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

RSA-7-OB for Georgia Vocational Rehabilitation Agency - H177B120058 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year626,269
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year441,846
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 21,068,115
A2. Total other federal35,000
(a) Title VII-Chapter 1-Part B10,000
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other25,000
A3. State (excluding in-kind)0
A4. Third party0
A5. In-kind190,215
A6. Total Matching Funds190,215
A7. Total All Funds Expended1,293,330
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs57,139
C. Total expenditures and encumbrances for direct program services1,236,191

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 1.0500 0.0000 1.0500
2. FTE Contractors 5.0000 16.3800 21.3800
3. Total FTE 6.0500 16.3800 22.4300

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 25 5.6100
2. Employees with Blindness Age 55 and Older 12 3.6700
3. Employees who are Racial/Ethnic Minorities 21 5.6000
4. Employees who are Women 55 13.4600
5. Employees Age 55 and Older 31 9.9000

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 FY430
2. Number of individuals who began receiving services in the reported FY1,176
3. Total individuals served during the reported fiscal year (A1 + A2) 1,606

B. Age

1. 55-59167
2. 60-64177
3. 65-69144
4. 70-74159
5. 75-79186
6. 80-84288
7. 85-89277
8. 90-94172
9. 95-9927
10. 100 & over9
11. Total (must agree with A3)1,606

C. Gender

1. Female1,028
2. Male578
3. Total (must agree with A3)1,606

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race16
2. American Indian or Alaska Native26
3. Asian15
4. Black or African American442
5. Native Hawaiian or Other Pacific Islander1
6. White1,043
7. Two or more races3
8. Race and ethnicity unknown (only if consumer refuses to identify)60
9. Total (must agree with A3)1,606

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)112
2. Legally Blind (excluding totally blind)704
3. Severe Visual Impairment790
4. Total (must agree with A3)1,606

F. Major Cause of Visual Impairment

1. Macular Degeneration734
2. Diabetic Retinopathy181
3. Glaucoma233
4. Cataracts19
5. Other439
6. Total (must agree with A3)1,606

G. Other Age-Related Impairments

1. Hearing Impairment623
2. Diabetes584
3. Cardiovascular Disease and Strokes1,073
4. Cancer119
5. Bone, Muscle, Skin, Joint, and Movement Disorders615
6. Alzheimer's Disease/Cognitive Impairment78
7. Depression/Mood Disorder131
8. Other Major Geriatric Concerns635

H. Type of Residence

1. Private residence (house or apartment)1,435
2. Senior Living/Retirement Community86
3. Assisted Living Facility59
4. Nursing Home/Long-term Care facility25
5. Homeless1
6. Total (must agree with A3)1,606

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)978
2. Physician/medical provider16
3. State VR agency70
4. Government or Social Service Agency59
5. Veterans Administration2
6. Senior Center16
7. Assisted Living Facility1
8. Nursing Home/Long-term Care facility1
9. Faith-based organization1
10. Independent Living center17
11. Family member or friend160
12. Self-referral174
13. Other111
14. Total (must agree with A3)1,606

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 505,484
1b. Total Cost from other funds 149,100
2. Vision screening / vision examination / low vision evaluation 1,020
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 535

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 160,808
1b. Total Cost from other funds 6,081
2. Provision of assistive technology devices and aids 627
3. Provision of assistive technology services 1,229

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 345,071
1b. Total Cost from other funds 26,234
2. Orientation and Mobility training 159
3. Communication skills 514
4. Daily living skills 456
5. Supportive services (reader services, transportation, personal 56
6. Advocacy training and support networks 252
7. Counseling (peer, individual and group) 776
8. Information, referral and community integration 1,425
. Other IL services 34

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 9,613
1b. Total Cost from other funds 33,800
2. Information and Referral 6,497
3. Community Awareness: Events/Activities 90 30,496

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) 1,712,337 1,293,330 -419,007
2. Number of Individuals Served 1,314 1,606 292
3. Number of Minority Individuals Served 382 563 181
4. Number of Community Awareness Activities 366 186 -180
5. Number of Collaborating agencies and organizations 215 257 42
6. Number of Sub-grantees 53 49

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 1,229 100.00%
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) 954 77.62%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 129 10.50%
B1. Number of individuals who received orientation and mobility (O & M) services 159 100.00%
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) 95 59.75%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 33 20.75%
C1. Number of individuals who received communication skills training 514 100.00%
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) 251 48.83%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 186 36.19%
D1. Number of individuals who received daily living skills training 456 100.00%
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) 230 50.44%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 99 21.71%
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) 457 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) 3 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 34 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 23 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) 7 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. The sub-grantees in Georgia are: • Center for the Visually Impaired • Vision Rehabilitation Services • Mons International • Savannah Center for Blind and Low Vision • Visually Impaired Specialized Training and Advocacy Services (VISTAS) • Walton Options for Independent Living • Mississippi State University - The National Research and Training Center on Blindness and Low Vision

To continue our outreach efforts, we maintained working relations with entities we contracted with in FFY 11 that included: • Helen Keller National Center — providing outreach and collaboration to deaf-blind seniors • Georgia Radio Reading Services — providing outreach via public service announcements • Disability Link Independent Living Center — providing peer support group training to increase outreach to our seniors • National Federation of the Blind of Georgia — speaking at meetings and continuing contact throughout the year to increase outreach • Georgia Council of the Blind — speaking at meetings and continuing contact throughout the year to increase outreach • Georgia Interpreting Services Network — providing interpreters for our deaf-blind seniors • Albany Advocacy Resource Center/Albany Center for the Blind — providing blindness services to seniors Our two main initiatives to reach underserved and/or unserved populations in Georgia this year were 1) increasing our peer support groups throughout different areas around the state, and 2) continuing to increase 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 CENTER is celebrating its 10th year with the Georgia Vision Program for Seniors formally known as Older Blind Program. VISTAS served over 15 counties in the Northeast Georgia Area. With the help of sub-contractors information about our program has been taken to rural areas. When a sub-contractor goes into the communities they try to find a Senior Center they can leave VISTAS CENTER’s brochures. They also leave some with the clients to pass out to others who they know may have a visual disability. VISTAS has been very successful with people signing up because of someone they know who is already in the program or has been in the program. We continue to get recommendations from the local eye doctor and the Low Vision Specialist. VISTAS joined a Senior Network Agency that collaborated with other senior agencies in the Northeast Georgia Area. Through this organization we were able to refer clients to one another. We subcontracted for the following skills/training: Technology, Orientation & Mobility, Vision Rehabilitation Therapy, Personal Adjustment Counseling to Blindness, Braille Instruction and Low Vision.

Savannah Center for Blind and Low Vision (Savannah CBLV) Savannah Center for Blind and Low Vision (Savannah CBLV) incorporates the Title VII-Chapter 2, Older Blind (OB), program into our overall service delivery model. The general service delivery model follows a progression of intake and qualification, low vision examination, assessment and service plan development, service delivery, plan completion, closure and finally, follow-up. The majority of services are delivered by in-house staff.

Training is either center or home based, depending on each client’s individual needs and living situation. The type, duration and location of services delivered is determined and delineated in the service plan. Some clients may receive a full range of compensatory skills training while others may receive short-term services. Center based services are usually long-term while home based services are generally shorter in duration. While most home based services are provided by in-house staff, a limited amount of these services are delivered by subcontractors for vision rehabilitation therapy and low vision.

Most outreach activities are performed by staff visits, in-services and personal communication with eye doctors, medical professionals, service agencies, senior centers and senior residential facilities. Savannah CBLV enjoys close working relationships with the eye doctors in our service region, where a majority of referrals are received. In addition, an increase in referrals to the Older Blind program is coming to the agency through our website.

Mons International, Inc. (MI) MI subcontracts with numerous professionals to provide services in southwest Georgia. Those subcontractors provide services/skills training in the following areas: Low Vision Evaluations, Technology, Orientation & Mobility, Vision Rehabilitation Therapy, Personal Adjustment Counseling to Blindness, Braille Instruction, and Peer Support.

Eye care professionals, family members, friends, rehabilitation counselors, etc. refer a low vision senior to Mons International, Inc. A copy of the senior’s eye medical is faxed by the doctor to Mons or to the clinic where their senior will be seen. The senior is called, and if appropriate, is scheduled in one of our nine clinics in South Georgia closest to the senior.

At the clinic, the doctor checks the refraction and makes suggestions about LV products or services. The LV Specialist discusses services, resources, and advocacy with the senior. Products that are matched to the seniors needs are demonstrated and recommended. A typed summary of the exam is given to the senior and the attending doctor at the time of the exam. A product catalog, the Client Assistance Program brochure, the Project Independence resource brochure, list of support groups, resource list, business card, library application, and Helen Keller registry application are also given to the senior if available and/or applicable.

The recommended products totaling no more than $350.00 are sent directly to the senior together with a packing slip for the senior to sign and return to Mons. If special services are needed, the appropriate teacher is contacted and he/she contacts the senior. Additional devices may be recommended and sent to the senior.

The senior may also choose to attend the Albany ARC Center for the Blind as a residential or non-residential senior to receive services on a more intense schedule.

Mons attends consumer group conferences, county fairs, teacher, counselor, and library conferences, and meetings involving the visually impaired or the elderly throughout the state to promote awareness of Project Independence. MI also provides workshops on low vision aids to senior centers, libraries, doctors’ offices, universities, and school systems. We call ophthalmologists throughout the state on a monthly basis reminding them of the services available in their area. Mons maintains two websites and two toll free numbers to help people find Georgia resources. We provide eye exams at the Indian Reservation in Whigham, GA. This year we also implemented a telephone support group to inform older blind in rural areas what services and events were available.

Center for the Visually Impaired (CVI) CVI’s Title VII- Chapter service model is a mixture of group and one on one service provision. All participants receive one on one assessments and individualized training for virtually 100% of group class attendees. Assignments are to group classes or one-on-one training if appropriate for the particular individual.

CVI implements Title VII-Chapter 2 programming in-house, with minimal support from fully qualified contractors. Sub-contractors used this year have been a certified orientation and mobility specialist, three part-time optometrists in the Atlanta Low Vision Clinic, and one part-time optometrist for the clinical low vision evaluations in Gainesville, GA. Program staff includes a Program director, Case Manager, and a full-time Certified Vision Rehabilitation therapist in CVI’s New View Community-Based Program, as well as a full-time Low Vision Clinic Director, two full-time Certified Low Vision Therapists, and one Case Manager for the Maxwell Low Vision Clinic. This fiscal year, the regular full-time employees in the Community Based Program have been supported by the addition of two professional interns as full-time temporary employees.

Two clinical low vision evaluation days are scheduled weekly at CVI’s headquarters in Atlanta, with occasional additional clinic days during the month, and one monthly clinical low vision evaluation day in Gainesville, GA. CVI will be providing clinical low vision evaluations in Middle Georgia (Macon) beginning after federal FFY 12. Development of relationships with Macon area senior facilities coincided with establishment of low vision services. Group Vision Rehabilitation Therapy classes with individual follow-up began in October 2011 and continued periodically throughout the fiscal year. Outreach efforts to reach unserved/underserved populations during the past year have included 92 unique presentations, spread across metro Atlanta, Central Georgia and Northeast Georgia, by 20 CVI staff members.

Vision Rehabilitation Services of Georgia (VRS) Implementing the Title VII-Chapter 2 program, Vision Rehabilitation Services of Georgia (VRS) offers comprehensive vision rehabilitation services to any resident of our 34 county, north Georgia service area, who is over 55 and who meets the requirements regarding functional vision loss. This year approximately 78% of our clients began their program with a comprehensive low vision evaluation (LVE) conducted by one of our consulting optometrists who specialize in low vision. We continue to average between 5-7 Low Vision Clinic days per month either in our Smyrna office or in different towns within our rural service delivery area.

VRS program participants often purchase their own prescribed devices and most receive at least one follow-up visit from an instructor to go over the use and care of the device. The instructor will also follow-up with the findings from the initial assessment performed by one of our counselors during the intake process. The Individualized Service Plan is created at the time of the LVE or initial visit from a VRS staff member. Generally, training sessions are scheduled once a week, until the training goals are met. All follow-up vision rehabilitation services are provided by university trained and ACVREP Orientation and Mobility and Vision Rehabilitation Therapist certified staff. Additionally, we provide Technology Access Training. To provide all of these services we utilize a core of staff teachers, as well as some independent contractors who reside in various regions within our service delivery area. To reduce continually increasing mileage reimbursement costs and our instructor’s driving time, we encourage clients to assume the responsibility of coming to centralized training sites or to our main office.

Walton Options for Independent Living (WO) Walton Options contracts with Vocational Rehabilitation to provide Chapter 2 services throughout a 16 county region. Because WO borders a state line, we also often get referrals from South Carolina that come to Georgia to access services. We have one full time instructor who travels throughout the counties to consumers’ homes to deliver training and resources. This encompasses an area approximately 125 miles wide and 150 miles deep from furthest points. This one person provides services to an average of 100 people in their homes each year, majority of which are living in rural, impoverished counties. Because the program is located within an Independent Living (IL) Center, there are peer mentors and IL Coordinators who can provide support services and information and referral services beyond what the Chapter 2 program may provide. The Center conducts Outreach on a regular basis at Senior Centers, Schools, and other partnering agencies.

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.

Georgia Radio Reading Service (GARRS) continued dissemination of public service announcements (PSA) about the Georgia Vision Program for Seniors about twice weekly. Their audience reached approximately 18,000 this year.

As part of Project Independence collaborative activities, two contractor meetings were held with providers and partners in attendance. Both meetings enhanced our collaborative activities and increased community awareness of various programs. We had one meeting in Atlanta, GA in February 2012. This meeting included various contractor staff and a variety of presenters on subjects pertinent to services e.g. equipment for deaf-blind, newest services from the Lighthouse and specialized products for the blind. The participants provided feedback from training attended, shared resource information and discussed program services to our seniors. In August 2012, we conducted a conference phone meeting to discuss the recommendations from the MSU evaluation. This was the first time we had conducted a phone meeting. Participants voiced positive feedback with this method commenting that it provided others a chance to participate not otherwise possible due to travel limitations. The group concluded this means of collaboration was most beneficial, cost and time effective.

The project manager conducted presentations and presented details of our program both as a collaborative and community awareness effort of our program at the: annual conventions of the GCB (Savannah) and NFBGA (Macon), the semiannual Statewide Coalition on Blindness held in Atlanta and Macon, the quarterly Georgia Statewide Independent Living Council meetings and the Business Enterprise Program (Duluth) and the Northwest Georgia Community Care Service Program (Rome). 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. Information was passed out and discussions were held with interested parties at the various locations. The collaboration and community awareness resulted in numerous phone calls and referrals.

Activities of the Project Independence Manager continued further collaborative activities and community awareness: 1. Received an award “2011 Collaborative Partner Award” by the Albany Advocacy Resource Center. 2. Met with staff at the Department of Veterans Affairs to review our respective systems and increase the community awareness of our respective programs so we could work collaboratively together. 3. Revisited the low vision process by soliciting information throughout the US in order to incorporate a better low vision system in Georgia. We revised our wording of the process as a result of this effort to better reflect what we do in Georgia. 4. Collaborated with the Independent Living system in sponsoring participants and aided in the set up of peer support group leader training. Project Independence is expanding the peer support groups and wants to have all peer leaders/facilitators receive formal training so there is standardization of competence and training for the group leaders. 5. Began process to have a website — for the first time — for our program. A website will greatly enhance our visibility and thus increase the community awareness of our program. The website is due to be up and running in early FFY13. 6. Distributed a number of training webinars and informational resources from various entities to our partners and the IL system so as to increase private and public awareness of services to seniors. In turn, the IL system sent various informational resources to Project Independence — we have a very good information and resource network setup. 7. Conducted program reviews of all seven contractors. These reviews helped ensure uniformity and standardization of services throughout the state. The process pinpointed any problems/issues that needed addressing that would improve our program and noted recommendations where we needed to expand services in Georgia. Items covered in the review included: • Contractor’s Process of Services • Documents Required in the Consumer’s File • Case Reviews • Review of Paperwork e.g. financial records • Senior Interviews • View A Lesson: VRT and/or O&M and/or LVE and/or Technology (With Senior’s Permission) and/or Group • Director and Staff/Subcontractors Interviews With Comments • Recommendations for Contractor • Corrective Action Needed, If Any • Contractor Strengths • Suggestions/Questions for Project Independence Program

Our primary subcontractors collaborated and incorporated new methods and approaches in various ways. Highlights are noted:

Visually Impaired Specialized Training and Advocacy Services (VISTAS) Throughout the years VISTAS has worked closely with the Talking Book Center of Athens providing information to persons in surroundings counties. A newsletter is mailed to at least 15 or more counties. We have continued mailing out brochures and resource guides to persons interested in the program as well as provided the same information to the local Optometrist. Through the Athens Senior Resources Network that provides care in the Senior Community Serving Athens-Clarke, Oconee and surrounding counties we are able to reach different types of entities that provide services to seniors. We also meet on a monthly basis and share ideas.

We continue to provide monthly an Advocacy Class in a local Assisted Living Facility. We share topics about blindness and have speakers discuss different topics of interest concerning blindness.

Our relationship with the local Center for Independent Living is a positive one. Because they serve persons with all disabilities we are able to refer to each other clients for services. Whenever they have a client that is 55 years old or older who has a visual disability they refer that person to the VISTAS CENTER.

We continue to provide transportation to persons who do not have a way to get to the center for training and to their eye appointments when necessary.

Savannah Center for Blind and Low Vision (Savannah CBLV) The Savannah CBLV video magnifier lending library program continues to expand. Thanks to a generous donation from a member of the board, several additional units are now out on loan. These units are circulated among clients as they become available. Demand continues to exceed supply. So, as a result, policies have been implemented to increase the circulation of each unit. Rather than loan a unit for an indefinite period of time, a client now has the use of a video magnifier through the program for a maximum of one year. During that year, Savannah CBLV staff maintains communication with the client and offers assistance in locating funding and other resources enabling the client to obtain his own personal unit.

Plans to develop a family Rehabilitation Program were postponed and will be revisited during 2013. The concept driving this program is to provide training and support for family members and people close to a person who is vision impaired or blind. It is expected this program will provide ten to twelve hours of direct training to each participant and be offered twice each year.

The Savannah CBLV has published a new web site and electronic communications system. The original plan for this project was to launch the new site during 2010. However, Savannah CBLV was not able to maintain this timeline; the site launched during the first quarter of 2011. The site has significantly improved our ability to communicate with all constituent groups. During 2013, a physician’s resources page will be added to the site. While this page will primarily be directed toward physicians and their staffs, it will be available to all site visitors.

Mons International, Inc. (MI) Mons incorporates new methods, collaborative and community awareness by a variety of means:

The Albany ARC Center for the Blind: Mons refers clients to the residential program for intense mobility, computer, independent living, and social skills. The clients receive training and then follow up with teachers in their home. The combination of residential training and in-home training is ideal.

Peer and Telephone Support Groups: This is an essential piece of the vision rehabilitation process. MI started three new peer support groups last year and they continue to thrive. The Douglas group is still the most successful to date with a good consistent attendance. We attribute this to the following three components: 1) it is run by a professional psychologist; 2) the local optometrist is a participant and takes a very active role; and 3) lunch is supplied. The peer support group leaders call clients throughout South Georgia to inform them of services and support available. Two support group attendees expressed their desire to lead a support group and were sent through a three day intensive Group Training Workshop. They will begin two additional groups in FFY13.

Helen Keller Registry: Mons incorporated into the Low Vision Exam the distribution of the Helen Keller Registry for those with dual sensory loss finding that nearly 30% of clients have a dual sensory loss. Mons used the Assistive Listening Devices - “Pocket Talker” in 40% of exams to enable clients to communicate with Mons. Mons used sign language interpreter services three times and would not have been able to help the client without the interpreters.

Presentations, Brochures and Resource Guides: Mons enjoyed presenting at doctor’s offices, support groups, and civic clubs and distributed Project Independence Brochures and Resource Guides and every available opportunity. This is an invaluable tool!

Center for the Visually Impaired (CVI) Collaborative/community awareness activities included 92 unique marketing and outreach events to visually impaired seniors, senior facilities, and organizations serving seniors. These activities were conducted by 20 different staff members and reached approximately 5,000 individuals.

Title VII-Chapter Two funds supported important staff training during this fiscal year. One agency staff member participated in peer support training and other staff attended locally sponsored training on human services needs and characteristics of seniors.

In FY 2010- 2011, Title VII-Chapter Two funds supported purchase of high-tech devices facilitating increased effectiveness of services; these continue to be used both in presentations and in service provision. These include a wireless tour guide audio system for speaking to up to ten hearing impaired presentation participants at one time, pocket talker personal audio systems for use during training and for issue to extremely hard of hearing visually impaired senior participants, and a high tech scanning device for reading with headphones by an extremely hard of hearing visually impaired senior. In addition, the program has purchased several iTouch and iPad devices, as well as two copies of the software package The Guide. These devices and software allow the program to offer a wider range of adapted technology options to elderly visually impaired seniors during technology demonstrations and group training in assistive technology.

Vision Rehabilitation Services of Georgia (VRS) In Fiscal year 2011-2012 we were pleased to see the development of three peer support groups in rural areas. These groups are being led by peer support group leaders trained with ARRA funds in FY 2010-11. Each group continues to grow and provide continued assistance and support both to past clients and to guide new clients through the Vision Rehabilitation process. Group leaders have covered a variety of topics during their meetings including braille, low vision, diabetic care and technology.

VRS has also had the opportunity to continue the growth of our Adjustment to Blindness Counseling program this year. We were able to hire a second counselor who works part-time to provide counseling and diabetic education to our clients. She is an RN who also speaks Spanish and continues to grow our Peachtree City group, while working with clients. As a team we have implemented the use of a depression scale with our clients, formalized our Counseling assessments and continue to provide diabetic education to those who need it with a curriculum designed to meet needs of our clients with the dual challenges of diabetes and vision loss.

Collaborations with other organizations continue to be a priority as VRS looks for ways to grow and maximize our funding to meet the needs of more clients. We have noted an increasing number of clients presenting with the dual sensory loss of hearing and vision. Our partnership with both Helen Keller National Center (HKNC) and the Georgia Council for the Hearing Impaired (GACHI) is an example of this. When the Southeast Regional Representative of HKNC partnered on a grant to purchase technology equipment for persons with dual sensory loss, she spoke with us about the need for persons working with the grant to have an overview of the needs of those with vision loss. VRS developed a four hour training program/observation time for the Regional Representative, the Executive Director of GACHI, the Co-Director of the FCC iCanConnect program, and another GACHI staff member to work with our Low Vision Consultant, the Program Director, and the Director of Low Vision Services. The purpose of this program was to familiarize key persons in these organizations with a comprehensive low vision evaluation and with the services/training available for persons who are visually/hearing impaired. We will partner with this group, so that our clients can benefit from the devices and services provided by the grant to the Helen Keller Institute and by GACHI. Also in this area, VRS has continued to work with interpreters to serve an occasional signing deaf client. This is just one example of the many ways VRS strives to work closely with numerous community organizations (i.e. senior centers, transportation services, home health agencies, etc.) in each region to assist us in locating resources for various client’s needs.

VRS continues to work with community service organizations to locate funding for some client devices, to utilize our loaner closet as needed, to work on expanding our use of volunteers to help us complete tasks that direct service staff do not have the time to do e.g. the development of a complex and effective database and data collections system — completely designed and collected by one highly skilled volunteer that has saved staff numerous hours of work and reduced frustration.

In order to resolve some of the funding struggles, VRS has worked to maximize its fundraising impact through increased number of special events and the use of social media. This year’s Spooktacular Chase was the most successful ever and the Development and Marketing Team have been able to increase our visibility in our various communities through multiple news stories and articles in local newspapers and on various television stations. Paired with the use of twitter, Facebook and email updates, our community partners are able to more easily follow what we do and know how to locate and contact us.

Walton Options for Independent Living (WO) Walton Options attends regular Statewide Independent Living Council (SILC) meetings and supports ongoing training of staff in areas that will serve consumers. We held a town forum this year in conjunction with the Tools for Life Program and the SILC in efforts to identify needs that the state plan should address. For example, we have asked our technology staff to direct time toward understanding and being able to provide training on phone and Ipad apps as these are more affordable options that are proving to enhance independence. In our strategic plan, we identify technology access as a key area upon which to focus training and resources.

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 The National Research and Training Center (NRTC) on Blindness and Low Vision at Mississippi State University to provide a program evaluation of the Project Independence program. As part of the evaluation consumers are interviewed about their experiences with the program. The six contractors providing direct services send the NRTC names of closed consumers on a quarterly basis. An experienced telephone interviewer then contacts consumers to complete surveys. Each year the NRTC prepares a program evaluation report that includes consumers’ feedback regarding satisfaction with services and how services have impacted their ability to live independently. In addition, demographic and service data from the annual 7-OB report and findings from site reviews of contractors are included in the report.

The GA program has contractual agreements with six regional agencies for provision of direct services to eligible seniors. A regional service delivery approach enhances the ability of project staff to be sensitive to and familiar with the needs of local consumers. Depending upon the contractor and/or individual consumer’s needs, an itinerant, center-based, or combination of itinerant/center-based model is used in providing services. An itinerant model is generally used to serve consumers in outlying rural areas who might not otherwise be able to participate in such a program.

During this project year, 359 consumers participated in telephone interviews. The majority of participants (65%) were 75 years of age or older. More than two-thirds (68%) were female. About 83% of participants reported living in a private residence; the others living in senior living/retirement communities, assistive living facilities, or nursing homes. The majority of the respondents (59%) reported macular degeneration as the reason for their vision loss; 24% reported glaucoma. Consumer satisfaction levels among those participating in the survey were very high. In responding to satisfaction questions regarding delivery of services, i.e., 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 the attentiveness, concern, and interest of staff (99%); followed by the manner in which those services were received (98%), and overall quality of services (97%). Consumer ratings of functioning after receiving different types of independent living service areas follow: • 95% reported that they were better able or had maintained their ability to travel independently • 95% reported that they were better able or had maintained their ability to function more independently having received assistive technology devices • 98% reported that they were better able or had maintained their ability to function more independently having received communication skills training • All respondents (100%) reported that they were better able or had maintained their ability to function more independently having received daily living skills training • 59% reported that they had greater control and confidence in their ability to maintain their current living situation; 35% indicated no change; and 5% indicated less control and confidence Program participants were asked what the biggest difference the program had made in their lives. Typical comments include the following: • When I first got my blindness, I lost my confidence. Now, I have regained it. • It has helped me to overcome my fear of going in my kitchen and putting together a meal. • They showed me different ways to do things to make my life easier, and my magnifiers have helped me read labels and other things too. • They gave me confidence again. I can now catch the bus and go shopping and walk all around the mall. I also walk around the airport. • They worked with me and helped me with aids, and now I am more independent again. • My ability to travel more independently was my biggest difference.

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).

Case 1 Pastor R. G. was referred to XXX after a losing all functional vision in her right eye, as well as decreased vision and field loss in her left eye. At the Center she received Low Vision services to learn how to use magnification to support using her remaining vision for reading her sermons, prescription bottles, food labels and price tags. In addition, Pastor R. G. received vision rehabilitation in all service areas; orientation & mobility, activities of daily living, communication and adapted computer technology, to increase her independence and safety in her home and to enable her to return to her ministries in her community.

The services she received were developed specifically for Pastor R. G.’s individual goal for independent living skills that would allow her to remain safely in her own home. She reported that prior to receiving services she had virtually remained in her home during the day for months, afraid to leave the home, afraid she would fall again by tripping over a curb or falling down stairs. Since her training, Pastor R. G. commented that she is not only safer in her mobility but that she has also increased her strength and endurance. She has committed to daily walking to keep her physical, mental and spiritual self healthy.

Pastor R. G. has reported that since her rehabilitation training she returned to her ministries, not only returning reading her own sermons but providing home visits to those that are shut-ins and cannot attend services. She also stated she is once again doing her own emails, online banking, sermon writing and internet research.

Pastor R. G. has not only increased her own safety and independence, she has developed a new sense of freedom. She has decided that she wants to share that with others in her community. She stated that she wants to start computer training group for seniors at her church. She believes the training she received made her more confident in her computer skills and thinks others will benefit from receiving support and guidance in using technology for their own independence.

Case 2 XXX saw a 95 year old woman in December of 2011. She came in with a walker, used the assistive listening device to hear me, and told me she wanted to read and crochet again. She was living in a nursing home and wanted to return to her own home again. A lighted magnifier enabled her to read small print, and a head-borne device enabled her to crochet. A talking pedometer enabled her to measure the three miles she walked each day. A talking clock and large print watch helped make reading the time easy. But the most incredible thing of all is at age 96 she was able to leave the nursing home and return to her own home as she requested.

Case3 Mr. S. is an African American 56 year old man who recently relocated to an apartment to live independently as a result of receiving services from XXX staff. His health concerns include AIDS, hypertension, seizure disorder, and a stroke suffered in 2004. After losing his vision in 2009 due to AIDS, Mr. S. became non-compliant with his medications, which resulted in additional medical complications. This forced him to ask to live with his wife, from whom he had been separated for 11 years. His stated goal was to return to living independently. Mr. S. received both individual and group instruction from a Vision Rehabilitation Therapist (VRT) to address his daily living skills. An Orientation and Mobility (O&M) instructor provided instruction on safely crossing streets and navigating unfamiliar environments. As a result of services, Mr. S. did return to independent living in January 2012. He now travels independently by bus and rail throughout the metro Atlanta area. He enjoys cooking, and he smiled as he related a recent trip by MARTA to Whole Foods for shopping. His current goal is to be employed, and XXX staff has referred him to the Georgia VR Program for vocational counseling. “You can’t give up, you have to stay positive. You all helped me out to realize I could make it. You all taught me I do not have to lean on anybody.”

Case 4 Mrs. “B”, an 80 years “young” widow, lives in a rural area of north Georgia. Her two daughters are ill, and there is no one to drive Mrs. “B” to the grocery store or to her doctors’ appointments. From the minute we met her, Mrs. “B” kept saying “I have to drive. I have to drive.” She started crying when the low vision consultant told her she did not meet the visual acuity guidelines to drive in the state of Georgia. However, she was a candidate for driving with bioptic spectacles. Between Mrs. “B’s” raising a certain amount of money and the Director of Low Vision Services requesting a donation from the company that makes the bioptic spectacles, Mrs. “B” was able to purchase the bioptic spectacles. During the time that elapsed between the dispensing of the bioptics and Mrs. “B’s” actually obtaining her driver’s license, she would call XXX and ask: “I’m out of food, or there is a family emergency. Can I drive just this one time?” We would say “No”. Mrs. “B” had been asked to call the Director of Low Vision Services on the day she received her driver’s license. One day, this message was on the telephone: “I have my driver’s license. I’m leaving now and won’t be at home. No need to call me back!!!” Thanks to the funding provided by Project Independence, Mrs. “B” was able to come for the initial low vision evaluation and learn what was available to ensure her living independently.

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

Areas of concern voiced by the providers: Funding and Staffing

Funding People are still not as aware of the program and we thought they would be at this time. We continue to struggle with funding and continue to look for extra funding.

Due to the continued dismal economic climate and the associated reduction in other previously available publicly-funded contracts, Title VII-Chapter 2 funds are becoming even more critical. If these funds continue to be flat-lined in national and state budgets, it seems inevitable that the number of consumers served or the amount of service offered each year will begin to decline in the not-too-distant future. Increasing service delivery contract deliverables and flat-lined funds will drive these decreases even in years when inflationary pressures are moderate.

One provider relayed a most important point. The struggle continues with the need to serve more clients with funding amounts that do not increase significantly from year to year. FFY 2012 has seen us continue our work with clients in the earlier stages of vision loss. Our data demonstrates that when clients enter the Vision Rehabilitation program early on in their diagnosis, they are better educated and learn — more quickly and easily - how to use the tools, strategies and adaptations they need to continue to live independently. These folks will continue to be clients and come to us as their vision changes; however, the numbers of services needed is reduced because the clients can use new adaptations more easily.

Staffing The dearth of qualified professionals in vision rehabilitation continues to be a serious problem, not only for individual agencies, but also state-wide. Despite offering competitive salaries and generous benefits, the pool of professionals looking for work shrinks even more every year. 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. This year we have been successful in attracting high-quality professional interns as temporary staff, but this may not be possible every year, as other agencies are also recruiting from a pool of interns that is shrinking as rapidly as the number of experienced practitioners. There is a lack of the required Certified Staff and the loss of so many Master’s Level Classes at Schools is not helping to rectify the issue.

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
TitleProgram Manager, Project Independence
Telephone404-638-5208
Date signed01/29/2013