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

RSA-7-OB for Arizona Rehabilitation Services Administration - H177B130003 report through September 30, 2013

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year625,556
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year82,163
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2599,430
A2. Total other federal357,034
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement148,327
(c) Title XX - Social Security Act208,707
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)94,486
A4. Third party0
A5. In-kind0
A6. Total Matching Funds94,486
A7. Total All Funds Expended1,050,950
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs357,034
C. Total expenditures and encumbrances for direct program services693,916

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 3.1000 4.8000 7.9000
2. FTE Contractors 5.1700 10.5400 15.7100
3. Total FTE 8.2700 15.3400 23.6100

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 22 7.3600
2. Employees with Blindness Age 55 and Older 3 1.4000
3. Employees who are Racial/Ethnic Minorities 13 3.7500
4. Employees who are Women 43 16.9100
5. Employees Age 55 and Older 15 7.2000

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 FY328
2. Number of individuals who began receiving services in the reported FY563
3. Total individuals served during the reported fiscal year (A1 + A2) 891

B. Age

1. 55-5954
2. 60-6460
3. 65-6988
4. 70-7494
5. 75-79110
6. 80-84188
7. 85-89187
8. 90-9486
9. 95-9922
10. 100 & over2
11. Total (must agree with A3)891

C. Gender

1. Female656
2. Male235
3. Total (must agree with A3)891

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race72
2. American Indian or Alaska Native10
3. Asian4
4. Black or African American28
5. Native Hawaiian or Other Pacific Islander0
6. White770
7. Two or more races7
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)891

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)46
2. Legally Blind (excluding totally blind)479
3. Severe Visual Impairment366
4. Total (must agree with A3)891

F. Major Cause of Visual Impairment

1. Macular Degeneration560
2. Diabetic Retinopathy43
3. Glaucoma108
4. Cataracts25
5. Other155
6. Total (must agree with A3)891

G. Other Age-Related Impairments

1. Hearing Impairment152
2. Diabetes140
3. Cardiovascular Disease and Strokes250
4. Cancer48
5. Bone, Muscle, Skin, Joint, and Movement Disorders315
6. Alzheimer's Disease/Cognitive Impairment27
7. Depression/Mood Disorder48
8. Other Major Geriatric Concerns230

H. Type of Residence

1. Private residence (house or apartment)652
2. Senior Living/Retirement Community163
3. Assisted Living Facility68
4. Nursing Home/Long-term Care facility7
5. Homeless1
6. Total (must agree with A3)891

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)30
2. Physician/medical provider32
3. State VR agency23
4. Government or Social Service Agency56
5. Veterans Administration6
6. Senior Center18
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization1
10. Independent Living center25
11. Family member or friend110
12. Self-referral548
13. Other42
14. Total (must agree with A3)891

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 199
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 364,237
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 749
3. Provision of assistive technology services 749

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 329,679
1b. Total Cost from other funds 0
2. Orientation and Mobility training 224
3. Communication skills 651
4. Daily living skills 651
5. Supportive services (reader services, transportation, personal 0
6. Advocacy training and support networks 195
7. Counseling (peer, individual and group) 1
8. Information, referral and community integration 563
. Other IL services 23

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 30 3,738

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) 1,719,426 1,050,950 -668,476
2. Number of Individuals Served 972 891 -81
3. Number of Minority Individuals Served 109 121 12
4. Number of Community Awareness Activities 41 30 -11
5. Number of Collaborating agencies and organizations 71 71 0
6. Number of Sub-grantees 19 13

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 749 100.00%
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) 650 86.78%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 74 9.88%
B1. Number of individuals who received orientation and mobility (O & M) services 224 100.00%
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) 41 18.30%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 128 57.14%
C1. Number of individuals who received communication skills training 651 100.00%
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) 263 40.40%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 184 28.26%
D1. Number of individuals who received daily living skills training 651 100.00%
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 55.61%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 244 37.48%
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) 474 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) 13 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) 6 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) 18 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 Arizona Rehabilitation Services Administration (AZRSA) uses staff employed directly by the DSU, as well as individuals and agencies who contract to provide local and itinerant services, to administer the Title VII, Chapter II Independent Living Older Blind Program. Arizona had seventeen internal staff, eleven individual contractors, and two agencies with thirty three direct service employees, for a total of sixty one individuals who provide services statewide to our elderly blind clients. The services provided helped our clients to live as safely and independently as possible in their homes or communities. AZRSA continues to provide services to older individuals who reside in rural Arizona. Certified Vision Rehabilitation Therapists 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 AZRSA services and community blindness related services. There were three major events that drew approximately three thousand attendees during this reporting period. The Hopi Veterans Special Needs Activity Day held on October 10, 2012, at the Hopi Veterans Memorial Center in Kykotsmovi, Arizona, was attended by approximately fifteen hundred individuals; the Sun City Health Expo, held on October 3, 2012, in Sun City, with approximately seven hundred attendees; and the 16th Annual Vision Rehabilitation and Technology Expo (VRATE) held on November 30, 2012 in Glendale, drew approximately eight hundred attendees. As a result of the efforts of the AZRSA Independent Living Older Blind (ILOB) staff who conducted thirty in-service presentations throughout Arizona, three thousand seven hundred and thirty eight clients, friends, family members, and service providers were given information about vision-related services. In addition, AZRSA continues to update the Arizona Directory of Services for Persons Who Are Blind & Visually Impaired which now also includes information for people who are deaf, hard of hearing or deaf-blind. This directory is available in alternative formats to address individual needs and is updated on a quarterly basis to keep the most current information available. AZRSA continues to maintain a website, which provides information and links to additional resources and services.

AGENCY/ORGANIZATION PROVIDERS: AZRSA Independent Living Blind providers consist of seventeen state agency employees and thirteen providers as follows:

State Agency Employees: Garcia, Vasant (Certified Vision Rehabilitation Therapist) Gunn, Suzi (Certified Orientation and Mobility Specialist and Certified Teacher for the Visually Impaired) Lindley, Pam (Certified Vision Rehabilitation Therapist) Miller, Anna (Certified Vision Rehabilitation Therapist/Certified Rehabilitation Counselor) Olson, Susan K. (Certified Vision Rehabilitation Therapist) Steen, Todd (Certified Vision Rehabilitation Therapist/Orientation and Mobility Specialist) Russell, Cindy (Non Certified Orientation and Mobility Specialist) Davis, Chris (Assistive Technology Specialist) Crist, Lanelle (Non Certified Vision Rehabilitation Therapist) Rutt, Duol (Non Certified Vision Rehabilitation Therapist) Anderson, Erick (Assistive Technology Inventory Lead) Six Administrative Support Staff Provider Agencies: Arizona Center for the Blind and Visually Impaired (ACBVI) Southern Arizona Association for the Visually Impaired (SAAVI)

Individual Providers: Arnold, Patty (Certified Vision Rehabilitation Therapist/Certified Low Vision Specialist) Carlise, Kathy (Certified Vision Rehabilitation Therapist) Gervasoni, Ed (Certified Orientation and Mobility Specialist and Certified Vision Rehabilitation Therapist) Hanna, Georgeanne (Certified Vision Rehabilitation Therapist and Certified Low Vision Specialist) - Harris, Ellen (Certified Vision Rehabilitation Therapist and Certified Teacher for the Visually Impaired) Klenner, Shelly (Certified Vision Rehabilitation Therapist and Certified Teacher for the Visually Impaired) Ohm, Laura (Certified Orientation and Mobility Specialist) Weaver, Sandra (Non-Certified Vision Rehabilitation Therapist) Rock, Julie (Certified Vision Rehabilitation Therapist) Rutkoff, Ethan (Non-Certified Vision Rehabilitation Therapist) Vangueety, Venu (Non-Certified Vision Rehabilitation Therapist)

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 increased community awareness by presenting (30) thirty events or activities in FFY 2013. Some of the presentations and collaborations include, but are not limited to the following: Association for Education and Rehabilitation American Foundation for the Blind Beatitudes Low Vision Support Group Devon Gables Healthcare Center Hopi Veterans Special Needs Activity Day Fellowship Square Low Vision Support Group Hadley School for the Blind Health Expo-Sun City Home Instead Senior Care La Frontera Homeless Services Program Low Vision Groups (Mesa, Scottsdale, Chandler, Tempe) Lutheran Social Services Meals on Wheels Program McDowell Village Support Group Mountain Park Senior Living Center Prescott Lakes Senior Community Red Mountain Low Vision Support Group Royal Oaks Monthly Health Forum Scottsdale Low Vision Support Group Scottsdale Adult Daycare Senior Circle Sierra Vista Low Vision Group Senior Circle Diabetes Group South Tucson Healthy Habits Fair Staff/Flagstaff Eye Care Staff/Peak View Optical Sun City Health Fair Sun City West Low Vision Group Tucson Medical Senior Services Tucson Society for the Blind Tuzigoot Village Apts. For seniors Vision Rehabilitation And Technology Exposition White Cane Day

These activities, combined with the smaller gatherings that occurred during this Federal fiscal year, provided outreach to three thousand seven hundred and thirty eight 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.

A survey to query participants on their experience and assess their satisfaction with the services received was sent to individuals after completion of their program with AZRSA ILOB. Postage-free return envelopes were provided. The comments had personal identifying text removed but the context is exactly as received. Of the 401 surveys that were mailed, 14 or 28.4% of the surveys were received with one or more response(s); 17 or 4.2% surveys were returned as undeliverable; 270 or 67.3% of the surveys were not returned. The AZRSA Independent Living Older Blind Program Survey yielded both quantitative and qualitative information to determine if the services provided benefited the clients. A Likert scale of one to four was used to determine the participant’s agreement with statements asking about changes in their functioning level as it applies to certain independent living skills. The final item asked clients to answer, in their own words, if the program made a difference in the participants’ lives. There were fourteen questions to obtain specific client demographic information. Please note that the calculation for the satisfaction rate does not include those responses in which the individual selected “no” as an answer. Please note that the client count/percentage follows the response

1. Services were provided in a timely manner. Of the 114 returned surveys:

Strongly Agree - 65 or 57.0% Agree - 33 or 28.9% Disagree - 6 or 5.3% Strongly Disagree - 0 or 0.0% No Response - 10 or 8.8% This represents a satisfaction rate of 86.0%

Comments: It was a blessed to me. Kathy came at a good time. I needed so much to help me. Shelly was professional and very kind and patient with mom. Comes promptly. Calls before she comes. I don’t know who referred you to me but I am grateful Wonderful! Very kind and helpful. Please let me say that the kindness of the providers gave me such happiness - and I thank all of you so much. I can’t thank Anna enough for her helping me, ginving me information on getting assit with my hearing loss. My mother passed away but thank you for all the services.

2. The instructor was attentive and interested in my well-being. Of the 114 returned surveys:

Strongly Agree - 82 or 72.6% Agree - 16 or 14.2% Disagree - 2 or 1.8% Strongly Disagree - 0 or 0.0% No Response - 13 or 11.5% This represents a satisfaction rate of 86.7%

Comments: She was a great advocate and mentor. kathy was not only interested in my welfare very encouraging Very accommodating and anticipates my needs. Great concerns

3. The instructor was familiar with techniques and aids used by blind and visually impaired individuals. Of the 114 returned surveys:

Strongly Agree - 77 or 68.1% Agree - 22 or 19.5% Disagree - 2 or 1.8% Strongly Disagree - 0 or 0.0% No Response - 12 or 10.6% This represents a satisfaction rate of 87.6%

Comments: Very knowledgable Kathy also provided aide that made life easier ie talking series, timer,knife for slicing. advised me of services I did not know about. Opened a whole new world of neils. amazingly how she does things inspite of her blindnes - God bless her. Sandy walks the walk & talks the talks since she is personally experienced.

4. I was satisfied with the quality of services provided by the program. Of the 114 returned surveys:

Strongly Agree - 73 or 64.6% Agree - 23 or 20.4% Disagree - 3 or 2.7% Strongly Disagree - 1 or 0.9% No Response - 13 or 11.5% This represents a satisfaction rate of 85.0%

Comments: Kathy aranged for Mr. perry to come out and provide higher power magnifiers which I needed. The best. Nancy was a mentor, a friend, and a guide into the world of blur and semi darkness Excellent services! harrah!! Thanks! Wonderful! Anna was very patient precice in her instructions for my clock recorder & machines to read me books. I received excellent quality service.

5. Travel Responses Of the 114 returned surveys:

I am now better able to travel safely and independently in my home and/or community - 58 or 50.9% There has been no change in my ability to travel safely and independently - 20 or 17.5% I am now less able to travel safely and independently (please explain below) - 1 or 0.9% I did not receive services that would help me travel safely and independently in my home and/or community - 12 or 10.5% I was not aware or offered these services - 4 or 3.5% No Response 19 or 16.7%

Comments: I have learned a much safer way to cross intersections with street lights All questions were answered. Happy with the providers. Thank you. Before, I was afraid to ride bus alone, or walk city streets. Now I feel confident and prepared to travel around town on my own. I never before realized the extent of disabality affects everything one does or can do ex blindness & HOH very frustrating & almost degrading. I am able s/proper magnifer to read recipes so I can still cook some dishes. White cane gives me more confidence walking w/my limited vision the talking weight scale allows me to check my weight. I could no longer read the scale this is just a few item that have been so helpful. She had a walking came for the blind brought to me and that helps me be able to get around better. Had I received more training prior to funding cats. I would agree with this statement. Great help with mobility The most important teaching from Nancy wa now to climb out o depression and feelings of helplessness. I began in Jan. 2013 w/15 classes offer by ACBVI, Incc. low vision exam. Garcia provided me s/vauable living aids (magnifiers - plus) one meeting w/Paul was an orientation to possible future services allowing me to continue working. I am very happy of the services I Reveived, i.e. going around with the sunglasses, folding cane and the magnifier video. Great help indeed. God is good. Services excellent! My traveling in the community has improved but I have a way to go to be independent. It is difficult to determine the answer to these questions. My mother is determined to remain independent & strive to maintain her home. She appreciates Sandra’s help in navigating house hold equipment, a light to make reading recipes easier, a watch that helps w/time. I was visiting when Sandra came & she was kind helpful & motivating. The cane & aptied devices have been great help. I have been legally blind for many years. I have a dog ie services and also have been cane trained since the 1980’s.

6. Meal Preparation After Receiving Services Of the 114 returned surveys:

I am now better able to prepare meals for myself - 35 or 31.0% There has been no change in my ability to prepare meals - 18 or 15.9% I am now less able to prepare meals independently (please explain below) - 3 or 2.7% I did not request services that would help me prepare meals - 28 or 24.8% I was not aware or offered these services 8 or 7.1% No Response - 21 or 18.6%

Comments: Except for marking my store I did not need any help in this area. This is due to the fact that at this time my brother lives with me and he does most of the cooking. myself confidence has been greatly boosted unbelievably. Geo Goreman grill and kitchen timer I cook for myself & my husband with ease and comfort. However the stickers that have been put up on my microwave oven do help.

7. Housekeeping Tasks After Receiving Services Of the 114 returned surveys:

I am better able to manage housekeeping tasks, such as cleaning floors/surfaces and organizing - 20 or 17.5% There has been no change in my ability to manage housekeeping tasks - 22 or 19.3% I am less able to manage housekeeping tasks (please explain below) - 4 or 3.5% I did not request services to help me manage housekeeping tasks - 34 or 29.8% I was not aware or offered these services - 10 or 8.8% No Response - 24 or 21.1%

Comments With talking pen we (Kathy & I) programed the rx so I can call pharmacy - using the pen give them the . I have hard time reading ’s. with the eception of thing I cannot do because of physical limitations my organization skills are better than they have ever been. Doing chores improve my muscles - good exercise. The light bulbs helped & floor lamp.

8. Paperwork After Receiving Services Of the 114 returned surveys:

I am better able to manage paperwork, such as mail, correspondence, and paying bills - 47 or 41.6% There has been no change in my ability to manage paperwork - 19 or 16.8% I am less able to manage paperwork (please explain below) - 7 or 6.2% I did not request services to help me manage paperwork - 21 or 18.6% I was not aware or offered these services - 4 or 3.5% No Response - 15 or 13.3%

Comments: Kathy taught me some techniques for writing checks. My ability to write is improving I am doing this servey completely on my own. my age, (84) other disabbilities no longer hinder. Thanks to the video magnifier I can read betters, newspaper, books. For this, I am very grateful. Optic & templates & how to use them. Large print helps a lot. :) Magnifiers from state help

9. After receiving services Of the 114 returned surveys:

I am now better able to access reading materials, such as books, newspapers, and magazines (whether with magnifiers, large print, Braille, or on tape) - 68 or 60.2% There has been no change in my ability to access reading materials - 14 or 12.4% I am now less able to access reading materials (please explain below) - 3 or 2.7% I did not request services to help me access reading materials - 11 or 9.7% I was not aware or offered these services - 3 or 2.7% No Response - 14 or 12.4%

Comments: She can see better with standing lights to see what she’s eating and magnifyers help some with looking at one or two words or numbers, if they are large print. I have an explorer from you Thank you. I love talking books! The magnifier has helped a lot and has made my life easier. I need multiple magnifiers and still time easily Information on large print book & magazines SmartView 360 (redder) and the pertable ott light are of great value. in daily use. Video magnifier a great help for me & my spouse. Thank you. Did not receive the reading aid I asked for. I love those tapes of books made available to me. Have some tools needed to read & access info. I read by large print most times. Listen to dvds many times ordered from library for blind phoenix. Tapes Love "Talking Books"

10. Compared with my functioning before services Of the 114 returned surveys:

I am now less dependent upon others in performing my customary day-to-day activities, such as getting around, cooking, cleaning, reading, laundry, etc. - 52 or 46.8% There has been no change in my ability to perform my customary life activities - 30 or 27.0% I am now more dependent upon others in performing my customary life activities (please explain below) - 4 or 3.6% No Response - 25 or 22.5%

Comments: Perfectly independent now sor of back to normal life again. Use of the cane, operatng the optical devices the radio, the recorder. I appreciated receiving a talking timer, etc. Mostly I had tech. instruciton. While the provider told me how to do things, & I took notes, I did not absorb & retain much. More assignments & drills would have helped.

11. Tell us the greatest difference this program has made in your life: Comments: One of the greatest differences is having more confidence in crossing streets without being hit. Also I am more confidente in the kitchen. It has helped me with reading by providing me with a magnifyer that would have cost me an amount that would have been difficult to pay due to my my fixed income. More easily function in my home, and out I now have a cane disignating a vision impaired person "Magnifyers and bright lamps help her some Coffee cup alarm good LG calendar and talking watch and clock she really enjoys and uses daily. She enjoys talking books if they would sent or old radio shows like ""Innersanctum"" or Westerns, Comedys like Fibber MgGee and Mercy (If such old radio shows are available)" I can see to read my bills, my mail, my newspaper which makes a big difference in my life. I am very pleased with the services. "Being able to care for myself and being able to contribute with housework and cooking and other daily activities. Thank you so much. p.s. I wrote this myself!! Made aware of try and try again. Cook healthy food exercise. Use all your equipment every day. Cleaning is hardist. "Restoring confidence that I have ability to travel around tucson on my own and be ok. Thank you for the opportunity to comment on services I received from Suzi and Anna. I stopped driving about 5 years ago, due to vision loss, and I was also fearful of riding the bus, due to deteriorating vision. Suzi gave me thorough and professional instruction in use of a cane and in using public transportation. She also helped me get access to services us as Sun Van. She encouraged me and helped me regain my confidence. Meanwhile, I worked with Anna on techniques to make household chores easier, which was very helpful. In addition, both Anna and Suzi helped connect me to many loval resources and introduced me to the blind community. I had been working for many years and just retired in may. This was a big readjustment for me, and Suzi and Anna helped me redirect my energy and existing skills with adaptive computer equipment and technology to the world after work. I feel very fortunate to have accessed these services and worked with these outstanding women. I hope funding and policy issues do not restrict these most valuable services. Access to reading material lighted task-at-hand talking alarm Magnification large-print calendar Not dependent on others for thing that everyone takes for granted such as knowing weight & time of day - also coloring helps a lot! Being able to receive things free is tremendous! The reading assistance equipment is helpful: -magni sight explorer -ABI see The talking books are wonderful I am now aware of these services that help me to live a more satisfactory life I am very appreciative. The program made me aware of many ades available to make life more normal more confident to handle my limited vision. Kathy was always so encourageing and pleasant to work with. I miss her! she is and asset to your program!! The audio books have been very helpful. Able to enjoy "reading" a good audio book. made me less independenat on others As stated above everything has improved. My reading ability has been increased significantly because of the time and effort that sandy put in with me. She did a great job and I am very Thankful! Able to know what bills of money are. Also talking clock lets me know time of day and wake me up on time. It helps others to see that I am blind and move out of my way or help with door. Better able to access reading materials and fix my own medicinces, also know were what is in my kitchen cabinets and pricies of items on selves in stores. All said and done I say it has helped me a lot. I can "read" my bible and other materials- Better mobility so I can walk. The time we spent together was worth while. I always feel like I learned something new. I would like for you to contact me, so we can sontinue make progress. I enjoyed your companship and the things you made me (illegible), both inside and outside my home. God bless you... "a) Learning techniques to use the white cane when I am out of the house (going to mailbox, doctors’ offices, grocery, etc.) b) Learning to use the cane properly when my wife & I are practicing ""guided walking"". c) Learning guided walking." Shelly was more than willing to help in anyway to assist my mom in adjusting to her loss of sight. Unwilling to accept virtually any help while still somewhat sighted; she waited till all sight was lost. As a consequence her ability to remain in her assisted living apt. became a serious safety issue. She now resides in a care facility that can keep her safe and are capable of dealing with a resident with no sight and cognitive problems. Shelly was a dream but depended with moms unwillingness to cope! To find this program - The meet with others with the same visual problems taught to organize - Pantry - Laundry Kitchen to know there are so many visual aids available. To have met Diane. So much help. Thank you. The additional lighting and magnifier as well as sun glasses has helped enormously in comfort and in performance. Thank you! Since working with Nancy and others at SAAVI, I feel like a new person. I am back to functioning like I did when I was a high school teacher. I received encouragement, was led in productive directions and was helped to realize that I was just another old lady who was no longer worth the time, money or care. DISPOSABLE. They showed me I still had value. your services, following 15 class meeting at ACBVI and new Rx Glasses by Lions, have definiely advanced my present level of independent living. An important element at ACBVI is that classmates shared their experience and discoveries. I am an elderly (age80) professional (ret public (illegible) licensee) w/some computer skills. Posting together (connecting the dots) w/transportation (incl. volunteer svs.) has been tedious and guidance seems lacking. (to extent of integrating services. "I feel happy now rather than being frustrated. At 79 years old, I feel young at heart to do things now like when I was young. The program has made a great impact in my life esp. at this age of mine. I can shout and jump with great joy in my heart. At last I am independent now. God is good. The program is good. Vasant is good. God Bless you all!" Encouragement Inspiration to try harder to function independently. It has put me back on track with my goals. That re-energizes my purpose in life. The fact that this service is available for people. I know I will need further help at a later time such as house keeping - kitchen help etc. But so far now I’m doing A-OK. I greatly appreciated the help from Vasant. Thank you. I am thankful "someone cares" It has abled me to dress with the right colors. I can make my coffee without pilling it. I’ve learned to use this one eye. Since Sandra has been here. She’s helpd me to do a lot of things. I thank you for her. "The lamps they gave me is priceless to me. It has made doing my paper much, much easier. Also, the large print calendar & address book has made my life so much easier. Thank you for everything. I also have a caregiver to help me when I take my shower." Such a joy to receive the books for the BLIND on tape. I still can’t believe the way I have been able to function these past two years with aids that were given to me. I want to thank Julie, which I have already done many times for her patience training me. God bless Julie and the Arizona Center for all the help given to me. Made me accept the fact that I am loosying my eyesight gradually and it won’t get better. But I have more confidence in doing things after I took the courses. I have learned to be more mobile, cook, do laundry, work on hygeine & needed life skills. Given me an ability to continue. She has helped me feel more confident about my future. Having the proper information & materials to enhance my life on a day to day basis. More confidence in my ability to perform daily tasks & maintain my home & schedule. The use of new techknowledge in magnification also lighting biphocals devices. Great tricks to make life easier. Sandy is a gem! Help me see. I can read & do things pertaining to understand what I am looking at. I am able to read material better. It has help a lot. But my husband helps me a lot too. It resolved some computer technical difficulties. Helping me to be as independant as I can. Thank you. It is consuling that people like you are out there caring about us. and trying to make our life more pleasant. It has helped me with my vision problems. None really magnifies helps. But macular degeneration does not get better & unless I can geta hearing aid that works for me, most sight devices are limited as they assume you can hear normally. It has given me a sense of independence + confidence to perform day to day activities. My life is free I am not confied at home She informed me of all the devices available to assist me. She is a very knowledgeable and dependable person. Having these assistive devices has definitely my life. Magnification items + lights supplied have changed to better see what I was missing. Talking watch + clocks are a great help also.M agnafying Glasses!! I was given a better-vision lamp which helped alot but it was defective after a while & a second lamp was not available from the state. I then bought an adequate lamp that Iam still using. (this happened about 2 yrs ago. I took it to a lighting store for repair & it was beyind repair.) It is the talking books. I look forward everyday to lisening the stories. Without the talking book- I would be lost. I travel to play bingo- 1 nite a week. I Furnishing aid materials- magnifiers, talking books are wonderful Made me more aware of my situation. Status in life. "I’m happier, more content and more independent. Thank you." The magnifing tools help alot Jesus was an excellent instructor & person. He provided me with tools to get around & safety take showers & move around.His concern for my well being, was for me more than expected.Thank you all you do for me.Jesus gave me a little freedom around my home. Thank you & God bless you all Providing equipment for telling,time, for hosting books on tape, for having better lighting ect. There is no one item but many little factors that make my daily living easer.

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 state agency staff member Pam L, CVRT:

Margaret is an 85 year old woman who lives in her home with an adult son. She has age related macular degeneration. Margaret contacted our agency when her low vision aids were no longer effective. Margaret had been successfully using a hand operated camera magnifier that was hooked to a 13” television to read her mail. However, as the scotoma increased and her vision deteriorated, this size screen was no longer effective. Margaret also had difficulty trying to write letters and pay bills with checks as she could not write easily under this magnifier. Margaret enjoyed working in her kitchen, preparing meals, working in her garden where she raised her own vegetables and walking to nearby stores to shop. These tasks were becoming increasingly difficult as her vision deteriorated. Margaret obtained a thorough low vision eye exam. The results of the exam helped to determine how large the scotoma was, as well as her current acuity and recommendations for magnification aids. Based on these recommendations and Margaret’s goals, we obtained an electronic camera magnification Prizma, as well as a large screen monitor. Margaret designated an area of her bedroom where we assembled the equipment and she was able to read and store her mail, file folders and banking materials. After several lessons on how to operate the equipment, Margaret has learned how to move her reading materials, adjust the camera to focus, magnify and determine contrast and use the camera for both near and distant tasks. Margaret also received a hand magnifier that she can use throughout the house and outdoors to read labels, settings on appliances, and look at items that she could not easily transport into her bedroom. In addition to these magnification aids, Margaret received a talking calculator to assist her with bank account reconciliation, a digital recorder in which she can record her shopping list and daily tasks, and a large print calendar on which she can track appointments. Margaret was shown the benefits of task lighting. She now keeps a task light near her desk, but can also carry it into the kitchen when preparing meals, eating and looking for items in the pantry. She has learned to use tactile skills with changing batteries, tactile labeling aids to locate settings without the need to also use the magnifier, and voice labeling with Penfriend to apply to her files and label food in her refrigerator and freezer. Margaret enjoys preparing soups and salads. Use of lighting as well as contrast aids such as a cutting board and adaptive aids of the Veggie Chopper have made these tasks not only easier, but safer as well. Margaret attended VRATE, the technology expo, last December. There she learned about new assistive technology. Initially her goal was to install software on her laptop. However, her goals with a computer have changed and she decided instead that she could benefit more with the Ipad tablet. Margaret purchased one but had difficulty understanding the accessibility features. Margaret received AT training on how to turn on the Voiceover feature, use Siri to read her emails and how to enlarge the screen to read some items. Margaret developed the habit of using her digital recorder to create her grocery list and then enlisting the assistance of an employee at the grocery store. Margaret received Orientation and Mobility instruction and a long cane to use for traveling to the store and when she takes a walk. As a result of the multi-team approach and training, Margaret has benefitted with greater independence and ability to resume the activities she enjoys.

Success Story 2 Submitted by Agency Provider, Southern Arizona Association for Visual Impairment:

I AM WRITING THIS LETTER AS A GRATEFUL STUDENT/ALUMNUS REPRESENTING THE SOUTHERN ARIZONA ASSOCIATION FOR THE VISUALLY IMPAIRED (SAAVI) TUCSON OFFICE. OVER THE PAST TWENTY MONTHS, I HAVE BEEN RECEIVING A VARIETY OF SERVICES OFFERED THROUGH THIS ORGANIZATION TO EMOTIONALLY AND FUNCTIONALLY ADJUST TO MY DECLINING VISION. SOME OF THESE SERVICES INCLUDE ORIENTATION AND MOBILITY TRAINING, REHABILITATION TRAINING, HEALTH AND WELLNESS, COUNSELING AND COMPUTER TRAINING. THIS ORGANIZATION IS STAFFED WITH TALENTED AND DEDICATED INSTRUCTORS WHO HAVE ASSISTED ME WITH RE-GAINING MY INDEPENDENCE IN THE HOME AND IN THE COMMUNITY BY TEACHING ADAPTIVE TECHNIQUES AND SKILLS THROUGH CONTINUED INSTRUCTION. I WAS DIAGNOSED A FEW YEARS AGO WITH MACULAR DEGENERATION, AND LOST MORE THAN HALF MY EYESIGHT. I THOUGHT THAT MY LIFE HAD CHANGED FOR THE WORSE. I LEARNED ABOUT SAAVI FROM A FORMER STUDENT WHO SHARED HER POSITIVE EXPERIENCES WITH ME REGARDING THE VARIETY OF SAAVI SERVICES SHE HAD RECEIVED AS A LOW VISION INDIVIDUAL. AS A 78 YEAR-OLD WOMAN RAISED BY CONGENITALLY BLIND PARENTS, MY EARLY LEARNING WAS PROVIDED BY BLIND INSTRUCTORS. COMING TO SAAVI AND LEARNING FROM PROFESSIONAL INSTRUCTORS HAS REAFFIRMED BY BELIEF REGARDING THE QUALITY OF TEACHING I HAD RECEIVED GROWING UP. THESE PROFESSIONALS HAVE THE ABILITY TO DEVELOP A BEGINNING REHABILITATION COURSE, INSTRUCT, COUNCEL AND ASSIST STUDENTS ALL STUDENTS, BOTH LOW VISION AND BLIND, TO BE BOTH FUNCTIONALLY AND EMOTIONALLY SUCCESSFUL IN THEIR EVERY DAY LIVES. AS A RESULT, THE COLLABORATIVE EFFORTS ON THE PART OF THIS AGENCY HAVE BEEN EXTREMELY USEFUL AND HELPFUL FOR INDIVIDUALS WITH VISION LOSS. EVERY BIT OF FUNDING THAT HAS BEEN utilized IS JUSTIFIED. CONTINUED FUNDING IS ESSENTIAL TO BE ABLE TO PROVIDE THESE QUALITY REHABILITATION SERVICES FOR THE BLIND POPULATION IN ARIZONA. EVERY PERSON WHO IS IN NEED OF THE EDUCATION AND SUPPORT PROVIDED THROUGH THIS ORGANIZATION WILL BE GRATEFUL AND WILL BENEFIT FROM CONTINUED FUNDING OF THIS NON-PROFIT AGENCY.

Success Story 3 submitted by Independent Provider, Sandra W, and VRT:

Mr. H is a seventy two year old Caucasian male with severe Age Related Macular Degeneration (AMD). Mr. H has had AMD for approximately ten years. Mr. H lives in an apartment with his wife in a retirement community in Sun City West, Arizona. He has multiple medical conditions and uses a walker or scooter for mobility. Mr. H already had talking books and 411 services. He and his wife had a bead shop back East before they retired to Arizona. Mr. H found out about the Arizona ILOB program from a friend who received help from the program and is now independent himself. On our first visit together, the client shared with me the issues he was having with not being able to see to do his beading, reading and many other things. Mr. H needs to be able to earn income from his beadwork. Since his visual loss, the client’s wife has had to do most of the beadwork. Mr. H could not do his beadwork without her help. As I started the intake, we talked about different issues that he was having and how I could help him be more independent and not to depend on his wife for everything. We talked about different talking aids, keeping his medications organized, being able to see his face to shave, being able to see his beads and see the TV. As I talked with Mr. H about his goals, I glanced at Mr. H’s wife and she had tears in her eyes. I told Mr. H that we would make a plan to help him overcome the barriers he identified. The initial service to be provided was Low vision aids that would enable him to do his beadwork again and see the TV. After my intake with Mr. H, it was apparent that Mr. H needed a desk magnifier with a light and Max Detail glasses to see his beading. Hr. H and his wife cried when the he did his first bead project all by himself. Mr. H wanted to be able to read small print when he was not at home so I suggested that a video magnifier might help him meet that goal. Mr. H read one of his bank statements and his wife cried. Next, aids and devices were provided such as a talking clock and a talking watch that enable him to know what time it was without having to call on his wife. Mr. H stated that the talking watch and talking clock clocked changed his outlook on his life. Mr. H has, he was able to push the button on his talking watch to know what time it was. Due to Mr. H’s Disabilities, he was unable to put the batteries in and set the time on his talking clock. I trained Mr. H’s wife how to do this. Mr. H said that he would tell his wife how to do it and she can put the batteries in and set the time and alarm with his verbal help. Our third step was to assist him with his grooming tasks. He needed to be able to see his face to shave. A 5X/10X mirror helped Mr. H to achieve that goal of shaving himself. Mr. H was amazed that he could see his face again to shave. Mr. H’s wife had tears in her eyes again. Our final step was to address his concerns with dispensing how own medications. Mr. H did not have any pill boxes to keep his numerous medications in. Mr. H’s wife was taking care of all his medications. Once the client was trained on his magnifier, he was able to see his pills and put them in his new pill box with his wife’s help. Once again tears flowed from Mr. H’s wife. In an over view of Mr. H’s story, he went from sitting in a chair all day to getting up and going to the table to join his wife and do their beadwork. He is now able to shave his face and put his medications in his large print pill box. After big hugs, I left knowing that I had changed Mr. and Mrs. H’s life.

Success Story 4 Submitted by state agency staff Anna M, CVRT/CRC:

Mrs. S is an eighty six year old woman who currently resides in an assisted living facility and was diagnosed with Age Related Macular Degeneration many years ago. Initially, she signed up with the Arizona ILOB program to receive services that would assist her with handwriting tasks. She was also interested in exploring her options for acquiring a hand held magnifier. However, as is often the case with the individuals we provide services to, Mrs. S identified several more areas she was having difficulty with during her vision rehabilitation therapy assessment; these included record keeping and time management activities. To address her needs, Mrs. S received instruction in the use of a talking clock, and was provided with adaptive bold-lined writing templates and special 20/20 low vision pens to focus both on her handwriting and record keeping. Additionally, she was provided with a hand held magnifier to perform short reading tasks and a task light to make reading, writing, and recreational activities easier to complete. Finally, Mrs. S was also provided training in the use of a digital recorder to assist with record keeping activities such as managing lists, appointments, and phone numbers. While the combination of all of this training bolstered Mrs. S’s confidence and independence, I will never forget how happy she was when she received large print BINGO cards. I actually did not realize the impact that this activity had on her level of independence, until some weeks later when she told me all about how she was playing BINGO and how she had tried different things to cover the numbers until she found what worked for her. Yes, I had provided Mrs. S with the adaptive tools she needed to enjoy BINGO again, but because of the services we provided and previous successes, she gained the confidence in her own creativity to come up with a solution that would allow her to again enjoy one of her favorite pass times.

Success Story 5 Submitted by state agency staff Susan O, CVRT:

Mr. D. is an eighty four year old man who was referred to the Arizona ILOB program by a social worker that works with various members of the household. He resides in a mobile home park with his wife, adult daughter, her four year old son and the daughter’s boyfriend. Mr. D. is a veteran but had never used his benefits — outside of accessing the commissary at Luke Air Force Base and receiving medication assistance from his insurance. The multi-generational household members all had various significant health issues that each were being treated for and receiving various community services. Mr. D. was diagnosed with the Wet form of Macular Degeneration OS and Ischemic retinal vein occlusion OD. Several of the household members smoke causing additional difficulty for Mr. D’s vision and eye health. Prior to his referral, as well as during his RT program, he received a number of Avastin injections and had ongoing issues with severe eye infections that required numerous antibiotics and was followed closely by his retinal specialist. His vision fluctuated from 20/400 to 20/200; however, his functional use of residual vision after a number of the Avastin injections had improved. Mr. D. had additional health issues that included: heart attack, prostrate issues, and complications from being on blood thinners, skin cancer, several TIA’s and respiratory issues. Despite these health conditions, he maintained a positive outlook on life. However, his wife had some difficulty in dealing with some of his restrictions. Several months prior to my assessment, Mr. D. had been advised that he was no longer legal to drive, however,Mr. D. felt that it was safe to drive a golf cart in the mobile home park to transport his grandson. Mr. and Mrs. D. developed a sense of trust in me and we were able to have open and honest discussions related to aging issues, effects of declining health on relationships and the physical restrictions that one faces. We were also able to discuss his golf cart driving and he eventually acknowledged that driving a golf cart was not a safe thing to be doing and stopped doing so. Mrs. D. was also able to acknowledge that she needed to change some of her expectations of her husband which also reduced his stress. Mr. D’s. ILOB program plan included training and items that addressed: Communication, Personal Management, and Money Management with minimal interest in Home Management. Provision and instruction on using the talking watch and Atomic talking clock, large print calendar, 20/20 pen, bold line paper and writing guides provided more independence. He was very pleased with his ability to inform his grandson that a favorite children’s program would be on TV in a few moments and a need to get toys put away. Mr. D. also wanted his wife to use the large print check register with him so he could participate more in their finances. He received instruction on using the check writing guide but would often defer to his wife. He valued the instruction on money/coin identification and man’s wallet. He allowed me to mark their microwave (originally he declined as his wife did things for him) and once he experienced the tactile markings, he asked to have his automatic coffee maker marked. On return visits, Mr. D. would continue to tell me “those bumps are the greatest invention”. Mr. D.’s other two favorite items were the LED flashlight and the 3x/8x magnifying mirror. The mirror allowed him to trim his beard and mustache, instead of having his wife “chop at it”. A family benefit of the services provided by the Arizona ILOB program was an opportunity for Mr. D. to “read” to his grandson. Mr. D. signed up for National Library Services and was encouraged to ask for some young children’s books on tape and children’s descriptive videos that he and his grandson could listen to and watch together. These materials allowed him quiet time to bond with his grandson. Throughout his ILOB program, I encouraged Mr. D. to contact the Veteran’s Vision Program not only for the male camaraderie and comprehensive services but also to determine his eligibility for other medical/care benefits since he had limited income and resources. Mr. D. had a very negative view of the medical care his buddies had received in other states, years ago, mainly during and/after the Vietnam war, and was reluctant to be involved with the Veterans hospitals system. Mr. D. eventually trusted my advice and arranged an appointment with a contact I gave him for the VA Hospital. He was very pleased with the exchange between himself and his contact and acknowledged that “perhaps I’ve been wrong about them” (services from the Veteran’s Administration). We discussed his ILOB goals and agreed that the only remaining area was low vision. Mr. D. indicated that he wanted to pursue that area with the Veteran’s administration. I agreed that this would be an extremely good option for him to consider as a comparable benefit to our services. . Mr. D’s entry into the Veterans Administration (VA) vision program should also make available other VA services he might be entitled to.

Success Story 6 Submitted by state agency staff Vasant G, CVRT:

Linda is a sixty eight year old married woman with Macular Degeneration. Linda has a very positive outlook and encourages other potential clients to apply for services. She has been taking social recreation classes at Arizona Center for the Blind and Visually Impaired for the past couple of years, and keeping busy with her volunteer job at the local hospital. When I met Linda her main goal was to receive assistive technology (AT) training so she could learn to use the zoomtext that she bought. She also had a few specific Independent Living devices that she felt would help her be more independent. I gave her some vision rehabilitation instruction in the areas of communication and food preparation. She received a bar code reader so she could shop with little assistance. She also received low vision services, and was given a CCTV, which she is using daily. She also received AT training through one of our contracted providers which she completed successfully, and is now able to perform tasks such as paying bills online.

Success Story 7 Submitted by Independent Provider, Georgeanne H, CVRT/CLVS:

Client CH is an eighty four year old Phoenix resident who was formerly a Benedictine monk in another state for twenty six years. He left the order and married later in life. He was diagnosed with severe dry macular degeneration OU in 2009; he also had a significant hearing loss and other health issues. He was unable to read his religious journals and keep up with daily correspondence with friends and other contacts since his vision loss. His wife was very caring and involved with the daily appointments and services that he needed. After an initial assessment, I worked with CH addressing the areas of handwriting, time management, telephone use, banking, and medication management, grooming and low vision over a three month period. I provided him with instruction in using the following aids and devices: writing guides, bold line paper, bold pen for writing needs; a talking watch and large print wall calendar for keeping track of time and dates; a large print phone/address directory, information on phone ordering a large button phone and free 411 services to improve his ability to use the telephone; a check writing guide and large print check register for writing checks on his own; a medical planner for organizing his own medicines; a magnifying mirror for shaving; and a support cane for use in the immediate environment. I arranged with a local low vision aids provider to obtain stronger magnification for CH, and also ordered a CCTV for him. I provided him with training in how to use these low vision aids for reading and writing needs, including reading his daily missal and weekly journals as well as writing checks and corresponding with others. I will quote from a letter his wife sent me: “Dear Ms. Hanna, Thank you so much for all you did to help CH deal with his vision impairment. It is thrilling to be able to read again with ease and this would not have happened without your kind intervention. We are so grateful for all the wonderful gifts that lend so much to his quality of life. Our whole experience with you, MP [low vision aids supplier], and your agency feels like a little bit of heaven dropped down on us. Thank you for your kindness, understanding and compassion. May God continue to bless you and the great work you do. Sincerely, JH.”

Success Story 8 Submitted by state agency staff Todd S, CVRT/O&M:

Nancy, age eight one, has been living with Age Related Macular Degeneration for nine years. She resides in a very nice 5th wheel travel trailer, on her son’s property, in a rural community outside of the Flagstaff city limits. She has been a resident of this community for a short time. Previously, Nancy made her home here only during the summer months to be closer to her son and enjoy the weather. She was a self-referral, gaining our contact information from Flagstaff Eye Care. Her vision loss was affecting her ability to accomplish many activities of daily living safely, timely and confidently. This was causing her to think of the possibility that she may not be able to live alone and the idea of an assisted living facility did not sit well with her. The core daily living tasks causing her difficulty included; handwriting, telephone use, time management, appliance usage, banking, mail management and medication management. These areas encompassed the main activities of communication, home management and personal management. We addressed each area of concern together making sure we covered safety concerns first and then moved forward. Together we worked with writing templates and peripherals to facilitate handwriting activities. We supplied, instructed and practiced with talking and large print time pieces and a large print calendar for time management activities. Marking of all controls on her appliances created independence and safety with kitchen, laundry and thermostat setting needs. Nancy actively participated in all areas of instruction, with her aids and/devices and practiced diligently in all areas to become independent living with vision loss. The provision, instruction and practice of magnification devices truly enhanced independence in almost all areas of daily living and greatly improved her quality of life. With magnification, including video magnification, she could access printed material from medications, recipes, mail, product labels, etc. She does not like to ask for assistance and with the services provided through our program, Nancy is actively striving to become a more active and independent woman within her home and community.

Success Story 9 Submitted by Independent Provider Ed G, CVRT/CO&M: Mr. and Mrs. V. are an elderly couple in their late seventies who both are completely deaf and blind. In the spring of 2013 they were ready to downsize and move from their home of fifteen years to a two bedroom apartment in a gated complex. All appliances including the microwave and washer and dryer came with the apartment and procedures for operation needed to be understood and tactually marked in Braille for complete and independent access. In addition they needed individual O & M instruction to find their way to the garbage containers, mailboxes, the front office, exercise area and routes for walking around and through the complex for exercise purposes. They required specialized services from someone who understood their unique communication and information access needs as totally deaf-blind individuals. Special communication cards and strategies were developed so that they could interact with the office staff, especially for the husband who doesn’t speak. After several sessions of instruction and support they became completely independent within their home environment for both daily living skills and for independent travel within the apartment complex. Without these critical services, this couple would not have been able to manage the transition so effectively and quickly.

Success Story 10 Submitted by state agency staff Susan O, CVRT:

Mr. J.B. Is an 87 year old Caucasian male whose wife contacted the Arizona ILOB program after they visited a long-time friend who was a client of mine. While visiting their friend, he was able to try out her video magnifier. For the first time in three years he was able to read regular size printed material with the device. Mr. B was being treated by a retinal specialist for the wet form of AMD. He was reported to have 20/CF OU (count fingers). Due to the AMD, he had stopped driving and deferred all financial and correspondence responsibilities to his wife. In conducting the Vision Rehabilitation Therapy assessment, it was also learned that Mr. B. had been recently diagnosed with early stage Alzheimer’s. I was concerned that while his medical providers had focused on the diagnosis of Alzheimer’s & medical treatment for the AMD, there was no vision rehabilitation training offered to address the effects of his AMD on his daily life skills. As the Vision Rehabilitation Therapy assessment continued, it was evident that Mr. B. had no way of knowing the date or time unless someone informed him. Once he was informed of the date, he was able to locate the correct month/day on the large print calendar; understand the one-button talking watch; and responded appropriately to my questions and provided accurate information. As we worked together, I was able to dispel some of the perceived severe limitations due to the diagnosis of Alzheimer’s. The B.’s were proud to inform me, that several of his medical providers were surprised that he was reading and more involved in various financial issues that had surfaced as well as helping his wife with some of the household chores such as unloading the dishwasher, washing/drying dishes and setting the table. ; He also began attending community concerts and being more social. When Mr. B. was provided with simplified step-by- step calm consistent instruction, he was able to learn and retain information to manage various adaptive items. Mr. B’s. ILOB program included training and items that addressed: Communication, Personal Management, Low Vision and Mail Management. Provision and instruction on using the table top Video Magnifier, the talking watch and Atomic talking clock, large print calendar, 20/20 pen, bold line paper, lap desk and writing guides; provided more independence. His love of golf was incorporated in the low vision area. Toward the end of our lessons he was watching the TV broadcast of the Masters Tournament. For a number of years he had not been able to access newspapers and was in awe at how the video magnifier not only allowed him to read the stories but see the pictures of Tiger Woods as well as the youngest player ever to play in the tournament. With this comprehensive access to information, he felt that he could participate more fully in conversations on the sport. Toward the end of our lessons, Mr. and Mr.s B were planning a trip back to Minnesota to address several business issues. He was provided a portable video magnifier prior to leaving on their trip so he would not be left out of accessing business documents during their four months away. We worked on developing a carry-on bag that would hold his various items so he could continue to practice and perform tasks while they were away. I was also able to provide resources and encourage the B.’s to reach out more to the Alzheimer’s community and service providers. The following will explain the importance of Mr. B’s being able to regain participation in his business role within his marriage/family. Mr. B. was born in 1925 in a medium size community in the Midwest. He struggled throughout school and found that his interest and skills in music and drama were not highly rated by his teachers and family. In fact, he distinctly remembers one female teacher telling him “J. B. you are a disgrace to your family and school and you will never amount to anything!” He also vividly remembers school administrators denying him the opportunity to speak on behalf of his class at graduation due to his poor academic performance (despite being voted class president). He served his country during WW II and upon his discharge attempted to use his GI bill benefits at the local community college. The admissions person denied his entrance due to his low grades in high school and informed him that he was not “college material”. From that point on, he became a self-made business person. He worked for a number of local business people, who valued his honesty and work ethic, his ability to learn on the job, as well as his wonderful marketing and sales personality. He later felt a sense of accomplishment when he arranged a short-term loan for the female teacher who once told him that he would never amount to anything. Mr. B. later became the owner of a school bus firm that served the Minneapolis/St. Paul, MN school districts (the largest school districts in the state of MN). This history was conveyed by Mr. B to me after one of our lessons in using the video magnifier to read a legal document relating to his former school bus company business. He became very emotional as he explained that all of his life he had to struggle to prove himself capable. He indicated that prior to the involvement of vision services he had given up hope and felt useless and a burden to his wife. Mr. B. is an example of the honored characteristics that the “Greatest Generation” continues to demonstrate. His situation also demonstrates the important role and the impact that vision services can have on a person’s desire to have a purposeful life.

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 was very limited Vision Rehabilitation Therapists available to cover many of the rural areas and in eastern Maricopa County resulting in placing clients on a six to seven 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 byLetitia Labrecque
TitleAdministrator
Telephone602-542-6298
Date signed12/31/2013