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

RSA-7-OB for Arizona Rehabilitation Services Administration - H177B120003 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year659,500
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year523,372
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 21,118,724
A2. Total other federal394,980
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement36,300
(c) Title XX - Social Security Act358,680
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)124,302
A4. Third party0
A5. In-kind0
A6. Total Matching Funds124,302
A7. Total All Funds Expended1,638,006
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs394,980
C. Total expenditures and encumbrances for direct program services1,243,026

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 2.7000 4.7000 7.4000
2. FTE Contractors 1.6200 16.1400 17.7600
3. Total FTE 4.3200 20.8400 25.1600

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 24 9.1000
2. Employees with Blindness Age 55 and Older 4 2.1000
3. Employees who are Racial/Ethnic Minorities 10 3.9000
4. Employees who are Women 49 18.3200
5. Employees Age 55 and Older 16 7.7800

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 FY272
2. Number of individuals who began receiving services in the reported FY700
3. Total individuals served during the reported fiscal year (A1 + A2) 972

B. Age

1. 55-5955
2. 60-6456
3. 65-6979
4. 70-7479
5. 75-79127
6. 80-84203
7. 85-89191
8. 90-94142
9. 95-9931
10. 100 & over9
11. Total (must agree with A3)972

C. Gender

1. Female716
2. Male256
3. Total (must agree with A3)972

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race64
2. American Indian or Alaska Native11
3. Asian5
4. Black or African American22
5. Native Hawaiian or Other Pacific Islander0
6. White863
7. Two or more races7
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)972

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)41
2. Legally Blind (excluding totally blind)586
3. Severe Visual Impairment345
4. Total (must agree with A3)972

F. Major Cause of Visual Impairment

1. Macular Degeneration641
2. Diabetic Retinopathy54
3. Glaucoma99
4. Cataracts35
5. Other143
6. Total (must agree with A3)972

G. Other Age-Related Impairments

1. Hearing Impairment165
2. Diabetes134
3. Cardiovascular Disease and Strokes237
4. Cancer40
5. Bone, Muscle, Skin, Joint, and Movement Disorders305
6. Alzheimer's Disease/Cognitive Impairment39
7. Depression/Mood Disorder43
8. Other Major Geriatric Concerns231

H. Type of Residence

1. Private residence (house or apartment)695
2. Senior Living/Retirement Community193
3. Assisted Living Facility75
4. Nursing Home/Long-term Care facility9
5. Homeless0
6. Total (must agree with A3)972

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)20
2. Physician/medical provider24
3. State VR agency20
4. Government or Social Service Agency36
5. Veterans Administration5
6. Senior Center16
7. Assisted Living Facility1
8. Nursing Home/Long-term Care facility0
9. Faith-based organization2
10. Independent Living center36
11. Family member or friend136
12. Self-referral645
13. Other31
14. Total (must agree with A3)972

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 579,208
1b. Total Cost from other funds 349,919
2. Provision of assistive technology devices and aids 448
3. Provision of assistive technology services 91

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 460,900
1b. Total Cost from other funds 21,454
2. Orientation and Mobility training 236
3. Communication skills 814
4. Daily living skills 814
5. Supportive services (reader services, transportation, personal 0
6. Advocacy training and support networks 207
7. Counseling (peer, individual and group) 0
8. Information, referral and community integration 700
. 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 0
3. Community Awareness: Events/Activities 41 4,026

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) 1,619,638 1,719,426 99,788
2. Number of Individuals Served 801 972 171
3. Number of Minority Individuals Served 75 109 34
4. Number of Community Awareness Activities 19 41 22
5. Number of Collaborating agencies and organizations 71 71 0
6. Number of Sub-grantees 19 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 91 100.00%
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) 9 9.89%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 61 67.03%
B1. Number of individuals who received orientation and mobility (O & M) services 236 100.00%
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) 7 2.97%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 140 59.32%
C1. Number of individuals who received communication skills training 814 100.00%
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) 166 20.39%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 143 17.57%
D1. Number of individuals who received daily living skills training 814 100.00%
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) 362 44.47%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 402 49.39%
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) 417 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) 12 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) 18 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) 2 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 Administration method of implementation for the Title VII-Chapter 2 program utilizes a combination of in-house staff and individual or agency contractors who devote their time providing direct instruction at their facilities or at the clients’ homes on an itinerant basis. We had of 9 internal staff, 17 individual contractors, and 3 agencies with 25 internal service staff, for a total of 53 individuals who provided services statewide to elderly blind people. The services provided helped our clients live safely and independently in their communities. 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 and Hopi Veterans Special Needs events. The focus of these outreach efforts is to educate interested individuals about the needs of seniors who are blind or visually impaired, including providing information on accessing all RSA senior-related community services. There were three major events that drew approximately 3,000 attendees during this reporting period. The Hopi Veterans Special Needs Activity Day was held on September 17, 2012, at the Hopi Veterans Memorial Center in Kykotsmovi, Arizona, and drew approximately 1,500; the Sun City Health Expo, Loving Life, was held on January 24, 2012, at the Sun Dial Auditorium and drew approximately 1,000 attendees; and the 15th Annual Vision Rehabilitation and Technology Expo (VRATE) was held on December 2, 2011, at the Shriner’s Auditorium in Phoenix, and drew approximately 800 attendees. Through 43 in-service presentations throughout Arizona, 4,041 clients, friends, family members, and service providers were given information about vision-related services. In addition to foregoing, AZRSA continues to update the AZ Directory of Services for Persons Who Are Blind & Visually Impaired, which is available in alternative formats to address individual needs. AZRSA continues to maintain a website, which provides information and links to additional resources and services.

AGENCY/ORGANIZATION CONTRACTORS: ARIZONA CENTER FOR THE BLIND AND VISUALLY IMPAIRED (ACBVI) SOUTHERN ARIZONA ASSOCIATION FOR THE VISUALLY IMPAIRED (SAAVI) SERVICES MAXIMIZING INDEPENDENCE LIVING EMPOWERMENT (SMILE) NEW ARIZONA FAMILY INC. LOW VISION PLUS DESERT LOW VISION VIEWFINDER LOW VISION

INDIVIDUAL CONTRACTORS: ADAMS LINDA ARNOLD, PATTY CARLISE, KATHY DOCKERY, JULIE HANNA, GEORGEANNE - HARRIS, ELLEN KLENNER, SHELLY MORELL, KATHY MACILROY, DEBORAH MORGAN, DARIAN OHM, LAURA PERRY, SANDRA ROCK, JULIE RUTKOFF, ETHAN RYNDAK, ALLISON VANGUEETY, VENU WHIPPLE, JAY

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 (43) forty-three events or activities in FFY 2012. Some of the presentations and collaborations include, but are not limited to the following:

AER American Foundation for the Blind Beattitudes Low Vision Support Group Dependable Nurses Devon Gables Healthcare Center Disability Awareness Day Grass Roots Wellness Center Hadley School for the Blind Health Expo-Loving Life In-service for Home Health Staff In-services (various organizations and cities) Kingman support group for BVI Low Vision Groups (Mesa, Scottsdale, Chandler, Tempe) McDowell Village Support Group Nursing Assistant Conference Pima County Main Library Pinal County Agency In-Service Prescott Lakes Senior Community Red Mountain Low Vision Support Group Red Mountain Ranch Low Vision Support Group Scottsdale Low Vision Support Group Senior Circle Special Needs Activity Day Senior Circle Diabetes Group Staff/Flagstaff Eye Care Staff/Peak View Optical Sun City Interagecy Sun City West Low Vision Group Tucson Medical Senior Services Tucson Services for the Blind VRATE Waymark Gardens Senior Housing White Cane Day

These activities, combined with the smaller gatherings that occurred during this FFY, provided outreach to over 4,000 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.

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. The comments were entered exactly as received. Of the 392 surveys that were mailed: 202 or 51.6% of the surveys were received with one or more response(s); 19 or 4.8% surveys were returned as undeliverable; 171 or 43.6% 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. 1. Services were provided in a timely matter. Of the 202 returned surveys: 119 or 58.9% strongly agreed 47 or 23.3% agreed 5 or 2.5% disagreed 2 or 1% strongly disagreed 29 or 14.3% no response This represents a satisfaction rate of 82.2%. Comments: She is excellent. Hanna Georgeanne does a fantastic job! Thank you. Very lucky to have such an understanding teacher, may I keep her? Linda has been great. Sandra was always promptly on time for each appointment Great services Susan was very helpful, polite and on time for all appointments. I will miss having her stop by. Very nice, thoughtful and friendly person Susan went beyond to help me. She was very pleasant. Todd got what I needed always. He tried hard. Sandra went into great details to present all items/classes and was always on time. She was always of time and very patient. Well informed teacher. The services were a pleasure, so nice to have newer ideas and a pleasant person. Always on time & gave me her undivided attention. 2. The instructor was attentive and interested in my well-being. Of the 202 returned surveys: 129 or 63.9% strongly agreed 43 or 21.3% agreed 2 or 1.0% disagreed 1 or 0.4% strongly disagreed 27 or 13.4% no response This represents a satisfaction rate of 85.2% Comments: Definitely! Georgeanne is very competent & caring It’s a pleasure working with her. Double checked all instructions to make sure I understood and answered my questions Helpful and kind person Susan was very caring to me. Showed me a lot of new things Very friendly and gave me hope that I could function when my eyes get worse. Great & She made me feel like someone cared. She is the best for this job - keep her. Very kind & considerate Vasant was very good in helping Mary. She questioned me about things I was wondering about. My safety, every aspect of my vision problem, sandy was very knowledgeable and helpful, in an effort towards me becoming more independent. It has restored my faith to improve my handicap. Vasant inspired me! Sandra does a very good job. She has lots of patience and a good personality I do appreciate the help Mike and Sandra have given me. Mike changed little things to make vision so much better. I enjoyed Sue Olson’s visit very much. 3. The instructor was familiar with techniques and aids used by blind and visually impaired individuals. Of the 202 returned surveys: 133 or 65.8% strongly agreed 38 or 18.8% agreed 3 or 1.5% disagreed 0 or 0.0% strongly disagreed 28 or 13.9% no response This represents a satisfaction rate of 84.6% Comments: Becomes informed about any new equipment. I’ll say she is very knows what she is doing. Sandra was very knowledgeable with all aids and explained them clearly She was helpful in so many ways. Showed me how to use them well Sandra is impaired and a wonderful representative of macular/blindness - Set an inspiring example. She sent us to a blind conference was very helpful. Greatly helped She demonstrated own hand cane abilities to be able to show life can be better. 4. I was satisfied with the quality of services provided by the program. Of the 202 returned surveys: 133 or 65.8% strongly agreed 34 or 16.8% agreed 5 or 2.5% disagreed 3 or 1.5% strongly disagreed 27 or 13.4% no response This represents a satisfaction rate of 82.6% Comments: Wonderful! She was professional/courteous/on time genuinely interested in helping me. A smart, intelligent individual, Pam is. I am very happy with all items supplied to me. Wonderful programs More than I expected. Very much so Thank you for services. They are helpful. Very informative My sight is continually getting a little worse and I’d love to have this again. I did not know what aids are available to make life easier. Very much so Sue is an awesome person and a delight. . . she knew exactly what I needed (smiley face)

5. Travel Responses Of the 202 returned surveys: 91 or 45.0% are now better able to travel safely and independently in my home and/or community. 33 or 16.3% - report no change in my ability to travel safely and independently. 4 or 2.0% - are now less able to travel safely and independently 16 or 8.0% - did not receive services that would help me travel safely and independently in my home and/or community. 11 or 5.5% - were not aware or offered these services. 47 or 23.2%- no response Comments: Previous visits directed at home living. Latest ones directed at using special new reading aids. Very helpful Thank you Vasant for making daily life less of a stress-inducing challenge my ability to cook safely is made possible by such tiny bumps! Betsey was great, she worked to get me to think for self on how to get around. I attended the classes to prepare myself for the future. I was considerably more able to be independent than others in the class. Thanks to Sue Olson. I am much more confident. I travel a great deal more. Everything I’ve gotten has been such a help. I thank God every day for all the help. More aware of movement and my strength Being more independent & feeling more capable. She gave me confidence to do things for myself now. 6. Meal Preparation After Receiving Services Of the 202 returned surveys: 71 or 35.1% are now better able to prepare meals for myself. 27 or 13.4% has been no change in my ability to prepare meals. 2 or 1% are now less able to prepare meals independently. 51 or 25.2% did not request services that would help me prepare meals. 8 or 4.0% were not aware or offered these services. 43 or 21.3% no response Comments: Oven & range were marked for different settings. Wow! Absolutely great! Have been using a lot. Besides, I can see it! The orange dot on the microwave makes it much easier to recognize which button I’m pushing - the magnifying glass helps with reading recipes. Sue Olson put colored buttons on my stove, microwave and washer so I could tell where everything is located ’coded’ measuring cups and spoons also a big help. The red Dots are wonderful. There were a few things for kitchen that have helped a lot! I had red labels put on my stove and washer & dryer. I was given measuring cups & cutting board to help me. It was made possible to see if burner was on or off. Different gadgets have helped me a lot. The gloves and thongs are great. - No more burns from oven toaster and micro. She taught me how to use the microwave and George Foreman I am 93 years old live in my house alone. 7. Housekeeping Tasks After Receiving Services Of the 202 returned surveys: 52 or 26.0% are better able to manage housekeeping tasks, such as cleaning floors/surfaces and organizing. 31 or 15.5% has no change in my ability to manage housekeeping tasks. 4 or 2.0% are less able to manage housekeeping tasks. 55 or 27.5% did not request services to help me manage housekeeping tasks. 12 or 6.0% was not aware or offered these services. 48 or 23.0% no response Comments Different spices were marked with talking tool. Cleaning stuff was marked. I found many suggestions helpful for anyone - impaired or not. White (small) discs help to mark where i’ve swept and where the dust pile is I needed just a little help with housekeeping. Received what I needed. Now with brighter light I can see dirt and messes I did not see before. Where-ever I asked about problems - I was helped. 8. Paperwork After Receiving Services Of the 202 returned surveys: 92 or 45.5% were better able to manage paperwork, such as mail, correspondence and paying bills. 28 or 13.9% has been no change in my ability to manage paperwork. 7 or 3.5% are less able to manage paperwork. 23 or 11.4% did not request services to help me manage paperwork. 7 or 3.5% was not aware or offered these services. 45 or 22.2% no response Comments: Different tools were given to help with checking and check writing. The magnifying glass is a good help. My enhanced vision machine is a god send - as are templates for writing & signing checks. I have a new light to see by. I was given a reader which was a life line to reading. Thank you. All the reading and large prints are great. Great calendar, check templates are great tools - large print address book is the best. Very much so I do use the lamp & magnifying glasses Georgeanne provided. Making less mistakes with telephone The items I received have helped me tremendously 9. After receiving services Of the 202 returned surveys: 117 or 57.9% is better able to access reading materials, such as books, newspaper, and magazines (whether with magnifiers, large print, braille or tape). 19 or 9.4% has been no change in my ability to access reading materials. 5 or 2.5% were less able to access reading materials. 13 or 6.4% did not request services to help me access reading materials. 5 or 2.5% was not aware or offered these services. 43 or 21.3% no response Comments: Reading my mail & now ballot info is possible at home and privacy is nice. The center helped me in getting talking books, sun sounds radio. The machine that enlarges print is a great help. The things given has given me more ability to see. My craft glasses now allow me to decorate hats and glasses to sell so I can add to my living. Thank you. I have tapes from P.O. Love to read Now and get so much out of reading. I receive braille/ audio books. 10. Compared with my functioning before services Of the 202 returned surveys: 99 or 49.0% less dependent upon others in performing my customary day-to-day activities, such as getting around, cooking, cleaning, reading, laundry, etc. 41 or 20.3% has been no change in my ability to perform my customary life activities. 13 or 6.4% are more dependent upon others in performing my customary life activities. 49 or 24.3% no response Comments: Can tell time because of new talking watch. It is really nice. Using all the kitchen gadgets & the lamp. She knew what i needed was very pleasant & warm. AZ has provided some helpful items provided by Georgeanne. Because the hints I was given were in a pleasant way which I enjoyed & remember. With the use of magnifiers & lamps & now very able to drive, I can function independently which is what I hoped for. Received new Magnifier (smiley face) Many thanks for all the lighting and light magnifiers 11. Tell us the greatest difference this program has made in your life: Comments: Access to a wealth of audio book materials, which will be particularly helpful if my vision continues to deteriorate People are more aware of my blindness & as a rule more courteous & helpful. I needed a new cane which enables me to walk more independently Good Magnifiers Talking Clock The glasses help a lot with the glare so I am able to take walks outside and the hearing aids make it possible to enjoy church and television again!! Thank you!! The program was wonderful in giving me confidence with vision impairment. The tools and explanation of how they work have helped greatly in my everyday life. Ability to know the time. Ability to tune radio etc. She is so patient, speaks so clearly & is very helpful. It is nice knowing that this service is available. I can now take care of myself better than before. Your program has really helped me. Being able to do paperwork such as finances & record keeping. Little things Vasant did make a HUGE difference. My make up (yes I am vain enough & want to wear eye brow pencil on my brows/ not lips & can always know how with my braille marks on 3 little drawers. Helping me with independence. Updating my equipment. I received the orange dots to see I received the big calendar to keep track of doctors apt. Big lamp They showed me that there are no limits to what I can do. I don’t feel sorry for myself anymore. With some effort & Discipline, she is able to read letters, phone ’s & addresses, bills, and to enjoy old photos on the reader. Two years ago when I started this program, it helped. I am now seeing changes in my abilities to simple tasks. I appreciate all the aids I have received. i appreciate Ethan and the computer help. I appreciate mike perry and all the aids for low vision. I admire Vasant. She is remarkable. Books on tape Misc - magnifiers & supplies I was able to have more confidence in my abilities Able to read my mail & to pay my bills by check. Understanding my disability After receiving the magnisight. I am more able to read my mail and pay my bills. It helps me read labels to help my with my cooking. I have made contact with others who have vision problems and are able to compare and contrast ideas, experiences, doctors M.D. and helps for easier home experiences. I am very apprecative of Pam, Jenny Trish, etc. for all their help and I thank the organization for all the great people (Pam, Jenny, Trish, etc.) being sent to help me. It helps me to read and to see small details. I am enjoying the books on tape that come in the mail. I have made a lot of wonderful friends. I am now more independent and I have more self-confidence. I am more aware of services for the visually impaired. It is easier Knowing that there is a place to get help is reassuring. I am more informed about organizing my kitchen and house. I no longer fear trying to tackle a task. Able to read and do paperwork better than before. When first I joined SAAVI I was new to this state. I knew nothing about area in my need for traveling shopping and even DLS. I met people of like kind. Trained by caring staff and was introduced to my Tuscon family because each member of the staff made me feel like a member. This all done while teaching me skill that changed my life. I have more confidence that I will be able to manage things - since I live alone. Ready better. Being able to read big print, signing checks. I am able to read & do things better. Such as seeing dials on oven etc. Sandra was very helpful. It has made me more independent. This lady is a delight, knowledgeable, helpful, caring, fulfills my needs and follows up on things. The braille books are a lifesaver. A++ I feel better knowing others are going through the same thing. Vasant was very personable. I have been made more aware of what is out there for the blind. It has helped in my ability to prepare meals and label products I need for cleaning. It has also helped to use my copy machine & fax and enlarging my font on my computer I can email do my record keeping & my banking. Thanks Sandy I think you are wonderful and one of a kind. My sense of well being and security has improved markedly. I am much more independent. I appreciate the great service that has been delivered to me. Mrs. Lindley has done an excellent job. New mach that magnifys. The lamps and light bulbs were a great help, also the clock and cooking helps have been very good. Pam explained every aspect thoroughly and professionally. The glasses are a blessing! Thanks for a job "well done". Mary The equipment you gave me helped a lot Books on tape. Camera & screen to view TV & to read also lamps & lighting. I have to say that Sue Olson’s visits were greatly helpful - I especially appreciated magnifying glass. Reading has been very hard - she put buttons on my stove (oven) and microwave - talking scale (wonderful and many other things (check register) etc. I knew there were services out there for low vision - finally found the help I needed. Pam made a great difference in my life by her caring ways of presenting new ways to me. Provided some materials to help with reading & using radio. I do my bills, read books, bible, etc. This "reader" is invaluable I have found a better life even though sight impaired. Thank you. I love to read & this program has given me back my ability to read. Thank you so much especially Linda. She was so helpful & understanding. I can’t thank her enough. The magnisight explorer LCD has helped so much because I can read my mail, pay my bills, write checks, etc. Georgeanne was a friendly, caring, knowledgable person. She was easy to talk to and gave me may helpful tips. I am so happy that she was assigned to my case. The biggest was giving me the reader. I would say sending Susan to help me she helped me very much. I have a friend always. Thanks Sandra Easier to read Items such as menu, mail, computer etc. Talking watch. I’ve become more confident in my everyday chores. She gave me great help in reading & working on the cct machine & that was the most important. Being able to read my mail. Magnifying glass is wonderful! Talking books are great now that I don’t see TV well. Knowing there’s help available as eyes get worse is comforting. Better lighting and vision aids. Tips for cooking and safety devices. magnification & lighting It has renewed hope in me. Excercises helped me walk better. Strength/Conditioning The large print items. All the sight seeing gadgets to read. See the ads in the paper. Read my own menu when we go out. See the books and etc when I work with the kids at school I volunteer at. Helped orientate me with my neighborhood and surroundings. The new measuring cups & spoons have made it much easier to cook Walking with my new cane makes me feel more secure. Given me the tools to function - glasses, clock, large print items and portable light so I can continue my life. Thanks for the big print survey! There has been some improvement in some housekeeping tasks & I can now read some few words with the magnifier but I cannot read a whole sentence. I have always took care of my paperwork, my bills, etc. Since I have gone blind in my right eye, and still losing sight in my left eye. All the material I have received to help me with my eye sight, has help me greatly. Helping me with doing me bills and paperwork. I have now just received my phone. It is great. Thank u all for your help! May God Bless. The greatest difference for me is the talking book program. I was not a reader of books before. Also the other sight aids I’ve been given. Thank you. There has been wonderful changes I am very grateful! I still fill there is much more I need and can learn to make my life better. To truly function in life not jus move around softly and survie. I can use mag’s to hel pme read better especially in Restaurants etc. Lamps have made a great difference in working in kitchen & where I sit. Love the timer for cooking works Great. I am now more able and better equiped to cope with my condition. Crossing street with my white cane & red bottome people care now & are willing to helpt. Not be fore. I felt helpless attaching compter probles, I was pretty much able to take care simple things in housework, but now with Ethans help I am able to see what I expected to see & do. I started using the computer as manger of a Savings & Loan & with staff to do that work I didn’t & compter work so with low eyesight there were all kinds of problems. Without her help I would not have had the opportunity to manage things as good as I am at this time. Thank you. The aids I have recieved and the instruction of their use from River have helped tremendously. "Bump Dots" are especially helpfull. We appreciate Rivers dedication & sense of humour. She was great. Thank you. I now know how to ride a bus and I go. I am much more independent, happier I am concerned about traveling alone Did not ask about air travel otherwise, I am so thankful for all the help it has changed my life so very much. Sandra was always like a breath of fresh air. Thank you for renewing my life. Large print calender & check register very helpful. My instructer Nancy was great lots of tips for the future. A chance to see other people & how they cope (I hope I can do as well) Will attend other classes as needed. I have forms for talking books telephone asst. etc. Way more able to see T.V. write & see my computor & read. The calender has made a huge difference, in keeping up with appointments birthdays etc. With the special lamp I received I am now able to read comfortably and do crafts much better than I did before. Being able to read every thing. Didn’t need to ask for help. I’m enjoying the story book tape. "Heaven in for Real" Thank you very much. Maria Dykstra More dependent in myself. It has given me convadence in myself to do things for myself. Able to see better with lights & check what time it is. better able to function. Magingy mach - reading, clock & watch - cannot see time, flash lite - see to put bills on box, white meas spoons & cups, Digital - Player When/if I lose sight I know there is help for me. Ability to read - handle mail. Georgeanne is always available by phone or a home visit. I appreciate her suggestions. I got the pleasure of meeting Vasant and her wonderful dog. Vasant was a great help in procuring aids for my vision. 1. Hear Better 2. Can record memos - todo’s Gave her more confidance. Aside from adapting to vision impairment, it has given me insight and confidence. I have more confidence because she was making me feel good and since I’m almost 75 yrs she helped me feel younger & better. I was ready to give up & not try to help myself but now since Sandy came into my life she has given me hoe & confidence and things are so much better - She has brought much joy because she is such a pleasure to be with - always optimistic & pleasant. Helps with my vision problems. I am doing more things for myself - She fit the glasses on me - put my chair in front of TV - now I can see better - before i just listened. I can be independent - Thank God! Providing magnifier. Talking books. Everything . Everything is much easier to handle & deal with. Confidence! I’m better able to confront new things and with all the aide I can even sew on a button or mend a seam - Wonderful! The sunglass has made a difference & the lights really help my reading. I love my alarm clock. Life is more comfortable with the tools Sandy suggested. Michael changed bulbs & made my house much brighter. You are the only one who have the large print calenders. Yeah!!! The acer explorer. Have more confidents. The were not offered this service due to instructor’s allergy. You are making a "BIG DEAL" out of this program. I eat foods that are better for the eye but as the day wears on the eyes feel worse - difficult to read books. Biggest problem is the periphial neuropathy & artheritus. I do choose foods that are better for me since taking this course. Help with reading studing books & paperwork. I can use mag’s to help me read better especially in resturants etc. Lamps have made a great difference in working in kitchen & where i sit. Have the timer for cooking works great. Greater independence. I have noone to help so I can still enjoy indendence. The lights provided are a great help. Large print equipment is very helpful and many helpful gadgets: e.g. oven mitts to avoid burns on my hands. Alarm clock is nother helpful thing to have. Yes I can read better with the cct and can see better with the glasses. Change in light gives better vision, mirrors help in both room and bedroom. Reading is easier Reading Watching television Better visibility in bathroom Driving vision Having these services helps me. Able to watch tv using my lighting and magnifiers as well without these services it made it very hard to cope on a daily basis. I am very thankful for these services The helpful things Sue gave me Magnifiers, necessary cups, spoons etc I can read my own mail and I am sure I am using the right product which I was not always sure of It has made me more independent and I now can travel. I know that there is some place I can go to help me and the people are so nice to me Has made me more able to be indpendent ITS MADE IT EASIER FOR ME TO READ MY MAIL. Made me able to read and able to hear books. Made me knowledgeable about the devices. I am able to go and do things for myself and be myself. I am able to be more independent. The little help to teach me about products in the kitchen Every little bit has helped me. Made me more alert to see better. Made more more independent with cooking. The safety has made me independent Help me be more independent Just seeing has made it simple.

Reported Demographics from the Returned Surveys:

Gender 33 or 19.1% male 140 or 80.9% female 29 skipped question

Living Arrangement 71 or 41.0% lived alone 102 or 59.0% lived with others 29 skipped question

Race/Ethnicity (171 answered/31 skipped this question) 161 or 94.2% White, not Hispanic/Latino 3 or 1.7% Black or African American, not Hispanic/Latino 1 or 0.5% American Indian or Alaska Native, not Hispanic/Latino 6 or 3.6% Hispanic/Latino of any race or Hispanic/Latino only 31 skipped question

Reason(s) for visual loss, check all that apply (289 reasons checked) 134 or 46.3% Macular Degeneration 36 or 12.5% Glaucoma 16 or 5.5% Diabetic Retinopathy 22 or 7.6% Cataracts 81 or 28.1% Other 30 skipped question

Visual Impairment 143 or 85.6% who rated their vision as poor (able read some regular or large print with glasses or magnification) 24 or 14.4% as completely blind 35 skipped question

Degree of Vision Loss 118 or 68.6% who reported their ability to see worsened during the past year 5 or 2.9% reported their ability to see improved during the past year 40 or 23.3% remained the same and can see some 9 or 5.2% remained the same and cannot see at all 30 skipped question

Hearing Related 67 or 40.6% reported they have a hearing loss 98 or 59.4% reported no hearing loss 37 skipped question

Additional significant health condition other than vision loss 92 or 55.4% reported yes 74 or 44.6% reported no 36 skipped question

Overall Health 43 or 25.1% reported that their overall health had worsened during the past year 13 or 7.6% reported their medical condition improved 115 or 67.3% reported their medical condition remained about the same 31 skipped question

Major Lifestyle Changes in Last Year (death of a spouse or family member, change in residence, etc.) 34 or 19.7% reported a change 139 or 80.3% reported no change 29 skipped question

Long Term Care/Nursing Home Outlook 102 or 62.2% stated they never considered going into a nursing home or other long-term care facility 47 or 28.7% stated they sometimes considered going into a nursing home or other long-term care facility 6 or 3.7% stated they often considered going into a nursing home or other long-term care facility 9 or 5.4% were already in a nursing home or facility 38 skipped question

Services Provided Helped Remain in Private Residence/Home 102 or 65.0% yes 28 or 17.8% no 27 or 17.2% unsure 45 skipped question

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 Mrs. B. is a 95-year-old woman who lives alone in a small rental apartment on the outskirts of Wickenburg, Arizona. She was diagnosed with Age Related Macular Degeneration in both eyes and reported as 20/160 OD and 20/400 OS. Due to an automobile accident 20 years ago, she suffered from crushed vertebrae, which created intense back discomfort. She was on medication for high blood pressure, thyroid, and angina and had developed a system to identify her medications. Mrs. B retired from an East coast telephone company a number of years ago and relocated to rural Wickenburg to be closer to her adult daughter, who lives nearby and provides weekly support. Mrs. B. lived through the Great Depression and World War II; she developed a strong sense of independence and self-sufficiency. At 95, Mrs. B wanted to continue to “do for herself.”

Mrs. B has a respectful and healthy relationship with her daughter; therefore, when her daughter wanted to be present during the assessment and first lesson, she was more of an observer than a participant in the sessions. The arrangement worked out very well; I provided additional information to Mrs. B’s daughter on modified human guide techniques, since Mrs. B uses a quad cane, and I demonstrated how she could provide more support to her mother by utilizing newly acquired skills and devices. Mrs. B was particularly interested in regaining the ability to read her mail and books and to independently pay her bills and pay for her own items when she and her daughter shop together. During the rehabilitation assessment, we identified the need for additional training in communication, time management, and recreational activities. The assessment also revealed that Mrs. B had adequate skills in cooking and was not interested in having her appliances marked, since she was very familiar with her microwave and crock pot.

Prior to Mrs. B’s involvement with the RAES Unit, her primary eye care provider had recommended a comprehensive clinical low vision examination. I completed her assessment and attended her low vision exam, which revealed that she required 24D power to read; however, she also had reduced contrast sensitivity and did much better with video magnifiers. I also addressed outdoor tints and indoor lighting. I worked with Mrs. B at a pace that allowed her to accept recommended items and training, and we mutually agreed that the portable video magnifier (Pebble), combined with the lap desk, was more comfortable because she conducted most of her reading in her easy chair. Even though, Mrs. B. followed the low vision recommendation of sitting closer to her TV, she still missed details. By using MAX TV glasses, Mrs. B was able to view details and text that showed up on the TV screen.

In addition, Mrs. B received items and training, which enabled greater independence. I provided her with: a one-button woman’s talking watch; an Atomic Talking Clock ;a large print calendar; bold line paper; 20/20 pens; writing guides; large print check register; and large print playing cards. Mrs. B had large print checks, but did not realize that the lines were also raised. She was given instruction on using a tactile sense to guide her when she wrote her checks. The use of the envelope guide allowed her to write more legibly and reduced return mailed. Mrs. B had previously played Solitaire and loved to read; however, she had set aside those hobbies with her vision loss, because she felt that she was “not as sharp” as she used to be. The large print cards allowed Mrs. B to enjoy cards again and use her mind for strategizing wins, which she reported were many. Mrs. B’s demonstrated her trust in our services when she finally relinquished her beloved glaring “jerry-rigged,” heat producing, bare-bulb floor lamp with a low vision floor lamp!

Success Story 2 Submitted by Frank Vance, Arizona Center for the Blind and Visually Impaired George came to ACBVI when he was 61 years old, just as he began to lose vision from glaucoma. Although George has tunnel vision, his night vision is very poor. When George first started instruction with the rehabilitation staff at ACBVI, he was very worried about how he would manage things now and in the future, as his vision was expected to get worse over time. Some of the things George learned in orientation and mobility included: the use of a white cane to detect drop offs and objects that he would miss with his limited vision; climbing stairs; analyzing traffic patterns; safely crossing streets; and the use of the trekker breeze GPS. George also learned a variety of skills to help in communications and independent living, such as Braille, which he uses for labeling; the use of Zoomtext on his computer; the use of a handheld video magnifier, which helps him read small print and change the colors for better contrast; the use of the George Foreman Grill and food chopper; and marking his clothes. He was provided with instruction in independent living skills, assistive technology, and orientation and mobility. George has or will soon be moving to out of state where his adult children live. We contacted Humanware, who made his GPS, and acquired the maps for the state to which he will be relocating. George now has the skills and devices he needs to navigate effectively and independently in his new community and provide care and support for his family.

Success Story 3 Submitted by Julie Rock, RT, Contractor PC is a legally blind, 83-year-old man with Macular Degeneration who has been living on his own in a rural area, near a grocery store, and has been very active in his community. PC’s sight loss began in 2002, and he is still receiving shots for his eye disorder, which continues to progress. PC was very independent when he began the program, but was limited in technology skills and lacked low vision aids.

After a low vision exam and instruction with his computer using Zoomtext, PC completed the program and was proficient at using his 360 Video Magnifier to view his coin collection and read his mail and other documents. PC received a monocular to help him better aim his bowling ball in his bowling league and to see light signals so he could safely cross the street when walking to the store. PC became proficient at using his computer to communicate with the HOA board and security office in his community. He also received equipment and instruction to increase his competency in completing daily living activities such as sewing buttons (infila and self threading needles) and telling time (talking clock and watch) and days (large print calendar) to continue arriving at appointments on time.

While PC was independent when he began the program, the skills and equipment he received will aid in his maintaining his independence and increase his quality of life. PC is very appreciative and mentioned his appreciation during each visit. PC is very thankful that the IL Blind program exists.

Success Story 4 Submitted by Sandra Perry RT, Contractor CL is a 91-year-old male who lives alone in Sun City West in a retirement community when he became widowed last year. CL has had Macular Degeneration for approximately one and one-half years and has a secondary disability, the start of short-term memory loss. Because he was unable to cook for himself, CL had been eating mostly hot dogs and frozen foods. When I first meet CL, he had an old 2x hand magnifier without a light. He was unable to read the paper or his mail. CL had to ask other people to assist him. Due to his AMD, CL had stopped reading. During our initial visit, CL took notes with bold lined paper and 20/20 pens. CL needed lighting, magnification, and glare control to regain independence and take care of his own needs. Proper lighting was the first thing CL needed, so I placed a floor lamp by his reading chair so he could turn the light away from his face to prevent glare. CL was given a 3x hand magnifier with a light, so he was able to read again. When CL was able to see his computer screen, tears came to his eyes. I also signed CL up for talking books, which he really liked. CL also wanted to be able to cook breakfast for himself the way his wife had done for him over the course of their life together. CL wanted to cook eggs sunny side up, shaded potatoes, and bacon. To help him learn this task, I provided CL with a double spatula and a skillet. By using a skillet, CL learned to safely cook his entire meal in the same pan on medium low heat. I also taught CL how to crack eggs so the shells do not make it into the pan. In our final lesson, CL cooked a full breakfast and timed everything perfectly. CL put the bacon on first for about 15 minutes, then added potatoes. After 15 minutes, CL cracked eggs in the pan without any shells, cooking the eggs for 3 minutes. CL used his double spatula to remove the food so none would fall on the floor. He was pleased that his entire meal was so easy to prepare and ready to eat. In the future, CL can review the notes he wrote in large print so he can continue cooking for himself. Due to the loss of his wife, CL felt particularly lost when it came to telling time, especially since CL’s wife had done most everything for him, including telling him what time it was when he asked. When CL received a talking watch, he almost cried. I taught CL how to use the talking watch and told him where he can get the batteries changed when needed.

Success Story 5 Submitted by Todd Steen, CVRT EC, age 91, is a veteran of World War II and has lived a very active and productive life. He lost a considerable amount of vision due to Age Related Macular Degeneration and currently resides in a private home with other family members in a small town in rural northern Arizona. EC continues to take daily walks to visit with neighbors and meet up with friends.

While working with EC, we addressed activities of daily living that were becoming more difficult for him to accomplish and enjoy due to vision loss: handwriting, time management, banking, low vision devices, mail management, money management, and pre-cane skills. The most important activity of daily living for EC was the ability to read his bank statements and manage his currency. With the provision of lighting, a stand-alone video magnifier, an organizational wallet, and instructions, EC was able to accomplish these activities independently and with confidence.

Success Story 6 Submitted by Deborah MacIlroy, RAES Assistant Manager JE, a 76-year-old male, was diagnosed with Macular Degeneration in 2006. Currently, JE lives with his wife in an assisted living facility in an urban area. Since 2006, JE’s vision deteriorated to the point that he is now legally blind and receiving injections. JE wanted to remain independent and learn to use a cane. He also wanted to continue to use his computer, read his mail, enjoy other activities that are now difficult, and travel outside his residence on his own, without guidance.

JE received Orientation and Mobility (O&M) instruction and a long cane, so he can safely and confidently walk alone to nearby stores. JE now receives services from Dial-A-Ride, so he can obtain transportation to locations out of the range of his facility transportation services. JE also enrolled in the Talking Book program and enjoys listening to stories. He also received a Close Caption Television (CCTV) and Pebble electronic magnifier, which he takes with him when he goes shopping and out to eat. JE has learned how to use contrast and lighting to his advantage; how to negotiate unfamiliar areas with trailing; and how he can use his sense of touch, sound, and smell to help identify things. We marked JE’s microwave, so he can easily reheat items; and he was provided with a portable magnifier to use for some household tasks.

Success Story 7 submitted by Georgeanne Hanna, CVRT, CLVT BJL, age 84, lives alone in a small home on a wooded side street in the mid-size town of Prescott in rural Yavapai County, where she has lived many years. BJL, legally blind with OD CF@3ft. and OS 20/400, wants to remain independent in her own home as long as possible, but her vision has continued to worsen over the last 10 years from Macular Degeneration affecting both eyes. BJL’s daughter lives in Prescott and visits regularly, but has MS and her symptoms keep her from doing much. BJL also has hearing loss, aided with 2 hearing aids, and has experienced depression from her concerns over her vision problems.

BJL proved to be an eager and willing participant. BJL now enjoys her talking books and is in the habit of listening to them between activities throughout the day, especially when it is too hot to do much else (BJL has no air-conditioning, only fans); and before going to sleep. She learned to use a talking watch and large print calendar to keep better track of dates and time. She also benefitted from near low vision aids for reading and distance aids for seeing her television. BJL uses her writing guides, bold paper, and pen to write and has large print checks so she can handle most of her own checking. BJL is able to care for her face and hair by using a magnifying mirror. She reports that she now gets “fixed up” every day. As a result of training, BJL can accomplish simple cooking and do her own laundry by using tactual markings on appliances. She has learned to use a support cane and sighted guide techniques to help her get around in her immediate environment. Her overall attitude toward life is more positive and she has gained confidence in many areas. I quote from a card I received from BJL’s daughter:

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 had substantial staff vacancies. To provide quality case management services, RSA utilized private contractors throughout the state. However there were very limited rehabilitation teachers available to cover many of the rural areas and in eastern Maricopa County resulting in placing clients on a three to four month wait list.

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
TitleAdministrator
Telephone602 542 6295
Date signed12/31/2012