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

RSA-7-OB for Iowa Department for the Blind - H177B150015 report through September 30, 2015

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 year315,736
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 2315,736
A2. Total other federal2,490
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other2,490
A3. State (excluding in-kind)548,906
A4. Third party0
A5. In-kind0
A6. Total Matching Funds548,906
A7. Total All Funds Expended867,132
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs187,405
C. Total expenditures and encumbrances for direct program services679,727

Part II: Staffing

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

A. Full-time Equivalent (FTE)

Program Staff a) Administrative and Support b) Direct Service c) Total
1. FTE State Agency 1.5900 6.6100 8.2000
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 1.5900 6.6100 8.2000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 8 2.3900
2. Employees with Blindness Age 55 and Older 0 0.0000
3. Employees who are Racial/Ethnic Minorities 0 0.0000
4. Employees who are Women 16 7.8800
5. Employees Age 55 and Older 3 1.5100

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 FY217
2. Number of individuals who began receiving services in the reported FY401
3. Total individuals served during the reported fiscal year (A1 + A2) 618

B. Age

1. 55-5960
2. 60-6439
3. 65-6947
4. 70-7456
5. 75-7967
6. 80-8490
7. 85-89140
8. 90-9491
9. 95-9918
10. 100 & over10
11. Total (must agree with A3)618

C. Gender

1. Female462
2. Male156
3. Total (must agree with A3)618

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaska Native3
3. Asian3
4. Black or African American14
5. Native Hawaiian or Other Pacific Islander0
6. White592
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)5
9. Total (must agree with A3)618

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)346
2. Legally Blind (excluding totally blind)34
3. Severe Visual Impairment238
4. Total (must agree with A3)618

F. Major Cause of Visual Impairment

1. Macular Degeneration374
2. Diabetic Retinopathy33
3. Glaucoma39
4. Cataracts10
5. Other162
6. Total (must agree with A3)618

G. Other Age-Related Impairments

1. Hearing Impairment270
2. Diabetes45
3. Cardiovascular Disease and Strokes278
4. Cancer36
5. Bone, Muscle, Skin, Joint, and Movement Disorders78
6. Alzheimer's Disease/Cognitive Impairment36
7. Depression/Mood Disorder0
8. Other Major Geriatric Concerns57

H. Type of Residence

1. Private residence (house or apartment)445
2. Senior Living/Retirement Community101
3. Assisted Living Facility51
4. Nursing Home/Long-term Care facility21
5. Homeless0
6. Total (must agree with A3)618

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)31
2. Physician/medical provider38
3. State VR agency44
4. Government or Social Service Agency41
5. Veterans Administration6
6. Senior Center13
7. Assisted Living Facility7
8. Nursing Home/Long-term Care facility13
9. Faith-based organization3
10. Independent Living center3
11. Family member or friend135
12. Self-referral256
13. Other28
14. Total (must agree with A3)618

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 22,760
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 103
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 2

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 151,889
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 481
3. Provision of assistive technology services 358

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 9,325
1b. Total Cost from other funds 0
2. Orientation and Mobility training 138
3. Communication skills 321
4. Daily living skills 313
5. Supportive services (reader services, transportation, personal 47
6. Advocacy training and support networks 125
7. Counseling (peer, individual and group) 480
8. Information, referral and community integration 56
. Other IL services 775

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 31,717
1b. Total Cost from other funds 0
2. Information and Referral 66
3. Community Awareness: Events/Activities 95 1,000

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) 677,500 867,132 189,632
2. Number of Individuals Served 936 618 -318
3. Number of Minority Individuals Served 30 20 -10
4. Number of Community Awareness Activities 127 95 -32
5. Number of Collaborating agencies and organizations 6 19 13
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 358 100.00%
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) 105 29.33%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 179 50.00%
B1. Number of individuals who received orientation and mobility (O & M) services 138 100.00%
B2. Of those receiving orientation and mobility (O & M) services, the number of individuals who experienced functional gains or maintained their ability to travel safely and independently in their residence and/or community environment as a result of services. (closed/inactive cases only) 55 39.86%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 66 47.83%
C1. Number of individuals who received communication skills training 321 100.00%
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) 146 45.48%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 150 46.73%
D1. Number of individuals who received daily living skills training 313 100.00%
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) 156 49.84%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 137 43.77%
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) 132 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) 10 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) 27 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 59 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) 9 n/a

Part VII: Training and Technical Assistance Needs

The program invites technical assistance and training in the following areas: i. Case management and case management report system. ii. Discuss and evaluate any potential updates needed to the IL program client survey and/or feedback evaluation form. iii. Management strategies to ensure client service delivery is maximized given current employment contract and fewer dollars to administer the program. iv. Assistance to talk about various staff training needs. Who can assist, what are the costs, when can training take place, etc.

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.

A. Title VII-Chapter 2 program is operated in-house at the Iowa Department for the Blind (IDB). The program currently has seven full-time Independent Living (IL) rehabilitation teacher positions across the state, one statewide project specialist and one program manager. IL rehabilitation teachers schedule community in-services and outreach activities within their designated service territories to assist with outreach to under and unserved populations. In addition, the statewide project specialist assists the program to carry out various special projects such our vision loss resource fairs, community-based trainings, and senior orientation; again all of which helps to reach under and unserved populations. Finally, the program administrator is also called to conduct annual outreach activities. Activities have included conducting speaking engagements across the state with support groups for the blind and visually impaired and community agencies.

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.

B. To expand and improve services, the IDB-IL program administrator worked in partnership with our sister agency; Iowa Vocational Rehabilitation Service IL administrator to talk about emerging challenges and opportunities. We also referred individuals to each other’s respective programs when those individual who applied would not otherwise be eligible for IDB-IL program services. The IDB-IL program administrator attended Iowa State Independent Living Council (SILC) meetings and has volunteered to assist with committee work if and when that might be needed. Voting members of SILC and the IDB IL program administrator seem to have a comfortable working relationship. There is a great amount of information that is exchanged to help one another to build better and stronger relationships and programs for those we serve in Iowa. In addition, the IDB-IL program administrator and IDB agency director have attended state plan for independent living (SPIL) quarterly review meetings to ensure the plan remains on track for meeting goals and objectives. As scheduled by the SILC executive director, the IDB IL program administrator is ready, willing, and able to attend as well as to report out on State IL program activities during center for independent living board of directors meetings. The IDB-IL program administrator and IL program staff continue to build relationships and partnerships with several agencies, professionals, and consumer groups across the state, including aging and disability resource centers (ADRCs), the Veteran’s Administration, consumer groups, the Independent Living Advisory Committee (ILAC), statewide IL area support groups, area targeted case management units, and social workers to ensure under and unserved IL blind consumers might access appropriate services, funding, and other comparable services to maintain or increase their opportunity to live more independently. During this reporting period, the IDB-IL program planned and executed five vision loss resource fairs (VLRFs) around the state. These events were also planned last fiscal year and were very successful so we again planned to hold them during this report period. We rotated service area locations to ensure we capture people from around the state who would not otherwise have an opportunity to participate and learn about our services and other vendor services. Our program marketed all VLRFs well in advance to ensure the highest possible attendance and positive results. Display tables were set up for our agency and IL personnel staffed our IL program table. We ensured every attendee would receive the information and attention needed to learn about our IL program and other agency services that would enhance their independence. Our program table was filled with various aids, devices, and equipment for attendees to look at, experience, and ask questions. We also had materials to share with attendees to take home. There were several program applications that had been taken as a result of these events. Several community service partners were invited to participate with our VLRFs at no charge including centers for independent living. Partner display tables were set up and manned the entire time. Partners reported that they found our VLRF to be well worth their time and effort to attend and requested future invitations to participate. Our IL program partnered with agencies who provided transportation services, rural housing, chamber of commerce, aging and community action programs, case management programs, Veteran’s Administration, the Iowa Department for the Blind Library, Aids & Devices, Vocational Rehabilitation Services, Newsline, Iowa Radio Reading Information Service (IRIS), and technology vendors just to name a few. Constituents provided feedback during and after the VLRFs asking if we planned to continue hosting these fairs. Our observation is that VLFR events continue to gain momentum and have been garnering positive results. Individuals are getting much needed IL, VR, and vendor information. As a result of these VLRFs, individuals were leaving their name and address so our agency could follow-up with an application for service and IL teacher visit. At this point, we continue to use this strategy to reach people in various service territories and communities that might not otherwise even know about our agency or the Title VII-Chapter 2 program services. This report period the locations and dates for all VLRFs included: Spencer Vision Loss Resource Fair October 1, 2014 Ottumwa Vision Loss Resource Fair March 25, 2015 Iowa City Vision Loss Resource Fair March 26, 2015 Des Moines Vision Loss Resource Fair June 23, 2015 Council Bluffs Vision Loss Resource Fair June 24, 2015 In addition, it is noteworthy to mention that as a result of hiring for the statewide position of independent living rehabilitation technology specialist, this specialist has conducted more technology assessments than the program ever offered in the past. IL older blind clients were asking for access to certain technologies and demanding training for iPhones, computers, and iPads. Some IL rehabilitation teachers were not adequately skilled to assess, recommend, and train ILOB clients to use certain technologies. After hiring the technology specialist, teachers began making referrals for technology assessments. Our IL technology specialist actively assessed client needs as referred around the state, made technology recommendations to the IL teachers and provided technology training to Title VII-Chapter 2 clients. Our technology specialist had and continues to have a very high case load plus he is required to travel the entire state which presents challenges; however, we have incorporated strategies to help maximize his time with clients. This period our technology specialist participated in a week long ILOB-Title VII-Chapter 2 senior orientation. We held three senior orientation events during this period; one early spring (April), one summer (July), and one late summer/early fall (September). We incorporated a technology class where clients were able to participate in group and individualized technology training all week long. Finally, as requested by IL teachers, our rehabilitation technology specialist may assist them with training during a community-based training (CBT). CBTs are scheduled around the state of Iowa in each IL teacher’s respective service area. This model helps to bring IL clients together in a community location to receive group IL skills training.

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.

C. Each individual served received an invitation to submit feedback that is used for program evaluation. In summary, survey results overall were positive. We realize that we must continue to strive to improve services. We work toward higher achievements through providing IL teacher with training and support, information, and feedback related to client survey results. Results for this report period are summarized below and copies of the applicable results can be found attached to this report. a. More than 90% of those individuals served under Title VII-Chapter 2 who responded to the survey reported: i. felt that IL rehabilitation teachers explained services well ii. that services they expected were delivered to them timely iii. that the client felt involved in the planning process iv. that they felt better about themselves and who they are following receipt of services v. that they felt better about their future following receipt of services b. More than 85% of those individuals served under Title VII-Chapter 2 who responded to the survey reported: i. Felt they maintained or gained independence as a result of training ii. Were provided with adequate information on services and resource available through other agencies. c. In order of importance to individuals served, services that individuals felt were most valuable: i. 58.21% - The training received. ii. 55.22% - Developing a more positive attitude about self and blindness. iii. 47.67% - The information provided about the services and resources available through other agencies (e.g., exemption from directory assistance charges, newspaper reading services, local support groups).

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).

D. Title VII-Chapter 2 funding has made it possible for our agency to deliver quality independent living program services to eligible older blind Iowans. Without these funds, these individuals would have been at risk of either of being under or unserved or potentially institutionalized. While we have multiple success stories, below please find three success stories. i. Success Story 1: An 85 year old female from rural Iowa came to the agency for assistance as a result of losing her vision from macular degeneration. This individual was interested in learning alternative techniques of blindness so she could remain in her own home for the balance of her life. She did not want to move to a nursing home. This individual and her IL teacher agreed on training objectives. She agreed to work toward her goal which was to stay in her home and live independently. She received training to learn how to cook, measure ingredients accurately, and time her cooking; all of which she achieved. Using alternative techniques of blindness, she learned to thread a needle and match her socks. She learned how to plug in all appliances, tell time, set her talking clock, take her own blood sugars, access phone numbers and her mail, use a support cane with confidence as well as to read books and play cards again. The client was engaged with all of her training and attended a community-based training where she received additional training and met others in her community who experienced vision loss or blindness. Ultimately, this client met all of her training objectives and overarching goal. She is happy to continue living in her own home and was very satisfied with Title VII-Chapter 2 services as delivered by our IL teacher and program. ii. Success Story 2: Our IL rehabilitation technology specialist (ILRTS) worked with a female client, age 65, who wanted to be able to get access to her recipes via recorded audio and then be able to mark them so she could navigate from recipe to recipe. After assessing which tool might be most useful to her situation, the ILRTS recommended a Book Port DT. This equipment was then demonstrated, showing her all the features which could enhance her ability to live independently. This individual has since purchased the device and through some training from the ILRTS which was funded under Title VII-Chapter 2, she is using the equipment very successfully to keep track of recipes as she likes to bake. This individual’s commitment to receive training and learn alternative techniques clearly demonstrates that with client commitment to learn alternatives taught by Il staff, to use tools and/or equipment as a means to manage daily living, and simply exercising a positive attitude about one’s blindness or vision loss that independence and individual IL goals can be achieved. iii. Success Story 3: An 82 year old male veteran from southeast Iowa referred himself to our agency to request Title VII-Chapter 2 services. He met with an IL teacher and at that time he was eligible. He and his teacher agreed that his goal would be a homemaker goal. His objectives included leisure to include learning how to continue to paint so he could use his free time better, daily living to use the microwave for cooking, label and identify items in his home and shop, and communications to include writing his name, taking notes, looking up and gathering information and staying in touch with friends and family. This individual received training in all areas mentioned above including learning to use his Mac computer to accomplish his communication objectives. His case was closed successfully following meeting all of his objectives. This gentleman was very pleased with services delivered under Title VII-Chapter 2 and reported he took a trip to Washington DC on the honor flight.

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

E. Areas of concerns: i. Title VII-Chapter 2 funds are not adequate to fund our program in a way that would lower the IL rehabilitation teacher to ILOB client ratio, whereby allowing more visits or time the IL rehabilitation teacher can spend with each ILOB client. Currently, IL rehabilitation teachers spend approximately 40 to 42 hours traveling per every 160 hours worked (i.e., approximately four weeks per month). This is equal to one full week of paid staff time that could otherwise be reduced if we could lower the number of counties served by each IL teacher. ii. IL teachers on an average serve 60+ clients not including new IL program applicants. IL applicants take priority so IL teachers must get to them right away to determine eligibility and assist them to develop a plan if they are eligible. IL teachers make visits to eligible clients approximately once every five weeks to provide training or instruction. As caseloads increase, it becomes challenging to meet with clients based on the case load size, the growth in the number of new clients adding to the caseload and travel time which will increase. Of possible interest, our program has nearly tripled the number of IL clients from three years ago iii. All but the IL program administrator, IL program staff are now covered under a union employment contract. The union contract now gives IL staff automatic cost of living and wage increases in accordance with what is allowable under the union contract. The union contract is negotiated with the State of Iowa every two years. Prior to the implementation of this most recent union contract, our IL staff only received increases based on performance and the availability to give a raise within the agency’s and/or program’s budget. This no longer holds true. With automatic raises given regardless of performance and automatic cost of living raises, our program’s costs of doing business will continue to rise annually. Title VII-Chapter 2’s formula does not take into account these types of issues. iv. We continue our focus on assisting Title VII-Chapter 2 clients who desire to move from a nursing home (i.e., most restrictive environment) to a least restrictive living environment (e.g., their own home or an apartment) as those situations present themselves. We know that clients desiring to make this type of move must either have adequate financial resources. Most clients we serve typically do not have the financial resource to make the move and their respective family members — if there are any - typically do not volunteer to provide financial assistance or simply don’t have it to give. In addition, we find that some of our Iowa counties operate on a small or conservative budget. Some of these rural counties lack resources to assist individuals who want to transition from the nursing home to a home or apartment within their respective community. When these resources do not exist or are limited to the extent that they would not help the individual make a successful transition, and all other avenues have been exhausted then Title VII-Chapter 2 should provide our program with additional funding that would allow our program to adequately assist clients to make their move from a nursing home in a smooth and safe manner. With the cost of moving, utilities and rent deposits, not to mention first and last month rents, setting up the home including initial groceries, utensils, beds and bedding, tables and chairs to mention a few could cost thousands of dollars. When other resources do not exist to help the Title VII-Chapter 2 client, it would seem that the program formula should be re-evaluated to take into consideration this situation so that our program can best assist individuals to transition from the nursing home to a home in their community. v. Offering IL program staff training opportunities can help staff to engage, grow, and optimize service delivery for clients. Opportunities to send IL program staff to trainings outside of our current in-house quarterly staff trainings and meetings is problematic due by and large to lack of funding. It is also challenging to find qualified trainers who understand the IL model and who will provide quality training at no cost. vi. In review of Part V: Comparison of Prior Year Activities to Current Report Year, we noted that the number of individuals served from the current period as compared to the previous year reflected a change of 318 fewer individuals served by the program. Per technical assistance advice received from our RSA representative Suzanne Mitchell on December 27, 2015, regarding this element we understand that individuals served may only be counted one time within the same fiscal year and not twice if a case is reopened during the same fiscal year. In analyzing this data over the past four years, the above mentioned standard historically was not applied consistently due to a difference in administration’s interpretation of this standard; therefore, the data now presented for FY ‘15 for this element reflects an accurate count of ILOB clients served when applying this standard per the technical assistance advice received from RSA. In addition, under the new IDB administration, as a means to improve IL service delivery for every client, we have implemented the following strategies: i. Phasing out and concluding all time-limited cases. As part of informed client choice, the ILOB program continues to offer a formal Independent Living Rehabilitation Plan (ILRP) or a Waiver Plan. ii. Policy development and implementation: 1. To ensure client plans are written for one year instead of an extended period of time. The purpose for this change helps to demonstrate the importance and urgency for the ILOB client and IL teacher to work timely toward completion of the client’s goal and objectives. 2. Clearly outlined ILOB teacher’s expectations for exemplary case documentation demonstrating extenuating circumstances where an ILOB client may need to have their ILRP or Waiver amended or extended beyond one year. IL teacher training was also provided. iii. Implementing a change to add an annual review to all Waiver Plans. This will help the ILOB client and IL teacher prior to the end of the plan to set quality time aside to discuss and analyze the client’s progress and strategies needed to complete the plan timely. In moving forward, as we apply the new method to measure this standard per advice by RSA, combined with our strategies as outline above we will be able to better analyze the 7OB result for this element; that is, we will now be able to compare apples to apples instead of apples to oranges. vii. In review of Part V: Comparison of Prior Year Activities to Current Report Year (ref. A4), this report period two IL rehabilitation teachers were out of work for extended periods of time for personal reasons. Due to this fact, the number of community awareness activities decreased for this report period; however, despite this factor the other 95 activities were positive and reached more than 1,000 people within the report period. We find that the quality of our activities we implemented had a positive impact on referrals this year and those we potential could serve in the future. We anticipate improvement this next report period as these teachers return to work and are able to fulfill community awareness requirements.

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 byKimberley Barber
Titleprogram director
Telephone515-281-1299
Date signed12/30/2015