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

RSA-7-OB for Massachusetts Commission for the Blind - H177B150021 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 year669,384
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year156,242
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2673,668
A2. Total other federal0
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)149,519
A4. Third party0
A5. In-kind0
A6. Total Matching Funds149,519
A7. Total All Funds Expended823,187
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs329,756
C. Total expenditures and encumbrances for direct program services493,431

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 1.6000 3.4000 5.0000
2. FTE Contractors 0.0000 0.5000 0.5000
3. Total FTE 1.6000 3.9000 5.5000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 0 0.0000
2. Employees with Blindness Age 55 and Older 0 0.0000
3. Employees who are Racial/Ethnic Minorities 1 1.0000
4. Employees who are Women 5 4.5000
5. Employees Age 55 and Older 5 4.5000

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 FY551
2. Number of individuals who began receiving services in the reported FY333
3. Total individuals served during the reported fiscal year (A1 + A2) 884

B. Age

1. 55-5921
2. 60-6440
3. 65-6951
4. 70-7477
5. 75-79131
6. 80-84186
7. 85-89221
8. 90-94122
9. 95-9934
10. 100 & over1
11. Total (must agree with A3)884

C. Gender

1. Female643
2. Male241
3. Total (must agree with A3)884

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race9
2. American Indian or Alaska Native0
3. Asian5
4. Black or African American29
5. Native Hawaiian or Other Pacific Islander1
6. White781
7. Two or more races56
8. Race and ethnicity unknown (only if consumer refuses to identify)3
9. Total (must agree with A3)884

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)16
2. Legally Blind (excluding totally blind)868
3. Severe Visual Impairment0
4. Total (must agree with A3)884

F. Major Cause of Visual Impairment

1. Macular Degeneration597
2. Diabetic Retinopathy57
3. Glaucoma89
4. Cataracts11
5. Other130
6. Total (must agree with A3)884

G. Other Age-Related Impairments

1. Hearing Impairment249
2. Diabetes152
3. Cardiovascular Disease and Strokes448
4. Cancer35
5. Bone, Muscle, Skin, Joint, and Movement Disorders354
6. Alzheimer's Disease/Cognitive Impairment24
7. Depression/Mood Disorder20
8. Other Major Geriatric Concerns191

H. Type of Residence

1. Private residence (house or apartment)742
2. Senior Living/Retirement Community76
3. Assisted Living Facility62
4. Nursing Home/Long-term Care facility4
5. Homeless0
6. Total (must agree with A3)884

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)8
2. Physician/medical provider3
3. State VR agency652
4. Government or Social Service Agency49
5. Veterans Administration0
6. Senior Center65
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization0
10. Independent Living center6
11. Family member or friend5
12. Self-referral68
13. Other28
14. Total (must agree with A3)884

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 74,513
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 99
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 0

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 153,068
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 472
3. Provision of assistive technology services 382

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 196,215
1b. Total Cost from other funds 0
2. Orientation and Mobility training 37
3. Communication skills 311
4. Daily living skills 51
5. Supportive services (reader services, transportation, personal 30
6. Advocacy training and support networks 1
7. Counseling (peer, individual and group) 564
8. Information, referral and community integration 39
. Other IL services 19

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 69,635
1b. Total Cost from other funds 0
2. Information and Referral 42
3. Community Awareness: Events/Activities 118 2,420

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) 899,704 823,187 -76,517
2. Number of Individuals Served 987 884 -103
3. Number of Minority Individuals Served 110 100 -10
4. Number of Community Awareness Activities 131 118 -13
5. Number of Collaborating agencies and organizations 86 88 2
6. Number of Sub-grantees 5 5

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 382 100.00%
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) 188 49.21%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 171 44.76%
B1. Number of individuals who received orientation and mobility (O & M) services 37 100.00%
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) 5 13.51%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 18 48.65%
C1. Number of individuals who received communication skills training 311 100.00%
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) 166 53.38%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 138 44.37%
D1. Number of individuals who received daily living skills training 51 100.00%
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) 3 5.88%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 40 78.43%
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) 382 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) 4 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 0 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 6 n/a
E5. Number of individuals served who died before achieving functional gain or experiencing changes in lifestyle as a result of services they received. (closed/inactive cases only) 6 n/a

Part VII: Training and Technical Assistance Needs

Training on federal grant budgeting process in order to more effectively manage the allotment funds dispersed over the course of the federal fiscal year (10/01-09/30).

Part VIII: Narrative

A. Briefly describe the agency's method of implementation for the Title VII-Chapter 2 program (i.e. in-house, through sub-grantees/contractors, or a combination) incorporating outreach efforts to reach underserved and/or unserved populations. Please list all sub-grantees/contractors.

The Massachusetts Commission for the Blind’s (MCB) Title VII, Chapter 2 Program (the BRIDGE Program) utilizes a program design that includes both In-House and Sub-Grantee components. The In-House BRIDGE Program employs a full time Program Director and three Case Workers who provide direct independent living services to blind elders age 55+. The direct IL services include: case management, information and referral, adjustment to blindness counseling, advocacy, low vision services, low vision devices, assistive technology products and services, as well as devices including the provision of magnifiers, cooking items, clocks and watches, communication devices, adaptive software, and assistive listening devices. The Sub-Grantee component includes contracting with a Public Education Consultant on Aging and Blindness to conduct outreach that targets under-represented populations as well as raising community awareness about benefits and services available to blind elders in Massachusetts. Outreach activities include presentations to low vision support groups, in-service training, speaking to groups of seniors, conference presentations and health fairs. During FY 15, the BRIDGE Public Education Consultant conducted 118 public education events with a combined audience of 2420 individuals. Outreach to underrepresented populations included The Mattapan Healthcare Revival which included 110 African Americans and 12 Haitian seniors, speaking with the Dorchester Peer Empowerment low vision group of 12 on aging and blindness at Harbor Point, Outreach to the Asian population included a presentation to the Chinese Golden Age Center in Brighton for 34 Asian seniors with an interpreter. The public education consultant targeted 27 towns in rural areas throughout the state. The consultant also targeted services to health care workers in the form of in-service training on aging and low vision. She delivered 13 presentations to a total of 280 workers. These included nursing homes, home care agencies, rest homes and hospice centers. Andrea was involved in an outreach collaborative with other agencies where she shared table space at 15 health and disability fairs to inform and educate on MCB and BRIDGE program and reached over 765 visitors. Outreach to new audiences made up 43% of her total activity. These new groups included informatlonal workshops, independent Low Vision Groups, Hospice workers, nurses and home health care agencies. The Public Education Consultant authored an article on audio-described theater at the Opera House in Boston that was posted on the Executive Office of Health and Human Services blog again in FY 2015. As a result of this blog in 2014 and 2015, the blind and low vision audience at the Opera House has continued to increase.

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 Massachusetts SPIL states that, "The priority of the public education component of the OIB program is the provision of information that will enhance the capacity for independent living to consumers and opportunities for collaboration and community awareness to service providers, with a particular emphasis on outreach to under-represented populations.” The SPIL further states that, "The BRIDGE Program contracts with a Public Education Consultant for approximately 1,000 hours/year to do outreach and in-service training. The contractor is selected through a competitive bidding process." During FY 15, the BRIDGE OIB Program sponsored an information booth at 15 conferences and teamed up with a variety of different state agencies that were visited by over 725 people. Some of these included Health and Wellness Fair at COA in Billerica, MA Association of Occupational Therapists Annual Conference in Norwood, Western MA Elder Care Conference, MCOA Annual Meeting. The lack of information about benefits, services, and assistive technology continues to be a barrier to independence for elder blind individuals however improvements have been made in the areas of collaboration with other agencies serving the elder blind and visually impaired as well as conducting more MCB outreach. Innovative programming included collaboration with Carroll Center for the Blind and Perkins School for the Blind to provide the third annual training for leaders of Low Vision Peer Support Groups unaffiliated with MAB Community Services or Sight Loss Services. The OIB BRIDGE Program continues to develop and present Community-Based Training in the areas of Essential Skills Training, Senior Low Vision Assessments and Diabetic Self-Management Training. During FY 14, three 6 Week Community Based Essential Skills Programs were conducted, effectively helping 10 consumers with using other senses, personal care, kitchen organization, eating and microwave cooking, time and money, and recreational resources. The sessions were held one day per week for six weeks for four hours each day. The feedback from group participants was extremely positive. In addition, there were four consumers who opted for the two week center based training at The Carroll Center, where they live there for 2 weeks to go through all independent living training and care in two fairly intensive weeks. The OIB Program used funds for Senior Vision Assessments to continue with the community-based model Diabetic Self-Management training and Community-Based Essential Skills Training. The expectation is to continue the community-based model for some of our programming and expand this model to other services which we provide adaptive software training. Future plans include technology training for our consumers through MCB’s partnerships with senior centers across the Commonwealth. The community-based training has been well received by the elder blind, and the model facilitates collaboration with public and private agency partners and further expands the community’s awareness of the OIB program and services. The BRIDGE Program Director and the MCB Orientation and Mobility team collaborated with the Department of Public Health and the Falls Prevention Coalition. The BRIDGE staff and OM instructors were able to participate in a 2 day training class called "A Matter of Balance" as a way to provide coaching in presenting information and daily exercises to our legally blind consumers that will contribute to their strength and overall health in helping them to alleviate the fear of falling.

C. Briefly summarize results from any of the most recent evaluations or satisfaction surveys conducted for your program and attach a copy of applicable reports.

A Program Participant Survey was conducted by the Training Center on Blindness and Low Vision from Mississippi State University in FY 2015 to determine the degree to which consumers are satisfied with the independent living services they received or are receiving from through The BRIDGE Program. In addition, the survey gathers outcome data from consumers related to the level of independence they gained from their program. This unique survey was designed to allow the administrative team to gather data to supplement reporting to RSA plus some additional data that would be useful in program analysis and planning. The survey is provided to a sample of successfully closed consumers throughout the fiscal year. As of November 15, seventy-four individuals completed and returned the survey instrument. There were 200 surveys sent out so this yields a return rate of 37%. All participants were persons who were served in FY 2015. Results of the overall Program Participant Survey were extremely favorable although the number of respondents is less than desired. Demographic characteristics of the respondents to the Program Participant Survey indicated an average age of 84 years, ranging from age 60 to age 97. Seventy-two percent were female, 55 individuals lived in their own home or apartment, 13 in a senior living/retirement facility, and 3 in assistive living. Thirty-six reported a hearing loss, with 14 rating their hearing loss as moderate to severe. All but 2 persons indicated that they were legally blind. Fifty-one percent of participants reported at least one secondary health condition. Respondents indicated the cause of their vision loss as 86% macular degeneration, 15% reported glaucoma, 7% diabetic retinopathy, 8% cataracts, and 13% reported another condition. A number of persons reported more than one eye condition which is why these numbers total more than 100%.The survey revealed that consumer satisfaction was favorable among most of those who responded to the survey. Only three persons (4.6%) indicated that they were not satisfied with the timely manner in which services were provided. Ninety-seven percent indicated that staff were attentive and concerned and that that staff listened and empathized. Only 2 individuals (3.1%) indicated that they were dissatisfied with the quality of the program. The survey also revealed that consumer satisfaction with specific services provided was favorable overall at a rate of 96.1%. The highest ratings were given to Diabetic Management (100%), Community-Based Low Vision Training (100%), Center-Based Low Vision Services (100%), Community-Based Essential Skills Training (100%), Center-Based Essential Skills Training (100%), Counseling and Guidance (98.4%), Low Vision Aids (97%), Adaptive Devices (96.4%), Instruction Received (96.3%), Orientation & Mobility (95%), and Personal Amplification Devices (95%). The four areas below 95% were Information Regarding Vision Loss (94.8%), Peer Support Groups (93.3%, n=15), Referrals to Other Agencies (90.6%), and Assistive Technology Training (84.2%, n=19). This shows a significant level of satisfaction for the BRIDGE Program and is especially significant due to the mean age and level of visual impairment of the consumers served by the program. The third section of the survey queried participants regarding their perceived outcomes of the program. In Section I consumer agreement with the overall outcome of services provided was favorable among most of participants. In this section specific areas are addressed and the perceived outcomes from services they received were rated by having either gained or maintained their ability to engage in communication activities was 93.8%. The number of persons indicating that they had either gained or maintained their ability to engage in customary life activities as the result of technology and devices they received was 91.4%. Three persons indicated that they had received devices, but were no longer using them. The number of persons indicating that they had either gained or maintained their ability to engage in personal management and activities of daily living was 94.2%. Sixty percent indicated that they had experienced a decline in vision while in the program and 32.9% indicated they had experienced a decline in general health while in the program. In summary, more than 27,000 citizens age 55 and older who reside in the Commonwealth experience the consequences of legal blindness. This number is expected to increase over the next 50 years.The Massachusetts BRIDGE Program has proven effective as a means of assisting older adults who are legally blind to maintain a reasonable level of personal independence. The program operates one of the most extensive and effective peer support networks for older blind individuals in the country. The success of the BRIDGE Program serves to extend the MCB's tradition of providing a vast array of services designed to assist people who are legally blind live up to their maximum potential.

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).

Case 1 Client is an 85-year-old widow who lives alone in an adult retirement community, which is located north of Boston, MA. She has regular contact with a son and a daughter. She had worked for an extended period as a computer systems analyst. Client has a visual diagnosis of myopic degeneration OU. She also has hearing loss and a heart condition. Worker completed initial home visit with client in July 2010. During her adult life, she raised children, worked successfully as a computer systems analyst, and had an extremely active social life. She was highly motivated to explore any vision rehabilitation services that might potentially increase her functional capacity. She was determined to remain as independent as possible. Her vision rehabilitation service plan included the following services: Talking desk clock With this adaptive time piece, she was able to monitor the time more easily. 20/20 pens, bold line writing paper.These writing aids enabled her to complete basic writing tasks with much less difficulty.Optelec PowerMag 5x LED-illuminated pocket magnifier.She is able to complete basic reading tasks at home and in the community with her pocket magnifier. Senior Vision Assessment by Bob McGillivray, low vision therapist/rehabilitation engineer, Carroll Center for the Blind, Newton, MA. During the assessment, client was able to significantly benefit from using a hand held video magnifier for various basic reading task (e.g., menus, food package ingredients/directions).Eschenbach Smartlux hand held video magnifier.Client told worker that she cherishes this portable, electronic magnifier, which has multiple contrast and magnification level settings. ZoomText Magnifier/Reader software, ZoomText LP keyboard. Client has used a computer since the 1960s. She had a strong desire to continue using her computer for basic computer tasks: With the ZoomText software and LP keyboard, she was able to use her computer for email, web browsing and financial record keeping. She was extremely impressed with effectiveness of the LP software and keyboard. iPad Training- Client received training on iPad accessibility features from an MCB technician. She is familiar with the Zoom and Voice Over features. Talking blood pressure monitor.Client’s medical doctor has recommended that she monitor her blood pressure on a regular basis. Eschenbach 2.1x MaxTV glasses.These telescopic glasses enhance her enjoyment of television. Orientation and mobility services Client received extensive O&M services from a certified O&M instructor. She was provided with a 52” white folding cane with roller tip and Noir dark gray sunglasses. She also received training in the following areas: sighted guide technique, cane technique, curb detection, sidewalk travel, and street crossings. Prior to training, client was very anxious about falling. At the completion of her very successful mobility, training program, she was able to walk safely by herself within her retirement community and to nearby stores. Also, she was able to travel alone by para transit to the post office and to her local medica appointments.Hearing aids.With her newly purchased hearing aids, she was able to participate in one-on-one conversations and group meetings with greater ease. Client attends many social events and meetings at her retirement community. For example, she participates in a low vision support group and arranges showings of descriptive videos for other visually impaired residents who live in her retirement community. As a result of OIB services, client was able to achieve functional gains in critical ADL skill areas such as time management, reading, writing, computer operation, record keeping, health management, mobility and leisure time activities. She made significant gains in reading, computer operation, and mobility. She is very grateful that she decided to participate in vision rehabilitation services. With her newly acquired adaptive skills and equipment, she is much more hopeful about her future as an elder with vision loss. Case 2 Mr. C’s eye impairment was due to Glaucoma. Mr. C is a 71 year old man who was diagnosed with Glaucoma in 1968 while he was in graduate school. His vision started to decline after 2003, and in 2008 he lost all the vision in his left eye. At that time, he decided it was best to retire from his job practicing law. Recently, the vision in his remaining (right) eye has further deteriorated. Client eye specialist has advised client that there are not many options left, as they have tried everything. Client hopes to continue to have some vision but he needs to know what training and services he can get to help him navigate at this point (and if his vision deteriorates further).Client was very motivated to become as independent as possible. The MA OIB Program was able to provide and create the following action plan: Essential Skills two-week training program allowed client to make progress in learning skills to promote self sufficiency in the household and the community and to support his adjustment process. Orientation and Mobility - worker made sure client got mobility instruction to enable him to use the local resources. Watertown Support Group. Worker assisted client in connecting with this support group. Aids and Appliances - Bridge assisted client in getting a number of aids and appliances to enhance his independence. Technology - Client was given instruction on how to use the iPhone, I-pad and JAWS. In conclusion, the client was very happy that the BRIDGE worker directed him to the Carroll Center. Client admitted that he wondered if the Carroll Center’s “essential skills” program would be too simplistic for him (given that he has been coping with low vision for so long), but afterwards, he admitted how wrong he was. The program has been excellent and has given him a solid foundation. He has started using the cane, he continues to work hard at mastering JAWS and has experimented with the devices and techniques he has been shown. The Client stated he feels less anxious and feels more hopeful and confident as he looks to his future.

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

We experience wait times during the fiscal year, often due to the allotment of federal funds. This could have a direct impact in delaying services to our BRIDGE consumers in the Commonwealth of Massachusetts.

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 byKaren R. Hatcher
TitleDirector - BRIDGE OIB Program
Telephone617-626-7462
Date signed12/21/2015