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

RSA-7-OB for Arizona Rehabilitation Services Administration - H177B140003 report through September 30, 2014

Instructions

Introduction

The revised ED RSA-7-OB form incorporates revisions to the four established performance measures for the Independent Living Services for Older Individuals who are Blind (IL-OIB) program. Added in 2007, these measures aim to better reflect the program’s impact on individual consumers and the community.

Added to capture information that may be required to meet GPRA guidelines, the performance measures can be found under Part VI: Program Outcomes/Performance Measures as follows:

Measure 1.1

Of individuals who received AT (assistive technology) services and training, the percentage who regained or improved functional abilities previously lost as a result of vision loss.

Measure 1.2

Of individuals who received orientation and mobility (O & M) services, the percentage who experienced functional gains or maintained their ability to travel safely and independently in their home and/or community environment.

Measure 1.3

Of individuals who received services or training in alternative non-visual or low vision techniques, the percentage that experienced functional gains or were able to successfully restore and maintain their functional ability to engage in their customary life activities within their home environment and community.

Measure 1.4

Of the total individuals served, the percentage that reported that they are in greater control and are more confident in their ability to maintain their current living situation as a result of services.

Revisions to these established program performance measures consists of the following additional five items:

E1. Enter the 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)

E2. Enter the 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)

E3. Enter the 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)

E4. Enter the number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only)

E5. Enter the 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)

Submittal Instructions

OIB grantees are expected to complete and submit the 7-OB Report online through RSA’s website (https://rsa.ed.gov), unless RSA is notified of pertinent circumstances that may impede the online submission.

To register with RSA’s MIS, please go to https://rsa.ed.gov and click on Info for new users. The link provides instructions for obtaining an agency-specific username and password. Further instructions for completing and submitting the 7-OB Report online will be provided upon completion of the registration process.

OIB grantees submitting the 7-OB Report online are not required to mail signed copies of the 7-OB Report to RSA, but they must certify in the MIS that the signed and dated 7-OB Report and lobbying certification forms are retained on file.

The Report submittal deadline is no later than December 31 of the reporting year.

Part I: Funding Sources for Expenditures And Encumbrances — Instructions

Please note: Total expenditures and encumbrances for direct program services in Part I (C) must equal the total funds spent on service in Part IV. Part I C must equal the sum of Part IV A1+B1+C1+D1.

A. Funding SourceS for Expenditures and encumbrances in reported fy

A1. Enter the total amount of Title VII-Chapter 2 funds expended or encumbered during the reported FY. Include expenditures or encumbrances made from both carryover funds from the previous FY and from the reported FY grant funds.

A2. Enter the total of any other federal funds expended or encumbered in the Title VII-Chapter 2 program during the reported FY. Designate the funding sources and amounts in (a) through (e).

A3. Enter the total amount of state funds expended or encumbered in the Title VII - Chapter 2 program. Do not include in-kind contributions (e.g., documented value of services, materials, equipment, buildings or office space, or land).

A4. Enter the total amount of third party contributions including local and community funding, non-profit or for-profit agency funding, etc. Do not include in-kind contributions (e.g., documented value of services, materials, equipment, buildings or office space, or land).

A5. Enter the total amount of in-kind contributions from non-federal sources. Include value of property or services that benefit the Title VII-Chapter 2 program (e.g. the fairly evaluated documented value of services, materials, equipment, buildings or office space or land).

A6. Enter the total matching funds (A3 + A4 + A5). Reminder: The required non-federal match for the Title VII-Chapter 2 program is not less than $1 for each $9 of federal funds provided in the Title VII-Chapter 2 grant. Funds derived from or provided by the federal government, or services assisted or subsidized to any significant extent by the federal government, may not be included in determining the amount of non-federal contributions.

A7. Enter the total amount of all funds expended and encumbered (A1 + A2 + A6) during the reported fiscal year.

B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs

Enter the total amount of expenditures and encumbrances allocated to administrative, support staff, and general overhead costs. Do not include costs for direct services provided by agency staff or the costs of contract or sub-grantee staff that provide direct services under contracts or sub-grants. If an administrator spends a portion of his or her time providing administrative services and the remainder providing direct services, include only the expenditures for administrative services.

C. Total expenditures and encumbrances for direct program services

Enter the total amount of expenditures and encumbrances for direct program services by subtracting line B from line A7.

Part II: Staffing — Instructions

Base all FTE calculations upon a full-time 40-hour workweek or 2080 hours per year. Record all FTE assigned to the Title VII-Chapter 2 program irrespective of whether salary is paid with Title VII-Chapter 2 funds.

A. Full-time Equivalent (FTE) Program Staff

A1. Under the “Administrative & Support” column (A1a), enter the full-time equivalent (FTE) of all administrative and support staff (e.g. management, program directors, supervisors, readers, drivers for staff, etc.) assigned to the Title VII-Chapter 2 program from the State agency. (For example, if 20% or 8 hours per week of a staff person’s time were spent on administrative and support functions related to this program, the FTE for that staff person would be .2). Under the “Direct Services” column (A1b), enter the FTE of all direct service staff (e.g. rehabilitation teacher, IL specialist, orientation and mobility specialist, social worker, drivers for individuals receiving services, etc.) assigned to the Title VII-Chapter 2 program from the State agency. If administrative or support staff of the State agency also provide direct services, report the FTE devoted to direct services in the “Direct Services” column (A1b). (For example, if 80% of a staff person’s time were spent in providing direct services, the FTE for that person would be 8). Finally, add across the “Administrative & Support” FTE (A1a) and “Direct Service” FTE (A1b) to enter the total State agency FTE in the TOTAL (A1c) column.

A2. Under the “Administrative & Support” column (A2a), enter the full-time equivalent (FTE) of all administrative and support staff (e.g. management, program directors, supervisors, readers, drivers for staff, etc.) assigned to the Title VII-Chapter 2 program from contractors or sub-grantees. Under the “Direct Services” column (A2b), enter the FTE of all direct service staff (e.g. rehabilitation teacher, IL specialist, orientation and mobility specialist, social worker, driver for individuals receiving services, etc.) assigned to the Title VII-Chapter 2 program from contractors and sub-grantees. If administrative staff of the contractors or sub-grantees also provides direct services, report the FTE devoted to direct services in the “Direct Services” column (A2b). Finally, add across the “Administrative & Support” FTE (A2a) and “Direct Service” FTE (A2b) to enter the total contractor or sub-grantee FTE in the TOTAL (A2c) column.

A3. Add each column for A1 and A2 and record totals on line A3.

B. Employed or advanced in employment

B1. Enter the total number of employees (agency and contractor/sub-grantee staff) with disabilities (include blind and visually impaired not 55 or older), including blindness or visual impairment, in B1a. Enter the FTE of employees with disabilities in B1b. (To calculate B1b, add the total number of hours worked by all employees with disabilities and divide by 2080 to arrive at the FTE)

B2. Enter the total number of employees (agency and contractor/sub-grantee staff) who are blind or visually impaired and age 55 and older in B2a. Enter the FTE of employees who are blind or visually impaired and age 55 or older in B2b. (To calculate B2b, add the total number of hours worked by employees who are blind or visually impaired and age 55 and older and divide by 2080 to arrive at the FTE)

B3. Enter the total number of employees (agency and contractor/sub-grantee staff) who are members of racial/ethnic minorities in B3a. Enter the FTE of employees who are members of racial/ethnic minorities in B3b. (To calculate B3b, add the total number of hours worked by employees who are members of racial/ethnic minorities and divide by 2080 to arrive at the FTE)

B4. Enter the total number of employees (agency and contractor/sub-grantee staff) who are women in B4a. Enter the FTE of employees who are women in B4b. (To calculate B4b, add the total number of hours worked by women and divide by 2080 to arrive at the FTE)

B5. Enter the total number of employees (agency and contractor/sub-grantee staff) who are ages 55 and older, but not blind or visually impaired, in B5a. Enter the FTE of employees who are ages 55 and older, but not blind or visually impaired, in B5b. (To calculate B5b, add the total number of hours worked by employees who are ages 55 and older, but not blind or visually impaired, and divide by 2080 to arrive at the FTE)

C. Volunteers

C1. Enter the FTE of program volunteers in C1. (To calculate C1, add the total number of hours worked by all program volunteers and divide by 2080 to arrive at the FTE).

Part III: Data on Individuals Served — Instructions

Provide data in all categories on program participants who received one or more services during the fiscal year being reported.

A. Individuals Served

A1. Enter the number of program participants carried over from the previous federal fiscal year who received services in this reported FY (e.g. someone received services in September (or any other month) of the previous FY and continued to receive additional services in the reported FY).

A2. Enter the number of program participants who began receiving services during the reported fiscal year irrespective of whether they have completed all services.

A3. Enter the total number served during the reported fiscal year (A1 + A2).

B. Age

B1-B10. Enter the total number of program participants served in each respective age category.

B11. Enter the sum of B1 through B10. This must agree with A3.

C. Gender

C1. Enter the total number of females receiving services.

C2. Enter the total number of males receiving services.

C3. Enter the sum of C1 and C2. This must agree with A3.

D. Race/Ethnicity

Hispanic or Latino means a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

D1. Enter the number of individuals served who are Hispanic/Latino of any race or Hispanic/Latino only. Hispanic/Latino means a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

D2. Enter the number of individuals served who are American Indian or Alaska Native. American Indian or Alaska Native means a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

D3. Enter the number of individuals served who are Asian. Asian means a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

D4. Enter the number of individuals served who are Black or African American. Black or African American means a person having origins in any of the black racial groups of Africa. Terms such as “Haitian” may be used.

D5. Enter the number of individuals served who are Native Hawaiian or Other Pacific Islander. Native Hawaiian or Other Pacific Islander means a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

D6. Enter the number of individuals served who are White or Caucasian. White means a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

D7. Enter the number of individuals served who report two or more races but who are not Hispanic/Latino of any race.

D8. Enter “race and ethnicity unknown” only if the consumer refuses to identify race and ethnicity.

D9. Enter the total of D1 through D8. This number must agree with A3.

E. Degree of Visual Impairment

E1. Enter the number of individuals served who are totally blind (e.g. have light perception only or no light perception).

E2. Enter the number of individuals served who are legally blind (excluding those recorded in E1).

E3. Enter the number of individuals served who have severe visual impairment.

E4. Add E1 + E2 + E3 and enter the total. This number must agree with A3.

F. Major Cause of Visual Impairment

(Please note that the primary site for the definitions of diseases is http://www.nia.nih.gov/AboutNIA/StrategicPlan/ResearchGoalA/Subgoal1.htm.)

Enter only one major cause of visual impairment for each individual served.

F1. Enter the number of individuals served who have macular degeneration as the major cause of visual impairment. Age-related macular degeneration (AMD) is a progressive disease of the retina wherein the light-sensing cells in the central area of vision (the macula) stop working and eventually die. The cause of the disease is thought to be a combination of genetic and environmental factors, and

It is most common in people who are age 60 and over. AMD is the leading cause of legal blindness in senior citizens.

F2. Enter the number of individuals served who have diabetic retinopathy as the major cause of visual impairment. Diabetic retinopathy is the leading cause of new cases of legal blindness among working-age Americans and is caused by damage to the small blood vessels in the retina. It is believed that poorly controlled blood sugar levels are related to its progression. Most persons with diabetes have non-insulin-dependent diabetes mellitus (NIDDM) or what is commonly called “adult-onset” or Type II diabetes, and control their blood sugar with oral medications or diet alone. Others have insulin-dependent diabetes mellitus (IDDM), also called "younger or juvenile-onset" or Type I diabetes, and must use insulin injections daily to regulate their blood sugar levels.

F3. Enter the number of individuals served who have glaucoma as the major cause of visual impairment. Glaucoma is a group of eye diseases causing optic nerve damage that involves mechanical compression or decreased blood flow. It is permanent and is a leading cause of blindness in the world, especially in older people.

F4. Enter the number of individuals served who have cataracts as the major cause of visual impairment. A cataract is a clouding of the natural lens of the eye resulting in blurred vision, sensitivity to light and glare, distortion, and dimming of colors. Cataracts are usually a natural aging process in the eye (although they may be congenital) and may be caused or accelerated by other diseases such as glaucoma and diabetes.

F5. Enter the number of individuals served who have any other major cause of visual impairment.

F6. Enter the sum of F1 through F5. This number must agree with A3.

G. Other Age-Related Impairments

Enter the total number of individuals served in each category. Individuals may report one or more non-visual impairments/conditions. The National Institute on Aging (NIA) Strategic Plan identifies age-related diseases, disorders, and disability including the following categories.

G1. Hearing Impairment: Presbycusis is the gradual hearing loss that occurs with aging. An estimated one-third of Americans over 60 and one-half of those over 85 have some degree of hearing loss. Hearing impairment occurs when there is a problem with or damage to one or more parts of the ear, and may be a conductive hearing loss (outer or middle ear) or a sensorineural hearing loss (inner ear) or a combination. The degree of hearing impairment can vary widely from person to person. Some people have partial hearing loss, meaning that the

Ear can pick up some sounds; others have complete hearing loss, meaning that the ear cannot hear at all. One or both ears may be affected, and the impairment may be worse in one ear than in the other.

G2. Diabetes: Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Type 2 diabetes, which results from insulin resistance and abnormal insulin action, is most prevalent in the older population. Diabetes complications, such as heart disease and loss of sight, increase dramatically when blood sugar is poorly controlled and often develop before diabetes is diagnosed.

G3. Cardiovascular Disease and Strokes: Diseases of the heart and blood vessels are the leading cause of hospitalization and death in older Americans. Congestive heart failure is the most common diagnosis in hospitalized patients aged 65 and older.

G4. Cancer: The second leading cause of death among the elderly is cancer, with individuals age 65 and over accounting for 70 percent of cancer mortality in the United States. Breast, prostate, and colon cancers, are common in older people.

G5. Bone, Muscle, Skin, Joint, and Movement Disorders: Osteoporosis (loss of mass and quality of bones), osteoarthritis (inflammation and deterioration of joints), and sarcopenia (age-related loss of skeletal muscle mass and strength) contribute to frailty and injury in millions of older people. Also contributing to loss of mobility and independence are changes in the central nervous system that control movement. Cells may die or become dysfunctional with age, as in Parkinson's disease. Therefore, older people may have difficulty with gross motor behavior, such as moving around in the environment, or with fine motor skills, such as writing.

G6. Alzheimer’s Disease/Cognitive Impairment: Alzheimer’s disease is the most common type of dementia (a brain disorder that significantly affects an individual’s ability to carry out daily life activities) in older people. It and other cognitive impairments impact parts of the brain that control thought, memory, and language.

G7. Depression is widespread, often undiagnosed, and often under-treated in the elderly. It is believed to affect more than 6.5 million of the 35 million Americans who are 65 or older. Depression is closely associated with dependency and disability. Symptoms may include: loss of interest in normally pleasurable activities, persistent, vague or unexplained somatic complaints, memory complaints, change in weight, sleeping disorder, irritability or demanding behavior, lack of attention to personal care, difficulty with concentration, social withdrawal, change in appetite, confusion, delusions or hallucinations, feeling of worthlessness or hopelessness, and thought about suicide.

G8. Other Major Geriatric Concerns: Several conditions can compromise independence and quality of life in older persons including weakness and falls, urinary incontinence, benign prostatic hyperplasia, and co morbidity (co morbidity describes the effect of all other diseases an individual might have on the primary disease).

H. Type of Residence

H1. Enter the number of individuals served who live in private residence (house or apartment unrelated to senior living).

H2. Enter the number of Individuals served who live in senior living/retirement community (e.g. housing designed for those age 55 and older).

H3. Enter the number of individuals served who live in assisted living facility (e.g. housing that provides personal care and services which meet needs beyond basic provision of food, shelter and laundry).

H4. Enter the number of individuals served who live in nursing homes/long-term care facility (e.g. any facility that provides care to one or more persons who require nursing care and related medical services of such complexity to require professional nursing care under the direction of a physician on a 24 hour a day basis).

H5. Enter the number of individuals served who are homeless

H6. Enter the sum of H1, H2, H3, H4 and H5. This number must agree with A3.

I. Source of Referral

I1. Enter the number of individuals served referred by an ophthalmologist or optometrist.

I2. Enter the number of individuals served referred by a medical provider other than an ophthalmologist or optometrist.

I3. Enter the number of individuals served referred by a state vocational rehabilitation agency.

I4. Enter the number of individuals served referred by a government or social services agency defined as a public or private agency which provides assistance to consumers related to eligibility and securing entitlements and benefits, counseling, elder law services, assistance with housing, etc.

I5. Enter the number of individuals served referred by the Veterans Administration

I6. Enter the number of individuals served referred by a senior program defined as a community-based educational, recreational, or socialization program operated by a senior center, nutrition site, or senior club.

I7. Enter the number of individuals served referred by an assisted living facility defined as housing that provides personal care and services which meet needs beyond basic provision of food, shelter and laundry.

I8. Enter the number of individuals served referred by a nursing home/long-term care facility defined as any facility that provides care to one or more persons who require nursing care and related medical services of such complexity to require professional nursing care under the direction of a physician on a 24 hour a day basis.

I9. Enter the number of individuals served referred by a faith-based (religious affiliated) organization.

I10. Enter the number of individuals served referred by an independent living center (ILC) defined as a consumer-controlled, community-based, cross-disability, nonresidential private nonprofit agency that is designed and operated within a local community by individuals with disabilities, and provides an array of independent living services.

I11. Enter the number of individuals referred by a family member or friend.

I12. Enter the number of individuals who were self-referred.

I13. Enter the number of individuals referred from all other sources aside from those listed above.

I14. Enter the sum of I1, I2, I3, I4, I5, I6, I7, I8, I9, I10, I11, I12, and I13. This number must agree with A3

Part IV: Types of Services Provided and Resources Allocated — Instructions

Please note: Total expenditures and encumbrances for direct program services in Part I C must equal the total funds spent on services in Part IV. Part I C must equal the sum of Part IV A1+B1+C1+D1.

In addition, salary or costs associated with direct service staff or contractors providing

direct services should be included in the cost of services provided in A, B, C, and D.

A. Clinical / Functional Vision Assessments and Services

A1. Enter the total cost from Title VII-Chapter 2 federal grant funds (A1a) and the total cost from all other sources of program funding (A1b) for clinical and/or functional vision assessments and services, whether purchased or provided directly.

A2. Enter the total number of program participants who received clinical vision screening or vision examinations from qualified or certified professionals such as ophthalmologists or optometrists, and who received functional vision assessments or low vision evaluations to identify strategies for enhancing visual performance both without and with optical and low vision devices and equipment. Assessment areas may include functional visual acuity and fields, efficiency of vision in the performance of everyday tasks, and evaluation for low vision aids or equipment. These assessments are typically provided by skilled professionals or those who are certified or have a master’s degree in low vision rehabilitation. Do not include evaluations for orientation and mobility. These should be included in C3.

A3. Enter the total number of program participants who received surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions; and, hospitalizations related to such services. Include prescription optics in this service category. Nonprescription optics should be reported in B2.

B. Assistive Technology Devices, Aids, Services and Training

B1. Enter the total cost from Title VII-Chapter 2 federal grant funds (B1a) and the total cost from all other sources of program funding (B1b) for the provision of assistive technology devices, aids, services and training.

B2. Enter the total number of program participants who received one or more assistive technology devices and aids. As defined in Section 3(4) of the Assistive Technology Act of 2004 (Pub. L. 108-364), “assistive technology device means any item, piece of equipment, or product system whether acquired commercially, modified, or customized that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.” Assistive technology devices may include such items as canes, slates, insulin gauges, CCTVs, computers, adaptive software, magnifiers, adaptive cooking items, adaptive recreational items, handwriting guides, Braillers, large button telephones, etc.

B3. Enter the total number of program participants who received one or more assistive technology services and training. As defined in Section 3(5) of the Assistive Technology Act of 2004 (PL 108-364), “assistive technology service means any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.” Services may include the evaluation of assistive technology needs of an individual, services related to acquisition of technology, costs of loan programs, maintenance and repair of assistive technology, training or technical assistance for the individual or professionals related to the use of assistive technology, programs to expand the availability of assistive technology, low vision therapy services related to the use of optical aids and devices, and other services related to the selection, acquisition, or use of an assistive technology device.

C. Independent Living and Adjustment Training and Services

C1. Enter the total cost from Title VII-Chapter 2 federal grant funds (C1a) and the total cost from all other sources of program funding (C1b) for the provision of services and adjustment training leading to independent living. Evaluation and assessment services (excluding those included in A2 or B3) leading to the planning and implementation of services and training should be included in these costs.

C2. Enter the total number of individuals who received orientation and mobility (O & M) services or travel training (i.e. learning to access public or private transportation and to travel safely and as independently as possible in the home and community with or without the use of mobility aids and devices).

C3. Enter the total number of individuals who received communication skills training (e.g. reading and writing Braille, keyboarding and computer literacy, computer skills training, using the telephone, handwriting guides, telling time, using readers, use of audio and tactile technologies for home, recreational or educational use; etc.). Training in the use of newspaper reading services and radio services should be included.

C4. Enter the total number of individuals who received personal management and daily living skills training (e.g. training in the use of adaptive aids and assistive technology devices for personal management and daily living, blindness and low vision alternative techniques for food preparation, grooming and dress, household chores, medical management, shopping, recreational activities, etc.)

C5. Enter the total number of individuals who received supportive services (e.g. reader services, transportation, personal attendant services, support service providers, interpreters, etc.) while actively participating in the program or attaining independent living goals.

C6. Enter the total number of program participants who participated in advocacy training or support network activities such as consumer organization meetings, peer support groups, etc.

C7. Enter the total number of individuals who received counseling (peer, individual or group) to assist them in adjusting to visual impairment and blindness.

C8. Enter the total number of program participants that received information and referral to other service providers, programs, and agencies (e.g. senior programs, public and private social service programs, faith-based organizations, consumer groups, etc.) to enhance adjustment, independent living, and integration into the community. Do not include individuals who received only information and referral and for whom no other services were provided.

C9. Enter the total number of individuals served who were provided any other service not listed above.

D. Community Awareness Activities / Information and Referral

D1. Enter the total cost from Title VII-Chapter 2 federal grant funds (D1a) and the total cost from all other sources of program funding (D1b) for providing information and referral services and community awareness activities/events to individuals for whom this was the only service provided (i.e. training for other professionals, telephone inquiries, general inquiries, etc.).

D2. Enter the number of individuals receiving information and referral services for whom this is the only service provided. (optional)

D3. Enter the number of community awareness events/activities in which the Chapter 2 program participated during the reported year (D3a) and the number or estimated number of individuals who benefited from these activities (D3b).

Part V: Comparison of Prior Year Activities to Current Reported Year — Instructions

A1. Program Expenditures and Encumbrances (all sources) Enter the total cost of the program for the prior fiscal year (A1a), and the fiscal year being reported (A1b). The total cost of the program can be found in Part I A7. Calculate the change (plus or minus) from the prior year to the reported year (A1c).

A2. Number of Individuals Served Enter the total number of eligible individuals served in the prior year (A2a), and in the current reported year (A2b). The total number of individuals served can be found in Part III A3. Calculate the change (plus or minus) in the numbers served from the prior year to the reported year (A2c).

A3. Number of Minority Individuals Served Enter the total number of minority individuals served in the prior year (A3a), and in the fiscal year currently being reported (A3b). The total number of minority individuals served is the total of Part III D1+D2+D3+D4+D5 +D7. Calculate the change (plus or minus) in the numbers served from the prior year to the reported year (A3c).

A4. Number of Community Awareness Activities Enter the number of community awareness activities or events in which the Chapter 2 program participated during the prior year (A4a), and in the fiscal year currently being reported (A4b). The number of community awareness activities is found in Part IV D3a. Calculate the change (plus or minus) in the number of events from the prior year to the year being reported (A4c).

A5. Number of Collaborating Agencies and Organizations Enter the number of collaborating organizations or agencies (formal agreements or informal activity) other than Chapter 2 paid sub-grantees or contractors in the prior year (A5a), and in the fiscal year currently being reported (A5b). Calculate the change (plus or minus) from the prior year to the year being reported (A5c).

A6. Number of Sub-grantees/Contractors If you provide services through sub-grantee agencies or contract, enter the number of sub-grantees or contracts in the prior year (A6a), and in the fiscal year currently being reported (A6b). Calculate the change (plus or minus) from the prior year to the year being reported (A6c). If you do not use sub-grantees, enter 0 in A6a, A6b, and A6c.

Part VI: Program Outcomes/Performance Measures — Instructions

A. Enter the number from Part IV B3 in A1. From available program data and evaluations, enter the 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 in A2. (closed/inactive cases only).

In A3, from available program data and evaluations, enter the number of individuals for whom functional gains have not yet been determined at the close of the reporting period (This number would not include those individuals who are no longer receiving services and who either did not make functional gains or maintain functional ability before case closure or inactivity).

B. Enter the number from Part IV C2 in B1. From available program data and evaluations, of those receiving orientation and mobility (O & M) services, enter 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 in B2 (closed/inactive cases only).

In B3, from available program data and evaluations, enter the number of individuals for whom functional gains have not yet been determined at the close of the reporting period (This number would not include those individuals who are no longer receiving services and who either did not make functional gains or maintain functional ability before case closure or inactivity).

C. Enter the number from Part IV C3 in C1. From available program data and evaluations, of those receiving communication skills training, enter the number of individuals who gained or maintained their functional abilities as a result of services they received in C2 (Closed/inactive cases only).

In C3, from available program data and evaluations, enter the number of individuals for whom functional gains have not yet been determined at the close of the reporting period (This number would not include those individuals who are no longer receiving services and who either did not make functional gains or maintain functional ability before case closure or inactivity).

D. Enter the number from Part IV C4 in D1. From available program data and evaluations, of those receiving daily living skills training, enter the 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 In D2 (Closed/inactive cases only).

In D3, enter the Number of individuals for whom functional gains have not yet been determined at the close of the reporting period (This number would not include those individuals who are no longer receiving services and who either did not make functional gains or maintain functional ability before case closure or inactivity).

E1. Enter the 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).

E2. Enter the 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).

E3. Enter the 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).

E4. Enter the number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss (Closed/inactive cases only). “Change in lifestyle” is defined as any non-vision related event that results in the consumer’s reduced independence, such as moving from a private residence (house or apartment) to another type of residence e.g. living with family, senior living community, assisted living facility, nursing home/long-term facility, etc. Reduced independence could also result in employing a caregiver to enable the consumer continue to live in his/her home. Examples of events that could result in reduced independence of the consumer include loss of spouse and onset or worsening of other health conditions such as diabetes, cancer, heart disease, etc.

E5. Enter the 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).

Part VII: Training and Technical Assistance — Instructions

On July 22, 2014, Public Law 113-128, the Workforce Innovation and Opportunity Act (WIOA) was enacted and included a new requirement under Section 751A that the RSA Commissioner shall conduct a survey of designated State agencies that receive grants under section 752 regarding training and technical assistance needs in order to determine funding priorities for such training and technical assistance. Please enter a brief description of training and technical assistance needs that you may have to assist in the implementation and improvement of the performance of your Independent Living Services for Older Individuals Who Are Blind grant (for example, financial management, reporting requirements on the 7-OB, program management, data analysis and program performance, law and applicable regulations, provision of services and service delivery, promising practices, resources and information, outreach, etc.).

Part VIII: Narrative — Instructions

Self-explanatory.

Part IX: Signature Instructions

Please sign and print the name, title and telephone number of the IL-OIB Program Director.

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year653,398
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year126,302
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2330,367
A2. Total other federal502,156
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement318,747
(c) Title XX - Social Security Act183,409
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)113,659
A4. Third party0
A5. In-kind0
A6. Total Matching Funds113,659
A7. Total All Funds Expended946,182
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs414,324
C. Total expenditures and encumbrances for direct program services531,858

Part II: Staffing

FTE (full time equivalent) is based upon a 40-hour workweek or 2080 hours per year.

A. Full-time Equivalent (FTE)

Program Staff a) Administrative and Support b) Direct Service c) Total
1. FTE State Agency 2.5000 5.0500 7.5500
2. FTE Contractors 2.0900 11.8800 13.9700
3. Total FTE 4.5900 16.9300 21.5200

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 24 6.4600
2. Employees with Blindness Age 55 and Older 4 1.9500
3. Employees who are Racial/Ethnic Minorities 15 3.2500
4. Employees who are Women 49 15.5400
5. Employees Age 55 and Older 19 14.9900

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 FY306
2. Number of individuals who began receiving services in the reported FY435
3. Total individuals served during the reported fiscal year (A1 + A2) 741

B. Age

1. 55-5949
2. 60-6457
3. 65-6987
4. 70-7468
5. 75-79108
6. 80-84153
7. 85-89128
8. 90-9473
9. 95-9915
10. 100 & over3
11. Total (must agree with A3)741

C. Gender

1. Female526
2. Male215
3. Total (must agree with A3)741

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race75
2. American Indian or Alaska Native5
3. Asian5
4. Black or African American23
5. Native Hawaiian or Other Pacific Islander1
6. White623
7. Two or more races4
8. Race and ethnicity unknown (only if consumer refuses to identify)5
9. Total (must agree with A3)741

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)49
2. Legally Blind (excluding totally blind)397
3. Severe Visual Impairment295
4. Total (must agree with A3)741

F. Major Cause of Visual Impairment

1. Macular Degeneration425
2. Diabetic Retinopathy48
3. Glaucoma98
4. Cataracts20
5. Other150
6. Total (must agree with A3)741

G. Other Age-Related Impairments

1. Hearing Impairment131
2. Diabetes121
3. Cardiovascular Disease and Strokes233
4. Cancer42
5. Bone, Muscle, Skin, Joint, and Movement Disorders277
6. Alzheimer's Disease/Cognitive Impairment28
7. Depression/Mood Disorder44
8. Other Major Geriatric Concerns198

H. Type of Residence

1. Private residence (house or apartment)590
2. Senior Living/Retirement Community105
3. Assisted Living Facility37
4. Nursing Home/Long-term Care facility7
5. Homeless2
6. Total (must agree with A3)741

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)46
2. Physician/medical provider27
3. State VR agency15
4. Government or Social Service Agency53
5. Veterans Administration1
6. Senior Center19
7. Assisted Living Facility1
8. Nursing Home/Long-term Care facility0
9. Faith-based organization4
10. Independent Living center11
11. Family member or friend88
12. Self-referral450
13. Other26
14. Total (must agree with A3)741

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 261
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 130,049
1b. Total Cost from other funds 8,244
2. Provision of assistive technology devices and aids 468
3. Provision of assistive technology services 468

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 168,807
1b. Total Cost from other funds 21,701
2. Orientation and Mobility training 253
3. Communication skills 457
4. Daily living skills 467
5. Supportive services (reader services, transportation, personal 26
6. Advocacy training and support networks 170
7. Counseling (peer, individual and group) 29
8. Information, referral and community integration 435
. Other IL services 125

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 33 1,985

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) 1,050,950 946,182 -104,768
2. Number of Individuals Served 891 741 -150
3. Number of Minority Individuals Served 121 113 -8
4. Number of Community Awareness Activities 30 33 3
5. Number of Collaborating agencies and organizations 71 64 -7
6. Number of Sub-grantees 13 14

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 468 100.00%
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) 468 100.00%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 87 18.59%
B1. Number of individuals who received orientation and mobility (O & M) services 253 100.00%
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) 55 21.74%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 135 53.36%
C1. Number of individuals who received communication skills training 457 100.00%
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) 219 47.92%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 183 40.04%
D1. Number of individuals who received daily living skills training 467 100.00%
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) 259 55.46%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 187 40.04%
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) 350 n/a
E2. Number of individuals served who reported feeling that they have less control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 12 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 1 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 12 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) 8 n/a

Part VII: Training and Technical Assistance Needs

Not Applicable

Part VIII: 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) Independent Living Blind Program (ILB) employs staff directly with the state agency; Arizona Independent Living Blind (ILB) Program, 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. During this reporting period, the Arizona ILB Program had eighteen internal staff, twelve individual contractors, and two agencies with thirty eight direct and indirect service employees, for a total of sixty eight individuals who provided 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. Vision Rehabilitation Therapists provide community outreach through in-service presentations to local health fairs, senior centers, nursing homes, retirement communities, medical facilities, hospitals, and 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 RSA and community blindness related services. There were two major events that drew approximately eleven hundred attendees during this reporting period. The Sun City Health Expo held on October 2, 2013 in Sun City, Arizona, which drew approximately four hundred, and the 17th Annual Vision Rehabilitation and Technology Expo (VRATE) held on December 13, 2013 in Phoenix, drew approximately seven hundred attendees. As a result of the efforts of the AZRSA Independent Living Blind (ILB) staff who conducted thirty three in-service presentations throughout Arizona, one thousand nine hundred and eighty five 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 and Visually Impaired which 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 eighteen state agency employees and fourteen providers as follows: State Agency Employees: 1. Garcia, Vasant (Certified Vision Rehabilitation Therapist) 2. Gunn, Suzi (Certified Orientation and Mobility Specialist and Certified Teacher for the Visually Impaired) 3. Lindley, Pam (Certified Vision Rehabilitation Therapist) 4. Miller, Anna (Certified Vision Rehabilitation Therapist/Certified Rehabilitation Counselor) 5. Olson, Susan K. (Certified Vision Rehabilitation Therapist) 6. Steen, Todd (Certified Vision Rehabilitation Therapist and Certified Orientation and Mobility Specialist) 7. Russell, Cindy (Non Certified Orientation and Mobility Specialist) 8. Davis, Chris (Assistive Technology Specialist) 9. Crist, Lanelle (Non Certified Vision Rehabilitation Therapist) 10. Rut, Duol (Non Certified Vision Rehabilitation Therapist) 11. Anderson, Erick (Assistive Technology Inventory Lead) Seven Administrative Support Staff Provider Agencies: 1. Arizona Center for the Blind and Visually Impaired (ACBVI) 2. Southern Arizona Association for the Visually Impaired (SAAVI)

Individual Providers: 1. Arnold, Patty (Certified Vision Rehabilitation Therapist/Certified Low Vision Specialist) 2. Bishop-Amavillah, Tamara (Certified Orientation and Mobility Specialist) 3. Hanna, Georgeanne (Certified Vision Rehabilitation Therapist and Certified Low Vision Specialist) 4. Harris, Ellen (Certified Vision Rehabilitation Therapist and Certified Teacher for the Visually Impaired) 5. Klenner, Shelly (Certified Vision Rehabilitation Therapist and Certified Teacher for the Visually Impaired) 6. Ohm, Laura (Certified Orientation and Mobility Specialist) 7. Thurber, Jeffrey (Certified Orientation and Mobility Specialist and Certified Low Vision Specialist) 8. Weaver, Sandra (Non-Certified Vision Rehabilitation Therapist) 9. Rutkoff, Ethan (Non-Certified Vision Rehabilitation Therapist) 10. 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 and Deaf (SBVID) has increased community awareness by presenting/attending thirty three (33) events or activities and by collaborating with different organizations to update knowledge in the area of technology and teaching techniques, and the availability of new programs that could benefit clients by addressing their multiple needs. Some of the presentations and collaborations during FFY 2014 include, but are not limited to the following: A Wright Place American Foundation for the Blind (AFB) Area Agency on Aging Arizona Bridge to Independent Living (ABIL) Arizona Council of the Blind (ACB) Arizona Military/Veteran Women’s Health and Knowledge Fair Arizona State University Hearing Program Arizona Technology Assistance Program Arizona Telecommunications Equipment Distribution Program Association for Education and Rehabilitation of the Blind and Visually Impaired (AER) Atria Bell court Garden assisted living Braille and Talking Book Library Cascades of Tucson Assisted Living Center for Disability Law Dependable Health Staff Conference Desert Springs Assisted living Desert Low Vision Center Digital Apex DUET — Community Faith Nurses Foundation Course Emerald Educations Systems Eschenbach Fellowship Square assisted living wellness expo Foundation for Blind Children — Dr. Lisa Chiles Low Vision Optometrist Governor’s Council on Blindness and Visual Impairment Guide Dogs for the Blind Hadley School for the Blind Independent Living Aids Lions Club Low Vision Day Low Vision Macular Degeneration Seminar/La Canoa Lions Low Vision Plus LS & S Low Vision Products Maricopa County Public Library Midwestern University Low Vision Center Mississippi State University Rehabilitation Research Training Center National Federation of the Blind Next Level Olive Branch Sr. Program Osher Lifelong Learning Palo Verde Community Network luncheon Parish Nurses East Parish Nurses West Payson Low Vision support group Pima Council on Aging: Case Managers Meeting Renaissance Support Group Southern Arizona Association for the Visually Impaired (SAAVI) - Thanksgiving alumni luncheon SC Grand Low Vision Support group Spofit Disability Sport Fitness Center Sun City Health Fair Sun City West Low Vision Group Sun Lakes Support Group Sun Sounds of Arizona The Forum assisted living The Forum touring SAAVI Tucson Sun Van Transit University of Arizona, Audiology Masters Class Valley Metro Dial a Ride Verde Valley Manor Verde Valley Medical Center/OT-PT Dept. Veterans Affairs ViewFinder Low Vision Vision Rehabilitation and Assistive Technology Expo (VRATE) Western Michigan University White Cane Day

These activities, combined with the smaller gatherings that occurred during this Federal fiscal year, provided outreach to one thousand nine hundred and eighty five participants, and enriched the ILB provider’s knowledge and resources to better serve ILB clients.

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.

2014 Client Satisfaction Survey 10/1/13-9/30/14 MONTH/YEAR of this Survey (Upper Right Corner) Answer Options Response Percent Response Count 10/13 38.9% 44 11/13 11.5% 13 12/13 5.3% 6 1/14 6.2% 7 2/14 1.8% 2 3/14 8.0% 9 4/14 0.9% 1 5/14 6.2% 7 6/14 8.8% 10 7/14 6.2% 7 8/14 6.2% 7 9/14 0.0% 0 answered question 113 skipped question 0

Services were provided in a timely manner. Answer Options Response Percent Response Count Strongly Agree 68.1% 77 Agree 22.1% 25 Disagree 2.7% 3 Strongly Disagree 0.9% 1 No Response 6.2% 7 Comments: 14 answered question 113 skipped question 0 Comments: Georganne Hanna is very knowledgable & hlepful. Hearing aid delay lax of fond from az? The provider has too many clients! Very prompt -very professional This program helped me a lot in understanding & copying with my visual problems. Thank you for your help (SAAVI) We did not see this person enough to answer with any validity. [personal information](only returned front page of survey with this comment) Ms. Lindley has always notified about the date and time she planned to visit. Although she travels from the valley to Payson she has always arrived on time. Did not respond to phone calls (wrote in) Sorta (and drew and arrow to "agree") Took time to answer all my concerns & questions She came to evaluate me soon after I called. Surprisingly quick! I appreciate the professionalism and compassion of Mr. Steen She was terrific! It’s hard to find service like he delivered in this day and age! You are very fortunate to have someone of his caliber working for you.

?

The instructor was attentive and interested in my well-being. Answer Options Response Percent Response Count Strongly Agree 75.7% 84 Agree 18.0% 20 Disagree 0.9% 1 Strongly Disagree 0.0% 0 No Response 5.4% 6 Comments: 5 answered question 111 skipped question 2 Comments: I had no instructor Pam was Naomi’s instructor. She was kind and matter-of-fact. She was pleasant and helpful. Extermely patient. I appreciate the There could not have been a more attentive individual.

The instructor was familiar with techniques and aids used by blind and visually impaired individuals. Answer Options Response Percent Response Count Strongly Agree 76.8% 86 Agree 14.3% 16 Disagree 1.8% 2 Strongly Disagree 0.9% 1 No Response 6.3% 7 Comments: 7 answered question 112 skipped question 1 Comments: She was very informative! An assistant at De Rinderknecht’s office called my name in -the Talking Book was mailed to me She was absolutely great & knew everything about the products & available services! Ms. Lindley is very skilled in using appropraite techniques in asking questions and following up in discussing my responses. on introductory classes with Anna Jose Coronado outstanding teacher!!! Unaware of my needs They brought someone else in

?

I was satisfied with the quality of services provided by the program. Answer Options Response Percent Response Count Strongly Agree 74.3% 84 Agree 15.0% 17 Disagree 2.7% 3 Strongly Disagree 0.0% 0 No Response 8.0% 9 Comments: 12 answered question 113 skipped question 0 Comments: Funds & time available was too short Pam was so thorough! Wonderful program provided invaluable assistance. I needed a maginfying glass. Not so much There have been many things (aids and informations) that Pam has provided. My wife and me were both social workers, and we are very aware and appreciative for Pam’s services. program was terminated before I finished - Leson plan Mr. Coronado (illegible) It was more than I expected. Thank you Services provided really changed my life and outlook on being visually handicapped - I didn’t realize there was help available. Sometimes there was a bit too much rehashing - but (intelligible), overall was very good She is & was very thoughtful & helpful. This is the best thing for me

After receiving services, Answer Options Response Percent Response Count I am now better able to travel safely and independently in my home and/or community. 48.2% 53 There has been no change in my ability to travel safely and independently. 22.7% 25 I am now less able to travel safely and independently (please explain below). 2.7% 3 I did not receive services that would help me travel safely and independently in my home and/or community. 12.7% 14 I was not aware or offered these services. 2.7% 3 No Response 10.9% 12 Explantation/Comments: 39 answered question 110 skipped question 3 Explantation/Comments: I did not receive services that would help me travel safely and independently in my home and/or communitiy. Under 54 I am not dressing but have incorporated some helps into my home. My vision changed dramatically I was only advised how to walk on the sidewalk by the proper of my husbands arm. I was not informed how to walk alone, outside. I cannot, or will try to, walk anywhere outside ALONE.! I did not receive services that would help me travel safely and independently in my home/or community. I was not aware of these services. I am able to follow the stop signs more carefully! I see less now and get afraid. I did not receive services that would help me travel safely and independently in my home. Not Needed Sue Olson instructed me on how to walk with help. Such as a touch on the shoulder/elbow. At the time I started to get me tapes for the tape recorder - I didin’t need this kind of service. My sight has gotten worse since then. My vision is not so limited that I have trouble in my home. I am Rodolfo Gaytan =Husband

My Wife-Ofelia is blind Completely

Can not see=Use A Walker

I’m trying to answer your question. I was told about Sun Van & use it often when necessary. I was not aware or offered these services. The services I received were appropriate to help me function better in my home. Much appreciated. My father enjoys the "talking books". *After brain bleed his vision is worse. He does not go to the stores anymore. he does everything else though, just like before. frank help me at storeand in & out of the pick-up - and going to Safeway, Bashas Betll.

but I need help walking with my cane the girl that came out to see me I did not get a long with Buck Susan Olson I like her a lot. per requested by us. I would like to know more about services (bus) to travel in the communities n/a I was terminated from program before I needed these services I don’t travel But my vision is getting worse. This presents extra problems. I live alone at the Rennaissance in Sun lakes and receive 2 meals per day, can walk indepepently to the dining room. I do not drive any more but i canstill use my golf cart in the parking lots. I can get to the bank and the CVS store. There is a bus that will take us within a 10 mile radius. Otherwise I can call on "Neighbors Who Care" to go to any doctors or places beyond the 10 mile range. I am so sorry this evaluation is so late, but it was stuck in a magazine until now. sandy was an excellent teacher. My husband was helped a lot [personal information] My greatest gift from you is my lamp by my recliner - chair. I read recipes here, newspapers, and was able to thread a needle. Thanks again B/C my caregiver are not able to drive my car which has extra issuance to drivers that can take me to the stores, DRS, Dentist and other items of interest & nessiesties The sunglasses Anna and I chose have made a big difference in my ability to get around outside. that vision gives me confidence to travel. I have other disabilities to deal with so eyes a big concern with me. I received services for vision lose due to strokes. Am able to now read & enjoy magazines Mixed feelings: Still feel somewhat like "Target" with cane But enjoy knowing ahead what (where) I’m stepping. At the time the instructor was here did not need anything to help me travel outside my apartment. Helen lives in our home - she requires casre with most ADL’s. She is 92. Questions 5-10 are n/a I was more interested in aids to help me read & write better I did not need these services Did not ask for these services. Use C.A.T. buses to get around. I could not even beleive there were things available to make life so much easier! Thank God for Todd and his supervisor who also made a trip up to share helps with me! What a blessing. I’m legally blind but can see enough to get around; but only for short distances, no reading normally or car driving. (Also indicated that they did not receive these services, and were unaware these services were offered) No comments

After receiving services, Answer Options Response Percent Response Count I am now better able to prepare meals for myself. 32.7% 37 There has been no change in my ability to prepare meals. 20.4% 23 I am now less able to prepare meals independently (please explain below). 4.4% 5 I did not request services that would help me prepare meals. 29.2% 33 I was not aware or offered these services. 1.8% 2 No Response 11.5% 13 Explantion/Comments: 24 answered question 113 Explantion/Comments: I recieved a chopper and a spatula very nice. The plastic pieaces help when using my oven. Unable to do anything around & in the kitchen. I feel very confident in the kitchen! The finger hold and cutting boards are a big help. My sight has goten worse & I now have less patience to mess with it. The reaised dots she gave me are a real help on the microwave N/A

LIVE IN ASSISTED LIVING FACILITY Boxes were also checked for the for:

I am now less able to prepare meals independently. I did not request services that would help me prepare meals. I was not aware or offered these services. From the begining was ok w/meal prop equipment & training made me safer. I was not aware or offered these services. frank does the cooking because because we have a gas stove - and I am not see the stove to use it. Could some one help me. Meals are provided Pam has explained ways and techniques I can perform to help myself in meal preparation as well as many other activities in daily living. She also cautions me in using sharp knives and other butcher tools. I am helped by marking controls on my stove I would like to received food training (personal information) I get 2 meals a day & take care of my own lunch (not applicable) I have problems period with managing my own meals unless they are prepared beforehand. Anna showed me ways to tell if a cup is full - a big help since my lack of depth perception meant lots of spilled beverages. The raised dots helped me set temperature ranges. Ove gloves awesome I don’t need this service! My wife does the cooking. However, he gave me tips that really helped me - i.e. using colored sups for pouring into - made the microwave easy to use. Do not prepare meals My wife does this

After receiving services, Answer Options Response Percent Response Count I am better able to manage housekeeping tasks, such as cleaning floors/surfaces and organizing. 20.4% 23 There has been no change in my ability to manage housekeeping tasks. 23.0% 26 I am less able to manage housekeeping tasks (please explain below). 2.7% 3 I did not request services to help me manage housekeeping tasks. 38.9% 44 I was not aware or offered these services. 1.8% 2 No Response 13.3% 15 Explanation/Comments: 20 answered question 113 skipped question 0 Explanation/Comments: I can clean my own home thank you I have help with house cleaning. My blindness prohibits me to do any house hold chores or duties, except; to make up my own bed, and fold a few clothes, after they have been washed. Blindness STOPS a person from doing a lot of things. I did not request services to help me manage housekeeping tasks. I have a cleaning service but I like my own place neat & work at that faithfully. I was not aware or offered these services. N/A

LIVE IN ASSISTED LIVING FACILITY I could do these things already. I was not aware or offered these services. frank does the Housework Dishe & mop floor - carpet. same answer @ above I do not do housekeeping tasks I would like to receive this training I’m 95 and cannot bend over, stand straight so I’m not capable of housekeeping tasks at all. I don’t remember covering this. However, using raised dots help me organize my mail. 1 dot important mail - 2 dots to file I had good skills in these areas, Thanks "Mom". Still need to get close, real close to do jobb..rely on feel! Don’t need My wife does housekeeping. My wife does this. I an very Happy & Pleased with everything & Thankful

After receiving services, Answer Options Response Percent Response Count I am better able to manage paperwork, such as mail, correspondence, and paying bills. 43.6% 48 There has been no change in my ability to manage paperwork. 22.7% 25 I am less able to manage paperwork (please explain below). 0.9% 1 I did not request services to help me manage paperwork. 20.9% 23 I was not aware or offered these services. 3.6% 4 No Response 8.2% 9 Explanation/Comments: 21 answered question 110 skipped question 3 Explanation/Comments: a little better with paperwork still hard. Again -Total blindness says that you CANNOT see! Try doing this with your eyes shut!! Devices I was given help that! End of Life The smartlux is a great help to read by. My daughter took over all the bills and bank account. She gave me several things to help me do paperwork more easily The Ruby & my computer adaptations helped a lot. I recevied a nice magnifing glass which helped me to read better. Also was given a helpful oversized calendar. services provided by someone else. My wife handles the necessary paperwork, paying bills, etc. Pam brought a large print check register. I t was helpful. I need help to do paperwork My son in Olathe, KS takes care if most of my paperwork and banking. I think I covered this 1. Anna brought me 2 great templates to writing checks & signing my name. Look for hours sometimes....misplaced this Templats & pens are very helpful. Equipment to help deal with paperwork small print and figures are my problem I requested a larger portable magnifyer, but was refused because I own a CCTV. This does not help outside my home. I can do every thing better

After receiving services, Answer Options Response Percent Response Count I am now better able to access reading materials, such as books, newspapers, and magazines (whether with magnifiers, large print, Braille, or on tape). 59.8% 67 There has been no change in my ability to access reading materials. 19.6% 22 I am now less able to access reading materials (please explain below). 4.5% 5 I did not request services to help me access reading materials. 4.5% 5 I was not aware or offered these services. 1.8% 2 No Response 9.8% 11 Explanation/Comments: 25 answered question 112 skipped question 1 Explanation/Comments: Yes I recieved books on recorder thank you I have become a good listener when the tape player is on & playing!! Again, I have devices that were given me that help a lot! End of Life The book reader is fantastic! It’s hard or impossible to read notices & posted The reading machine & the magnifiers are a great help The Ruby electronic maginifying glass I received was especially helpful. The machine, CCTV that was given to me doesn’t work. He likes the taped books. :) Need more help with reading.. I need a floor lamp with good lighting. Could some ibe help me. it dark in my living room. This was the single best service provided to us. A million tanks for this! Pam brought a magnifyer with a light. But my sight is getting worse Vision has grown worse Sue Olson got a computer magnifyer and digital tape machine for me. I still play Bridge. I often confuse the suits, but friends are patent with me. can’t read or write I’ve only 1/2 an eye make words out. Tape are sometime hard to hear, because of the speaker I had given up lots of reading. Now I can read anything with my lamp and my magnifier. I even used the lighted magnifier to find and remove a splinter. Love Aud/Library Awesome! The magnifyer (electronic) is a lifesaver. I cannot read without it. When shopping, I am now able to read labels & small print. I can now able to see into the closets, etc. Helped with library tapes from talking books They really helped me - the lights and magnifiers have made all the difference for me. except for use w/iPad and the tips I received were helpful Kan do so much Better with ALL The Help I Get

Compared with my functioning before services, Answer Options Response Percent Response Count I am now less dependent upon others in performing my customary day-to-day activities, such as getting around, cooking, cleaning, reading, laundry, etc. 45.0% 50 There has been no change in my ability to perform my customary life activities. 29.7% 33 I am now more dependent upon others in performing my customary life activities (please explain below). 6.3% 7 No Response 18.9% 21 Explanation/Comments: 18 answered question 111 skipped question 2 Explanation/Comments: Cooking would be easier if I had more magnified cooking utencils. Use of phone to call in refills on med. to small. Numbers on phone too small. Everything needs to be done before any task is done! Except bathroom duties; (can shower alone, use the stool alone, tooth brusing can be done, and dressing c an be done, when cothers are laid out for me. I am more independent because Pam gave me the confidence I needed to feel I was doing ok on my own. End of Life Magnifying mirror is wonderful With shots in my hip & back - and two my age. I don’t feel liek doing anything. My specific needs were seeing better - This helped me very much Still am able to cook, clean and shop by myself he does my laundry - for me. but now we have a washer & dryer in our apt. The items given to naomi to help her read. Vision has worsened vision determination to 20/400 I have to hire handyman to do outside & inside work. Cleaning person to help clean. reading, writing checks YES! And what is also wonderful is knowing there are so many aides available and people who can show! Checked between top 2 answers. Wrote in " I rely on myself...never easy" Any external (away from home) reading requires outside help.

Tell us the greatest difference this program has made in your life. Answer Options Response Percent Response Count No Response 100.0% 23 The greatest difference is: 90 answered question 23 skipped question 90 The greatest difference is: Sunglasses are great in teh A.Z. sun and help glare thank you. Chopper makes preparing food faster magnifer helps with reading mail a little easier. The lighting made a big difference in my home. Thank you. The magnifiers are very helpful and necessary. Also am listening to taped books which I am very happy with. Items given to organize colors closets. to help me with oven, micro markers.every item thanks. I’ve learned lots of helpful information in dealing with my vison problems. Also helpful items concerning reding an going from room to room in the dark. Lights to help writing my bills. I had great encourgement from my worker. She was so faithful coming way out here. She is a blessing to your company. Thank you for this service. NONE -Needs to provide more information as to help for the blind. I found the AZ Talking books on my own, computer software, supply catalog also on my own. I would like to find a cell phone the bind or low vision persons can use. The one support group meets at 9:00 AM which to me is inconvient for elderly persons He gave me confidence to keep trying Not much except: 1) I have a legal white cane, 2) I have a talking writst watch; 3) The cloth color-minder helps, some, to give me an idea of the clothes I might be wearing. I’ve learned about more carefully, and slowley to avoid any falls or tripping. I can manage to move about in the apartment by myself when the need is necessary. The most and beneficial help & advice came from your visual & reahab teacher: Sandy Perry. She got me the white cane, talking wrist watch, cup gauge & fill cup with liquid, measuring tape, color minder-clothes. We appreciate her services greatly -as we do with all the services of the blind. Self Confidence knowing there is help if needed. My vision was just so befor getting help with my glasses other then the help with reading lamps etc. what program? I was given equipment to help tell time and cards to help me sign documents in proper place. Also given equipment to help with colors for dressing. Some reading lights are helpful.The eyeglasses given me do not help at all. Pam made sure I had the best lighting available and it really makes a difference. I never knew what was available to me. Pam was a kind, respectful, caring provider and I feel I not only gained a "provider", I made a friend. Large print books mailed to me. The recorder. The GPS. The "aids" for seeing has been very helpful. These programs have a more postive confidence in my worth. I find it verys satisfying to function more independently. I AM HAPPIER WITH MY SITUATION, I AM ABLE TO ACCOMPLISH DAILY ACTIVITIES, TAKE CARE OF MYSELF, BETTER THAN BEFORE. Ms. Olson has been so compassionate & informative whenever my mother saw her! Thank you Sue! Gave me all the currrent info about what is available to me. Such as the View Finder and pr. Noon. Sue is a wonderful and special person in my life. The watch and alarm clock are a great help. I am so thankful for the Talking Book as I use to read a Lot _now I can no longer read. The Talking Book has saved my sanity_Thank you The biggest help in teh reading machine. I love to read but cannont read without it. Able to preporm tasks easier

Pam Linley & Vera are amazing. They are both good teachers & patient. provided some self confidence I called about this and never recevied a returned call. I have never heard of Dave DeWeese so, of course I have not worked with him. Please send all future correspondence in braille as I am toatally blind. Me-Husband-Wife Blind

NONE

Thank you

5-21-14 All of the devices given to me have been very beneficial but the one item, the magnifyer has helped the most and also the "Talking Books" program. I have always been a big time reader and without the Talking Books, I would experience deep depression. I am more confident in taking care of my day to day life. I have not received any services from anyone The program aquainted me with a broad range of resources to enable me to cope with my visual problems and especailly to better understand them. I very much appreciate the assistance I received and sincerely hope that others will continue to be offered these services in the future. Heaven Up Above

Yes everything was very helpful& I sent the book recorder & radio & tapes. Thank you, I’d say everything is postive.

Died Dec. 13, 2013 I feel more confident in reading and keeping a busy calendar current. I am able to write checks and talking book help me with my time. Its not boring anymore, Thank you. I, we have noticed no difference. With equipment supplied me I am more confident in my every day living The variety of hearing things I have difficulty seeing - clock, watch scale, adding machine, the Pebble, table lamp. All the equipment & paper & pens, the calendar in big print & address book - so helpful - Thank you! getting the talking books has been nice for my father. He goes to bed with them.

Waiting to go to the V.A. with me to get their evaluation on his sight. Then I can take to the initial Appt. then Pam said she can do the rest. More condifence -

Feel safer in my home

Enjoy - watch-clock and other help Aids. Tho I’m able to care for myself yet, the "aids" given have been a great help to ease my day to day life. - a great help-

Requested a L S & S catalogue be sent - Hope to receive one for my future use. Well I got a new cane to walk with to the store & around my apt - I am doing OK, but ineed a new floor lamp I am having a hard time reading and doing my artwork. (personal information) I am having knee replacement on feb. 28 and will be home on March 3, 2014 and you may call me (personal information) any time after the 3th. after 9:00 a.m. seen I will get up tell tehn. Maybe you could have someone come out and see me we live (personal information) up now. up. On 2 floor. (personal information) Thank you, (name) We were not requesting specific independent services, but looking for a product/service that might include & help improve quality of life.

This program has helped tremendously by bringing hundreds of talking books into the home for my mother to listen to. It keeps her mind active. keeps her up-to-date & provides hundreds of hours of pleasure. Many, many thanks to Vasant! It has given me more confidence in takleing new situations. I am also aware of where I can reach out for some more help if I need it. The lamp provides light and helps her read. 1)the electronic magnifying glass

2)the lamp, clock

ALL very helpful Marked microwave The digital recorder has saved my eyes from reading as that has become a great hobby I can use my magnifyer No my way around the apt complex better and also my way to the store and my kids school. We have been informed about services available to visually impaired persons in Arizona. While we had some prior knowledge about available services, we now have current information about available services and the professionalism of DES Staff, Referral to VA. Personal tasks.

Garcea is great and timely and helpful! Very little.

She only came here once tehn she had a foot problem & we haven’t heard from her sense. (personal information) Provided OTT Lamp making it easier to read large print books. Thank you! How to prepair some meals, and I’m more confident about myself and other The magnifying aides have been beneficial for reading and the book-tapes have been very enjoyable at times. The computer keyboard, pens, and magnifyer and trashliner have been helpful. The magnifyer & digital tape player Helped in my ability to read papers, documents, cards, etc Enjoy reading more. Better read menu. Read mail without asking for assistance. I use the magnifying glass & lights regularly too see. The lamp has helped tremendously. The "optelec magnifier has been a great help to me

The new sunglasses are a lot better than I had used before.

sandy Weaver’s life experiences with MD was such a great help to me in coping with daily chores life grocery store shopping, etc. The program has helped in small ways, but at 95, what can one expect. The dots on the microwave and washer and dryer were helpful. The talking watch enables me to know the time without asking others. Am enjoying the talking books and the magnifyer and lamp. Sandra was very enthusiastic and patient in explaining procedures. I wish the TV station would announce telephone numbers instead of saying call the number on the screen. Can you contact them as we cannot see to write them down! Training from Venu Vangueety. See attached letter. [attached ltter dated June 3, 2013. In it the client states Mr. venu Vangeety’s training on on a laptop with software for the blind, how to use an iPhone and how to access other valuable services has improved their ability to communicate 100 fold. Client also staes the tariner was patient and understood their specific needs and tailored the training to them.] I now have better lighting in my apartment & more aids to help me with things requiring better vision. I realize my vision is worse than it was, but it’s not as bad as others I know who have poor vision. Fortunately I have good hearing which is not true for mnay others. I appreciate the help youve given me and want to say thank you very much [personal information] Sandy was an excellent teacher, I learned a lot. She helped me to become more confident in using microwave, finding cereal, getting milk from refigerator, medicines, handling many things but I do not practice. As stated in 5, it is my lamp. Also my over temperature is marked to I know where to find 350 degrees. Same for wash on my washer & dryer laundry, help prepare my meals, (chopping, vegetables, protien drinks, and having other items ready to, put on plate. Reading, able to read bank statements, write checks know colors, money, clock, small clock was handy, TV, glasses dots on microwave, cane - never used before People who can show you new ways to do things without your eyes. Anna’s cane interested me as I watched her "feel" new walking surfaces, obstructions, steps and more. Now I do things better AND I have HOPE for the future. Thank you so much! P.S. Anna is terrific! Aids help m e, not so frustrated with people so much. I have been so independant since 30 years old when I got divorced & raised son on own & do not know any other way to live. I want to stay independent as long as I can. Thank you for the helping aids and for the service of Todd Steen. As stated above, I am able to watch TV & enjoy some reading material also signed up for "Talking Book".

Shelley was always personable & we looked forward to her visits. Having understanding! Someone I can call that knows what I go thru. I never mind "my" effort. I don’t like being pushed around...real world like that...getting used to less function isn’t always fun. Thanks! Watch (talking) has been great! Talking clock very helpful. Thank you for these devices! Shelley was wonderful! :) I never knew all the aids on the market for low vision/blind. It has been a tremendous help fo rme - especially the special magnifier, templates & pens and the make-up mirror. Special sunglasses also are used daily. Thank you for this program. Sandra was a delightful person & very knowledgable. The apparatus that was given to me helped me to see better as a result, I was able to perform more effichenly and less frustrated Talking clock, weighing machine and timer. More independent I can now have my eyes protected from glare. I can now wathcn TV quite well! I can use the computer & make it work for my sight.

I feel more normal in my everyday life!! This program is great & it is Georgeanne Hanna who did it for me Being able to read & cook I had really missed reading. The Audio Books have been wonderful. Also, with the lights provided I am able to read some. The ability to move around with a white cane to maximize my safety To be more comfortable with my blindness I should explain that, as a result of a stroke, I am unable to perform many tasks that I used to before I lost my eyesight. But the help of Lanelle made it easier to do what I can do.

My digital book reader and my viewer really help to give my life some purpose. And I thank all of you fo rthe help you have provided. Seeing better- labeling buttons help me to work around my stove and other things in home Able to use magnifyer to see calander and menus. I think preparing food is my greatest improvement. The kitchen gadgets are great! Thank you very much! Could you please get me a large 2014 calendar as soon as possible, it really helps me, (personal information) Knowing how many things are avablie In past years (2003 > 2010) the agent (Bridget) helped me with many items. I can now read fine print with the help of the magnifying glass. I am more comfortable going outside of my area Items Received Have Helped me In Daily Living. I couldnt Believe They could so much For Peple who Are Legally Blind I couldnt even write A check or see my medicine. I can’t Thank you enough. I had to depend on Alot OF People Now I dont Have T Thank you For everything What Would I do wthout you.

Age: Response Count 94 answered question 94 skipped question 19 Response Text Under 20 = 1 35 — 59 = 8 60-75 = 15 76 — 86 =41 87 - 97= 26 90 + = 3

Gender: Answer Options Response Percent Response Count Male 19.2% 19 Female 80.8% 80 answered question 99 skipped question 14

Living Situation: Answer Options Response Percent Response Count Live alone 37.5% 42 Live with others (includes spouse, family, roommate, nursing home or retirement facility) 52.7% 59 No Response 9.8% 11 answered question 112 skipped question 1

Ethnicity: Answer Options Response Percent Response Count White (includes all countries) 78.6% 88 Black or African American 1.8% 2 American Indian or Alaska Native 0.9% 1 Native Hawaiian or Other Pacific Islander 0.0% 0 Hispanic or Latino of any race 5.4% 6 Asian 0.9% 1 No Response 12.5% 14 answered question 112 skipped question 1

Reason for visual loss (check all that apply) Answer Options Response Percent Response Count Macular Degeneration 61.3% 68 Glaucoma 18.0% 20 Diabetic Retinopathy 5.4% 6 Cataracts 9.9% 11 Other, list below: 22.5% 25 No Response 10.8% 12 Other (please specify) 31 answered question 111 skipped question 2 Other (please specify) Stargardt’s Stroke Prostetic eye on left. Three cornia transplants on right eye. Blood clots to the retina Maybe a botched laser surgery.! Retna Picmentosia Dry Eyes Optic Nerve Atrophy Wrinkle of Retina Graves Orbitopathy Stroke Had CATARACTS THEN SURG. Retnal Pickmentosa Strokes & brain blees & brain surgery. Failed surgery (one eye), severe retina damage, failed corneal transplant (other eye), severe optic nerve damage cornea rejection & enyserol Arteritis Legally blind since birth spent 8 years in a sight saving class 20/2400 both eyes Born Blind Detatched retina, Surgery failed retinal vein occlusion gave me cheesecloth vision in rt eye Multiple strokes TBI? Trauma Related Boating Acc - Degeneration stretched retina - legally blind now Retina Pigmentosa an eye infection Macular Edima, Scar Tissue from laser surgeries. Macular hole in the right eye due to laser afetr lense replacement (took away vision-center) Optic Atrophy Retinitis Pigmentosa Graves Disease RP

Would you rate your vision? Answer Options Response Percent Response Count Poor (I can read some regular or large print with glasses or magnification) 75.2% 85 Completely Blind (I cannot read print at all, even with glasses or magnification) 15.0% 17 No Response 9.7% 11 answered question 113 skipped question 0

My ability to see has: Answer Options Response Percent Response Count Worsened during the past year 53.1% 60 Improved during the past year 3.5% 4 Remained the same and can see some 25.7% 29 Remained the same and cannot see at all 6.2% 7 No Response 11.5% 13 answered question 113 skipped question 0

Do you have a hearing loss? Answer Options Response Percent Response Count Yes 40.7% 46 No 46.0% 52 No Response 13.3% 15 answered question 113 skipped question 0

Do you have any significant health condition(s) other than vision loss? Answer Options Response Percent Response Count No 33.6% 37 Yes 51.8% 57 No Response 14.5% 16 If yes please list: 58 answered question 110 skipped question 3 If yes please list: Migrains from strain and sun. Knee and ankle issues from walking a lot. Heart Condition severe lumbar spondey-losis High blood pressure -Kidney failure -Diabetes Quest. 8 Ringing in both ears Kidney problems -asthma -poor hearing Peripheral Neuropnuopathy -Diabetes Feet neurophay; anxiety; depression; Copd, Emphysema, oxgen, sleeping machine (cpad, osteoarthitis Cardias Problems possible hernia Diabetes pace maker DIABETIC NEUROPATHY, DIABETES Stroke 12/18/13

Fall 5/24/14 Hip replacement from orignal one. 2 Back operations ATRIAL FIBULATION, HIGH BLOOD PRESSURE Severe back problems Diabetes, MIBI (temportary) Graves orbitopathy Diabetis Osteoporasis all over and severe lower back pain COPD Diabetes - Type 2 on insulin High blood pressure diabetes Diabetes Type II Polycythemia & high blood pressure as well as other one. I am having knee replacement Feb. 28 2014 2 time. 2 heart stints Hearing, balance when walking Hearing, becoming a problem Hearing Loss balance, lapses in some memory, Because of my vision I don’t recognize some people whom I know. Lumbar stenosis CHF Diabetes - heart COPD, Hypertension, Peripheral artery disease, heart disease High Blood Pressure Congestive Heart Failure Hearing, Knees, back, Parkinsons COPD, Arthritis, poor circulation, AF, etc. High blood pressure Hypertension, heart, neuropathy, thyroid Tremor when standing Diagnosed with Prostate Cancer High blood pressure High Bloood pressure 3 vertrabes out of place. Right arm not fundtion b/c of badly paralyzed chronic kidney disease, hypertension, senositis, bronchial problems (not chronic) obesity arthristis in knees & hips Diabetes - Hypertension Migraines, Arthristis, Spinal Biffuda, Herniated disc, Knees, shoulder...teaching myself Yoga has helped everyting more than Docs, hate meds too many side effects. pacemeaker for a-fib Atrial Fibrilation 2 Lung diseases. Have never smoke except have inhaled the smoke of smokers. retinal failure (End stage) - Dialysis 3 day/week/4 hours per session Graves Disease, Arthritis, Rapid Hearthbeat Moderate Autism I have Nycethers Grieofis High blood pressure, memory Heart

My overall health has: Answer Options Response Percent Response Count Worsened during the past year 16.1% 18 Improved during the past year 7.1% 8 Remained about the same 67.0% 75 No Response 9.8% 11 answered question 112 skipped question 1

Have you had any event, such as death of a spouse or family member, change in residence, etc. that resulted in a major lifestyle change this last year? Answer Options Response Percent Response Count Yes 16.1% 18 No 74.1% 83 No Response 9.8% 11 answered question 112 skipped question 1

On a scale of 1 to 5 (1 indicating no difficulty and 5 indicating significant difficulty), rate how much difficulty your health and your vision currently (right now) causes your ability to function independently. Answer Options 1 2 3 4 5 No Response Response Count Health 26 18 31 13 12 12 112 Vision 4 10 26 30 26 16 112 answered question 112 skipped question 1

On a scale of 1 to 5 (1 indicating no difficulty and 5 indicating significant difficulty), rate how much difficulty your health and your vision caused before receiving our services in your ability to function independently. Answer Options 1 2 3 4 5 No Response Response Count Health 20 16 22 20 10 22 110 Vision 2 10 19 29 31 21 112 answered question 112 skipped question 1

Before you received services, did you consider going into a nursing home or other long-term care facility? Answer Options Response Percent Response Count Never 64.3% 72 Sometimes 15.2% 17 Often 2.7% 3 Already in a Nursing Home or Facility 8.0% 9 No Response 9.8% 11 answered question 112 skipped question 1

Did the services you received help you remain in your home or private residence? Answer Options Response Percent Response Count Yes 53.2% 59 No 19.8% 22 Not Sure 13.5% 15 No Response 13.5% 15 answered question 111 skipped question 2

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 Stories submitted by state agency staff members: 1 Pam Lindley, CVRT Ms. R was eighty nine years old when Independent Living Blind (ILB) services first began. She lives alone in an apartment, close to bus and trolley service. Ms. R was diagnosed with age-related macular degeneration. At the time of her assessment, she was still able to read large print books with adequate lighting. At the assessment, it was discovered that she is a veteran from World War Two. A phone call was immediately made to refer her to the Veteran Affairs (VA) program. She was enrolled with VA and had an eye exam. Because she was not legally blind, she was not eligible to participate in the VA residential program in Tucson, but they were willing to provide some low vision aids to allow Ms. R to be more independent. Ms. R became an Arizona Rehabilitation Services Administration (AZRSA) Independent Living Blind (ILB) client, but the Veterans Affairs provided the low vision aids. Ms. R had enjoyed taking walks at a park across a busy intersection from where she lives. She would use hiking sticks as she walked, but had difficulty seeing the signal to cross the street. A referral was submitted for Orientation and Mobility instruction. Ms. R was instructed in the use of a long cane, and guidance on how to cross the intersection safely. She was also enrolled in Dial-a-Ride and Ride Choice, as well as free trolley rides. Ms. R had been wearing hearing aids that she purchased on her own. Even with these aids, she still had difficulty hearing and had the volume on her television turned to the maximum volume. AR and this Vision Rehabilitation Therapist (VRT) attended a seven week course at Arizona State University (ASU) on living with hearing loss and determining appropriate adaptive aids. At the completion of the course, Ms. R was referred to an audiologist in the VA system and obtained a new pair of hearing aids. She was unaware that this was another expense covered by VA. Also, an application with the Arizona Telecommunications Distribution Program (AZTEDP) was completed and she obtained an amplified, large numbered telephone. With the assistance of this VRT, AR set up the phone and input her primary phone numbers. Ms. R was amazed at how clear the phone sounded and the ease of dialing or using the speaker. The new hearing aids had additional features, such as t-coil and settings for different environments. Ms. R is an active member in a book club, bible study group and widow’s club, but had difficulty participating in conversations due to the hearing loss. As a result of the lessons provided through the ASU Speech and Hearing Clinic and new hearing aids, she was able to participate better in conversations. Because Ms. R was such an avid book reader, she was enrolled in the Maricopa County large print book program, so books would be mailed directly to her. Ms. R was also enrolled in the Talking Book program so she could listen to books when her eyes tired. Headphones were obtained so she would not need to turn the volume up. A friend gave AR a Kindle e-reader. She enjoyed this because she could change the font, size of print and download books for her book club. However, purchasing the books was hard on her budget. At a visit to the local city library with this VRT, AR was instructed on how to register and download books through her computer onto her Kindle. Ms. R’s computer had become slow and difficult for her to use. Because she needed to magnify the size print, she had difficulty reading on the computer monitor. The VA was notified and they provided her with a large, flat monitor. Shortly after this, Ms. R called to state that her vision was suddenly getting worse. She was advised to call the VA to inform them; they arranged for her to be seen immediately. Fortunately, Ms. R had not developed wet Age related Macular Degeneration, but her eye acuity was diminished. Ms. R was now declared legally blind and eligible to attend the VA residential program. This ended our agency involvement in services for Ms. R. However, when she returned from the residential program in Tucson, Ms. R called stating she had a wonderful experience and training she had received. In addition to more O&M and low vision instruction, she also received computer instruction and a brand new computer. Although Ms. R experienced deterioration in her vision since ILB services first began, she gained a whole new perspective on how to live and cope with vision and hearing loss. As a result, she remains active with her friends and organizations, continues to take daily walks and has become a more experienced computer user. She was a true pleasure to work with and truly epitomizes what the ILB program is all about.

2 Susan K. Olson, CVRT Mr. H is a seventy eight year old male who was diagnosed with the wet form of Age related Macular Degeneration (AMD). He was seeing a retinal specialist and receiving injections at the time of his referral to the Independent Living Blind (ILB) program. He was reported as 20/400 OD and his left eye initially was reported as 20/70, but within five months it was reduced to 20/120 — which indicates that despite having medical treatment that the progression of vision loss continued in his left eye. After that period of time, the treatments were able to stabilize the progression and he remained at 20/120 in the left eye. Mr. H lives in a retirement community with his wife in a single family home. He is a retired regional salesman for a national whole-sale distributor. He was accustomed to closing multi-million dollar sales and traveling not only his region, but also calling in to other parts of the country. His retirement plans were to move to the Colorado River area, having family/friends enjoy his fish fry’s at gatherings, being available to his aging in-laws and checking out his favorite home building stores. ILB lessons always revolved around the timing of the full moon, the best fishing times and dates, when he and his buddies would travel to their Colorado River fishing spots. His life dramatically changed with the diagnosis of wet form of AMD. He previously was advised by his retinal specialist that he was no longer legal to drive. However, JH continued to drive his golf cart in his community, as well as to an area shopping center, which required crossing over a major main road with stop lights. Use of golf carts for street driving in the Sun City area is legal, but a person must have a valid driver’s license and the golf cart must be “street legal”. As ILB work progressed, Mr. H gained skills and was eventually able to “voice” his original hidden feelings of fearfulness and hopelessness that were being replaced by hope and a sense of accomplishment. During the course of ILB work, MR.H was able to benefit from instruction and items relating to adjustment services, low vision, communication, home management & personal management. His case demonstrates the importance of community outreach activities and interagency collaboration efforts that are part of the ILB program. He chose to pursue a clinical low vision examination even though his insurance did not cover the cost. As a result of this exam, he learned that he could be legal to drive his golf cart, if he pursued being fitted for and trained on a bioptic system. This CVRT had an opportunity to conduct an outreach/in-service activity at one of the low vision support groups in the area. On the day of the outreach, several items that members in the group could no longer use were being offered for donation to others. One item was a bioptic system which no one in the group knew what it was. CVRT asked if the membership would be willing to have someone outside of their group try it. The group was eager to do so. This device was taken to the Low Vision examiner to inquire about the appropriateness for JH. The bioptic was the correct magnification and mounted in frames that could be utilized for JH. Specific lenses and mounting for his needs would need to be done by the low vision practice, but they would only charge for those services. This would be a savings to JH of over a thousand dollars. He would still need to complete and pay for training on the use of bioptics. CVRT took the system to show Mr. H to determine if he liked the frames and was interested in moving forward with this device. JH was thrilled with the serendipitous event and the frames were very similar to what he had used in the past. A month before we finished working together he was proud to inform this CVRT that he had taken the driving test at the local Department of Motor Vehicle and passed. Mr. H was also provided and trained on a portable video magnifier, now he could return to his visits to the local hardware supply stores and locating specific supplies he needed. The recorder proved to be extremely helpful for him in recording shopping lists, notations and appointments. He had a few food specialties that he had given up on making and the Vidalia food chopper combined with other kitchen/cooking items and instruction allowed him to regain ability to make his famous ceviche as well as be safer with his fish fries. Various personal grooming and health items with instruction allowed him to be less dependent on his wife. At the last ILB lesson, Mr. H reflected on this training and made the following statement, “You know before I met you and got help, I wasn’t feeling real great about things and a little scared about the future. Your agency has helped me so much.” He felt so highly of ILB services that he and his wife had arranged for their neighbors to come meet this CVRT so they could ask some questions and help them make a decision about pursuing services for the husband. Mr. H is of the generation where a business reputation is based on integrity and commitment to quality services which is his view of Arizona’s Independent Living Blind Program.

3 Anna Miller, CVRT Mrs. C is an eighty-two-year-old woman who currently resides with her husband and son. Four years ago, she was diagnosed with Age Related Macular Degeneration, and stated during her initial assessment that while the condition had progressed gradually, she had noticed a drastic change in the last few months leading up to the time of assessment. During the first meeting with ILB, Mrs. C expressed that she was having difficulty in a variety of daily living activities such as writing, keeping track of records, and keeping track of addresses and phone numbers for family and friends. Furthermore, while she stated she felt reasonably confident in her ability to perform cooking tasks, Mrs. C sited trouble she was having in the areas of cutting foods and measuring both wet and dry ingredients. In the area of personal management, Mrs. C indicated that one of the largest sources of stress for her was her ability to manage the family finances and pay bills. Along with this, she also expressed difficulty in identifying and managing both coin and paper money. Finally, as her home was an older model, she indicated that the lighting was not sufficient for completing the daily living activities, and reading mail and other items was a hardship, as the print was often not big enough. To address Mrs. C’s communication needs, she was provided instruction in the use of adaptive handwriting templates, bold lined paper for contrast, and in the use of a special bold pen, commonly known as a 20/20 pen. To assist her in general record management (e.g. phone numbers, doctor appointments), she was provided training in the use of a digital recorder, and was further instructed in the use of a large print address book for the contact information of important people in her life. Furthermore, in the area of home management, Mrs. C was instructed in adaptive and safety techniques for performing both cutting and measuring tasks, but also in the use of adaptive aids including large print measuring spoons and a black and white cutting board to be used when engaging in food preparation. Because the area of financial management was particularly stressful, Mrs. C was instructed in the use of a large print check register, check writing guide, and talking calculator. Additionally, she was provided information about large print checks that are available through her bank, and was also provided training in adaptive techniques for identifying and organizing coin and paper money. Additionally, Mrs. C was provided with a hand held lighted magnifier, as well as instruction in the use of several task lighting devices, which would enhance her ability to complete all activities worked on as part of her vision rehabilitation therapy plan. As a result of receiving instruction through the Independent Living Blind program, Mrs. C reported feeling a greater sense of confidence. During the completion of her plan, several members of her family unfortunately experienced some serious medical occurrences, and she stated at time of closing that she felt she would have never been able to manage her finances had it not been for the devices and methods she received. Additionally, Mrs. C. reported that numerous other daily activities that were not focused on as a part of her services were made easier as a result of receiving instruction in the use of her task lighting devices and hand held magnifier. Lastly, Mrs. C also stated that she enjoyed the talking books she was reading from the Arizona Talking Book Library which had been applied for during her ILB training. She was also looking forward to participating in many of the low vision support groups around the city which had been provided as resources during her training with ILB.

4 Suzi Gunn, CTVI COMS Seventy eight year old Ms. B has Age related Macular Degeneration. She has had several Transient Ischemic Attacks (TIA’s) which cause her some memory loss and cognitive issues. She lives with her husband in a mobile home in a remote area of southern Arizona, about an hour from Tucson. The closest stores for grocery shopping and other necessities are more than ten miles away. She cares for herself and her husband who is terminally ill. He has hearing issues, uses oxygen and has very limited stamina; usually he is found sleeping in a recliner during lessons. They have several services that come to the home for her husband which she must keep track of. She recently had knee replacement surgery which delayed receipt of Arizona Independent Living Blind (ILB) services. She was in a nursing home recovering from her TIAs prior to receiving instruction. She now has physical therapy at her home to assist her recovery. During the instruction period she transitioned from a walker to a support cane. With ILB instruction, Ms. B received a large print calendar and bold marker with which she can write down and track the numerous medical appointments for herself and her husband. She improved her safety when cooking by using a double spatula, marking the microwave and cooktop and participating in discussions about turning burners off and how to safely check that they are off.

There was an issue with a skunk under Ms. B’s mobile home, causing a strong odor to come through the vents. With support, using the Arizona Resource Directory, she contacted the Area Agency on Aging and was able to find a source for remedy via removal of the dead animal. Until she explored this option, it was uncertain whether the animal was alive or might have rabies creating a bigger problem for her and others visiting the home to attend her husband.

During a recent visit Ms. B beamingly stated that she used the LED flashlight to locate dropped pills on a dark faux wood floor when she was sorting them to care for herself and her husband. Once located with the flashlight she used the systematic search technique with a broom to pull the pills near her. She cannot bend down very readily yet due to her knee surgery. This prevented a potential fall and gave her a sense of both capability and control in her life.

Ms. B was also provided and assisted in processing paperwork to obtain a reduction in her phone bill. This was very important due to her limited income. With advocacy support, Ms. B returned a mobile device she was given as a promotion that added to her financial stress. She began the process of returning the device she could not see or use; reducing the significant cost that it burdened her with monthly. Ms. B continues to learn new methods/skills to improve the quality, independence and safety in her and her husband’s lives which began with ILB training.

5 Todd Steen, CVRT, COMS

Ms. M, age ninety four is legally blind with Advanced Age Related Macular Degeneration. She lives alone in a home outside of the city limits of Flagstaff. Ms. M is a long time resident of Flagstaff with her beginnings starting in France. She was a self-referral, gaining our contact information from Flagstaff Eye Care. Her vision loss was affecting the 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 she was having difficulty in 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. Each area of concern was addressed during her training with ILB, making sure safety concerns were covered first and then moving forward. Training included working with writing templates and peripherals to facilitate hand-writing activities. Ms. M practiced with talking/large print time pieces and a large print calendar for time management activities; supplied by the ILB program as well as the instruction. Marking of all controls on her appliances created independence and safety with kitchen, laundry and thermostat setting needs. Ms. M actively participated in all areas of instruction, aids/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, and other materials as needed. Ms. M does not like to ask for assistance and with the services provided through the ILB program with DES/RSA/SBVID; Ms. M is actively striving to become a more active and independent woman within her home and community.

6 Lanelle Crist, VRT

Mr. T, age eighty three, residing in Mesa, Arizona, experienced rapid vision loss related to health issues and a reaction to contrast dye for a scan. At the time of assessment there was a sense of desperation in his wife of over sixty years regarding his emotional well-being. One of the first things noticed was the obvious love and mutual respect Mr. T and his wife shared. Mr. T’s loss of independence and sense of self were most obvious in his expression of wanting to be able to do the things for his wife that he was used to doing. He seemed to have the attitude that it was his duty to be able to support and care for his wife. One of the things he wanted to be able to do was make her a cup of tea. He wanted to do more than that, but was unaware of what was possible and what tools were available to him. During training in activities of daily living, Mr. T was instructed in personal record keeping. He was provided with the Wilson voice recorder to keep track of appointments, contacts and other information. He also practiced writing using handwriting guides, bold line paper and 20/20 pens which he could see to read. He was able to obtain the time easily with a talking watch and talking clock. He learned to manage his medications with the use of a medi-planner and the Pen Friend talking labeler. With the use of a money identifier along with coin identification and adaptive currency identification techniques, plus the use of a compartmentalized wallet, Mr. T could now handle his cash independently. The provision of an electric razor enabled him to shave safely. A 5X handheld magnifier, along with a couple of task lights made various tasks doable. Yellow and orange tints took care of the glare he encountered inside and outside. It was such a joy to see the increased hope and genuine excitement Mr. T and his wife shared with every new skill he developed and the abilities he regained. There were many moments that evidenced successful work with Mr. T. He did indeed learn to fix his wife a cup of tea independently, but he learned so much more. The culmination was the day of a cooking lesson. Mr. T was excited to make brunch for his wife. He successfully chopped onions, diced ham and various cheeses using the contrast cutting board, finger guard Vidalia chop wizard and adaptive, safe cutting and chopping techniques learned during previous lessons. He scrambled eggs and made perfect omelets for the meal with the electric skillet and double spatula provided by ILB. He was able to manage the cooking time with his talking timer and prevented burning his hands by wearing the gloves. His wife cheerfully buzzed around setting the table and making it a true occasion. T’s increase in confidence and renewed hope were powerful to witness and it was an honor to take part in the process.

7 Vasant Garcia, CVRT Mrs. W is a ninety seven year old woman with macular degeneration. Mrs. W has several other disabilities in addition to her vision loss. One thing Mrs. W enjoyed was making rosaries. She thought this task was impossible for her since she could not thread the beads without vision; her solution was to ask her daughter for assistance. She was provided with a 3.5x handheld magnifier and a rechargeable task lamp which enabled her to thread the beads through the string and even read a holy card. She was also given a black and white cutting board for contrast which she uses like a placemat. She also received a device that enabled her to distinguish colors and match items appropriately. She was dependent on others to know the time, so a talking clock was provided. Due to her other health problems she gets tired easily so other daily tasks are difficult for her. ILB services have restored a task which she enjoys and gives meaning to her life. While she may not be as independent as she was when she was younger, her quality of life has improved due to the ILB services and devices provided.

Success Stories submitted by agency providers who contract with the state agency 8 Christie Delmonico, CVRT, Southern Arizona Association for the Visually Impaired (SAAVI) Some clients begin their journey at SAAVI when they have been first diagnosed or when their visual impairment is preventing them from activities they did with ease prior to vision loss. This particular consumer found our agency on the Internet. She stated, “I came to SAAVI to look ahead towards my future. I wanted to be prepared to deal with life without sight”. Ms. P is sixty-five years young, as she proudly boasts with a giant grin on her face. Ms. P was diagnosed with Age Related Macular Degeneration- ARMD, four years prior. Recently, Ms. P experienced a decrease in vision that affected daily living tasks. This prompted her to seek services as she states, “I needed to learn how blind people do it; live independently with limited or no vision”. Ms. P participated in SAAVI’s General Orientation to Adapted Living Skills and Special Training and Advanced Rehabilitation Services (GOALS and STARS) class. She expressed her gratitude for the vast amount of resources provided during the class, “remarkable and very much appreciated!” She commented that the time spent with SAAVI staff allowed her to gain perspective about her visual impairment and learn strategies to begin the process of coping with issues surrounding the loss of her vision. “Of course, I have to mention my instructor Nancy Lacock (Certified Vision Rehabilitation Therapist, CVRT). Nancy presented the information taught in the class with a “real world” approach. She was informational, entertaining, and professional”. Ms. P commented that she appreciated the fact that the course encouraged family members and friends to participate during the class. Ms. P closed out the interview by stating, “I came to SAAVI for one purpose yet I received so much more. I learned simple changes such as using 20/20 pens, bold lined paper, the importance of contrasting colors, and lighting can make a world of difference in your life. I am so glad that I did not wait until my vision grew worse before I came to SAAVI to receive services”.

Success Stories submitted by independent providers who contract with the state agency 9 Venu Vanguetty, AT instructor Ms. K is a ninety year old woman with Macular Degeneration. She wanted to use her computer for emailing, but became increasingly frustrated with it. After receiving a recommendation from a vendor at a vision expo, she decided to purchase a smart-device, but she had no clue how to use it. She contacted the Arizona Independent Living Blind program and began training on the use of the smart-device. At the start of training she stated, "I am ninety years old and technology is not for me, but I want to learn." She learned how to Facetime, email, use zoom capability to magnify the screen, Voiceover along with determining when it is best to use the Voiceover instead of Zoom, and internet web browsing. By the end of the training, she was not only using her smart-device effectively, but she was teaching her grandson how to work with the Smart-device with the help of Voiceover. She was quite thrilled and proud that she could learn to use this new technology. She kept saying how bright she is to learn it. She is not only bright, but she has quite a lot of determination to persevere until she mastered the device. It was a pleasure to watch her enthusiasm and excitement as she progressed through the ILB training.

10 Sandra Weaver, VRT The client is female, born in 1948, residing in a retirement community in Sun City, Arizona with a roommate. The client has Albinism causing her to be extremely sensitive to the sun both physically and visually, and causing other complications with her vision. The client has been visually impaired since birth. This client thrives on being independent and shows it in her every day independent living. Due to the client’s loss of vision, she has no distance vision. She cannot see well enough to walk to the bus stop, the senior center or walk around her neighborhood. The client was issued a 6x16 monocular for seeing in the distance. After the client received training, she was able to see across the street, all the bushes, signs in the food store, bingo board, concerts, and bus stop signs. This visual aid has changed the client’s life, giving her the freedom to go where she wants to any time. This aid and training has allowed her to keep her independence.

11 Georgeanne Hanna, CVRT CLVT Male client age eighty nine is living on his own in a small town in Yavapai County. He previously owned his ranch, was a veterinarian for thirty years and was an outdoorsman and custom rifle maker. He states that he had always been a visual learner, was never much good as a husband or father, and that he was always better with animals. Now, due to severe macular degeneration and Chronic Obstructive Pulmonary Disease (COPD) requiring oxygen round the clock, he has had to move into town and is very isolated. He is not close to any of his family members so cannot or will not ask for help from them. He cannot see well to read or write, and has difficulty cooking. He cannot walk more than ten feet without being exhausted due to his COPD. He cannot do any of the things he used to enjoy. He stated on the first visit that he thinks about committing suicide every day. After the initial visit, because of his suicidal ideations, referrals were immediately made to both the local guidance clinic and another local volunteer group that supplies friendly visits and assistance with daily tasks, as well as rides for shopping. On the next visit he was provided with a magnifier that allowed him to read most print, along with practice reading materials and instruction in holding the print at a very close focal distance. He wanted a stand for his new magnifier so that he could have it positioned on a forty five degree angle in order to change the batteries and clean his very small hearing aids on his own by holding these under the magnifier. A volunteer community member and woodworker made him a stand for this particular use. His microwave was marked so he could cook and reheat his own foods. He was supplied writing aids with instruction in using these so he could continue to write on his own. He did not want talking books or a talking watch due to his severe hearing loss, but he has a large print digital clock he can see if he is up close. This client will need many other services, but ILB training with him has helped him to have something to live for. His outlook is improving.

12 Tamara Bishop Amavillah, COMS This client is a woman with low vision who had loved going for walks. Since her vision loss, she had confined herself to her home; relying on others to drive her to the places she needed to go. She was especially scared of street crossings at lighted intersections, and encountered them frequently during her walks to the local grocery store and other shops she frequented. At the time of her assessment, she was even afraid of standing on the corner. She was not able to consistently see the walk/don’t walk sign. She learned how to cross at signal intersections with a long cane, using the near side parallel traffic surge. By the end of her training she could confidently cross streets, and was walking to friends’ houses and multiple stores in her neighborhood. She was excited to get out on her own without having to depend on others to take her places. She has a new freedom and independence which she had not experienced in a while and did not think was possible.

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 several staff vacancies. In order to provide services, RSA utilized private contractors throughout the state. Rural areas continue to be underserved.

Part IX: Signature

Please sign and print the name, title and telephone number of the IL-OIB Program Director below.

I certify that the data herein reported are statistically accurate to the best of my knowledge.

Signed byLetitia Labrecque
TitleAuthorized Certifying Official
TelephoneOn file
Date signed12/30/2014