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

RSA-7-OB for Alabama Department of Rehabilitation Services - H177B120001 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year510,940
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2418,639
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)56,771
A4. Third party0
A5. In-kind0
A6. Total Matching Funds56,771
A7. Total All Funds Expended475,410
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs157,463
C. Total expenditures and encumbrances for direct program services317,947

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 5.3900 8.5000 13.8900
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 5.3900 8.5000 13.8900

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 12 2.8000
2. Employees with Blindness Age 55 and Older 5 1.5000
3. Employees who are Racial/Ethnic Minorities 11 4.2000
4. Employees who are Women 44 12.3900
5. Employees Age 55 and Older 20 5.2500

C. Volunteers

0.00

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 FY444
2. Number of individuals who began receiving services in the reported FY636
3. Total individuals served during the reported fiscal year (A1 + A2) 1,080

B. Age

1. 55-5950
2. 60-6494
3. 65-6993
4. 70-74114
5. 75-79151
6. 80-84196
7. 85-89213
8. 90-94128
9. 95-9938
10. 100 & over3
11. Total (must agree with A3)1,080

C. Gender

1. Female801
2. Male279
3. Total (must agree with A3)1,080

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race2
2. American Indian or Alaska Native1
3. Asian3
4. Black or African American185
5. Native Hawaiian or Other Pacific Islander2
6. White887
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)1,080

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)57
2. Legally Blind (excluding totally blind)471
3. Severe Visual Impairment552
4. Total (must agree with A3)1,080

F. Major Cause of Visual Impairment

1. Macular Degeneration606
2. Diabetic Retinopathy105
3. Glaucoma135
4. Cataracts21
5. Other213
6. Total (must agree with A3)1,080

G. Other Age-Related Impairments

1. Hearing Impairment357
2. Diabetes332
3. Cardiovascular Disease and Strokes737
4. Cancer147
5. Bone, Muscle, Skin, Joint, and Movement Disorders621
6. Alzheimer's Disease/Cognitive Impairment74
7. Depression/Mood Disorder74
8. Other Major Geriatric Concerns430

H. Type of Residence

1. Private residence (house or apartment)995
2. Senior Living/Retirement Community28
3. Assisted Living Facility45
4. Nursing Home/Long-term Care facility12
5. Homeless0
6. Total (must agree with A3)1,080

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)190
2. Physician/medical provider59
3. State VR agency66
4. Government or Social Service Agency143
5. Veterans Administration0
6. Senior Center14
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization0
10. Independent Living center0
11. Family member or friend237
12. Self-referral322
13. Other49
14. Total (must agree with A3)1,080

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 15,061
1b. Total Cost from other funds 1,674
2. Vision screening / vision examination / low vision evaluation 262
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 90,810
1b. Total Cost from other funds 10,090
2. Provision of assistive technology devices and aids 911
3. Provision of assistive technology services 937

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 180,132
1b. Total Cost from other funds 20,015
2. Orientation and Mobility training 278
3. Communication skills 775
4. Daily living skills 816
5. Supportive services (reader services, transportation, personal 11
6. Advocacy training and support networks 178
7. Counseling (peer, individual and group) 509
8. Information, referral and community integration 529
. Other IL services 543

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 148
1b. Total Cost from other funds 17
2. Information and Referral 0
3. Community Awareness: Events/Activities 264 7,400

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) 1,283,024 475,410 -807,614
2. Number of Individuals Served 1,129 1,080 -49
3. Number of Minority Individuals Served 190 193 3
4. Number of Community Awareness Activities 264 264 0
5. Number of Collaborating agencies and organizations 25 27 2
6. Number of Sub-grantees 0 0

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 937 100.00%
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) 556 59.34%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 381 40.66%
B1. Number of individuals who received orientation and mobility (O & M) services 278 100.00%
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) 170 61.15%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 108 38.85%
C1. Number of individuals who received communication skills training 775 100.00%
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) 453 58.45%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 322 41.55%
D1. Number of individuals who received daily living skills training 816 100.00%
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) 501 61.40%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 315 38.60%
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) 648 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) 2 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) 56 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 37 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) 1 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.

The Alabama Department of Rehabilitation Services (ADRS) Older Alabamians System of Information and Services (OASIS) Program administers older blind services funded under Title VII Chapter 2 through a network of twenty Rehabilitation Teachers and two Orientation & Mobility Specialists positioned throughout the state in eleven ADRS offices in order to make services available in all 67 counties of the state. The two Orientation & Mobility Specialists are positioned one in the Dothan area and one the Huntsville area in order to provide maximum coverage utilizing these staff. There are an additional three vacancies in Homewood, Mobile, and Tuscaloosa areas for Orientation & Mobility Specialists. There are also a number of Orientation & Mobility Specialists on the state vendor list for purchased services as needed to maintain coverage to all areas. Three Rehabilitation Teachers are employed at 1.0 FTE using VII-2 funds and devote 100% of their time to the Program. Seventeen Rehabilitation Teachers are employed with funds jointly provided by the Alabama Department of Rehabilitation Services and the Alabama Institute for Deaf and Blind and devote 25% of their time to the Program. The two Orientation & Mobility Specialists are employed with funding jointly provided by the Alabama Department of Rehabilitation Services and the Alabama Institute for Deaf and Blind and devote 25% of their time to the Program.

OASIS continues to offer center-based services in Birmingham, Mobile, Muscle Shoals, and Huntsville in collaboration with the Alabama Institute for the Deaf and Blind Regional Centers and the Birmingham Independent Living Centers. A new center-based program opened in Dothan during this past year. Plans to expand center-based services in other areas of the state continue.

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.

The Alabama Department of Rehabilitation Services seeks to incorporate the unique approach of the Title VII Chapter 2 Program into the State Plan for Independent Living under section 704 of the Rehabilitation Act of 1973 as amended. Of note are several methods and approaches implemented and/ or maintained in fiscal year 2012.

OASIS has been building collaborative partnerships to plan for center-based rehabilitation teaching services in several parts of the state. Center-based services are now established between OASIS and the Alabama Institute for Deaf and Blind Regional Centers in Mobile, Muscle Shoals, Birmingham, Huntsville, and with the Wiregrass Rehabilitation Center in Dothan. As previously indicated, plans to expand center- based services in other areas of the state continue. The OASIS Advisory Council is made up of over twenty agencies and organizations and consumer groups who serve the population of older citizens and persons who are blind. The OASIS Advisory Council, which meets quarterly, forms the basis of many collaborative partnerships for the OASIS Program. One of these collaborative partnerships is with the Cahaba Valley Health Care providing vision and dental screenings to Hispanic residents in Jefferson County. A Rehabilitation Teacher working with the OASIS Program is fluent in both English and Spanish and has been an important part of this collaboration. OASIS continues to maintain a strong collaborative partnership with the Alabama Department of Senior Services (ADSS). There are over 350 nutrition sites throughout Alabama and many are located in rural underserved areas of the state. The ADSS Statewide Nutrition Coordinator also serves on the OASIS Advisory Council. OASIS/ADRS maintains a Memorandum of Agreement with the Middle Alabama Area Agency on Aging to increase collaboration efforts between the two agencies. OASIS is represented at quarterly Middle Alabama Area Agency on Aging Meetings. OASIS staff participated in the Blooming Benefits Day projects in Jefferson, Shelby, Chilton, Blount, and Walker counties. This was collaborative effort initiated through the Middle Alabama Area Agency on Aging. Community awareness and collaboration is also enhanced in a long standing partnership with Senior Companion Program. OASIS staff, when needed, provides "Orientation to Blindness" training to newly employed companions who will be working in local communities in contact with individuals and families who could benefit from OASIS services. The training allows Senior Companions to be better equipped to work with individuals who have lost vision.

On-going collaboration between OASIS and the Department of Veterans Affairs Southeastern Blind Rehabilitation Center serves to coordinate services to older Alabamians who are veterans. OASIS consumers who are eligible for VA Blind Rehabilitation Services are referred to the VA VIST Coordinator. In addition to on-going collaboration with the Department of Veterans Affairs, OASIS continues to maintain an on-going collaboration with The University of Alabama at Birmingham (UAB) Center for Low Vision Rehabilitation which serves older patients from around the state. A multi-faceted approach incorporating various products and activities is used to disseminate information concerning services available to persons who are older and blind with regard to community awareness. An exhibit board and Program brochures are used at various health fairs and other events to provide Program awareness. One such event is the Alumni and Workers for the Blind/Alabama Institute for the Deaf and Blind and Alabama Department of Rehabilitation Services Technology Symposium held annually for consumers and the public. An update of the OASIS brochure was completed. Program brochures are distributed in print, Braille, on CD, on cassette tape, and in large print. The brochure is also available in Spanish. Over 68,000 brochures have been distributed as of September 30, 2012. The Oasis Resource Guide, which was edited in 2011, is now being updated, printed in house, and distributed to consumers, families, and other professionals working with older Alabamians. To improve facilitation of this process, a Braille machine was purchased for in-house production. The Oasis Resource Guide is also available on-line at www.rehab.alabama.gov/OASIS.

Several other outreach activities were initiated during 2012. Presentations providing an overview of the OASIS program were given at several Senior Centers, physicians’ offices, local housing programs, and other programs serving seniors throughout the state. In-services to address awareness on low vision and blindness were provided to schools, local businesses, and home health programs. Staff participated in the Senior Health Fairs in Mobile and at Westminster Village in Spanish Fort, a Diabetic Workshop in Dothan, and a Weatherization Event in Shelby County.

Collaborative activities are being achieved through a network of consumer driven support groups throughout the state. A total of 34 support groups have been developed by OASIS over the past fourteen years. Staff provided information and guidance to support groups throughout the year. An e-mail distribution list of statewide support group members was initiated during this year. E-mails regarding current events and resources are distributed regularly.

Rehabilitation Teachers and Orientation and Mobility Specialists have also benefited from other various training opportunities. They have been able to participate in RT/ O& M meetings throughout the year. Opportunities for attending regional and national conferences have also been available.

OASIS continues to support on-going staff training and other learning experiences. An "E Learning" internet license was purchased from the American Foundation for the Blind to provide training to Rehabilitation Teachers and Orientation and Mobility Specialists on a variety of topics related to serving older individuals who are blind or visually impaired. Several Rehabilitation Teachers and Orientation and Mobility Specialists have completed the 20 training modules. This project allows new and existing staff an opportunity to learn additional information regarding working with the older low vision/ blind population. CEU’s are available for staff that completes the 20 training modules. This training resource is available through fiscal year 2014. OASIS was able to purchase 15 individual licenses for Vision Rehabilitation Assistant training, and 30 individual licenses for the Multi-E-Skills Vision Rehabilitation Training Program through Lighthouse International. These training resources have also proven beneficial to staff during this fiscal year.

OASIS also has one rehabilitation teacher who serves as a Hadley Ambassador. As Hadley Ambassador, they collaborate with Hadley to assist consumers and to enhance the expertise and services of professionals through free distance education courses. This collaboration helps to improve consumer rehabilitation experiences and cost-effectiveness. A total of 7,400 individuals were contacted through 264 community awareness activities; and a total of 6,203 outreach contacts and a total of 4,763 community collaboration contacts were recorded for fiscal year 2012.

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 Consumer Satisfaction Survey was distributed to each OASIS consumer at closure during fiscal 2012. Findings from analyses of returned surveys indicate that 99.5% of consumers agreed or strongly agreed that services were provided in a timely manner; all respondents agreed or strongly agreed that teachers were attentive and interested in their well-being and that teachers were familiar with blindness-specific techniques and aids. Further, 99% agreed or strongly agreed that they were satisfied with the quality of services received.

Consumers responded to questions regarding services related to their ability to travel safely and independently in their home and/or community, prepare meals, manage housekeeping tasks, manage paperwork, access reading material, their dependence on others in performing daily activities, their perceptions of control and confidence in maintaining their living situations, and how devices and equipment had impacted their ability to engage in life activities. For each of these questions, consumers were asked if they felt they experienced an improvement, no change, or a decrease in their level of functioning because of receiving services. If they did not receive/request a service, they indicated so on the respective question. Note that percentages may not total 100% due to rounding. • When asked about their ability to travel in the home and community, 51% of consumers reported they were better able to travel in their home and/or community, 21% reported no change, 2% reported less able, and 26% reported not receiving the service. • When asked about meal preparation, 48% of consumers reporting being better able to prepare meals, 22% reported no change, 2% reported less able, and 29% reported not receiving the service. • When asked about their ability to manage housekeeping tasks, such as cleaning floors/surfaces and organizing, 33% of consumers reported being better able to manage housekeeping tasks, 28% reported no change, 2% reported a decline, and 38% reported not receiving the service. • When asked about their ability to manage paperwork, 63% of consumers reported being better able to better manage their paperwork, 16% reported no change, 3% reported a decline, and 19% reported not receiving the service. • When asked about their ability to access reading materials, 82% of consumers reported being better able to access reading materials, 10% reported no change, 3% reported being less able to access reading materials, and 5% reported not receiving the service. • Of consumers reporting receiving one or more of the previous services, 58% indicated being less dependent on others, 38% reported no change, and 5% reported being more dependent on others. • When asked about functioning before services, 85% indicated they now have greater control and confidence in their ability to maintain their current living situation, 14% reported no change, and 2% indicated feeling less control and confidence. • Among consumers receiving devices or equipment, 78% indicated that devices had improved their ability to engage in customary life activities, 20% reported devices had helped them maintain their ability, and 2% reported that they were not using any of the devices or equipment provided by the program.

If consumers participated in a peer support group or the OASIS Peer Support Network, they were asked how helpful it was. Forty-three consumers (25%) reported they had participated in a peer support group. Of those reporting peer support group participation, 24 found it very helpful, 13 found it helpful, 4 found it somewhat helpful, and 2 found it not very helpful. In addition, 33 consumers reporting no peer support participation indicated that they were interested in participating in a support group.

In addition to demographic questions, the survey included questions regarding changes in vision and health over the previous year. Results indicated that 64% of consumers had experienced reduced vision, 6% had improved vision, and 31% had stable vision. With respect to overall health, 29% reported that their health had worsened, 9% reported improved health, and 62% reported stable health. Consumers were also asked if they had considered going into a nursing home before services and if services had helped them remain in their homes: 24% of respondents reported they had sometimes or often considered a nursing home; 75% reported that OASIS services had helped them remain in their homes. Overall, results demonstrate the quality and benefits from services provided by the OASIS program. A copy of the complete program evaluation report conducted by Mississippi State University’s Rehabilitation Research and Training Center will be sent when the final version is available.

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).

The following accounts submitted by Rehabilitation Teachers illustrate important aspects of the impact the OASIS Program has had on persons who are older and blind or visually impaired and their families with regard to their maintenance of and/or increase in independence during 2012. Ms. Jones is a 72-year old female consumer. Her vision loss is due to Retinitis Pigmentosa and her vision has been affected for many years by this condition. She has previously received Rehab teaching and O&M services. Ms. Jones has a very good support system as she has family and friends that assist her if needed. She lives alone in her home of many years, in West Alabama.

Ms. Jones needed assistance with many independent living skills to aid her. She needed assistance in telling time to enable her to perform personal management tasks. She was provided a talking clock and talking watch to assist her ability to tell time independently and effectively.

The skills to manage money were addressed. Folding techniques and coin recognition skills were taught to her. A writing guide value kit was provided to aid her with her check writing and budgeting and bill paying. A talking calculator was provided to afford Ms. Jones the ability to calculate numbers.

The utilization of low vision accommodations was addressed. Magnifier evaluations were completed on more than one visit to determine if she was able to be assisted by magnification. She was unable to benefit from any of the magnifiers. The portable CCTV was demonstrated to determine if she would benefit from this reading machine. She was unable to see printed material with this device. Therefore, an Eye-Pal Solo was ordered with instructions in the operation of this reading machine. She was delighted to have this adaptation and informed her teacher that she had been going through her papers that she could not see before she received the Eye-Pal, and now she was able to determine what papers to keep. A floor lamp was provided to aid her with illumination. Solar Shield glasses in yellow and plum were provided to alleviate the problems that glare causes her. The yellow glasses enabled her to see her mailbox more effectively. A large print calendar was provided to assist her with her appointments. Communication skills were provided writing guides, bold line paper and low vision pens. She also received O&M services. Due to services received from the OASIS program, Ms. Jones gained more confidence and independence. Ms. Jones is excited about all of the skills she learned from the rehabilitation teacher. Ms. King is a female consumer who is in her mid- 80’s. She is a widow and lives alone in her home in Etowah County. She is dependent upon her daughter to meet her independent living needs. Her Rehabilitation Teacher provided Ms. King with assistance in the following areas: Time Telling, Magnification, Lighting, and Money Identification. She was provided with a large wall clock and a hand-held and stand magnifiers for reading. She takes the hand-held magnifier to stores when shopping and restaurants when eating out. The rehabilitation teacher also ordered Ms. King a Better Vision Lamp through the Library Resource Center at Talladega through Quota funds. The Ms. King likes to cook/bake. Her stove, microwave, washer and dryer were marked so that she can operate the appliances without assistance. She received instruction on money folding techniques so that she will be able to identify her bills.

In the area of information and referral, Ms. King was informed of the local support group, the library service, audio bible, and other available resources. Because she is a widow of a veteran, her rehabilitation teacher helped her to explore available benefits through VA. She discovered that she will be able to draw a pension and receive assisted living services should she ever need them. Ms. King is very happy with services.

Mr. Moore is a 67-year old male consumer in Birmingham, referred by the UAB Center for Low Vision Rehabilitation because he needed to be able to read. He has Macular Degeneration. His inability to read print affected a number of areas in his life. When he could see, he worked in jobs that required a lot of interstate driving. He has only lived in Birmingham the last few years. He previously lived in Arkansas and Georgia before moving here. Print reading allowed him to keep up with the financial world to the extent of his interest, keep track of his medicines, read the local newspaper, file his own tax forms, manage his checking account, and play word search games. He lives with a sister and has to depend on her for transportation to go anywhere. He went to Camp SAVI (Seniors Adapting to Visual Impairment) in 2011; and there was a recommendation that we provide an Eye Pal Solo, which scans print and then speaks the text. This enabled him to read the financial news of interest, his mail, and newspaper, especially the ads. Lighting in his household was not compatible for what reading he could do. He was provided a Verilux lamp with a gooseneck for directing the light and a magnifier. He says he can read a little with that now. For his own note taking, he was provided bold-line pads and spiral notebook, along with some 20-20 pens. He was instructed in the use of a check writing guide. He was put in touch with an AARP tax volunteer, for handling the filing of his taxes. To increase his independence in managing his medicines, he was provided a Pen Friend to record the name of each medication on a sticker that he adheres to the bottle. He can keep track of when his refills are due. He can use this device to label cassettes, CD’s, or all sorts of other things because it is not restricted to one area of life. The labels will diminish his risk of taking the wrong medicines. To meet his wish to get out from home some, his rehabilitation teacher introduced him to a local senior center near his home, and helped with a Clastran application for getting to and from the Center. Mr. Moore is happy with his new level of independence in the community and the services that he received through the OASIS Program.

A total of 1,080 persons were served by the OASIS Program during fiscal year 2012. During 2012, 816 received services in daily living skills training. 775 received training in communication skills. Training in orientation and mobility skills was received by 278 consumers and 911 benefited from assistive technology provided by the OASIS Program. Functional low vision assessments were provided by OASIS during 2012 to 636 consumers. During 2012, 529 persons were integrated into additional services available to them in their communities. Approximately 18,336 community awareness contacts were made on behalf of the OASIS Program during 2012. For fiscal year 2012, a total of 603 persons reached their independent living goals and reported that they felt that they had greater control in their ability to maintain their current living situation as a result of OASIS Program services.

With regard to age, it is important to note that 54% of the population, served during 2012, was age 80 or older. Based on data from previous years, it is clear that the OASIS program continues to serve an ever increasingly older population and helping them to live independently for as long as possible. During 2012, 2,751 secondary disabilities were recorded among consumers served by OASIS. As in previous recent years cardiovascular disease and stroke were the leading causes of secondary disabilities during 2011 followed by bone, muscle, skin, joint, and movement disorders; diabetes; hearing loss; and other disabilities. For many of these consumers, OASIS is the primary resource and, sometimes, the only resource available to them.

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

The demographics of an aging population requiring services using limited resources in terms of funding and qualified staff continues to be the greatest concern of staff working in the older blind program. Additional areas of concern include the increased cost of technology and overall operational costs.

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 byDr. Cary Boswell
TitleCommissioner Al Dept of Rehabilitation Services
Telephone334-293-7201
Date signed12/20/2012