when I travel because I was taught to use my walking cane. I am happy and fortunate to be able to walk safely. Thanks to trainer Nancy Lacock at SAVVI.

6. Meal Preparation After Receiving Services Of the 287 returned surveys: 106 or 37% are now better able to prepare meals for myself. 52 or 18% has been no change in my ability to prepare meals. 5 or 1% are now less able to prepare meals independently. 8 or 2% did not receive services that would help me travel safely and independently in my home and/or community. 7 or 2% were not aware or offered these services. 109 or 40% no response Comments: More independent in kitchen, I can heat the oven now to bake or warm leftovers. I hardly ever cut or burn myself any more. Due to all the wonderful gadgets, she suggested for me (something as simple as a knife) I am more able to feel somewhat normal in the kitchen. I was helped with microwave, etc., but I need to be extra careful around the stove cooking. Buttons were put by certain numbers that help some for feel, but I can no longer see them. Cannot see to really cook anymore, I’m afraid of burning myself or burning my food or doing something that may start a fire. I was given better lighting, my measuring cups, microwave, TV, etc. are marked. Have special glasses for reading. Devices such as filling a glass timer, hand held light and magnifying glass help me to cook, chop and measure with recipes.

7. Housekeeping Tasks After Receiving Services Of the 287 returned surveys: 68 or 4% are better able to manage housekeeping tasks, such as cleaning floors/surfaces and organizing. 69 or 24% has no change in my ability to manage housekeeping tasks. 2 or 1% are less able to manage housekeeping tasks. 81 or 28% did not request services to help me manage housekeeping tasks. 12 or 4% was not aware or offered these services. 55 or 19% no response Comments: I can’t see if I get the floors clean and have to hire someone to have them done. Also my strength has weakened; I don’t remember being offered services. Pam was wonderful in suggesting things that I didn’t even know existed. I am not quite afraid of the future. Amazed at the instructions of how easy they made household cleaning tasks. I loved the class. Lighting helps me see more dirt.

8. Paperwork After Receiving Services Of the 287 returned surveys: 138 or 48% were better able to manage paperwork, such as mail, correspondence and paying bills. 49 or 17% has been no change in my ability to manage paperwork. 6 or 2% are less able to manage paperwork. 46 or 16% did not request services to help me manage paperwork. 5 or 2% was not aware or offered these services. 43 or 10% no response Comments: The talking calendars are great to balance my check book etc. I am now able to address cards, write short notes, etc. I especially appreciated the lighted magnifiers, they are life savers! The lamp I was given that now sits on my piano and enables me to see music again.

9. After receiving services Of the 287 returned surveys: 179 or 62% is better able to access reading materials, such as books, newspaper, and magazines (whether with magnifiers, large print, braille or tape). 25 or 9% has been no change in my ability to access reading materials. 7 or 2% were less able to access reading materials. 26 or 9% did not request services to help me access reading materials. 2 or 1% was not aware or offered these services. 48 or 17% no response Comments: Can only read and see print with the enlarger provided to me. I appreciate it very much. Special lamps, magnifiers and talking books were a great help. I am very pleased with talking book service. Love talking book machine and sun sound radio Mimi gave me magnifying tools to see better especially my medication.

10. Compared with my functioning before services Of the 287 returned surveys: 133 or 46% less dependent upon others in performing my customary day-to-day activities, such as getting around, cooking, cleaning, reading, laundry, etc. 75 or 26% has been no change in my ability to perform my customary life activities. 17 or 6% are more dependent upon others in performing my customary life activities. 62 or 22% no response Comments: Except I was given lamps for more light. With the magnifying glass I can now cook my meals at home. When I am cooking I can see better what I’m doing with food; I used to burn lots of things I could not see in the oven to know when things were done. This is a big help. The red buttons allow me to use my oven without worry. My reading machine helps me make out a check and write letters. About the same quality of living has been increased. I am more independent in all aspects of my life, except reading because my eyes hurt. I can take care of myself and my apartment.

11. Tell us the greatest difference this program has made in your life: Comments: With magnifiers I can read more than before. With my vision, I can read and write better than before. The items that Sue brought me have helped greatly. My husband helps me with anything I need help with especially meals and cleaning up. Can read and write letters. Life is not so stressful. I really enjoy the large wall clock Vasant gave me and the large numbered wrist watch. I am more than pleased with the things she gave me and showed me how to use. Vasant was very nice and pleasant to be in her company. I enjoyed her well behaved dog companion - very quiet and calm. I had never seen a seeing-eye dog perform before. Vasant was a pleasure she showed me how to thread a needle so I can sew on buttons now. She’s a jewel! I use the magnifying glass to open my mail and read every day. Georgeanne Hanna has been an inspiration for me and very helpful along with the program I have tried to maintain a positive attitude since Christmas of 2002 when I discovered I had become legally blind overnight. Everything had always been visual with me-learning in school work designing and sewing arts crafts etc. I had a vivid visual memory. I’ve learn to listen-thanks to the program. At this point about the only thing I see is color-for which I’m very thankful. I’ve learned to get around everywhere by observing color and contrast. Thankful this didn’t happen when I was young but hasn’t caused many problems at this age!! The view master is great, the wrist watch also, the strokes of the type writer are great; magnifiers and mirror are helpful I have lined paper. Susan was kind and caring and she helped me each time. The large faced playing cards and the listening books so helpful. Thank you times over for each and all of the above and more! Words cannot express how much I appreciate what Kathy Carlise has done for me. She was so helpful and patient with me. She is a great asset to your program. Because of Mimi, the services, and vision aids she provided I have the confidence that I can function on my own. It definitely made it easier for me to function in day to day living. Knowing there are "gadgets" to help me write a check, etc. and that there’s someone to contact when changes occur. I am able to see items in the store. It is easier to read and do picture puzzles. It’s like new life machine to read to me! It’s like having my life back, magnifier is a big help. Thank you so very much I love listening to audio books almost daily. The bright lights I was given, the talking microwave, the can opener, walking with a cane, and how to walk with another person. Brighter lights in the bedroom. Clocks provided are helpful. Improved attitude, I appreciate the new 5+ magnifying glasses for cooking, sewing, etc., and finding grocery items.

Reported Demographics from the 287 Returned Surveys: Gender 71 or 24% male 197 or 69% female 19 or 7% no response

Living Arrangement 97 or 34% lived alone 148 or 52% lived with others 42 or 14% no response

Race/Ethnicity 233 or 82% White, not Hispanic/Latino 1 or 0% Black or African American, not Hispanic/Latino 3 or 1% American Indian or Alaska Native, not Hispanic/Latino 10 or 3% Hispanic/Latino of any race or Hispanic/Latino only 40 or 14% no response

Visual Impairment 206 or 72% who rated their vision as poor (able read some regular or large print with glasses or magnification) 34 or 12% as completely blind 47 or 16% no response

Degree of Vision Loss 155 or 54% who reported their ability to see worsened during the past year 12 or 4% reported their ability to see improved during the past year 58 or 20% remained the same and can see some 22 or 8% remained the same and cannot see at all 40 or 14% no response

Hearing Related 128 or 45% reported they have a hearing loss 108 or 38% reported no hearing loss 51 or 17% no response

Additional significant health condition other than vision loss 53 or 18% reported yes 83 or 29% reported no 151 or 53% no response

One or more additional disorders (138 responses): Epilepsy 2 Orthopedic 36 Heart Conditions/High Blood Pressure 42 Diabetes 16 Parkinson’s Disease 5 Severe Mobility Impairment 12 Kidney Disease 10 Hepatitis C/Liver 3 Hearing Loss 6 Neuropathies 8 Cancer 7 COPD 6

Overall Health 68 or 24% reported that their overall health had worsened during the past year 15 or 5% reported their medical condition improved 162 or 56% reported their medical condition remained about the same 42 or 15% no response

Major Lifestyle Changes in Last Year (death of a spouse or family member, change in residence, etc.) 45 or 16% reported a change 198 or 69% reported no change 44 or 15% no response

Cause of difficulty in ability to function independently 29 or 10% cited their current health 54 or 19% cited their current vision 204 or 71% no response

Long Term Care/Nursing Home Outlook 156 or 54% stated they never considered going into a nursing home or other long-term care facility 62 or 22% stated they sometimes considered going into a nursing home or other long-term care facility 21 or 7% were already in a nursing home or facility 48 or 17% no response

Services Provided Helped Remain in Private Residence/Home 132 or 46% yes 46 or 16% no 45 or 16% unsure 64 or 22% no response

D. Briefly describe the impact of the Title VII-Chapter 2 program, citing examples from individual cases (without identifying information) in which services contributed significantly to increasing independence and quality of life for the individual(s).

Success Story 1 Submitted by Susan K. Olson CVRT, RSA Employee

Ms. J. is an 85 year old woman who lives in a single family house in the retirement community of Sun City West. She had been sharing her home with a friend who passed away about 6 months prior to contacting AZRSA Rehabilitation Adjustment Employment Services (RAES) for services. Ms. J. had a history of various medical issues, which included several forms of cancer. Several weeks prior to her Rehabilitation Teaching assessment, Ms. J. underwent a mastectomy and was recovering at home. She was diagnosed with AMD and possibly Glaucoma, several years prior to contacting RAES for services. At the time of referral, her vision was reported as 20/100. Due to the above events, Ms. J. was experiencing very little control of her life. Throughout her RT plan, Ms. J’s goals reflected her efforts to regain control of her life and minimize the effects of her visual condition. RT services including aides/devices were offered to address time management, handwriting, telephone, food preparation, cleaning, money identification, clothing, grooming/hygiene, low vision and mail management. Using prescribed low vision aids (Mobilux 4X, 3x Eschenbach, and portable video magnifier) Ms. J. was able to access her mail, food product directions and community outings that required reading (restaurants, shopping, etc.). Instruction in various adaptive cooking techniques and provision of appliances/devices allowed her to regain independence to cook healthy/nutritious meals. RAES staff was also instrumental in requesting/obtaining improved coordination of support services for Ms. J. Prior to RAES involvement, Ms. J. was reluctant to disclose some of her limitations and unmet needs. When her RAES case was closed, she had in-home care services, Social Work services from a faith-based community provider that has monthly Low Vision Support group meetings as well as helps to link residents to additional services. Ms. J. had also completed paper work designating a nephew to be her medical/financial Power of Attorney. This was a major accomplishment as she was a single woman who had outlived her parents and siblings and would have been at risk of having no one available to make decisions for her.

Success Story 2 Submitted by Frank Vance, Arizona Center for the Blind and Visually Impaired

In January of 2011, Ms. N., a retired elementary school teacher from Mesa, introduced herself to the Arizona Center for the Blind and Visually Impaired. She had lost significant vision from diabetic retinopathy. Ms. N. reported that she had been falling on curbs and stairs as she had no way to discern their presence and depth. When Ms. N. came to ACBVI, she quickly learned that there are many programs and services that would help her to cope with the vision loss and to regain her personal independence. She was very enthusiastic about our Fundamental Aspects of Skills Training (FAST class and our Getting Your Self Together (GYST) support group. The fast class provided instruction on a variety of adaptive living skills including check writing, money identification, home management, kitchen safety, and clothing identification. Ms. N. found that being able to coordinate her clothing and applying cosmetics with limited vision was a big boost to her self-esteem. In the GYST group, Ms. N. learned that the feelings she experienced concerning her blindness aren’t very different from those of lots of people in similar circumstances. Most importantly, she learned how to replace depression with hope and to have a positive “can do” outlook. Ms. N. expressed gratitude for the training she received in orientation and mobility. A specialist worked with Ms. N. and taught her how to use a white cane to detect obstacles such as curbs and stairs. Ms. N. learned how to adapt her travel skills and can now travel confidently and freely without falling and injuring herself. She is excited about improving her traveling abilities even further when she gets her new dog guide, which should happen within the next year or so. Because of the services Ms. N. received at ACBVI, she has a full and enjoyable life. Presently, she has happily resumed volunteering at the school where she taught reading skills to elementary children for several years. These services have been made available because of funding through the Rehabilitation Services Administration. Ms. N’s. success is only one example of how RSA funded programs and services have been making a very positive difference in the lives of individuals who have been affected by vision loss and whose lives would be very different if such funding was not available.

Success Story 3 Submitted by Julie Rock, RT, Contractor

Ms. W. is a 57 year old diabetic woman with age related macular degeneration. She had to give up driving about 2 years prior to the beginning of her vision rehabilitation and had moved in with a friend. Her back ground included working as a hair stylist, nail technician, and paralegal. She was passionate about her ability to work with computers including rebuilding a hard drive. After the onset of her disorder, she lost confidence and began to stay home the majority of the time. After several months of IL training, she moved to an apartment on her own. She now travels to and from the grocery store and uses her Summit ID Mate to find grocery products that are best suited for her diabetes. She uses a Zoom Text Keyboard and software to connect with family members and friends. She organizes pot lucks at her apartment complex and is working on organizing trips to the Phoenix Library and local museums. Although she independently signed up for Dial—A-Ride, Ms. W. has acted as her own advocate to improve her medical needs through a company that can visit her in home for basic checkups to save time from cab rides and using Dial—A-Ride. Ms. W. uses various aids and devices for food preparation. For example, large print measuring cups and spoons, a talking kitchen thermometer, one touch can opener, double spatula, and talking cooking timer. She also uses a video magnifier to read recipes good for her diabetes as well as her mail. She uses writing guides to sign checks and forms. She is also able to pay bills on line and research information on any health concerns. Ms. W. is continuing to increase her training with Braille, thereby increasing her independence. Through her independent living vision rehabilitation training and provision of aids and devices, Ms. W. has increased her abilities and confidence thereby increasing her independence.

Success Story 4 Submitted by Sandra Perry RT, Contractor

Mr. O. is a 96 year old male with Age-related Macular Degeneration. He resides in an independent living apartment in Peoria, Arizona. At the time of the initial assessment, Mr. O. was unable to use any hand held magnifier effectively. He required an electronic video magnification system to allow him to meet his needs. Mr. O. needed to be able to see his correspondence to ensure that his investments and financial information were appropriate. He also needed to be able to see what he wrote. Mr. O. was instructed how to use his magnification system to write a check, write a letter and fill out forms. After Mr. O. was ready, he was provided homework. Mr. O. had to write using a guide, then thick lined paper, and eventually using no guides. I had him print his ABC’s and write three different sentences. Eventually, Mr. O. was able to write using his CCTV in straight lines and with clarity. Giving client’s homework makes them feel young again and stimulates their minds. At this time, Mr. O. can read anything under his CCTV, write a check, and write a letter and print big enough that he could see what he wrote. These services have changed his life and given him much greater independence.

Success Story 5 Submitted by Services Maximizing Independent Living & Empowerment (SMILE) - Yuma

Patricia, 87 years of age, was diagnosed with ischemic optic neuropathy. Patricia came to SMILE for blind services to see what can be done to help her with her visual disability and help her maintain as much independence as possible. SMILE staff was able to provide Information Access/technology services to client after an assessment. Through RSA funding SMILE was able to provide consumer with a large print timer, 20/20 pens, low vision essential kit, talking food thermometer, oven mitts, double spatula turner, black/white large print playing cards, low vision measuring cups and teaspoons, talking prescription bottles, ultimate slicing guide with fork with block, high contrast black/white cutting board, big print date calendar, jumbo LED digital alarm clock, needle threader, adjustable support cane, and a sewing machine magnifier. With the devices supplied to Patricia, she is able to continue cooking her meals independently, mend her clothing, keep track of her daily schedule, keep track of time, and continue to enjoy her community with her continued independence. Patricia no longer needs her husband to help her with every household task thereby giving her the self-independence she wanted and needed.

Success Story 6 Submitted by SMILE

Elizabeth, 77 years of age was diagnosed with geographic atrophy in the eyes. Elizabeth came to SMILE for help in her gaining some of her independence back due to her vision loss. SMILE was able to qualify Elizabeth for services with her vision loss and provided devices/aids for the visually impaired. With RSA funding SMILE was able to provide Elizabeth with a talking alarm clock, talking prescription bottles, 7 day pill organizer, color cue measuring cups and spoon set, one touch can opener, double spatula turner, low vision black/white cutting board, EZ fill liquid alarm, black leather can holster with adjustable strap, 20/20 pens, jumbo talking calculator, a writing guide kit, bump dots, lady’s two tone low vision talking watch, support cane, big print calendar, and a knife with slicing guide with fork. Before Elizabeth received the devices and aids from SMILE, she was unable to independently manage her medications, daily schedule, tell the time, write, manage her finances, or cook. Since receiving her devices and aids, she can now handle a majority of her daily living needs independently without having to wait on her husband and son.

Success Story 7 — In Marilyn Love’s Own Words Marilyn, age 68 is severely visually impaired, diagnosed with Macular Degeneration

"I have told so many people about my experiences with the Southern Arizona Association for the Visually Impaired (SAAVI), including my friends, my Pastor, and my apartment manager (who has a visually impaired relative). I was told about SAAVI through Desert Low Vision Services. My intake in January of this year was the beginning of a new perspective as a visually impaired individual. I could not believe the variety of services this agency provides. I have graduated from the introductory Rehabilitation classes called GOALS; the advanced classes called STARS, and are scheduled for my final lesson in Mobility Training. The Rehabilitation classes taught me a lot about how to perform everyday activities in a different way, learn how to express myself in a support group with other visually impaired people, and how to explore a variety of low vision adaptive aids. The skills I learned in these classes have enabled me to continue to live independently, organize my home the way I need it to be, and rely on adaptive techniques and aids as needed to perform day to day activities. The friendships I have formed at SAAVI have been invaluable to me.

Orientation and Mobility training has given me a new sense of independence and confidence as I travel in the Community using the folding white cane. I have learned the importance of safe travel, as well as a variety of techniques to identify sidewalks, curbs, and other obstacles I may encounter, but not recognize visually.

I am waiting to attend additional classes I am interested in - including Health and Wellness, Yoga, Braille instruction and beginning adaptive cooking.

My ultimate goal is to continue attending classes and hopefully volunteer my time at SAAVI with other low vision students. I have learned to be more independent and careful in my everyday life as a result of SAAVI. The atmosphere at this agency is one of professional camaraderie. What the staff is teaching is awesome — no one is made to feel as though they are less than anybody. The staff makes the transition workable and helpful for everyone who is affiliated with this agency."

E. Finally, note any problematic areas or concerns related to implementing the Title VII-Chapter 2 program in your state.

During this reporting period, AZRSA continued to provide direct services to older individuals with vision loss. During this reporting period, AZRSA has had substantial staff vacancies, however, AZRSA continued to provide quality case management services utilzing contractors throughout the state with no higher case management costs. AZRSA implemented a new case management system which is more accessible for staff and contractors who are visually impaired. The System 7 will result in more accurate reports. The Client Satisfaction Survey was sent out to clients upon case closure. This procudure has been more effective in obtaining client feedback about services received.

Part VIII: Signature

As the authorized signatory, I will sign, date and retain in the state agency's files a copy of this 7-OB Report and the separate Certification of Lobbying form ED-80-0013 (available in MS Word and PDF formats.

Signed byKatharine Levandowsky
TitleRSA Program Administrator
Telephone602 542 6295
Date signed12/29/2011