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

RSA-7-OB for North Dakota Division of Vocational Rehabilitation - H177B140034 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 year225,000
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2225,000
A2. Total other federal0
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)125,194
A4. Third party0
A5. In-kind0
A6. Total Matching Funds125,194
A7. Total All Funds Expended350,194
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs0
C. Total expenditures and encumbrances for direct program services350,194

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 0.5000 3.5000 4.0000
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 0.5000 3.5000 4.0000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 0 0.0000
2. Employees with Blindness Age 55 and Older 0 0.0000
3. Employees who are Racial/Ethnic Minorities 1 0.5000
4. Employees who are Women 5 2.5000
5. Employees Age 55 and Older 2 1.0000

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 FY518
2. Number of individuals who began receiving services in the reported FY270
3. Total individuals served during the reported fiscal year (A1 + A2) 788

B. Age

1. 55-598
2. 60-6424
3. 65-6927
4. 70-7441
5. 75-7981
6. 80-84161
7. 85-89195
8. 90-94181
9. 95-9961
10. 100 & over9
11. Total (must agree with A3)788

C. Gender

1. Female572
2. Male216
3. Total (must agree with A3)788

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race2
2. American Indian or Alaska Native35
3. Asian2
4. Black or African American0
5. Native Hawaiian or Other Pacific Islander0
6. White749
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)788

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)5
2. Legally Blind (excluding totally blind)167
3. Severe Visual Impairment616
4. Total (must agree with A3)788

F. Major Cause of Visual Impairment

1. Macular Degeneration542
2. Diabetic Retinopathy42
3. Glaucoma61
4. Cataracts53
5. Other90
6. Total (must agree with A3)788

G. Other Age-Related Impairments

1. Hearing Impairment246
2. Diabetes136
3. Cardiovascular Disease and Strokes232
4. Cancer66
5. Bone, Muscle, Skin, Joint, and Movement Disorders289
6. Alzheimer's Disease/Cognitive Impairment35
7. Depression/Mood Disorder36
8. Other Major Geriatric Concerns167

H. Type of Residence

1. Private residence (house or apartment)670
2. Senior Living/Retirement Community37
3. Assisted Living Facility80
4. Nursing Home/Long-term Care facility1
5. Homeless0
6. Total (must agree with A3)788

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)99
2. Physician/medical provider21
3. State VR agency94
4. Government or Social Service Agency80
5. Veterans Administration3
6. Senior Center115
7. Assisted Living Facility2
8. Nursing Home/Long-term Care facility0
9. Faith-based organization9
10. Independent Living center2
11. Family member or friend292
12. Self-referral43
13. Other28
14. Total (must agree with A3)788

Part IV: Types of Services Provided and Resources Allocated

Provide data related to the number of older individuals who are blind receiving each type of service and resources committed to each type of service.

A. Clinical/functional vision assessments and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 0
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 0

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 29,740
2. Provision of assistive technology devices and aids 491
3. Provision of assistive technology services 610

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 226,785
1b. Total Cost from other funds 0
2. Orientation and Mobility training 58
3. Communication skills 403
4. Daily living skills 257
5. Supportive services (reader services, transportation, personal 0
6. Advocacy training and support networks 39
7. Counseling (peer, individual and group) 339
8. Information, referral and community integration 265
. Other IL services 13

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 1,208
1b. Total Cost from other funds 0
2. Information and Referral 0
3. Community Awareness: Events/Activities 71 1,596

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) 352,728 350,194 -2,534
2. Number of Individuals Served 976 788 -188
3. Number of Minority Individuals Served 48 39 -9
4. Number of Community Awareness Activities 66 71 5
5. Number of Collaborating agencies and organizations 44 35 -9
6. Number of Sub-grantees 0 0

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 610 100.00%
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) 1,137 186.39%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 1,188 194.75%
B1. Number of individuals who received orientation and mobility (O & M) services 58 100.00%
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) 186 320.69%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 265 456.90%
C1. Number of individuals who received communication skills training 403 100.00%
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) 993 246.40%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 962 238.71%
D1. Number of individuals who received daily living skills training 257 100.00%
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) 693 269.65%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 731 284.44%
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) 1,209 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) 0 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 11 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 945 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) 0 n/a

Part VII: Training and Technical Assistance Needs

Requests for Technical Assistance/Training have been expressed in the following areas:

Training on how to teach a person with vision loss how to use eccentric viewing to maximize their remaining vision.

Requests for assistance in using the Accessibility features of tablets and smartphones to help people with vision impairments be able to access their devices is becoming more and more frequent. There is a need for training on how to utilize the Accessibility features on tablets/smartphones and identify the apps for each brand that are most beneficial to the visually impaired.

Training on secondary disabilities that impact the Vision Rehabilitation process, such as strokes, TBI, etc.

Training on the new treatment options available that impact the visual system in regards to diet, medical advances, medications, etc.

Technical assistance to acquire more ACVREP accredited courses in order to maintain certification.

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.

In North Dakota, the OIB Program is administered statewide through the Division of Vocational Rehabilitation. The DVR offices are located in 8 regions across the state. The Vision Rehabilitation Specialists are located within the same DVR offices as the 110 DVR staff, providing vision services to both 110 and OIB clients. Our VRSs travel their region, going into people’s homes to provide the services the program offers. There are 7 VRSs, one being responsible for covering Regions I and II. All services are provided by the VRSs; there are no third party contracts with other agencies. In the three regions where Native American Reservations are located, efforts continue to be made to reach out to as many of the individuals with visual impairments as possible. Those who show interest in the services of the OIB Program are served on all reservations. In the region where the Spirit Lake Nation Reservation is located, the VRS regularly attends the monthly gatherings called “Elderly Day Out”. This allows her to remain visible in the community and gives Native Americans the opportunity to request OIB Services when needed. A booth was set up at a day-long health fair on this reservation. In another region where there is a University Campus on the reservation, a booth with information on the OIB Program was set up during a health fair. In the region of the state where there is a variety of ethnicity, a network has been established with referral sources that provide assistance to the homeless, new Americans, minorities and the mentally ill. The VRS in that region attends these meetings on a regular basis, networking with other agencies in the community. Outreach efforts in low population counties have also been increased this past FFY. In another region, information packets are sent out to all the eye care facilities in the region and surrounding major cities. The VRS in this region began and is the coordinator of the Stepping On Program — a fall prevention program. This has generated many referrals in this region.

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.

The Lions Foundation of North Dakota Video Magnifier Program has been in operation for four year now. In the time since its inception on July 31st, 2010, 147 applicants have been approved to receive a CCTV and there have been 86 CCTVs placed in people’s homes. The Lions Clubs across the state have donated $79,051 toward the purchase of CCTVs for individuals with visual impairments who qualify for the program. Personal donations and program income totals $88,509. There are no individuals on a waiting list at this time. A Scholarship Fund has been started which will pay for 1 year of lease payments for an individual who is not able to afford the lease payments. This fund currently has $490 for a balance. This program has been very well received by the Lions clubs across the state as well as the individuals who benefit from it. Discussions are now being held as to which AT device can be added to the program after the program has purchased the number of CCTVs it needs to fulfill the need in the state. The Division of Vocational Rehabilitation and North Dakota Vision Services/School for the Blind had a joint Strategic Planning Meeting on August 21, 2014. The main priorities identified that the two entities will work on that will improve vision services for individuals with vision loss in North Dakota are to work together to provide comprehensive services to transition students with visual impairment/blindness, train DVR staff on issues related to vision loss and the two entities will assist individuals who have visual impairments with locating resources for needed technology and training. The Vision Specialists and the Vocational Rehabilitation counselors’ CJEs continue to include the presence of the Vision Specialist in all stages of the VR process for all clients with vision impairments. All new staff continue to be trained on the process they need to use when a visually impaired client is referred for Vocational Rehabilitation Services. A listserv has been established and is used by all vision staff across the state to share information, ask questions related to client services and share new product updates. The most recent employee hired attended Adult Week training at the School for the Blind in September of 2014 to give her hands on experience working with adults with vision loss. All training is done under the blindfold. She has been accepted into the Mississippi State University Vocational Rehabilitation Certificate Program for the visually impaired. She will begin this training in January of 2015. The OIB Program Administrator is also the State Liaison to the Statewide Independent Living Council. At the time the current SPIL was developed, there were no new methods or approaches to incorporate into the plan.

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.

During the past year, an OIB Client Satisfaction Survey was administered to all OIB clients who completed all their goals during the year. The results for FFY 2014 are as follows:

Cumulative Return Rate: 82.4% Customer Service Satisfaction questions: Q1: I am satisfied with the services provided by the OB Program — 99.2% Q2: The services I received were provided in a timely manner — 99.2% Q3: My Vision Rehabilitation Specialist was easy to work with - 100% Q4: I was given the opportunity to identify my independent living goals — 98.4% Q5: I received the services I needed to meet my goals — 99.6% Q13: If I need additional services, I know how to contact or reach my Vision Rehabilitation Specialist — 98.0% Outcomes questions: Q6: I can move confidently around my house, apartment, and yard — 97.4% Q7: I can move confidently in the community — 83.6% Q8: I can manage my daily activities — 96.2% Q9: I can manage paperwork, such as reading mail and paying bills — 65.5% Q10: I can read print materials, such as books or newspapers with magnifiers, large print, Braille, or on audio tape — 80.3% Q11: Following Vision Services, my quality of life has: Improved — 68.3% Stayed the same — 26.7% Declined — 4.9% Q12: If my quality of life has declined following Vision Services, it is because of the following reasons: Decline in Health — 14.5% Change in Family Circumstances — 1.0% Other — 10.0% Does not apply — 74.5%

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).

A 90-year-old gentleman with AMD has a hobby of making miniature, extravagant and ornately jeweled harnesses and bridles for miniature hobby horses. He had almost stopped making these because he could not see well enough to do his work and had given up hope that he would ever enjoy that as a hobby again. He couldn’t even see many of those that he had completed over the years. He was becoming depressed. He was wonderful to work with and tried so many devices for me! Nothing seemed to work until we found the right kind of mountable table top lighted, high power magnifier like you would see mounted in a doctor’s exam room. His first reply to this lamp after trying it out for a few minutes after getting the right angle, the right distance, etc. was this…. “Well, I think I could probably see a pimple on an ant now!” He and his wife both got tears in their eyes. They both hugged me and I felt great relief that we had finally gotten it right. He continues his hobby and spends many hours a day in his workshop again. Region 8 — Kristina Brown, VRS

The OIB Program began serving this person and her husband in 2009. We assisted them in staying in their home as long as they possibly could. Eventually, however, they moved to an assisted living apartment. We followed them and helped them get settled. In their new environment, they had the choice of cooking their own meals or eating in the cafeteria. Unfortunately, her husband passed away two years ago. She is an “active” 102 year old. She remains independent in the apartment. We have assisted her by marking her appliances so she can still prepare her own meals, providing magnifiers to assist her in the portability of a reading device, signing her up for the Talking Book Program to help fill her leisure hours as necessary, setting up appropriate lighting so she can safely move around her apartment and complete the tasks she chooses to do independently, and teaching her how to use the CCTV they purchased some time ago. She remains active in a vision support group, which does not meet regularly, but periodically, in the building where she is living. She is an inspiration to those “younger” (70 — 95) than she is. Region 7 — Mike Beck, VRS

I assist legally blind clients with property tax exemptions on their homes. The financial benefit to an elderly person on a fixed income is significant, often exceeding $2,000. Everything costs more than it used to, so having this money for living expenses and needed medication is appreciated. If a person is not able to access the phone book, I have assisted with applications for free directory assistance. Again, saving the expense of paying for this service helps meet the costs of other living expenses incurred by the client each month. Region 5 — Rebecca Anderson Falde, VRS

A person I recently did an assessment on needs to read nutrition and medication labels to manage his diabetes. He had seen a 4x pocket magnifier on display at a diabetes health fair. This office had one to show during the initial assessment. He liked it and on this day it was sufficient power to read a nutrition label. However, this client’s vision fluctuates significantly from diabetic retinopathy. While a 4x was adequate today, there will be another day that it will not be. A hand held Ruby was demonstrated. The client had the opportunity to try the 4x pocket magnifier alongside the Ruby hand held video magnifier. The Ruby was more effective for him. He was appreciative of the ability to amend color and contrast and the ability to take photos of medication and nutrition labels. He was also appreciative of the ability to increase power on demand. In addition to diabetes, this client experiences rheumatoid arthritis and chronic tremors in his hands. The Ruby’s auto-focus maintained a clear magnified image, despite the tremors, which was not the case with the pocket magnifier, which requires manual focus. The Ruby also has an option to be used as a self-standing device which allowed further options for this client’s dexterity limitations from arthritis. The push buttons on the Ruby were easier for him to manipulate than the sliding switch on the pocket magnifier. Furthermore, with a Ruby he will not have the added challenge of changing batteries. Overall, the Ruby was a better device for his fluctuating visual needs and ongoing dexterity limitations. It is a necessary device in order to manage his health independently. Region 3 — Cathy Bryce, VRS

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

Finding qualified vision staff in North Dakota is a rarity. There is currently an open position that covers two of the regions greatly affected by the oil boom. A qualified, out of state individual was interviewed and offered this position, however, due to the high cost of living, he turned down an inflated salary offer due to his fear of the inability to make ends meet due to the high cost of living in the area. Continuing to impact North Dakota is the lack of housing and tremendous rise in the cost of living in the western and central regions of the state due to the amount of people moving in as a result of the oil drilling. This has also affected the number of clients served in at least five regions of the state. Because the elderly can no longer afford the cost of housing, they are moving out of their region to a more cost effective part of the state, moving out of state, and even moving into nursing homes because they feel they have no other living arrangement alternative. The effects of the oil boom is beginning to affect not only the western and central areas of the state, but is moving further and further east as time goes on. There is a trend toward more severe secondary disabilities arising along with the vision impairment, causing it to become more difficult to provide the needed vision rehabilitation services. Secondary disabilities such as Alzheimer’s disease, advanced cancer and severe strokes are some examples of the added challenges faced when attempting to teach adaptive techniques to people with visual impairments. Due to the ruralness of our state, it is difficult to obtain the professional training to improve the level of expertise our vision staff desires to improve their skills in working with the clients they serve. The technology available to do outreach is also very minimal, requiring them to do all the narrative and data entry in their office rather than out on the road when an appointment with a client ends early or is cancelled. With all the mandatory meetings, travel time, and documentation requirements, some days there is not enough time in a day to meet the needs of the clients we are required to serve. This will only get worse with the rise in the elderly population as the baby boomer generation continues to age. In Part IV, D2, since I&R is optional, "0" was recorded in that box.

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 byRussell Cusack
TitleDivision Director
Telephone701-328-8950
Date signed12/16/2014