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

RSA-7-OB for Massachusetts Commission for the Blind - H177B160021 report through September 30, 2016

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 year224,369
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2694,079
A2. Total other federal49,907
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement49,907
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)0
A4. Third party0
A5. In-kind164,738
A6. Total Matching Funds164,738
A7. Total All Funds Expended908,724
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs325,194
C. Total expenditures and encumbrances for direct program services583,530

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 FY492
2. Number of individuals who began receiving services in the reported FY300
3. Total individuals served during the reported fiscal year (A1 + A2) 792

B. Age

1. 55-5924
2. 60-6440
3. 65-6945
4. 70-7486
5. 75-79108
6. 80-84173
7. 85-89189
8. 90-9491
9. 95-9934
10. 100 & over2
11. Total (must agree with A3)792

C. Gender

1. Female568
2. Male224
3. Total (must agree with A3)792

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race8
2. American Indian or Alaska Native0
3. Asian4
4. Black or African American27
5. Native Hawaiian or Other Pacific Islander0
6. White708
7. Two or more races43
8. Race and ethnicity unknown (only if consumer refuses to identify)2
9. Total (must agree with A3)792

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)14
2. Legally Blind (excluding totally blind)778
3. Severe Visual Impairment0
4. Total (must agree with A3)792

F. Major Cause of Visual Impairment

1. Macular Degeneration487
2. Diabetic Retinopathy56
3. Glaucoma89
4. Cataracts9
5. Other151
6. Total (must agree with A3)792

G. Other Age-Related Impairments

1. Hearing Impairment201
2. Diabetes129
3. Cardiovascular Disease and Strokes399
4. Cancer25
5. Bone, Muscle, Skin, Joint, and Movement Disorders312
6. Alzheimer's Disease/Cognitive Impairment28
7. Depression/Mood Disorder21
8. Other Major Geriatric Concerns175

H. Type of Residence

1. Private residence (house or apartment)674
2. Senior Living/Retirement Community57
3. Assisted Living Facility58
4. Nursing Home/Long-term Care facility3
5. Homeless0
6. Total (must agree with A3)792

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)8
2. Physician/medical provider1
3. State VR agency570
4. Government or Social Service Agency44
5. Veterans Administration0
6. Senior Center60
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization0
10. Independent Living center6
11. Family member or friend12
12. Self-referral86
13. Other5
14. Total (must agree with A3)792

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 81,952
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 91
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 203,721
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 382
3. Provision of assistive technology services 322

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 217,866
1b. Total Cost from other funds 0
2. Orientation and Mobility training 42
3. Communication skills 389
4. Daily living skills 45
5. Supportive services (reader services, transportation, personal 24
6. Advocacy training and support networks 10
7. Counseling (peer, individual and group) 497
8. Information, referral and community integration 34
. Other IL services 10

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 79,991
1b. Total Cost from other funds 0
2. Information and Referral 30
3. Community Awareness: Events/Activities 123 2,419

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) 899,704 908,724 9,020
2. Number of Individuals Served 884 792 -92
3. Number of Minority Individuals Served 100 113 13
4. Number of Community Awareness Activities 118 123 5
5. Number of Collaborating agencies and organizations 88 90 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 322 100.00%
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) 133 41.30%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 175 54.35%
B1. Number of individuals who received orientation and mobility (O & M) services 42 100.00%
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) 38 90.48%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 4 9.52%
C1. Number of individuals who received communication skills training 389 100.00%
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) 111 28.53%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 129 33.16%
D1. Number of individuals who received daily living skills training 45 100.00%
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) 11 24.44%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 26 57.78%
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) 310 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) 2 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) 2 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) 4 n/a

Part VII: Training and Technical Assistance Needs

Training on best practices in managing an OIB Program Information sharing through a centralized portal for OIB Directors Managing Federal funds effectively. what are other states doing?

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 the 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 FY16, the BRIDGE Public Education Consultant conducted 123 public education events with a combined audience of 2530 individuals. Outreach to underrepresented populations included The Mattapan Healthcare Revival which included 98 African Americans and 9 Haitian seniors, speaking with the Dorchester Peer Empowerment low vision group of 13 on aging and blindness at Harbor Point, Outreach to the Asian population included a presentation to the Chinese Golden Age Center in Brighton for 38 Asian seniors with an interpreter. The public education consultant targeted 26 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 21 presentations to a total of 315 workers. These included nursing homes, home care agencies, rest homes and hospice centers. The Public Education Consultant 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 35% of her total activity. These new groups included workshops, independent Low Vision Support Groups, Hospice workers and nurses and home health care agencies. Entertainment options for our blind consumers increased in FY16, as communications circulated among our Low Vision Support Groups, publicizing the addition of schedules for audio described shows in play theaters both in Watertown and in the Boston area. Many Consumers spoke of a positive experience and look forward to an increase in productions throughout the Commonwealth.

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 contractor is selected through a competitive bidding process." During FY 16, the BRIDGE OIB Program sponsored an information booth at 17 conferences and teamed up with a variety of different state agencies that were visited by over 800 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 in Falmouth and the VA Stand Down Fair for Veterans. 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 Evaluations and Diabetic Self-Management Training. During FY 16, five 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 the 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. In FY 16, MCB formed a partnership with the MA Council on Aging Special Projects Director with the goal of setting up 3 Low Vision Technology Centers located in three different Senior Centers in the Commonwealth as pilot sites that will continue to spread to other towns each year. The community-based training plan 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 an instructor from the MCB Orientation and Mobility team collaborate on a quarterly basis with the Department of Public Health on the Falls Prevention Coalition. This Coalition consists of over 35 State Agency and Non-Profit organizations, with the goal of helping to prevent falls among the senior population. The OIB BRIDGE staff and OM instructors were able to participate in a two-day intense training class in FY 2015 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 falls and the fear of falling. As a result of this training in FY 2016, MCB conducted a total of three 8 week Matter of Balance classes that were very successful for 20 of our OIB consumers. The MA OIB BRIDGE Program will continue to lead this effort into FY 2017 and beyond.

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.

2016 End of Year Evaluation Summary The BRIDGE Program Commonwealth of Massachusetts Commission for the Blind Provided by BJ LeJeune, CRC, CVRT National Research and Training Center on Blindness and Low Vision Mississippi State University A Program Participant Survey is being conducted in FY 2016 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 some type of outcome data from consumers related to the level of independence they gained some their program. Included in the survey were 4 questions related to participant satisfaction with manner in which services were provided, 9 questions related to the types of services provided, 5 questions related to perceived outcomes of the program, and a question asking if consumers needed additional assistance with hearing loss, transportation, computer application, or some other service. In addition, the survey includes multiple demographic, health, secondary disability, and vision related questions. This unique survey was designed to allow the administrative team to gather outcome 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, 2016 seventy individuals had completed and returned the survey instrument. There were 175 surveys sent out so this yields a return rate of 40%. All participants were persons who were served in FY 2016. 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 63 to age 98. Seventy-three percent were female, 49 individuals lived in their own home or apartment, 11 in a senior living/retirement facility, and 3 in assistive living. Thirty-three reported a hearing loss, with 18 rating their hearing loss as moderate to severe. Only one person indicated a level of visual impairment other than legally blind. Thirty-four percent of participants reported at least one secondary health condition. Respondents indicated the cause of their vision loss as 77% macular degeneration, 28% reported glaucoma, 16% diabetic retinopathy, 9% cataracts, and 14% reported another condition. A number of persons reported more than one eye condition which is why these numbers total more than 100%. Section I of the survey revealed that consumer satisfaction with the manner in which services were provided was favorable among most of those who responded to the survey. Only two persons (2.9%) indicated that they were not satisfied with the timely manner in which services were provided. Ninety-eight percent indicated that staff were attentive and concerned, while 97% indicated that staff listened and empathized. Only 2 individuals (2.9%) indicated that they were dissatisfied with the quality of the program. Section II of the survey revealed that consumer satisfaction with specific services provided was favorable overall at a rate of 99.1%. During this reporting year all areas were above the 90% rating that has long been a bench-mark for the title VII-Chapter 2 Programs. 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%), Peer Support Groups (100%), Assistive Technology Training (100%), Information Regarding Vision Loss (100%), Personal Amplification Devices (100%), Instruction Received (100%), Referrals to Other Agencies (100%), Orientation & Mobility (100%), and Counseling and Guidance (98.3%). The two areas below 95% were Adaptive Devices (94.6%), and Low Vision Aids (93.9%). 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. Section Ill 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. All items started “As a result of services you received through the BRIDGE program….” However, comments seem to point to the fact that the question was not fully understood to be related to services. The overall perceived outcome rating was 92.4%. The percentage of persons who agreed that they had either gained or maintained their ability to travel independently was 88.4%. The percentage of persons who agreed that they had either gained or maintained their ability to engage in communication activities was 92.3%. 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 94.6%. One person indicated that they had received devices, but was 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 94.1%. The overall rating of 92.4% meets the target score of 90%. Ninety-eight percent indicated that that were in either the same or better control of their lives because of the services they received. Fifty-three percent indicated that they had experienced a decline in vision while in the program and 25.4% indicated they had experienced a decline in general health while in the program. In summary, the Massachusetts BRIDGE Program has proven to be very 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 peer support networks for older blind individuals in the country. The success of the BRIDGE Program serves to extend the MCB 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).

We are dedicated to providing low vision products and services with the goal of keeping our consumers living independently in their homes and communities. Here are three examples showing the BRIDGE Program's commitment to the OIB population here in MA. 1. Client is a 76 yo married female, who has been registered with MCB since 2015. Visual acuity at the time was OD 20/480 and OS 20/100. Vision loss stem from age related macular degeneration. Since, she has had significant vision loss. She lives in an apartment building in Brookline. She has no children.Prior to her vision loss, client owned a home based travel service, and was independently active. Her case manager referred her to the BRIDGE program for low vision devices that included a magnifying mirror, MaxTV glasses, a talking timepiece, liquid indicator, and 20/20 pens. On initial contact, client was very depressed and fearful. She presented and verbalized feeling of hopelessness and helplessness, and openly wept. She was resistant to any kind of RT/OM adaptive training, but open to low vision devices that would enable her to read with minimal physical change. Clearly, she was in the angry stage of her vision loss. With constant contacts, addressing each difficulty, and slowly introducing more of BRIDGE services, it took one year for the client to begin to accept her vision loss. Client received a Senior Vision Assessment (SVA) at the Carroll Center. She hesitantly agreed to OM services. She received an Aladdin desktop CCTV, Pebble portable video magnifier, a 6X Optelec Power Magnifier. And, she attends the MCB/MAB Brookline low vision support group.The effect of BRIDGE services is evidenced in enabling this client to gain control over her daily living as a visually impaired elder. The provision of low vision devices reinforced the client’s capacity to complete daily reading tasks, to navigate safely in/out of the home, and develop confidence in socializing with others. 2. Consumer is a 97-year-old widow who lives alone in an apartment in Woburn, MA, an assisted living center. She has a son, who lives in VT and 2 daughters who live in MA. She has frequent contact with her daughter who lives in Woburn and describes this daughter as “her rock.” Consumer became registered with MCB in May 2016 with a visual diagnosis of end stage glaucoma, corneal transplant, and macular degeneration OU. She also has double vision. She takes 4 different eye drops for her glaucoma. In addition to her visual condition, consumer has high blood pressure, hearing loss and balance problems. She wears a hearing aid in each ear. She broke her pelvic bone in August 2016. As far as mobility aids, she uses a Winnie Walker in her apartment and a GoGo Ultra scooter when traveling within the assisted living center. Consumer was referred to the MCB BRIDGE Program by the SR in Region 4. BRIDGE worker completed initial home visit with consumer to explain BRIDGE services. At that time, consumer was extremely eager to investigate any rehabilitation service that would enable her to remain as independent as possible. Consumer’s BRIDGE service plan included the provision of various independent living aids. It was important for consumer to be able to monitor the time independently. She was given three adaptive time pieces: talking clock with keychain, talking watch, and talking desk clock. She also wanted to continue to be able to write and record checks by herself. She was provided with 20/20 pens, check writing guide, and LP check registers. She was especially impressed with the usefulness of the LP check registers. She also had difficulty operating household appliances. She found it useful to place bump-on dots on the controls of household appliances. Consumer also received a Senior Vision Assessment (SVA) at the Carroll Center for the Blind, Newton, MA. Based upon the results of the SVA, consumer was provided with an Optelec PowerMag 3.5x LED-illuminated pocket magnifier for spot reading tasks and an Eschenbach Smartlux hand held video magnifier for extended reading tasks. With the handheld video magnifier, her long-term reading ability increased significantly. Finally, consumer was struggling to read her computer screen and keyboard. She was highly motivated to explore adaptive computer services. She used a trial version of ZoomText Magnifier reader software and found the adaptive software to be very helpful. She received BRIDGE funding for a permanent copy of ZoomText Magnifier/Reader software, version 10.1. The MCB Technology Department installed the adaptive software on her computer and provided consumer with training on the basic features of ZoomText. She also received basic training on this software from an SR supervisor. Consumer adapted quickly to using a magnified screen. She was also given LP keyboard labels (white print on black background) so she could use her keyboard more easily. With her new adaptive software and LP keyboard labels, she can continue using her computer for web browsing, on-line banking, on-line shopping, email, and games. The provision of BRIDGE service enabled consumer to achieve functional gains in several key areas: time management, writing, financial record keeping, short-term reading, long-term reading, use of household appliances, and computer operation. Consumer is very grateful that she decided to explore vision rehabilitations services. At the completion of BRIDGE services, consumer was more hopeful about her future as visually impaired elder. 3. Client is a 78-year-old man who lives in a single-family house with his wife. Client has recently become legally blind due to “ischemic optic atrophy” Client was very depressed about his decreased vision. In addition to his vision conditions, client has cardiac disease and depression. Client was referred to the MCB Bridge program. Client is able to benefit from the following services and equipment. Pen friend, double spatula, Large Print key board, a 3.5 Magnifier, and TV glasses. Client was also provided with a CCTV for newspaper reading. Client went to Carroll Center for a Senior Vision Assessment. Based on the results, client was given a hand-held video magnifier, TV glasses and a 10.75 LED hand held magnifier. Client was referred to the MCB Technology Unit to be instructed on how best to use the adaptive settings on his apple computer. Finally, client has been referred to the Natick Support group. The provision of Bridge services has enable client to gain and maintain a high level of independent. Client is more hopeful about his future.

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

There are times during the Federal year that we experience longer wait times for our funding stream. This impacts our response time in providing services to our OIB consumers in MA.

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
Telephone(617)-626-7462
Date signed12/14/2016