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

RSA-7-OB for Indiana Bureau of Rehabilitation Services - H177B120014 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year660,399
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year661,626
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2893,312
A2. Total other federal0
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)0
A4. Third party340,998
A5. In-kind0
A6. Total Matching Funds340,998
A7. Total All Funds Expended1,234,310
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs81,741
C. Total expenditures and encumbrances for direct program services1,152,569

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 1.0000 0.0000 1.0000
2. FTE Contractors 4.2370 20.2630 24.5000
3. Total FTE 5.2370 20.2630 25.5000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 23 10.0050
2. Employees with Blindness Age 55 and Older 9 7.1630
3. Employees who are Racial/Ethnic Minorities 11 4.4160
4. Employees who are Women 32 16.6250
5. Employees Age 55 and Older 13 5.9520

C. Volunteers

1.00

Part III: Data on Individuals Served

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

A. Individuals Served

1. Number of individuals who began receiving services in the previous FY and continued to receive services in the reported FY613
2. Number of individuals who began receiving services in the reported FY886
3. Total individuals served during the reported fiscal year (A1 + A2) 1,499

B. Age

1. 55-59113
2. 60-64140
3. 65-69155
4. 70-74138
5. 75-79171
6. 80-84245
7. 85-89294
8. 90-94169
9. 95-9962
10. 100 & over12
11. Total (must agree with A3)1,499

C. Gender

1. Female1,075
2. Male424
3. Total (must agree with A3)1,499

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race20
2. American Indian or Alaska Native0
3. Asian3
4. Black or African American162
5. Native Hawaiian or Other Pacific Islander0
6. White1,310
7. Two or more races3
8. Race and ethnicity unknown (only if consumer refuses to identify)1
9. Total (must agree with A3)1,499

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)112
2. Legally Blind (excluding totally blind)640
3. Severe Visual Impairment747
4. Total (must agree with A3)1,499

F. Major Cause of Visual Impairment

1. Macular Degeneration721
2. Diabetic Retinopathy153
3. Glaucoma177
4. Cataracts84
5. Other364
6. Total (must agree with A3)1,499

G. Other Age-Related Impairments

1. Hearing Impairment474
2. Diabetes334
3. Cardiovascular Disease and Strokes530
4. Cancer124
5. Bone, Muscle, Skin, Joint, and Movement Disorders603
6. Alzheimer's Disease/Cognitive Impairment45
7. Depression/Mood Disorder119
8. Other Major Geriatric Concerns513

H. Type of Residence

1. Private residence (house or apartment)1,139
2. Senior Living/Retirement Community199
3. Assisted Living Facility112
4. Nursing Home/Long-term Care facility49
5. Homeless0
6. Total (must agree with A3)1,499

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)68
2. Physician/medical provider108
3. State VR agency23
4. Government or Social Service Agency135
5. Veterans Administration9
6. Senior Center177
7. Assisted Living Facility56
8. Nursing Home/Long-term Care facility13
9. Faith-based organization17
10. Independent Living center169
11. Family member or friend524
12. Self-referral105
13. Other95
14. Total (must agree with A3)1,499

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 46,528
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 265
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 170,939
1b. Total Cost from other funds 18,934
2. Provision of assistive technology devices and aids 1,124
3. Provision of assistive technology services 1,003

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 421,113
1b. Total Cost from other funds 271,960
2. Orientation and Mobility training 72
3. Communication skills 652
4. Daily living skills 1,007
5. Supportive services (reader services, transportation, personal 248
6. Advocacy training and support networks 317
7. Counseling (peer, individual and group) 625
8. Information, referral and community integration 1,116
. Other IL services 204

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 118,709
1b. Total Cost from other funds 810
2. Information and Referral 2,279
3. Community Awareness: Events/Activities 263 4,290

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) 1,697,099 1,234,310 -462,789
2. Number of Individuals Served 1,381 1,499 118
3. Number of Minority Individuals Served 147 188 41
4. Number of Community Awareness Activities 293 263 -30
5. Number of Collaborating agencies and organizations 242 270 28
6. Number of Sub-grantees 10 18

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 1,003 100.00%
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) 447 44.57%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 645 64.31%
B1. Number of individuals who received orientation and mobility (O & M) services 72 100.00%
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) 25 34.72%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 45 62.50%
C1. Number of individuals who received communication skills training 652 100.00%
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) 252 38.65%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 337 51.69%
D1. Number of individuals who received daily living skills training 1,007 100.00%
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) 346 34.36%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 648 64.35%
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) 290 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) 33 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) 11 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 68 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) 28 n/a

Part VII: Narrative

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

The Older Independent Blind Program administered by Indiana Blind and Visually Impaired Services (BVIS) provides skills training through grant contracting with seven (7) community based programs and one (1) Orientation and Mobility independent instructor. The following network of eight (8) contractors and (10) subcontractors are utilized in delivering Older Independent Blind services: 1) Bosma Enterprises for the Blind is an Indianapolis based rehabilitation center for the visually impaired with Rehabilitation Instructors stationed in four areas of the state: Indianapolis, Valparaiso, Evansville and Lafayette. Bosma employs seven full time Rehabilitation Instructors and two part time RTs with defined territories covering all 92 counties in the state. Bosma contracted with a company, Bright Star, in developing a strategic outreach program providing social workers to provide mental assessments and provide short term counseling. Some other highlights of the program were training nineteen (19) outreach volunteers, a mass mailing to all ophthalmologists and optometrist in the state, new print marketing materials, and development of radio and print announcements and Public Service Announcements. Bosma also subcontracted with Bishoff Consulting Services to develop a strategic outreach plan to identify priority outreach areas of the state. Another outreach initiative is The Vision Venture Van purchased with ARRA funds travelled to 17 events and conferences throughout the state, mostly to southern counties where there is high need. Several events the van was utilized were the Mid-America Institute on Aging conference, the Vision Expo at the State Library, the Indiana Activity Director Association’s semi-annual conference, and to several pre-planned visits at senior living facilities and senior centers around the State. 2) Access Ability is an Indianapolis based Center for Independent Living responsible for services in Boone, Hamilton, Hendricks, Marion, Hancock, Morgan, Johnson and Shelby counties providing services through one (1) Outreach Specialist, four (4) Senior Advocates and two(2) subcontractors delivering independent skills training. To increase minority outreach Access Ability networked with the Latino Resource Round Table, Indiana Minority Health Coalition, Julian Center, senior centers, assisted living facilities, and Area Agencies on Aging. During FY 2012 Access Ability has reached approximately 797 consumers via response to requests for information and referral as well as direct services such as advocacy, peer support, and independent living skills training. 3) The Wabash Independent Living and Learning Center is a Center for Independent Living located in Terre Haute and responsible for services in Owen, Vermillion, Parke, Putnam, Clay and Vigo counties with one Coordinator/Teacher and one Driver Assistant delivering independent skills training. The Will Center maintains outreach contacts with the Area Agency on Aging, residents of independent living communities, the Minority Health Coalition, and Senior Citizens Centers. Brochures and large print contact cards have been distributed throughout the service areas including eye clinics, local independent living facilities, and physician’s offices. The Center collaborated with the Vigo County Minority Health Coalition and Lions Club to offer free vision screenings. Presentations have been delivered at several venues including health fairs, public libraries, Lion’s Club, and the Veteran’s Health Health/Information fair. 4) The Independent Living Center of Eastern Indiana is a Richmond based Center for Independent Living responsible for services in Henry, Wayne, Rush, Fayette, Union, Decatur and Franklin counties with a Service Coordinator/Grant Administrator (1) and four (4) Service Coordinators providing independent skills training. ILCEIN has expanded its outreach services by partnering with Southeastern Indiana ILC (SIILC) in six new un-served southeastern counties serving over 100 consumers. They also partnered with Easter Seals Crossroads providing computer training, Minority Health Coalition of Wayne County collaborating health training events for the minority community of Richmond, Mike Neese an independent O&M instructor, and Wayne Irvin a driver for low vision support groups, educational field trips, and social outings. ILCEIN sponsors five low vision support groups in three counties and recently initiated three more. Through outreach efforts and very active word-of- mouth promotion by consumers and supportive agencies, 40 organizations were added to the list of referring entities in FY 2012 for a total of 195. 5) The League for the Blind and Disabled is a Fort Wayne based Center for Independent Living responsible for services in Lagrange, Steuben, Noble, DeKalb, Whitley, Allen, Huntington, Wells and Adams counties with a Rehabilitation Teacher (1) and a Driver/Assistant (1) delivering independent skills training. The League supports ten (10) support groups with five (5) in counties outside of Allen County. Additional outreach efforts were made by placing ads in the Hispanic owned newspaper el Mexicano. The company Briljent was contracted to target outreach efforts to the African American community. The League collaborated with the Center for Independent Living Future Choices for O&M instruction. 6) ADEC is a Bristol based rehabilitation center responsible for services in LaPorte, St. Joseph, Elkhart, Marshall and Kosciusko counties. Staff consists of two Rehabilitation Teachers (2) and the Director with one clerical (1) support. ADEC‘s outreach efforts were to community centers with large African American and Hispanic populations. Outreach efforts include community centers with a large African American presence, agencies that work with the Hispanic community and nutrition sites in five counties. 7) Future Choices is a Muncie based Center for Independent Living responsible for services in Blackford, Delaware, Grant, Howard, Madison, Randolph and Tipton counties. This is the second year this contractor was awarded Older Independent Blind funds. On staff is one (1) Coordinator, two (2) Outreach OIB Specialist, and one (1) Peer Counselor. They were awarded through a competitive process additional Orientation and Mobility training funds to outreach those underserved customers in Jennings, Dearborn, Clark, Jefferson, Switzerland, Ohio, Clinton, Carol, Tippecanoe and Warren counties. Future Choices subcontracts with The League for the Blind utilizing their O&M Instructor and a Low Vision Specialist. 8) Michael Neese, independent Orientation & Mobility Instructor, was awarded a contract for the goal of locating and providing mobility instruction to the most isolated elderly. Mr. Neese obtained his own referrals through networking in local communities. This fiscal year will terminate Mr. Neese being awarded any further individual contract awards. Mr. Neese performed his contractual duties competently, however it was determined the older blind funds would be used more efficiently by awarding to organizations rather than individuals. Mr. Neese will have the opportunity to subcontract with any organization receiving older independent blind funds.

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.

Bosma Enterprises: • A program titled Bosma Connections involved seniors in interactive telephone sessions. Offering nine telephone sessions per week and average attendance on the calls are eight to twelve participants. The sessions included a low vision support group, trivia question game, a story telling hour, a book club, social hour, and an educational presentation. The educational presentations were done by interviewing professionals in the field of low vision and blindness or other fields relating to seniors. Skype is being used where participants can call in from a landline or cell phone and there is no toll cost. • With ARRA funds Bosma purchased a custom built mobile training unit in 2011 for the purpose of expanding the Senior Program to underserved and un-served area s of the state. The mobile training unit has provided functional vision assessments, assessments for magnification and other adaptive aids, training for the use of aids, and instruction in the areas of communications, daily living skills and personal care. To date, the van has travelled to 17 events and conferences throughout the state. ADEC: • Staff routinely conducts in-service trainings in the community. During the grant year 86 community awareness events were conducted. Collaborative efforts have included working with area agencies to provide information and referral services. • Three (3) support groups are facilitated; in St. Joseph County with an average attendance of 25-30 individuals, in Kosciusko County with an average of 10-15 individuals attending and in Laporte County with an average of 10-15 individuals attending. Collaborative efforts have included working with the AAAs to provide information and referral. • Awareness events occurred throughout the five (5) county catchment areas. At these events, staff discussed current trends in independent living, display and demonstrates adaptive equipment and low vision aids. Presentations were also conducted with many ophthalmologists and optometrists throughout the service area. Many of these in-services and presentations have resulted in increased awareness and increased referrals to the program. Independent Living Center of Eastern Indiana: • Accomplished a 13% increase in consumers served (from 269 to 305) and continued to serve nine (9) additional counties added to the service area. Partnered with Southeastern Indiana Independent Living Center (SIILC) in Versailles, IN and collaborated with senior programs, hospitals, libraries, and isolated retirement communities in rural SE Indiana. • Collaboration with the Minority Health Coalition in Wayne County continued for the second year increasing access to African American and Hispanic communities. Working with this organization provided vision, blood sugar and hearing screenings establishing a promising base for minority outreach. • Partnered with Easter Seals Crossroads providing an assistive technology demonstration site offering three training programs. Fifty two customers participated in this training. Also held the second annual Mini Vision Expo Open House with sixty five consumers being in attendance.

Access Ability: • The SAIL program continues to partner with organizations/agencies to expand capacity including assisted living and nursing home facilities such as Green Tree, Masonic Homes, Rosewalk Assisted Living Centers, local senior communities, faith based organizations, senior centers, eye clinics, and service providers such as Crossroads Easter Seals, Bosma Enterprises, CICOA, and Vocational Rehabilitation. • In Johnson County a new support group was implemented, several disability workshops were held serving thirty five (35) new consumers. The League f/t Blind and Disabled: • Vision impairment talks were given to senior living complexes on visual impairments and adaptive equipment. Digital talking book equipment, large print calendars, and 20/20 pens are some of the adaptive aids that most interest the consumers. • Attend meetings of the Hispanic Social services Network. At the meetings each group represented does a short presentation on their programs. • Google’s Translation Tool is used for the League’s blog, web site and Disability Information Site. This tool converts the information into 66 different languages including Spanish. • Ads were developed and appeared in the El Mexicano, Hispanic owned newspaper beginning in October 2011 and running through September 2012. • Briljent, a woman owned business, targeted outreach activities for the African American population.

The Wabash Independent Living Center: • Collaboration with the Area Agency on Aging of Southern Indiana and Vincennes University in hosting a Low Vision Expo which brought in one hundred (100) seniors. • Provided services information to city administrations, county health departments, Area Agencies on Aging, Vocational Rehabilitation Services, Veterans Administration, eye clinics, public libraries, local Lion’s Clubs, media outlets, senior program managers, and the Independent Living Center serving the southern seven counties. • Collaborated with Easter Seals Crossroads to ensure the latest technology is available to consumers. The Chapter 2 Program Manager serves on the advisory board of the Easter Seals Crossroads INDATA project. • Implementing a plan to launch a sight loss support group next year in Knox County. Also, the Center participated in thirty six (36) peer group meetings during the grant cycle.

Future Choices: • Partnered with the regional AAA, Open Door, Muncie Eye Center, and United Way to recruit customers. Presentations were provided to the Senior Center Social Club, Christian Women’s Connection, Lutheran Terrance, and Madison County Chapter for the Blind. Provided services to sixty nine (69) new customers and distributed aids to forty eight (48) individuals. • Expanded into nine (9) counties in which there were outreach services in peer to peer counseling, independent living skills training, purchase of participant aids and technology, adjust me to vision loss, mobility instruction, recreation, and socialization.

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.

Total Surveys: 480 1. I feel confident in my ability to live independently with my vision loss? 1. Strongly Agree_______________216 Customers 2. Agree______________________218 Customers 3. Disagree____________________ 42 Customers 4. Strongly Disagree_____________ 4 Customers

2. I have considered moving to a nursing home or assisted living because of my vision? 1. Agree_____________192 Customers 2. Disagree___________288 Customers

3. As a result of this training, I will be more capable of remaining in my home? 1. Strongly Agree_____________186 Customers 2. Agree____________________248 Customers 3. Disagree__________________ 39 Customers 4. Strongly Disagree___________ 7 Customers

4. As result of this training, I am able to travel independently? 1. Strongly Agree____________36 Customers 2. Agree___________________96 Customers 3. Disagree_________________89 Customers 4. Strongly Disagree__________ 8 Customers 5. Was not an issue with me prior to services_________251 Customers

5. As a result of this training, I am able to read and manage my paperwork (e.g. mail, check writing, and correspondence)? 1. Strongly Agree____________162 Customers 2. Agree___________________187 Customers 3. Disagree_________________ 70 Customers 4. Strongly Disagree__________ 13 Customers 5. Was not an issue with me prior to services________48 Customers

6. As a result of this training, I am able to take care of my personal needs like grooming cooking, laundry, etc? 1. Strongly Agree____________126 Customers 2. Agree___________________195 Customers 3. Disagree_________________ 47 Customers 4. Strongly Disagree__________ 3 Customers 5. Was not an issue with me prior to services_________109 Customers

7. As a result of this training, I am less dependent on others? 1. Strongly Agree_____________158 Customers 2. Agree____________________239 Customers 3. Disagree__________________ 48 Customers 4. Strongly Disagree___________ 10 Customers 5. Was not an issue with me prior to services________25 Customers

8. As a result of this training, I am better able to participate with family, friends, and community life? 1. Strongly Agree_____________145 Customers 2. Agree____________________224 Customers 3. Disagree__________________ 55 Customers 4. Strongly Disagree___________ 6 Customers 5. Was not an issue for me prior to services________50 Customers

9. As a result of this training, you were able to meet all the goals you wanted to accomplish? 1. Strongly Agree____________171 Customers 2. Agree___________________249 Customers 3. Disagree_________________ 53 Customers 4. Strongly Disagree_________ 7 Customers

10. Would you recommend this program to others? 1. Strongly Agree___________326 Customers 2. Agree__________________148 Customers 3. Disagree________________ 5 Customers 4. Strongly Disagree________ 1 Customer

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

The following personal consumer narratives were submitted by individual contractors.

Mrs. C., age 85, recently came into our Center to tell us how invaluable to her are two of the vision aids that she received, one through our loaner program and one via mini-grant. She lives alone and wants to continue to do so for as long as possible. She loves the loaner Zoom Text program she received because it allows her to keep in touch with family and friends by helping her to read and reply to her e-mails. In addition, she has a talking medication reminder that is loud enough to hear no matter where she is in her home. Her daughter has recorded six reminders for her to take her various medications throughout the day and the device has helped Mrs. C. to be more consistent in taking her pills, helping to reassure her family members and herself that she can safely and independently manage this self-care task so vital to her continued good health and independent living. Gloria O., age 68, was brought to us by her husband because he was concerned that she was deeply depressed over substantial vision loss that had left her legally blind and unable to read which had once been her favorite pastime. We loaned her a desktop CCTV so she could read her Bible for her morning devotions and signed her up for Talking Books through the State Library. We also had one of our volunteers download the Bible for her from the BARD website so she could keep it for continued use. She has turned around from being depressed to being excited about life again and is devouring the books that she receives from the State Library on a wide variety of educational topics. She has a renewed zest for life and enjoys having new topics to discuss with her husband over dinner now that she can read again. Mrs. L, age 96 with macular degeneration, was brought in by her daughter. She was highly dubious we could do anything to help her as her eye doctor himself had told her there was nothing more he could do for her. She was resigned to living out the rest of her life able to do very little. We sat her down with our demo magnifier kit, with magnifiers from 3x to 14x and she found one that worked perfectly for her. She started crying when she realized she could read again for the first time in three years. Then we showed her talking clocks and watches, a talking calendar, talking bathroom scales, talking microwave and coffeemaker, and talking books. She could not understand why her eye doctor had not told her there were vision tools available that could help her to read and to continue doing things around the house despite her low vision. She left happier than she been in a very long time and her daughter was delighted and relieved as well.

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

There are no problematic areas or concerns in implementing the Indiana Older Independent Blind program at the State level. There are, however, the ongoing systemic concerns of limited funding and the ability to deliver statewide quality services. The current and future problem of having qualified personnel trained in the field of visual impairments is a persistent concern. Indiana is addressing the training issue by contractually mandating that all field staff involved with elderly services participate in online courses provided by the American Foundation for the Blind in the coming year 2013. Another concern with the emphasis to study STEM courses in college there will be fewer graduates gravitating to the field of visual impairment rehabilitation. The field of rehabilitation should be incentivized to attract future rehabilitation specialists.

In Indiana the elderly demographics will increase from 12% (65+) to 21% share of the population by 2030 as the share of all other ages decline. With ageing will come higher populations with visual impediments. The rural elderly will age in place while younger populations move into more urban settings for economic reasons leaving less prosperous pockets around the state. This will cause more expense in reaching and delivering services to the rural elderly in the future. A few counties in Indiana are likely to become “economic dead zones” due to younger population shifts causing professionals such as doctors, teachers, business people, and personnel that manage community programs to not locate in or near these areas. The anticipated outcome will be higher costs to outreach the elderly in these areas for all services including visual rehabilitation.

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 byLocket Phillips
TitleManager of Blind Services
Telephone317-232-1441
Date signed12/21/2012