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

RSA-7-OB for Pennsylvania Office of Vocational Rehabilitation - H177B140038 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 year1,412,308
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 21,412,308
A2. Total other federal3,944,814
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement3,944,814
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)155,982
A4. Third party0
A5. In-kind0
A6. Total Matching Funds155,982
A7. Total All Funds Expended5,513,104
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs2,443,881
C. Total expenditures and encumbrances for direct program services3,069,223

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 12.3067 25.4761 37.7828
2. FTE Contractors 0.0000 9.5778 9.5778
3. Total FTE 12.3067 35.0539 47.3606

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 27 9.2195
2. Employees with Blindness Age 55 and Older 4 0.7941
3. Employees who are Racial/Ethnic Minorities 16 3.3077
4. Employees who are Women 99 29.4034
5. Employees Age 55 and Older 41 11.0785

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 FY2,419
2. Number of individuals who began receiving services in the reported FY1,329
3. Total individuals served during the reported fiscal year (A1 + A2) 3,748

B. Age

1. 55-59200
2. 60-64324
3. 65-69323
4. 70-74362
5. 75-79483
6. 80-84623
7. 85-89802
8. 90-94490
9. 95-99124
10. 100 & over17
11. Total (must agree with A3)3,748

C. Gender

1. Female2,796
2. Male952
3. Total (must agree with A3)3,748

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race74
2. American Indian or Alaska Native4
3. Asian22
4. Black or African American458
5. Native Hawaiian or Other Pacific Islander5
6. White3,173
7. Two or more races12
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)3,748

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)136
2. Legally Blind (excluding totally blind)1,520
3. Severe Visual Impairment2,092
4. Total (must agree with A3)3,748

F. Major Cause of Visual Impairment

1. Macular Degeneration2,342
2. Diabetic Retinopathy350
3. Glaucoma567
4. Cataracts54
5. Other435
6. Total (must agree with A3)3,748

G. Other Age-Related Impairments

1. Hearing Impairment761
2. Diabetes1,085
3. Cardiovascular Disease and Strokes1,367
4. Cancer455
5. Bone, Muscle, Skin, Joint, and Movement Disorders1,748
6. Alzheimer's Disease/Cognitive Impairment510
7. Depression/Mood Disorder143
8. Other Major Geriatric Concerns4,198

H. Type of Residence

1. Private residence (house or apartment)3,536
2. Senior Living/Retirement Community69
3. Assisted Living Facility110
4. Nursing Home/Long-term Care facility31
5. Homeless2
6. Total (must agree with A3)3,748

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)1,054
2. Physician/medical provider188
3. State VR agency82
4. Government or Social Service Agency561
5. Veterans Administration12
6. Senior Center19
7. Assisted Living Facility22
8. Nursing Home/Long-term Care facility9
9. Faith-based organization4
10. Independent Living center238
11. Family member or friend494
12. Self-referral830
13. Other235
14. Total (must agree with A3)3,748

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 106,379
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 510
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 295

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 621,838
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 1,397
3. Provision of assistive technology services 352

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 486,352
1b. Total Cost from other funds 0
2. Orientation and Mobility training 767
3. Communication skills 221
4. Daily living skills 388
5. Supportive services (reader services, transportation, personal 115
6. Advocacy training and support networks 379
7. Counseling (peer, individual and group) 1,243
8. Information, referral and community integration 1,690
. Other IL services 1,310

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 3,124
1b. Total Cost from other funds 0
2. Information and Referral 56
3. Community Awareness: Events/Activities 451 8,162

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) 5,261,857 5,513,104 251,247
2. Number of Individuals Served 3,805 3,748 -57
3. Number of Minority Individuals Served 537 575 38
4. Number of Community Awareness Activities 236 451 215
5. Number of Collaborating agencies and organizations 353 473 120
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 352 100.00%
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) 151 42.90%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 189 53.69%
B1. Number of individuals who received orientation and mobility (O & M) services 767 100.00%
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) 384 50.07%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 274 35.72%
C1. Number of individuals who received communication skills training 221 100.00%
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) 123 55.66%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 86 38.91%
D1. Number of individuals who received daily living skills training 388 100.00%
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) 201 51.80%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 168 43.30%
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) 334 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) 86 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) 62 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 205 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) 129 n/a

Part VII: Training and Technical Assistance Needs

Pennsylvania would benefit from sharing ideas from other states regarding the following: Collaborations and capacity-building with other agencies; Processes for low vision evaluations; Services that are offered for aged deaf-blind individuals; Themes used for expositions and outreach events; Dollar spending limits for ILOB cases; Group AT, RT and O&M instruction; Recruitment and retention of staff; Overcoming transportation barriers; Access Technology offered to ILOB customers and; Improvements to the case review process. Training to strengthen staff knowledge regarding the following would enhance our ability to provide the best customer service in the ILOB program: Slip and Fall prevention; Diabetes management; Common age-related eye conditions; Hearing loss; and other topics pertinent to the aging population.

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.

Independent Living for Older Individuals who are Blind (ILOB) program funds are used by Pennsylvania’s Bureau of Blindness and Visual Services (BBVS) to provide independent living services for individuals over the age of 55 who are blind and visually impaired, conduct activities that will improve or expand services for these individuals and conduct activities to improve public understanding of the problems of these individuals. BBVS one-on-one direct services are provided in our customers’ homes and within their communities to optimize their ability to gain independence and maintain community inclusion. Outreach and educational activities are conducted through BBVS’s six District Offices to inform the public of available services, to cultivate referrals to and from other agencies and professionals, and to improve public understanding of the issues surrounding vision loss and blindness. The direct services in our program are provided through in-house District Office professional staff. However, contractors are utilized to provide direct services to customers when the District Offices are experiencing a shortage in staff or an unusually high demand for services.

The direct services provided through BBVS’s ILOB program include in-home assessments; Orientation and Mobility (O&M) instruction; Rehabilitative Teaching (RT); training in activities of daily living and access technology; adjustment to blindness counseling; provision of adaptive aids and access technology; advocacy training; individual and family counseling; communication skills; referrals for low vision exams, aids and training; referrals to other agencies; and facilitating community inclusion and the management of secondary disabilities. BBVS’s District Offices promote awareness of the ILOB program through informational presentations and providing educational material and demonstrations of low vision devices and RT teaching tools to hospitals; physicians; nurses; physical therapists; occupational therapists; optometrists and ophthalmologists; audiology providers; nursing homes; health fairs; expos sponsored by local State Legislators; senior expos; senior centers; sight-loss support groups; independent living facilities; schools, colleges and universities; disability advocacy groups; senior apartment buildings; personal care homes; churches and other faith-based organizations; physical and mental health managed care organizations and providers; social service agencies; and other agencies and advocacy groups related to the elderly, disabled or blind. BBVS’s ILOB workers strive to develop and maintain collaborative relationships with low vision doctors in an effort to better serve our mutual customers and encourage referrals. In addition, BBVS provides consultation services to optometrists in an effort to expand the availability of high-quality low vision evaluation services across the Commonwealth of Pennsylvania.

Pennsylvania also promotes awareness of our services through print and social media, the Pennsylvania Department of Labor and Industry’s website and by imprinting the Bureau’s telephone number and email address on brochures and promotional material such as Braille alphabet cards, signature guides, 20/20 high-visibility pens, and portable pocket magnifiers. These materials are given to customers and selectively distributed at outreach and educational events to increase customer referrals and public awareness and understanding. These activities are part of Pennsylvania’s ongoing effort to reach out to underserved and unserved populations.

As noted above, due to staff shortages or high demand for services, district offices are sometimes required to purchase services from contractors to meet customer demand in a timely manner. The services purchased in ILOB were limited to Rehabilitative Teaching and Orientation & Mobility instruction. Services were purchased from the following contractors in FFY 2014: Joy A. Wilson, Gary L Davis, Kinshasa A. Coghill, Michele Marie Jones, John S. Ford, Carrie Diane Hannon, Karen L. Hornberger, Debra Sokol Mckay, Donald L. Sundell, Keystone Blind Association, and Montgomery County Association For The Blind.

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 Bureau of Blindness and Visual Services continues to increase efforts to become a more mobile workforce. Staff is able to use secure “hot spot” connections that allow the use of laptop computers to access email, input and process data, enter case progress notes, process purchase orders, generate correspondence, and access information from the electronic case management system (CWDS) while providing direct service to customers away from the District Office. The iPhone pilot project also continues its roll-out to additional field staff enabling them to send and receive emails, access and utilize CWDS, and make and receive telephone calls. Customer service and efficiency have improved due to the increased availability of our staff on mobile phones to customers, colleagues, service providers and other professionals.

In Federal Fiscal Year 2014, all six of BBVS’s District Offices continued to offer group instruction classes for ILOB customers, called JumpStart. These classes are designed to help seniors who are visually impaired understand that they can remain active and independent by introducing them to the different types of training and assistive technology devices available to them. JumpStart sessions address independent living skill needs such as food preparation, labeling, clothing care, writing skills, recording/listening devices, and cleaning. Classes also instruct customers on how to travel safely indoors/outdoors, using a cane, and how to navigate stairs, elevators, public transportation (if appropriate for the training building and area). Finally, many classes include group discussion sessions to allow participants to talk and learn about issues like adjusting to vision loss, medication management, community resources, elder abuse, and family interactions. The specific skills addressed at each group instruction program are based on the training needs of the ILOB customers attending the class and the professional judgment of the Rehabilitation Teachers, Orientation and Mobility Instructors, and Social Workers. Feedback solicited from participants has been overwhelmingly positive, including specific examples of how their quality of life has improved; how much they learned from BBVS staff and from the other participants; and how much the participants value being connected to other people who have similar challenges.

Pennsylvania’s district offices also continue to collaborate with community groups and integrate new methods and strategies to service our customers. District Offices work closely with the twenty-eight offices run by the Pennsylvania Association for the Blind (PAB) to coordinate referral and support services which include transportation, support groups, life skills education, grocery shopping assistance, and reading services provided by volunteers. PAB offices also provide low-vision screenings designed to detect potential vision problems for children/adults and conduct educational programs which stress the need for early detection, eye safety, and information about specific diseases. BBVS staff delivered an presentation to PAB staff at their annual statewide conference to provide information regarding services and to encourage referrals. Pennsylvania also continues to foster collaborations with local Consumer Advisory Committees (CAC), the Department of Aging, Associated Services for the Blind, Senior Centers, Sight Loss Support groups, Senior Expos, Keystone Blind Association, community service organizations, home health agencies, and nursing homes. BBVS staff attended consumer conferences, and statewide conferences for the National Federation of the Blind and Pennsylvania Council of the Blind. Informational materials are provided at doctor’s offices, churches, and retirement homes. We also encourage customers to attend the Office of Vocational Rehabilitation annual public meetings to share their comments and suggestions on the ILOB Program. CAC meetings are also conducted via telephone conference, which allows customers to participate from home and provide direct input about the Independent Living Program.

As part of a continuing effort to recruit high-quality instructional service staff, Pennsylvania also works collaboratively with Salus University, Kutztown University, and The University of Pittsburgh to strengthen their respective curricula for RT, O&M, and Teachers of the Visually Impaired and to facilitate internships for their students at BBVS’s six District Offices.

In FFY 2014 Pennsylvania Department of Labor & Industry’s Office of Vocational Rehabilitation, Bureau of Blindness and Visual Services and Office for the Deaf & Hard of Hearing have partnered with the PA Statewide Independent Living Council and the Center for Independent Living of Central PA to fund the first statewide program of Support Service Providers (SSPs) for individuals who are deaf-blind. This pilot grant, “Deaf Blind Living Well Services” (DBLWS), is a State Plan for Independent Living initiative funded with federal and state dollars with the goal of increasing outreach and services to persons who have a dual sensory loss of both vision and hearing. A very important key to greater independence and increased quality of life for persons who are deaf-blind includes the use of Support Service Providers. SSPs link individuals to their environment by providing relevant information and acting as a guide and communication facilitator to allow individuals who are deaf-blind to make informed decisions. The Center for Independent Living of Central PA will administer the program, recruit SSPs, and provide training to both SSPs and participants who are deaf-blind. DBLWS is a consumer-driven program that is committed to supporting the rights of the unserved and underserved population of persons who are deaf-blind in accessing their environment and community.

In FFY 2014 the Office of Vocational Rehabilitation conducted statewide staff development training sessions with the goal of improving customer service, ensuring statewide consistency and sharing of best practices. BBVS Social Workers, Rehabilitation Teachers and Orientation & Mobility Instructors from across Pennsylvania participated in the sessions which included ILOB case management; Outreach, Education and Referrals; and Access Technology.

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.

Customer satisfaction surveys are sent to ILOB clients after their case is closed successfully. In FY 2014, 482 customers responded to the survey. Of those surveys, 69% of customers reported that they felt more confident to perform activities they had previously given up on; and 60% of customers reported that they are less dependent on others because of the services provided by the ILOB program. The majority of respondents (48%) reported that they live alone and approximately half of customers (53%) reported that they are better able to prepare meals for themselves. In addition, 61% of customers reported that they are better able to enjoy reading materials (whether with magnifiers, large print, Braille, or on tape) and 62% reported that they are better able to participate in the life of family, friends, or the community. Consistent with surveys conducted in previous years, the main type of eye problem reported was macular degeneration (61.00%); followed by glaucoma (7.88%), diabetic retinopathy (7.88%), cataracts (1.87%), and other causes (12.45%). The results from our satisfaction survey follow:

IL Survey Answer Totals Question Answer Total Percentage 01. I feel more confident 5. No Answer 21 4.36% 4. Strongly Agree 103 21.37% 3. Agree 230 47.72% 2. Disagree 57 11.83% 1. Strongly Disagree 25 5.19% 0. N/A 46 9.54% Total: 482 02. I am less dependent 5. No Answer 19 3.94% 4. Strongly Agree 72 14.94% 3. Agree 218 45.23% 2. Disagree 101 20.95% 1. Strongly Disagree 39 8.09% 0. N/A 33 6.85% Total: 482 03. I am better able to move 5. No Answer 19 3.94% 4. Strongly Agree 78 16.18% 3. Agree 249 51.66% 2. Disagree 56 11.62% 1. Strongly Disagree 16 3.32% 0. N/A 64 13.28% Total: 482 04. I am better able to prepare meals 5. No Answer 27 5.60% 4. Strongly Agree 69 14.32% 3. Agree 187 38.80% 2. Disagree 79 16.39% 1. Strongly Disagree 37 7.68% 0. N/A 83 17.22% Total: 482 05. I can better manage housekeeping 5. No Answer 27 5.60% 4. Strongly Agree 46 9.54% 3. Agree 198 41.08% 2. Disagree 83 17.22% 1. Strongly Disagree 36 7.47% 0. N/A 92 19.09% Total: 482 06. I can better manage paperwork 5. No Answer 24 4.98% 4. Strongly Agree 73 15.15% 3. Agree 151 31.33% 2. Disagree 109 22.61% 1. Strongly Disagree 76 15.77% 0. N/A 49 10.17% Total: 482 07. I am better able to read 5. No Answer 20 4.15% 4. Strongly Agree 118 24.48% 3. Agree 177 36.72% 2. Disagree 84 17.43% 1. Strongly Disagree 56 11.62% 0. N/A 27 5.60% Total: 482 08. I am better able to participate 5. No Answer 24 4.98% 4. Strongly Agree 50 10.37% 3. Agree 247 51.24% 2. Disagree 69 14.32% 1. Strongly Disagree 29 6.02% 0. N/A 63 13.07% Total: 482 09a. I feel more in control 5. No Answer 21 4.36% 4. Strongly Agree 75 15.56% 3. Agree 238 49.38% 2. Disagree 70 14.52% 1. Strongly Disagree 16 3.32% 0. N/A 62 12.86% Total: 482 09b. I am better able to access community 5. No Answer 32 6.64% 4. Strongly Agree 39 8.09% 3. Agree 167 34.65% 2. Disagree 117 24.27% 1. Strongly Disagree 37 7.68% 0. N/A 90 18.67% Total: 482 09c. I am better able to use library services 5. No Answer 37 7.68% 4. Strongly Agree 48 9.96% 3. Agree 97 20.12% 2. Disagree 96 19.92% 1. Strongly Disagree 54 11.20% 0. N/A 150 31.12% Total: 482 09d. I feel I have more control and confidence in my ability to maintain my current living situation 5. No Answer 31 6.43% 4. Strongly Agree 67 13.90% 3. Agree 262 54.36% 2. Disagree 62 12.86% 1. Strongly Disagree 22 4.56% 0. N/A 38 7.88% Total: 482 11a. Have you experienced changes in your lifestyle that was not caused by your vision loss? Yes 205 42.53% No 236 48.96% N/R 41 8.51% Total: 482 11b. Age 99 1 0.21% 98 1 0.21% 97 4 0.83% 96 7 1.45% 95 11 2.28% 94 16 3.32% 93 16 3.32% 92 13 2.70% 91 15 3.11% 90 22 4.56% 89 17 3.53% 88 22 4.56% 87 11 2.28% 86 20 4.15% 85 20 4.15% 84 22 4.56% 83 19 3.94% 82 15 3.11% 81 13 2.70% 80 16 3.32% 79 22 4.56% 78 10 2.07% 77 8 1.66% 76 4 0.83% 75 6 1.24% 74 6 1.24% 73 3 0.62% 72 7 1.45% 71 6 1.24% 70 12 2.49% 69 4 0.83% 68 7 1.45% 67 8 1.66% 66 3 0.62% 65 4 0.83% 64 7 1.45% 63 5 1.04% 62 7 1.45% 61 4 0.83% 60 8 1.66% 59 6 1.24% 58 1 0.21% 57 2 0.41% 56 1 0.21% 55 1 0.21% 46 1 0.21% 100 1 0.21% 0 47 9.75% Total: 482 12. I am Male/Female U 37 7.68% M 120 24.90% F 325 67.43% Total: 482 13. Live Alone/Spouse/etc. With Spouse 135 28.01% With Relatives 56 11.62% With Non-relatives 25 5.19% No Answer 37 7.68% Live Alone 229 47.51% Total: 482 14a. Type of Eye Problem Other 60 12.45% No Answer 43 8.92% Macular Degeneration 294 61.00% Glaucoma 38 7.88% Diabetic Retinopathy 38 7.88% Cataracts 9 1.87% 14b. Vision Loss Time No Answer 35 7.26% Less than 1 year 158 32.78% Don’t know 23 4.77% 7-9 years 107 22.20% 4-6 years 108 22.41% 1-3 years 41 8.51% 10 years or more 10 2.07% Total: 482 15a. Cardiac / Circulatory Yes 131 27.18% No 351 72.82% Total: 482 15b. Stroke Yes 53 11.00% No 429 89.00% Total: 482 15c. Hearing Yes 170 35.27% No 312 64.73% Total: 482 15d. Muscular / Skeletal Yes 89 18.46% No 393 81.54% Total: 482 15e. Cancer Yes 42 8.71% No 440 91.29% Total: 482 15f. Pulmonary Yes 48 9.96% No 434 90.04% Total: 482 15g. Renal Disease Yes 25 5.19% No 457 94.81% Total: 482 15h. Diabetes Yes 127 26.35% No 355 73.65% Total: 482 15i. Other Yes 86 17.84% No 396 82.16% Total: 482 15j. None Yes 53 11.00% No 429 89.00% Total: 482 16. Considered Nursing Home Seriously considered 20 4.15% No answer 102 21.16% Never needed 285 59.13% Briefly considered 47 9.75% Already live in one 28 5.81% Total: 482

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).

Services provided through BBVS’s ILOB program have helped individuals over 55 who are blind or visually impaired across the commonwealth of Pennsylvania to gain independence in their daily living, increase involvement in their local communities, and improve their overall quality of life. Below is an individual case example from each of the six BBVS District Offices:

1) Ms. J is 79 years old and lives in the Altoona District. During the past year she lost a significant amount of her vision that prevented her from reading printed materials and performing daily living tasks. Ms. J received a low vision evaluation as well as low vision aids from BBVS’s ILOB program. She also participated in the Jump Start Program which included the following RT modules: Telephones (exposed to a variety of telephones, dialing techniques, using directory assistance and methods of taking messages); Managing personal finances (coin and bill identification, wallet organization, bill paying, managing checking and/or savings account, managing debit and credit cards and calculating finances); Clothing care and laundry (closet organization, drawer organization, matching and color identification, handing, folding, stain detection and removal, washing methods and drying methods); Time management (watches and clocks); Food prep and cooking techniques (eating and dining at a restaurant, adaptive techniques); and Sewing (threading a self-threading needle). In addition, she participated in Orientation and Mobility instruction during the Jump Start program and received follow-up lessons at her home. She received sunshields, learned sighted guide and protective techniques and is now using a red/white support cane. Since receiving services through BBVS’s ILOB program, Ms. J feels more confident and independent in her home and is able to be involved in her local community. 2) Ms. S received low vision aids, Rehabilitation Teaching and participated in Orientation & Mobility group class instruction through the Erie District Office’s ILOB program. With the CCTV BBVS provided to her, she is able to read her mail, financial paperwork and other household correspondence. She participated in the Jump Start Orientation & Mobility group class and is capable of identifying and navigating around potential obstacles while traveling in dimly lit areas using a flashlight and flashlight holder. Using the ice cleats that BBVS provided, Ms. S is able to safely and independently travel in inclement weather conditions. BBVS paid for Ms. S’s transportation to and from the Orientation/Mobility group classes. The classes allow all participants to learn, interact and socialize with other individuals who are blind or visually impaired.

Ms. S also received Rehabilitation Teaching equipment and instruction. NOIR sunshields reduced the glare from the sun she was experiencing. An Ott table lamp helped to increase task lighting for detailed chores and self-care at home. Ms. S received lessons for adaptive labeling techniques and regularly uses bump dots to identify settings on her washer and stove. With detailed instruction for using the Pen Friend digital labeler, she is able to record recipes and record and listen to labels. Ms. S uses large print measuring cups and spoons to measure wet and dry ingredients for baking. She also uses a high contrast cutting board and a large print timer, as part of the adaptive cooking skills she learned. Ms. S practices adaptive pouring techniques on a daily basis using her liquid level indicator to assist with pouring water and hot liquids. BBVS provided her with a large print calendar that she uses daily to keep track of her appointments. She also completes occasional mending tasks with her self-threading needles. Ms. S reports she is now much more independent, socially connected and happier as a result of BBVS services.

3) Ms. J is a 67 year-old with Glaucoma who lives within the Harrisburg District. She loves to write poems and children’s books. She became depressed when she was unable to continue writing due to her loss of vision. She was involved with a local Pennsylvania Association of the Blind member organization and they referred her to BBVS. From BBVS she received low vision services, access technology services and rehabilitation services; she also participated in the Jump Start Program. The services she received from BBVS ILOB program has allowed her to take up writing again and she has since produced several poems and books. She wrote a poem for the Jump Start Program and asked to present it to the group. As she read the poem she cried and thanked all of the Social Workers and customers involved in the program because it had given her hope when she thought all was lost. BBVS was able to show Ms. J that she could continue to thrive, be involved in the community and enjoy an independent life as she did before she started losing her vision. She continues to write and has sent some of her writing to the BBVS office during the past year.

4) Mr. C requested services from the Philadelphia District Office in 2012 due to vision problems due to Retinitis Pigmentosa. He was highly independent until he began losing his vision a few years ago. At the time of the referral he was legally blind; however, his vision loss became progressively worse. He limited his travel due to extreme anxiety about his safety. He used to take public transportation everywhere but stopped due to his vision loss. He resorted to walking most places and restricted travel to his immediate neighborhood. He stated he was falling and tripping often when out in the community due to very poor peripheral vision.

He received low vision devices including glasses for distance and sunglasses for glare protection. His primary service through BBVS’s ILOB program was Orientation and Mobility. With the instruction and guidance of his O&M Instructor, he learned how to use a long cane and started using public transportation again. He learned to use the subway, elevated train and bus systems independently. He and his instructor agreed that given the progression of his vision loss, he would be an excellent candidate for a guide dog. He went to guide dog training school and was matched with his own guide dog. When he returned from this training school, his BBVS O&M instructor provided instruction on using the guide dog throughout the city of Philadelphia, not just in his neighborhood. He became so proficient that he mentored another customer who was recommended for guide dog training school but was initially reluctant.

Mr. C’s BBVS Social Worker observed him during O&M sessions with his guide dog and was very impressed with his newly-learned travel skills. He is very appreciative of BBVS and its services and feels that BBVS helped him with regaining his confidence and independence. He stated that prior to his BBVS services he was depressed but now he feels he has a new lease on life and can participate in activities in his local community.

5) Ms. K is a 63 year old and lives within the Pittsburgh District. She has a diagnosis of Bilateral Congenital Albinism. She received Vocational Rehabilitation Services earlier in her life to increase her ability to succeed at employment; she had a long career as a social worker. She recently retired and realized she needed adaptations in order to be self-reliant and independent as a retiree. She wanted to be able to use the computer for bill-paying and other financial matters and to research medical and health information online. She wanted to feel safer when traveling alone and using the bus. She noticed that sun glare was an increasing problem when outdoors.

Through BBVS’s ILOB program she received a Low Vision Aid Evaluation and Low Vision Equipment from a Low Vision provider. The equipment helped to increase her access to written materials and the computer as well as improve the comfort and security of her travel. She received Access Technology Instruction, learning to use the computer for her personal tasks and research. She also received adapted equipment from the agency Rehabilitation Teacher and Orientation & Mobility instruction from the agency O&M Instructor. In addition, her Social Worker provided her with Information & Referral, Advocacy Training, and Counseling & Guidance services. She has adjusted to her new daily routine and has developed new social activities and ties within her community. All of the services provided through the ILOB program have made a great difference in her life and her ability to be more independent in her retirement.

6) Mr. J is a customer in the Independent Living Older Blind program in the Wilkes-Barre District Office. He was diagnosed with macular degeneration which led to significant loss of vision. Visual acuities were 20/80 in his right eye and 20/200 in his left eye with best correction. When Mr. J first came to BBVS he believed that his quality of life had deteriorated, having lost the ability to do things he once enjoyed. He always enjoyed fishing and golfing but had not been able to enjoy either of these activities due to his visual impairment. He found tying the fishing line impossible due to his vision loss and also was unable to see the golf ball at a distance therefore losing his ability to do his two favorite leisure activities. Mr. J also enjoyed watching the news and sports channels on the television, but due to his vision loss he was no longer able to see the TV. He reached out to the BBVS hoping that he might be able to improve his visual functioning through services.

Mr. J wanted to watch television with some ease and less eye strain. He hoped to tie fishing line so he could fish again. He hoped to be able to see labels when shopping and read his mail and newspaper. Mr. J also hoped to increase his independence with daily living activities such as identifying money, self-administering his medication and writing. After determining eligibility for services an IL case plan was developed collaboratively with him outlining the services necessary to meet his outcome goals.

As a result of his low vision evaluation and RT assessment BBVS purchased the recommended low vision aids and assistive devices to enhance his remaining vision. A hands-free magnification device allows him to see and tie fishing line and read his mail and newspaper again. He can read item labels with the magnifiers enabling him to shop independently. The Max TV Glasses give him the ability to see and enjoy his television. He uses the assistive devices to identify money, administer his medication, handwrite notes and accomplish other daily living tasks independent from his wife. His IL plan goals were achieved and his case was closed successfully. He stated that the BBVS services he received have drastically improved the quality of his life and that he feels more independent, confident, included in the community and in control of his daily tasks and for this his is very thankful.

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

Pennsylvania ranks fifth in the nation in terms of residents aged 55 and above. By 2020, it is projected that one in five Pennsylvanians will be 55 and older; and one in three will be 65 and older. This presents challenges for the Social Workers, Rehabilitation Teachers, and Orientation and Mobility Instructors to provide timely services to the ever increasing referral base for the eligible ILOB population.

Forty-eight of Pennsylvania’s sixty-seven counties are rural; the rural elderly is the fastest growing segment of our population. Lack of public transportation in rural areas continues to be a major obstacle for the elderly in our state. Visually impaired and blind elderly residents of Pennsylvania find it difficult to access community and medical services due to transportation issues. Our District Offices attempt to work with local agencies to obtain transportation for these individuals, but funding limitations often limit the number of individuals these agencies can serve and the territories they can reach.

We have insufficient funds to contract services such as residential Personal Adjustment to Blindness Training or other complimentary services where special needs exist due to an absence of natural supports and multiple disabilities. Delays in federal Title VII-Chapter 2 funding allotments also result in a delay in services provided to our ILOB customers.

We continue to experience difficulty in recruiting and maintaining qualified staff based on shortage of qualified Social Workers, Rehabilitation Teachers and Orientation and Mobility instructors. There is considerable competition for these individuals among employers who can offer higher salaries.

There is an increasing need for our ILOB customers regarding Assistive Technology, both high and low tech. The evaluation and training for these services is extremely expensive and although our customers can greatly benefit from AT evaluations and training the funding is not available to offer it as a standard service.

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 byRyan Hyde
TitleAuthorized Certifying Official
TelephoneOn file
Date signed12/30/2014