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

RSA-7-OB for Georgia Department of Labor - Division of Rehabilitation Services - H177B110010 report through September 30, 2011

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year868,032
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year894,054
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 21,541,104
A2. Total other federal0
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)171,233
A4. Third party0
A5. In-kind0
A6. Total Matching Funds171,233
A7. Total All Funds Expended1,712,337
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs58,996
C. Total expenditures and encumbrances for direct program services1,653,341

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 0.8200 0.0000 0.8200
2. FTE Contractors 11.4600 17.8100 29.2700
3. Total FTE 12.2800 17.8100 30.0900

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 22 7.9190
2. Employees with Blindness Age 55 and Older 7 3.6660
3. Employees who are Racial/Ethnic Minorities 24 7.4080
4. Employees who are Women 61 26.3770
5. Employees Age 55 and Older 33 14.9480

C. Volunteers

2.00

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 FY242
2. Number of individuals who began receiving services in the reported FY1,072
3. Total individuals served during the reported fiscal year (A1 + A2) 1,314

B. Age

1. 55-59120
2. 60-64133
3. 65-69131
4. 70-74139
5. 75-79171
6. 80-84214
7. 85-89243
8. 90-94129
9. 95-9928
10. 100 & over6
11. Total (must agree with A3)1,314

C. Gender

1. Female860
2. Male454
3. Total (must agree with A3)1,314

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race14
2. American Indian or Alaska Native32
3. Asian8
4. Black or African American295
5. Native Hawaiian or Other Pacific Islander1
6. White932
7. Two or more races3
8. Race and ethnicity unknown (only if consumer refuses to identify)29
9. Total (must agree with A3)1,314

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)79
2. Legally Blind (excluding totally blind)661
3. Severe Visual Impairment574
4. Total (must agree with A3)1,314

F. Major Cause of Visual Impairment

1. Macular Degeneration666
2. Diabetic Retinopathy168
3. Glaucoma161
4. Cataracts19
5. Other300
6. Total (must agree with A3)1,314

G. Other Age-Related Impairments

1. Hearing Impairment455
2. Diabetes407
3. Cardiovascular Disease and Strokes744
4. Cancer98
5. Bone, Muscle, Skin, Joint, and Movement Disorders415
6. Alzheimer's Disease/Cognitive Impairment44
7. Depression/Mood Disorder107
8. Other Major Geriatric Concerns513

H. Type of Residence

1. Private residence (house or apartment)1,166
2. Senior Living/Retirement Community84
3. Assisted Living Facility50
4. Nursing Home/Long-term Care facility12
5. Homeless2
6. Total (must agree with A3)1,314

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)811
2. Physician/medical provider9
3. State VR agency31
4. Government or Social Service Agency42
5. Veterans Administration0
6. Senior Center30
7. Assisted Living Facility15
8. Nursing Home/Long-term Care facility1
9. Faith-based organization1
10. Independent Living center14
11. Family member or friend139
12. Self-referral133
13. Other88
14. Total (must agree with A3)1,314

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 564,782
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 949
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 491

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 404,203
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 686
3. Provision of assistive technology services 893

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 444,053
1b. Total Cost from other funds 0
2. Orientation and Mobility training 155
3. Communication skills 425
4. Daily living skills 569
5. Supportive services (reader services, transportation, personal 336
6. Advocacy training and support networks 241
7. Counseling (peer, individual and group) 516
8. Information, referral and community integration 1,161
. Other IL services 263

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 240,303
1b. Total Cost from other funds 0
2. Information and Referral 5,861
3. Community Awareness: Events/Activities 366 28,225

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) 886,715 1,712,337 825,622
2. Number of Individuals Served 1,026 1,314 288
3. Number of Minority Individuals Served 282 382 100
4. Number of Community Awareness Activities 225 366 141
5. Number of Collaborating agencies and organizations 160 215 55
6. Number of Sub-grantees 37 53

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 893 100.00%
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) 718 80.40%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 146 16.35%
B1. Number of individuals who received orientation and mobility (O & M) services 155 100.00%
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) 105 67.74%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 27 17.42%
C1. Number of individuals who received communication skills training 425 100.00%
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) 311 73.18%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 67 15.76%
D1. Number of individuals who received daily living skills training 569 100.00%
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) 426 74.87%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 88 15.47%
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) 0 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) 0 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) 0 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 0 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) 0 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.

Project Independence: Georgia Vision Program for Seniors (also referred to as the Older Blind Program — OBP) implements the Title VII-Chapter 2 program through 7 main sub-grantees. Many of our sub-grantees further subcontract with various vision specialists throughout Georgia. We continued using our main sub-grantees in FFY11 utilizing the regular OBP funds as well as the ARRA funds. The main sub-grantees in Georgia are: • Center for the Visually Impaired • Vision Rehabilitation Services • Mons International • Savannah Association for the Blind • Visually Impaired Specialized Training and Advocacy Services (VISTAS) • Walton Options Center for Independent Living • Mississippi State University

Utilizing the ARRA funds, we contracted with the above service providers (Mississippi State University was not included in the ARRA funds) and other entities in order to provide outreach efforts to reach the underserved and unserved seniors. The additional sub-grantees included: • Helen Keller National Center • Georgia Radio Reading Services • Disability Link Independent Living Center — Peer Support Training • Alberta Orr — Gerontology Training • National Federation of the Blind of Georgia • Georgia Council of the Blind • Georgia Interpreting Services Network • Albany Advocacy Resource Center/Albany Center for the Blind

In addition to contracts with various providers, we also procured high and low tech aids and devices, sponsored training for staff and seniors and conducted outreach presentations. Details will be found in B.

Our two main initiatives to reach underserved and/or unserved populations in Georgia this year were 1) conducting outreach presentations to various community organizations and areas not previously accessed throughout Georgia and 2) increasing awareness and services to seniors with a dual sensory loss. Our primary subcontractors implemented outreach in various ways:

Visually Impaired Specialized Training and Advocacy Services (VISTAS) VISTAS went into different communities, distributed brochures and let the population know about Georgia Vision Program for Seniors. VISTAS population this fiscal year almost doubled. The sub-contractors, low vision specialist, and seniors helped bring in new clients. Seniors were seen in their homes for training.

Mons International (Mons) Various eye care professionals and others, referred seniors to Mons International, Inc. A structured process then took place including obtaining eye reports, scheduling, and if appropriate, a low vision exam, seeing specialists, and discussing services, resources, and advocacy with the senior. Services were recommended and aids/devices were provided.

Mons attended and participated in consumer group conferences, county fairs etc., and provided workshops on low vision aids to senior centers to promote awareness of OBP; maintained two websites, a catalog and two toll free numbers that helped people find Georgia resources; provided eye exams at the Indian Reservation in Whigham, GA.; and implemented a telephone support group to inform seniors in rural areas what services and events were available.

Walton Options (WO) With ARRA funding this year, an additional CVRT was employed to do outreach in the 22 senior centers in WO service area as well as participate in various health fairs.

Center for the Visually Impaired (CVI) CVI implements Title VII-Chapter 2 programming primarily in-house and subcontracting with other blindness professionals, providing a service model of group and one on one service provision, whatever is appropriate for the particular individual. This fiscal year, CVI has been supported by the addition of two professional interns as full-time temporary employees.

Vision Rehabilitation Services (VRS) Program participants began their program with a comprehensive low vision evaluation (LVE) by a consulting optometrists who specialize in low vision. Seniors receive follow-up to discuss the findings from the initial intake/assessment performed by a licensed clinical social worker. If it is determined that additional training is needed an Individual Learning Service Plan is created.

All follow-up vision rehabilitation services are provided by university trained and ACVREP certified staff. To reduce continually increasing mileage reimbursement costs and our instructor’s driving time, VRS encourages seniors to assume the responsibility of coming to centralized training sites or to the main office and use group trainings, when possible, to maximize instructor effectiveness.

Savannah Association for the Blind (SAB) SAB’s general service delivery model follows a progression of intake and qualification, low vision examination, assessment and service plan development, service delivery, plan completion and closure and finally, follow-up. Services are delivered by in-house staff and limited subcontractors. Training is either center or home based, depending on each client’s individual needs and living situation.

Thanks to additional ARRA funds, a wide variety of outreach activities were conducted across southeast Georgia. SAB also published a completely new website. The number of referrals received for older blind services significantly increased as a result of these activities.

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.

In our efforts to improve and expand our services, Georgia collaborated and contracted with many new providers. The providers we contracted with this year were: • Center for the Visually Impaired • Vision Rehabilitation Services • Mons International • Savannah Association for the Blind • Visually Impaired Specialized Training and Advocacy Services • Walton Options Center for Independent Living • Mississippi State University • Helen Keller National Center • Georgia Radio Reading Services • Disability Link Independent Living Center • Alberta Orr — Gerontology Training • Georgia Interpreting Services Network • Albany Advocacy Resource Center/Albany Center for the Blind • National Federation of the Blind of Georgia • Georgia Council of the Blind

A brief description of our efforts will describe the collaborative activities, community awareness and efforts to incorporate new methods developed by the program.

Helen Keller National Center (HKNC). One of our major initiatives this year was to increase awareness and incorporate new methods and approaches in working with seniors who have a dual sensory loss. Many of our seniors do not identify their hearing loss; this initiative was put in place to open the doors for this group and to teach and guide our providers in working with the deaf-blind.

We collaborated with HKNC on three different projects: • Training at HKNC in NY for a signing deaf-blind senior. These comprehensive resources are not available in Georgia or elsewhere in the United States or other countries. HKNC is the only facility that can provide the skilled staffing resources needed for a 24/7 intensive training program. • Providing consultation and training regarding the provision of services for seniors who are deaf-blind (dual sensory loss or combined hearing and vision loss) to collaborating agencies, interpreters, providers and contractors of the Older Blind Program, and • Providing assessments and recommendations for training, services and resources in order to enhance the ability of the deaf blind senior to live independently.

These efforts incorporated new methods and approaches developed by the program to provide needed training to providers in how to work with those seniors with a dual sensory loss.

Georgia Radio Reading Services (GaRRS) (Statewide listenership is 15,375.) Collaborating with GaRRS increased community awareness of Project Independence by: • assisting the Older Blind Program (OBP) in the creation, production and dissemination of public service announcements (PSA) and a half-hour radio program about the Georgia Vision Program for Seniors. The OBP program manager was interviewed for a program called the “Senior Scene” that was broadcast statewide, and • recording audio brochures and resource guides in CD’s and tapes so an audio format — not previously available - of the program and resources was available.

As GaRRS broadcast PSA’s about the program throughout the year, we feel confident we reached the statewide listenership of 15,375 this year!

Disability Link Independent Living Center — Peer Support Training. The result of collaborating with Disability Link for this training was: • to provide training to Peer Supporters so the Peer Supporters were empowered to assist seniors with significant visual impairments to lead a self-determined life through supports and resources, and • to provide training to Peer Supporters so they can educate seniors with visual impairments on the aspects of building relationships, finding community resources and learning effective listening and communication skills.

Participants from the six main providers, along with NFBGA and GCB received this training by the OBP collaborating with an Independent Living Center, Disability Link. These peer support participants are functioning in various capacities throughout the state in peer support roles and conducting peer support groups.

Alberta Orr — Gerontology Training. We collaborated with Ms. Orr, a nationally known teacher in Gerontology for a new method and approach to help increase knowledge of aging and better equip providers and contractors working with seniors. The course provided instruction that: • enhanced participants’ knowledge, attitudes and perceptions about vision loss and aging, • explored the physical, psychosocial, and mental health issues encountered by aging adults and examined some strategies and rehabilitation for living with a visual impairment, and • identified services and resources, to help older individuals with visual impairments, their families, associates, and communities deal with their individual losses.

Albany Advocacy Resource Center/Albany Center for the Blind. Georgia collaborated with the Albany Center for the Blind, the only GA residential program for the blind. The Albany Center provided a skilled training (day or residential) environment to our senior blind to learn to maximize independence and self sufficiency in the home while promoting empowerment and inclusion in the community. The training included independent living skills, training in a variety of blindness skills, and adjustment services needed for independence. National Federation of the Blind of Georgia and Georgia Council of the Blind. Georgia collaborated with our state affiliates of NFBGA and GCB. We believed it was essential to have the largest consumer organizations of the blind involved in this program in order to increase awareness of the program. Outreach was presented to potential participants of the Older Blind Program (OBP) through local community organizations in unserved or underserved very rural Georgia by: presenting programs describing the OBP, providing coping and alternative strategies, sharing personal stories and accommodations, and sharing resource and contact information on other providers of services.

Georgia Interpreting Services Network (GISN). We collaborated with GISN to provide tactile and close vision interpreters statewide so our seniors with the dual sensory loss would be able to access services. Without the interpreters our signing deaf-blind would not be able to access services, increase community awareness or have an opportunity to improve and expand their independent living skills.

These services were provided in a teaching environment with vision professionals e.g. vision rehabilitation therapists, low vision therapists, orientation & mobility specialists, along with the HKNC consultant and providers of the Older Blind Program.

Outreach Initiative - Other collaborative and new methods developed: Outreach was one of our major collaborative and community awareness initiatives this year. Presentations were conducted by all six main providers, as well as the GCB, NFBGA and the Program Manager. Presentations, resource guides, brochures, and demonstration items all made up this effort. Participants presented to senior centers, area agencies on aging, libraries, senior living communities, health fairs, exhibits, and gatherings of seniors in local communities. The presentations had standard components to be sure that all providers were presenting a consistent program statewide, customizing it to fit the style and personality of the speaker.

Also, as part of our outreach, two contractor meetings were held in Atlanta, GA in February and August 2011. These meetings included various contractor staff and a variety of presenters on subjects related to our ARRA contracts. The participants provided feedback from training attended, shared resource information and discussed program services to our seniors.

The project manager conducted presentations and outreach of our program at the: annual conventions of the GCB and NFBGA, the semiannual Statewide Coalition on Blindness held in Rome and Savannah, the quarterly Georgia Statewide Independent Living Council meetings (program manager serves as an ex-officio member) as well as agencies across Georgia. The assistive listening devices for those with a dual sensory loss were a major hit in the presentations throughout as more and more blind and low vision seniors are letting it be known they cannot hear.

Equipment procurement With the additional ARRA funding, we were able to purchase a number of different high and low aids and devices for seniors that previously we had been unable to do. These items were and will be given to our seniors to expand and improve their independent living skills, used for demonstration purposes to make sure which item/s is most appropriate for that senior, and help facilitate learning specific tasks pertinent to the seniors needs.

In the Program Manager’s opinion, the assistive listening devices provided to our seniors with the dual sensory loss made more difference than any one piece of equipment. Seniors told us they could hear in meetings and others talking clearly for the first time.

Special Training for Staff and Seniors The program sponsored staff to attend a variety of seminar/conferences that aided in bringing back information to help improve our program. Those trainings were National Federation of the Blind annual national convention, American Council of the Blind annual national convention, Association for Education and Rehabilitation of the Blind and Visually Impaired (AER) regional conference held in Boston.

For our seniors, sponsorship was provided to the American Association of the Deaf-Blind national conference and to the Oral Hull Foundation for the Blind camp in Oregon. These experiences helped increase the seniors’ self confidence and independence.

Our primary subcontractors collaborated and incorporated new methods and approaches in various ways. Highlights are noted: • Participated in many community based activities and collaborated with the local Center for Independent Living on a Confident Living Program. • Provided insight for persons who did not know how to work with clients with a mild hearing loss. • Confident Living Program and dual sensory loss training by HKNC. I learned that to help a person with dual sensory loss seemed very close to saving a life! • Albany Center for the Blind. The clients could receive intense day or residential training and then follow up with teachers coming to their home. • Support groups, that included telephone support groups. • Provided an overview of the Chapter 2 program and safety and wellness training for seniors at every senior center in our counties last year. • Provided Peer Mentor training and advocacy training in order to build a group of persons who would be actively involved in outreach and education to policy makers. • Gerontology, Peer Support, and AER training, as well as specialized training for dual sensory through HKNC. • New methods and approaches included inclusion of group O&M, ADL/Communication, and group Vision Rehabilitation Therapy classes. • Through marketing and research advertised our program and had interested participants attend “Vision 101” presentations. • When tools are no longer needed by a client, they can be returned and then lent or given to someone else who may need them. • A new Public Relations Coordinator worked hard to market our program to the community; our visibility has greatly increased. • Rather than loan technology for an indefinite period of time, a client has use of a CCTV through the program for a maximum of one year. Staff maintains communication and offers assistance in locating funding and other resources enabling the client to obtain their own personal unit. • Developed a family Rehabilitation Program - the program will provide training and support for family members and people close to a person who is visually impaired or blind. • Launched a new web site and electronic communications system in FFY11. The site has significantly improved our ability to communicate with all constituent groups.

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.

GA contracts with Mississippi State University (MSU) to conduct satisfaction surveys administered through telephone interviews. Closed consumer names were provided by the six contractors to MSU to conduct the survey. Each year MSU prepares a program evaluation report that details manner, type, and outcome of services as well as a host of demographic information. Following is a summary of the most recent report.

The Project Independence program is an innovative model that facilitates the provision of independent living services to older individuals who are visually impaired throughout various locales within the state. The Director of Blindness Services is commended for hiring part-time an experienced individual to solely manage the older blind program, including spending of stimulus monies. The GDOLRS has contractual agreements with six regional agencies for provision of direct services to eligible seniors. These contractors generally use an itinerant approach, allowing the program to serve consumers who might not otherwise be able to participate in such a program, particularly individuals in outlying rural areas. Further, a regional service delivery approach enhances the ability of project staff to be sensitive to and familiar with the needs of local consumers.

During this project year, 142 consumers participated in telephone interviews. The majority of participants (60%) were 75 years of age or older. More than two-thirds (69%) were female. About one-third (34%) of participants reported living alone, with a similar percentage (36%) living with a spouse. The majority (61%) reported that they were legally blind. Half of the respondents reported macular degeneration as the main reason for their visual impairment. Consumer satisfaction levels among those participating in the survey were very high. Among the three broad aspects of the program targeted by the survey—manner of service delivery, types of services provided, and perceived outcomes of services—almost all of the participants expressed satisfaction. Participants were most satisfied with services they had received (99%) and the manner in which those services were received (98%). Although still high, ratings were lowest for IL outcomes. Eight-six percent of participants agreed or strongly agreed that they had increased their functioning on IL activities (e.g., cooking, mobility, accessing print, participating in the community). Narrative comments also reveal that participants generally have a great deal of appreciation for the program and its staff. The survey information collected will help the administrator develop training programs specific to needs of the contracted providers.

The Georgia Department of Labor, Rehabilitation Services Project Independence is a well conceived rehabilitation model that facilitates the provision of independent living services to older individuals who are blind or visually impaired. Because of the rural nature of the state and the limited funding that is available, older blind individuals in several rural counties are not served at the level needed. However, the model that is in place certainly serves as a framework to reach all older individuals who are blind throughout the state once adequate funding becomes available.

Although the number of individuals served slightly decreased from the FYs 2005-2007 levels, numbers have increased in the last three years (983 in 2008, 992 in 2009, and 1,026 for FFY10). This year’s federal funding increased because of the ARRA funds which are still available in FY 2011, but in FY 2012 those funds will no longer be available. Georgia Project Independence will need to secure state funds as well as previously identified in-kind contributions to assure that consumers are served as comprehensively as possible.

In conclusion, the suggestions contained in the "Recommendations" section of this report should be considered as a part of the ongoing program planning process for the development of a comprehensive state model of services for individuals age 55 and older with visual impairments. Those recommendations are: • Incorporate discussions at semi-annual contractor meetings on strategies to improve independent living functioning of program participants as measured by ratings on the Program Participant Survey. • Review "Section II: Types of Support Services Provided" on the Program Participant Survey to determine if revisions need to be made to include items that are more related to questions in "Section III: Outcomes of Services Provided." • All Project Independence contracting agencies are encouraged to continue to make maximum utilization of the Georgia Lions Lighthouse Foundation resources to purchase eyeglasses, hearing aids, corrective eye surgery, and emergency vision treatment in those cases where other resources are not readily available. • Request that all contractors provide the MSU-RRTC contact information for closed cases quarterly so that telephone interviews can be conducted in a more timely manner following case closures. • Continue to increase awareness and impact of dual sensory loss among consumers of the Project Independence program. • Each Project Independence contractor is encouraged to adopt a formal Individualized Independent Living Service Plan on each case accepted for services and ensure that a Service Plan is included in each case file. In addition, a system to recognize clients as “closed” or “inactive” is encouraged.

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).

“In cooperation with Helen Keller National Center, a contractor held a Confident Living Program three day workshop for dual sensory loss seniors. The six seniors were introduced to hearing and vision devices plus daily living and mobility training. The second night we all went to dinner together and Mr. X just sat quietly at the table like he was lost. I asked him to turn on his hearing device so I could speak to him in the microphone. He became a new person! He was now part of the conversation in a noisy restaurant. The same thing happened a few weeks earlier at a support group with Mr. Y. He was not participating in the support group discussions at all and I thought he was bored or ill. When spoken to he barely answered. I asked him if he was hearing okay and he said “no”. Once he put on the assistive listening device - he actually “took over” the group. (Manager’s note: we have had example after example of seniors “lighting up” and taking on a different persona once the ALD’s were introduced and implemented. What a difference these devices have made in the lives of our seniors with a dual sensory loss.)”

“Fred lives out in the country on a dirt road. He’s 68 and has completely lost his vision. The mailbox sits quite far away from the house, and with no landmarks or traffic sounds to help him, he has had an impossible task to get from his front door to the mailbox. His gait is a bit unsteady, so it’s hard for him to travel with his cane without veering off one way or the other. He and the rehab teacher finally came up with an idea. They got a couple of loud doorbells and attached one to the underside of the mailbox. The other is brought out onto the front porch when Fred decides to go for the mail. He carries the doorbell button in his pocket and it activates both units; since they have differing sounds, he can distinguish them as he walks. By following the sound, he is easily able to get to the mailbox and back to the porch. Such a simple thing, but he is delighted with it and is glad to have someone in the Older Blind program work with him on the things he needs in an area with few services.”

“Mr. I., a 65 year old African American man, has been an active client for two years. Health concerns include hypertension, diabetes, and left sided weakness resulting from two CVAs; his vision loss is the result of diabetic retinopathy. Relocated to public housing due to losing his home to foreclosure, the case manager provided him with supportive counseling, housing resources, and community referrals. Referral to Low Vision resulted in use of magnifying devices to read labels, mail, and medical information. The program provided independent living skills instruction at home and through group classes, which resulted in maintaining ability to live independently. Following group classes, Mr. I was evaluated by the agency’s Diabetic Educator and has continued to attend the Diabetic Support group meetings weekly. Mr. I. recently participated in a focus group of visually impaired seniors who met at a Senior Center, to discuss creating a senior center program accessible to visually impaired participants; he has begun attending this program as the first member of this new group of participants.”

“Following are some of the comments we hear over and over: • Why didn’t I know about your services before now? • Why did my doctor not refer me until now? • Had I known about your services sooner…What a difference it would have made in my life! • I had given up. I didn’t think there was anything that could be done. I am overwhelmed by the difference in the quality of my life now that I have a magnifier and have received training. • I live on a fixed, limited income. This funding source that enables me to receive these services….What a great service! After coming to the program, I now have hope.”

“Mrs. C, who resides in another county, was able to read her medication pamphlets with the help of a loaner CCTV. The ability to have a device that enabled her to read about her medications in more depth may have saved her life. She was having side effects that she did not realize, nor did her physician realize, were caused by the adverse affects of the medication. While reading the literature with her CCTV, it became apparent that the medication needed to be stopped.”

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

1. Georgia still found it difficult to identify those signing deaf-blind due to their isolation and a lack of a systemic deaf-blind process in Georgia. With the resources we do have available, we need to: • encourage staff to continue to become familiar with, and knowledgeable about, the use of communication and alerting devices, as well as technology that enhances the independence of individuals with combined vision and hearing loss, and • continue to host Confident Living Programs throughout Georgia and encourage staff to take an active role in the training.

2. Having certified personnel remains an issue with the growing needs; we continue to have a lack of professionals in the South to deliver the services i.e. COMS, CVRT, and CLVT. Overall, we have not found a magic bullet to encourage new folks to go into the blind professions; the pool of professionals looking for work shrinks even more every year. The Georgia Department of Labor is competing with Veterans Affairs (VA) and the Georgia Department of Education who offer much higher salaries than the private providers can pay. The VA’s ongoing expansion of their services, for which they continue to aggressively recruit from the same limited pool of professionals, plays a huge role in provider availability.

3. If the 7OB funds continue to be flat-lined in national and state budgets, it seems inevitable that the number of consumers served each year will begin to decline in the not-too-distant future. With the increasing number of older people experiencing low vision or blindness, it will be difficult, if not impossible, to serve everyone at current levels.

Note: there was an error in the reporting of the sub-grantees for FY10 - it should have been reported as 37 sub-grantees, not 8 as reported. The Program Manager inadvertently omitted the contractors’ sub-grantees.

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 byKay McGill
TitleOlder Blind Program Manager
Telephone404-638-5208
Date signed12/13/2011