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

RSA-7-OB for Nevada Rehabilitation Division - H177B150028 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 year257,051
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 2257,051
A2. Total other federal109,765
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement109,765
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)28,561
A4. Third party0
A5. In-kind0
A6. Total Matching Funds28,561
A7. Total All Funds Expended395,377
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs27,204
C. Total expenditures and encumbrances for direct program services368,173

Part II: Staffing

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

A. Full-time Equivalent (FTE)

Program Staff a) Administrative and Support b) Direct Service c) Total
1. FTE State Agency 0.7400 1.7000 2.4400
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 0.7400 1.7000 2.4400

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 2 0.2000
2. Employees with Blindness Age 55 and Older 1 0.5000
3. Employees who are Racial/Ethnic Minorities 2 0.4200
4. Employees who are Women 8 2.0400
5. Employees Age 55 and Older 5 0.8200

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 FY142
2. Number of individuals who began receiving services in the reported FY183
3. Total individuals served during the reported fiscal year (A1 + A2) 325

B. Age

1. 55-5930
2. 60-6423
3. 65-6930
4. 70-7438
5. 75-7950
6. 80-8456
7. 85-8959
8. 90-9430
9. 95-998
10. 100 & over1
11. Total (must agree with A3)325

C. Gender

1. Female218
2. Male107
3. Total (must agree with A3)325

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race15
2. American Indian or Alaska Native2
3. Asian4
4. Black or African American30
5. Native Hawaiian or Other Pacific Islander4
6. White255
7. Two or more races15
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)325

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)21
2. Legally Blind (excluding totally blind)179
3. Severe Visual Impairment125
4. Total (must agree with A3)325

F. Major Cause of Visual Impairment

1. Macular Degeneration203
2. Diabetic Retinopathy18
3. Glaucoma45
4. Cataracts7
5. Other52
6. Total (must agree with A3)325

G. Other Age-Related Impairments

1. Hearing Impairment56
2. Diabetes23
3. Cardiovascular Disease and Strokes81
4. Cancer19
5. Bone, Muscle, Skin, Joint, and Movement Disorders70
6. Alzheimer's Disease/Cognitive Impairment22
7. Depression/Mood Disorder21
8. Other Major Geriatric Concerns4

H. Type of Residence

1. Private residence (house or apartment)311
2. Senior Living/Retirement Community10
3. Assisted Living Facility4
4. Nursing Home/Long-term Care facility0
5. Homeless0
6. Total (must agree with A3)325

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)71
2. Physician/medical provider60
3. State VR agency12
4. Government or Social Service Agency9
5. Veterans Administration2
6. Senior Center16
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization0
10. Independent Living center0
11. Family member or friend33
12. Self-referral75
13. Other47
14. Total (must agree with A3)325

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 13,508
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 49
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 5

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 64,006
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 218
3. Provision of assistive technology services 2

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 39,546
1b. Total Cost from other funds 0
2. Orientation and Mobility training 115
3. Communication skills 2
4. Daily living skills 185
5. Supportive services (reader services, transportation, personal 7
6. Advocacy training and support networks 40
7. Counseling (peer, individual and group) 325
8. Information, referral and community integration 325
. Other IL services 287

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Information and Referral 325
3. Community Awareness: Events/Activities 0 0

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) 437,350 395,377 -41,973
2. Number of Individuals Served 346 325 -21
3. Number of Minority Individuals Served 86 70 -16
4. Number of Community Awareness Activities 0 0 0
5. Number of Collaborating agencies and organizations 83 94 11
6. Number of Sub-grantees 2 2

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 2 100.00%
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) 2 100.00%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
B1. Number of individuals who received orientation and mobility (O & M) services 115 100.00%
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) 115 100.00%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
C1. Number of individuals who received communication skills training 2 100.00%
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) 2 100.00%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
D1. Number of individuals who received daily living skills training 185 100.00%
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) 185 100.00%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
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) 325 n/a
E2. Number of individuals served who reported feeling that they have less control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 0 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 0 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 0 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

OIB staff statewide have identified these areas as ones they feel confident in if technical assistance is needed in the future: • Support Groups and Advocacy • ADL and Low Vision Skills • Braille • RSA-7OB reporting requirements • Provision of services and service delivery specific to OIB low vision and ADL • Training on financial management as it relates to bulk purchases and financial participation

Part VIII: Narrative

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

In the Northern District, there are no subcontracted services for daily living skills, orientation, mobility or functional low vision assessments. All services have been provided in-house. In order to reach underserved populations in the Northern District, our staff has met with Yerington Paiute Tribal Health Services to inform them about services that the BSBVI OIB Program can provide. Staff have also been in contact with the Center for Advanced Eye Care in Minden in order to reach more of the outlying older population. In the Rural District, daily living skills are provided by in-house staff. The OIB Program contracts with Vision Rehabilitation Services for low vision and orientation / mobility services. In the Southern District, all daily living skills and mobility skills are taught in-house. We contract with Dr. Alysa Neagle for our low-vision clinic. She is a local optometrist with a low vision practice. Our OIB program markets our low vision services to all the entities and we give multiple presentations. OIB clients are referred to the VA for the purchase of assistive technology. Depending upon immediate need, clients are seen for Orientation and Mobility training in the OIB Program. Staff members participated as volunteers manning an information table at the Vision Forum held at the Las Vegas Senior Center. This venue provides local community services to the blind and visually impaired population. Additionally, the OIB Program provides outreach activities within the following 94 forums, agencies and organizations: 1. Adult Protective Services 2. American Association of Retired Persons (AARP) 3. American Council of the Blind 4. Atrium Assisted Living 5. Battle Mountain Shoshone Band Council 6. Beehive Home (Assisted Living) 7. Blind Center of Southern Nevada 8. Blind Connect — Angela’s House Project 9. Braille Bible International 10. Bridge Assisted Living 11. Bright Path (Adult Enrichment) 12. Care Chest of Nevada 13. Carlin Open Door Senior Center 14. Carson City Community Center 15. Carson City Senior Center 16. Carson Plaza Retirement Residence 17. Catholic Charities 18. Center For Advanced Eyecare 19. Continuum 20. Community Resource Center in Wendover 21. Department of Health and Human Services 22. Department of Leisure Service 23. Department of Veterans Affairs 24. Douglas County Senior Center 25. Duck Valley Senior Center 26. Easter Seals 27. Elko Senior Center 28. Ely Senior Center 29. Ely Shoshone Elders Center 30. Eureka Senior Center 31. Family Stability Council 32. Fannie Komp Center 33. Foundation for Fighting Blindness 34. Genesis Home Health 35. Great Basin College 36. Hawthorne Senior Center 37. Helen Keller National Center 38. Helping Hands of Nevada 39. Henderson Senior Center 40. Herbage House 41. Home Health Agencies 42. Hope Link 43. Idaho Commission for the Blind and Visually Impaired 44. International Transportation Network 45. Jarbridge Community Center 46. Lander County Senior Center 47. Las Vegas Adaptive Recreation 48. Lend A Hand 49. Lions Clubs 50. Meals on Wheels 51. Merrill Gardens at Gardnerville 52. National Federation of the Blind 53. Nevada Assistive Technology Council 54. Nevada Blind Professionals 55. Nevada Community Partners 56. Nevada Council for the Blind 57. Nevada Cancer Institute 58. Nevada Disability and Advocacy Law Center 59. Nevada Hispanic Services 60. Nevada Home Health 61. Nevada State Talking Book Library 62. Nevada Elder Protective Services 63. Northern Nevada Center for Independent Living 64. O’Murphy Senior Center 65. Owyhee Indian Health Services 66. Rebuilding All Goals Effectively (RAGE) 67. Red Cross 68. Retired Senior Volunteer Program (RSVP) 69. RTC Access and Paratransit 70. Ruby View Center 71. Rural Eye Care Professionals 72. Senior Fair 73. Senior Network 74. Silver Sage Senior Center 75. South West Medical Center 76. Southern Nevada Blind Center 77. Southern Nevada Center for Independent Living 78. Southern Nevada Transportation Commission 79. Sparks Family Resource Center 80. State of Nevada — Division of Aging Services 81. State of Nevada — Welfare Division 82. Sun City Anthem Community Center 83. Te-Moak Tribal Diabetes and Eyewear Program 84. Truckee Meadow Community College 85. Veteran’s Administration Hospitals 86. Vision Forum and VIST (Visual Impairment Service Team) 87. Washoe County Senior Services 88. WARC 89. Wells Senior Center 90. Western Nevada Community College 91. White Pine Senior Center 92. Winnemucca Senior Apartments 93. Winnemucca Senior Center 94. Yerington Paiute Tribal Health Services Please see B for more details regarding our outreach activities.

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.

Reno OIB staff presented at the monthly luncheon of the Senior Companion Program. There were approximately sixty Senior Companions present and many of them had visually impaired clients that they work with. This was a good opportunity to explain the program and how we could assist with some of the seniors the Companion Program comes in contact with. Senior Companions also had questions on how they could better serve their visually impaired clients. Reno OIB met with staff of the Helen Keller National Center which is the provider of ICanConnect in Nevada. This program has become a great resource to provide assistive communication technology for the visually impaired and hard of hearing population. Additionally, the Deaf and Hard of Hearing Advocacy Center (DHHAC) continues to be a resource for our hard of hearing OIB participants. OIB staff attended the annual Senior Fest in Reno. Multiple agencies and vendors were present in order for seniors to find local services. Staff were able to connect with many of the presenters and participants to share what our agency has to offer. Reno OIB staff also attended an advisory committee meeting of the stakeholders in Nevada involved with the implementation of Unified English Braille (UEB). The event was hosted by the State of Nevada — Department of Education. UEB is the revised code adopted in the United States that is due to be implemented January 2016. A state plan for UEB implementation is being created.

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.

For older individuals who are blind (OIB) clients, 94 interviews were completed from an eligible population of 164. The raw response rate was 57%. The cooperation rate was 85% (94 out of 110 clients actually reached). OIB clients reported a high level of satisfaction with the overall quality of the program’s services (90%) and the timeliness of services (91%), but were somewhat less satisfied with the amount of choice they had between providers (74%). Clients also were very positive in their ratings of their program counselors in all areas, including agreement that counselors were understanding (87%) and treated clients with respect (95%). The majority of OIB clients (80%) indicated that they were satisfied with their ability to choose the kind of help that they received and services that they received (85%). Most clients (90%) also indicated that they would recommend the program to other people who needed the services. Unfortunately, less than half of the clients (44%) agreed that they were able to receive employment information when they were interested. Almost all of the OIB clients (94%) reported that they had received assistive technology services of some kind, and the majority of clients (86%) indicated that the quality of the devices received were “excellent” or “good.” The most frequently received type of assistive technology device was vision related (86%), including glasses, specialized magnifiers, screen readers, talking equipment, or Braille equipment. Approximately 56% of clients received devices to help with mobility or getting around, such as transportation, canes or wheelchairs, orthotics or prosthetics, while 20% received devices to help make their home or workplace more accessible. 27% of clients received devices to help with communication. OIB clients provided feedback on aspects of the program that they felt should be continued or improved in the future. Most comments were positive, but clients did ask for improvement in counselor-client interactions (e.g., more communication between counselors and clients, counselors should be easily contacted, increased empathy of clients’ needs and situations). Clients also indicated a need for better advertising of the program and the services offered by the program.

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).

Specific Case 1: Mrs. C is a 82 year old female with Macular Degeneration who lives with her husband in a residential setting. Mrs. C’s husband suffers from dementia and she was having a difficult time caring for him. A system for labeling and dispensing her husband’s medication was worked out. Low vision devices allowed her to maintain control of the finances and bill paying. Mobility services were provided and she is now able to use the Senior Van for her shopping and medical appointments. Mrs. C does not have any family support and was feeling discouraged and isolated. Due to depression, she had isolated herself. Counseling and guidance helped her come to terms with her vision loss. She became more outgoing and made several friends which greatly boosted her outlook on life. Specific Case 2: Mr. B is a 64 year old male, totally blind from birth, who recently moved to Nevada. He applied for services in order to receive orientation to the area and bus system. During the course of his case, he moved twice which necessitated new routes to be developed. Mr. B now uses the bus system independently for all of his travel needs. In addition, Mr. B was referred to several local agencies. He came to Nevada with very little and had no means to write Braille. Equipment was provided to him to increase his communication skills. Specific Case 3: Ms. J is a 58 year old female with Diabetic Retinopathy. Before losing her vision, she had her own successful catering business. When her vision decreased drastically, she thought working in the kitchen again would not be a possibility. She is now able to safely prepare meals that were on her menu and has added additional recipes. She also moved into an apartment to live independently. This confidence is a result of learned ADL skills Specific Case 4: Mrs. P is an 80 year old female who is totally blind from a stroke. The stroke also left her weak on the left side making it difficult to keep her balance. She began an exercise program to increase her balance and stamina. As a result, she is able to use her mobility skills to travel independently in her assisted living facility and other places she has been orientated. Specific Case 5: Mr. C is a 79 year old male who lives with his wife in rural Nevada. He is legally blind caused by Dry Macular Degeneration. He applied to the OIB program in hopes of increasing his visual functioning and independence. He expressed a desire to continue with his projects such as working on engines and writing his life stories. He was assessed in ADL, low vision and orientation / mobility. He still struggles with reading; however, the various devices such as portable CCTV, allow him to read his mail and magazines for short periods of time. He also enjoys utilizing the Nevada Talking Book Service. He is writing his life stories utilizing 20/20 pens and bold lined paper. Various low vision devices and training such as a Megaview Head Magnifier, Optivisor, LED hand magnifiers and a talking tape measurer have helped him to complete projects in his garage. O&M has provided him the ability to get out in his community more often. He was provided with both a folding mobility cane and support cane with ice pick. He feels his canes are very helpful and doesn’t know how he would travel independently without then. With ADL devices and training, he is able to make and pour himself his own coffee, write checks, make phone calls, tell time, shave, identify money and monitor his own blood pressure. He was provided ADL devices such as liquid level indicator, check writing guide, big button phone, magnifying mirror, talking watch and a talking blood pressure monitor. Specific Case 6: Mrs. P is an 88 year old female with Macular Degeneration that was seen at the low vision clinic. Her goal was to be able to read her bible and to participate in bible study. She was dispensed lighted reading spectacles and hand and stand magnifiers to achieve this goal. Mrs. P left with such joy that she was able to read once again. Other Examples: An 89 year old Native American female with Macular Degeneration, Open Angle Glaucoma and Bilateral Cataracts who lives alone on a reservation in rural Nevada is able to continue doing her Native American crafts. While doing her crafts, it is important to have devices that are hands free such as the Optivisor which works well for her. Other low vision devices have helped her to read and write. ADL devices have made it possible for her to sew, watch television, write checks and record entries and do her daily grooming independently. A 79 year old female with Macular Degeneration and Cataracts who lives alone in rural Nevada is able to continue playing her keyboard and read sheet music. She is very pleased with the low vision devices provided. Before the devices, she felt she would not be able to continue with her music. She is able to watch television and play cards. She is able to be more independent in the kitchen using ADL devices.

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

Nevada has many of the OIB clients living in rural areas with limited resources and transportation. Travel time needs to be taken into account when providing services which may limit time for other clients. In the North, staff may travel for several hours to meet with one client. The senior citizen population in the United States continues to grow and is expected to double in the next fourteen years. As our population ages, funding and services need to increase. Decreases in funding limits the ability to purchase necessary low vision assistive devices.

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 byHeather Johnson
TitleBusiness Process Analyst II
Telephone775-687-6865
Date signed12/22/2015