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

RSA-7-OB for Maryland Division of Rehabilitation Services - H177B160020 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 year552,590
Other federal grant award for reported fiscal year379,807
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 2552,590
A2. Total other federal379,807
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement379,807
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)61,399
A4. Third party0
A5. In-kind67,391
A6. Total Matching Funds128,790
A7. Total All Funds Expended1,061,187
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs53,536
C. Total expenditures and encumbrances for direct program services1,007,651

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 0.3000 5.0000 5.3000
2. FTE Contractors 1.1200 11.2400 12.3600
3. Total FTE 1.4200 16.2400 17.6600

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 11 8.8000
2. Employees with Blindness Age 55 and Older 6 5.3000
3. Employees who are Racial/Ethnic Minorities 12 5.4300
4. Employees who are Women 22 12.6300
5. Employees Age 55 and Older 5 3.4000

C. Volunteers

104.00

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 FY300
2. Number of individuals who began receiving services in the reported FY508
3. Total individuals served during the reported fiscal year (A1 + A2) 808

B. Age

1. 55-5989
2. 60-64100
3. 65-69124
4. 70-7499
5. 75-79103
6. 80-8490
7. 85-89112
8. 90-9475
9. 95-9915
10. 100 & over1
11. Total (must agree with A3)808

C. Gender

1. Female538
2. Male270
3. Total (must agree with A3)808

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race13
2. American Indian or Alaska Native5
3. Asian15
4. Black or African American337
5. Native Hawaiian or Other Pacific Islander4
6. White429
7. Two or more races4
8. Race and ethnicity unknown (only if consumer refuses to identify)1
9. Total (must agree with A3)808

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)322
2. Legally Blind (excluding totally blind)244
3. Severe Visual Impairment242
4. Total (must agree with A3)808

F. Major Cause of Visual Impairment

1. Macular Degeneration245
2. Diabetic Retinopathy105
3. Glaucoma184
4. Cataracts31
5. Other243
6. Total (must agree with A3)808

G. Other Age-Related Impairments

1. Hearing Impairment94
2. Diabetes180
3. Cardiovascular Disease and Strokes68
4. Cancer16
5. Bone, Muscle, Skin, Joint, and Movement Disorders102
6. Alzheimer's Disease/Cognitive Impairment10
7. Depression/Mood Disorder27
8. Other Major Geriatric Concerns96

H. Type of Residence

1. Private residence (house or apartment)741
2. Senior Living/Retirement Community50
3. Assisted Living Facility14
4. Nursing Home/Long-term Care facility3
5. Homeless0
6. Total (must agree with A3)808

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)222
2. Physician/medical provider77
3. State VR agency45
4. Government or Social Service Agency61
5. Veterans Administration1
6. Senior Center86
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization4
10. Independent Living center1
11. Family member or friend81
12. Self-referral170
13. Other60
14. Total (must agree with A3)808

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 9,832
1b. Total Cost from other funds 8,692
2. Vision screening / vision examination / low vision evaluation 112
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 3

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 193,416
1b. Total Cost from other funds 191,554
2. Provision of assistive technology devices and aids 229
3. Provision of assistive technology services 339

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 261,779
1b. Total Cost from other funds 251,993
2. Orientation and Mobility training 381
3. Communication skills 129
4. Daily living skills 412
5. Supportive services (reader services, transportation, personal 178
6. Advocacy training and support networks 123
7. Counseling (peer, individual and group) 191
8. Information, referral and community integration 523
. Other IL services 206

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 34,027
1b. Total Cost from other funds 50,641
2. Information and Referral 237
3. Community Awareness: Events/Activities 111 3,185

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) 1,240,378 1,007,651 -232,727
2. Number of Individuals Served 846 808 -38
3. Number of Minority Individuals Served 363 379 16
4. Number of Community Awareness Activities 62 111 49
5. Number of Collaborating agencies and organizations 30 33 3
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 339 100.00%
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) 213 62.83%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 123 36.28%
B1. Number of individuals who received orientation and mobility (O & M) services 381 100.00%
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) 192 50.39%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 160 41.99%
C1. Number of individuals who received communication skills training 129 100.00%
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) 124 96.12%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 5 3.88%
D1. Number of individuals who received daily living skills training 412 100.00%
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) 266 64.56%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 143 34.71%
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) 451 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) 17 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) 30 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 50 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) 12 n/a

Part VII: Training and Technical Assistance Needs

In Maryland our needs are similar to the concerns reported in section E of this report. We continue to struggle with having sufficient qualified and certified staff to provide the vast services needed all over the state. When an opening becomes available, the recruitment and the hiring process is slow and often yields applicants who lack an expertise in blindness and/or aging. An annual training for all program managers should be made mandatory to ensure consistency and the integrity of the program. Unfortunately, not all states can take advantage of the trainings being offered by the OIB-TAC.

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.

During FY16, the Maryland Division of Rehabilitation Services (DORS) collaborated with two sub-grantees: The Columbia Lighthouse for the Blind (CLB) and Blind Industries and Services of Maryland (BISM). The purpose of the partnerships is to enhance and increase services to older blind individuals in Maryland. In addition, in-house Rehabilitation Teachers continues to serve consumers being referred through various means. When appropriate, consumers are cross-referred with sub-grantees to ensure that appropriate services are provided in a timely manner. Services provided include but are not limited to, education, demonstration, and instruction in: Daily Living Skills for Independent Living, Braille/Communication, Orientation & Mobility, Adapted Computer Technology, Adjustment and Advocacy, Diabetic Management & Nutrition, Community Activities, Peer Interaction, Low Vision and Blindness Resources, plus adaptive aids, devices, and equipment. Statewide outreach efforts included speaking engagements, presentations, media exposure, conferences, and literature dissemination targeting senior consumers, senior centers, retirement communities, blindness-related agencies, and professionals in the field in an effort to reach seniors in all areas of the state including those in rural, remote, and underserved areas. In this fiscal year we logged at least 111 outreach activities reaching over 3100+ individuals. During this fiscal year, mixed media efforts reached thousands across the state and beyond through television, radio, and press releases including: ABC-2, Arbutus Times, Baltimore Sun, WMDT-47 ABC, The Daily Times, Fox 45, WJZ-TV, MD Public Television, Delmarva Public Radio, The Fan 105.7 Orioles Radio, WCBC Talk Radio -- plus, Facebook, BISM Grapevine Newsletters, Salisbury Training Center Newsletters, and agency websites as well as strong support from community partner websites, list-serves, local publications and bulletin boards. CLB continues to strengthen its community partnerships to provide outreach to Maryland residents at Senior Wellness Centers at Holy Cross, Bethesda Rehab Center, The Archdiocese of Washington Center for Deaf Ministries, Riderwood, Springvale Terrace assisted living homes and other underserved communities. They provide O&M and IL services in those retirement communities. They also have monthly support groups and senior call live for those who are having difficulty adjusting to their vision loss as well as those without family support. Lastly, as we know, dual sensory loss is very prominent with the seniors we serve. As a result, Support Service Provider (SSP) services continues to be offered to MD deaf-blind residents to assist them with meeting, appointments, going shopping, reading emails, friendly visitors, and exercise activities. This is very important as visually impaired seniors begin to experience a dual sensory loss of vision and hearing. Since CLB was the Maryland contractor for the Deaf-blind equipment distribution program, eligible deaf-blind seniors were be provided with needed adaptive equipment and training. Seniors and their families are taking advantage of these services and the numbers are increasing month by month.

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.

During this fiscal year, we sustained our time tested and proven strategies for expanding our services. DORS and the Sub-grantees work collaboratively to ensure that a full spectrum of services is available for seniors in all areas of the state. Throughout the grant year, a wide variety of outreach efforts take place. Staff members educate the senior blind, their families and supporters, plus professionals in the field of vision loss and community organizations about ILOB training and services. The ongoing recruiting effort plays an important role in identifying blind and low vision seniors in need of blindness skills training. By providing education to members of the public, they become better equipped and more willing to share valuable resource information. DORS continues to be a major supporter and co-sponsor of the Possibilities Fair for Seniors Losing Vision. This is an annual statewide event that brings together many participants, vendors, families, government agencies and visually impaired consumers. The purpose of the Fair is to enhance the participant’s knowledge of low vision and blindness and provide resources through a variety of presentations, demonstrations, networking and a keynote speaker. For the nominal fee of $20, participants are provided a tote bag filled with free samples, literature and some other goodies. They are strongly encouraged to visit each vendor to get additional information, samples and freebies. They often sign up for free services, purchase needed low vision aids and even free massages. The Fair serves as a mechanism to reach out to seniors throughout the state in a systematic manner. Each year, more than 250 seniors who are losing vision have attended the Possibilities Fair. DORS consumers are supported financially through a fee waiver and transportation subsidy. Vendors included organizations like the Bureau of Printing and Engraving, Maryland Library for the Blind and Physically Handicapped, the Maryland Transportation Authority, AARP, National Aquarium, Van Dyke and Bacon and the Wilmer Eye Institute. This year included outreach presentations to 111+ entities, with over 3100 attendees as well as meetings and communications with service providers of the elder blind population. Presentations were made at senior residential facilities, churches, transportation agencies, governmental agencies, state and national conventions of the blind, centers for independent living, local events, & to medical professionals. ILOB events are publicized through webcasts, radio and TV, publicity campaigns, health and wellness fairs, magazine articles, community partner newsletters, conference presentations, program advertising, DVD distribution, and the DORS and BISM website updates.

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

A Satisfaction Survey is administered to each ILOB program participant; this is an important tool used to assess consumer feedback following each training event. FY16 featured the presentation of one Life Enhancement Workshop in Montgomery County, MD serving 14 participants. Event 9 Riderwood Retirement Comm. 14 participants This workshop provided demonstrations, hand-on instruction, and discussion on a variety of labeling techniques to assist seniors in identifying important items such as medications, recipes, instructions, appliance settings & controls, money, clothing, and many things commonly found in the home. All demonstrations presented a method for accomplishing tasks that could be used without vision or with reduced vision. Demonstration items ranged from low-tech tactile items to higher tech devices such as the Pen Friend and recorders. Each senior in attendance received a bag of tactile labeling supplies that they could take home and immediately put to use. They also received a Resource Guide, Labeling Guide, and other useful information. Following are results from this 4th quarter’s training event: Overall Rating: Event 9: Riderwood Retirement Comm. 95.6% Overall Satisfaction Rating 95.6% Blind Industries & Services of Maryland ILOB SURVEY SATISFACTION RATING Q4 FY16 Event 9 Riderwood 8.10.16 1 The services I received have helped me 91% improve my quality of life and/or independence now. 2 The services I received will aid in my quality 96% of life and/or independence for the future. 3 Services were well organized. 87% 4 I learned new information and skills. 90% 5 Instructors were knowledgeable. 100% 6 I was satisfied with the overall experience 97% of the program. 7 I would recommend this program to others. 100% 8 I liked the program hours and the scheduled day. 99% 9 Rate the training facilities. 100% 10 The hotel accommodations were n/a TOTAL OVERALL RATING 95.6% *numbers are shown in % of satisfaction 95.6% Event 9 — Riderwood Retirement Comm.

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).

Throughout the fiscal year, discussions with program participants as well as compiled survey results produced very positive results. Seniors are encouraged to seek ongoing training through the many training options available to them. Following their participation in ILOB programming, they are motivated and hopeful for an independent future. They are excited by the new possibilities that were unrealized prior to ILOB training. Peer supports are encouraged and established and are ongoing. Consumer A had a number of challenges to executing daily living activities in his home and community, including those related to communication, household tasks, feeding and grooming. The consumer previously enjoyed cooking, watching movies, grooming and dressing up for a night out with friends. The rehabilitation teacher helped him make a number of low cost adaptations to his environment that made an immediate impact on his independence, safety and confidence. These included adding task lighting, tactile markings to commonly used household items, such as the TV remote control, radio and telephone. In addition, a number of strategies were taught for bathroom alterations and advice for safety, eating, dressing (e.g., color coordinating outfits with safety pins), personal care (e.g. using dark curtains, towels and non-skid rug in bathroom to help with contrast), reading and writing. It is clear that ILOB services contribute significantly to the independence and quality of life for blind and low vision seniors. At a BISM retreat, a gentleman told how he desired to hold his position on the Board of Directors in his retirement community, but because of his vision loss, had given up the dream. At the retreat closing ceremony, he gave an emotional testimonial stating that upon returning home because of the skill and confidence gained at the retreat, he was going to make plans to announce he would not be resigning from his position as previously considered. He was so excited about the things he could do with his iPhone to help him in his position. Prior to this, he was considering resigning from a position where he had lots of great ideas and influences in what goes on in his community. He left the retreat with so much hope and enthusiasm. CLB provided support group services to a 73 year old male. He reports that services have been extremely helpful to him as he adjusts to his vision loss. He appreciates connecting with others who are dealing with similar issues to him, and has found support groups to be very beneficial. Other consumers have commented: --Enjoyed Pen Friend demo, enjoyed everything, excellent program --Liked kitchen tips, money reader, digital recorder training, & learning skills --Made me feel hopeful; this program should go to more places! --Building my confidence; had never used a cane to cross a street or on an escalator --Thankful to be there & be taught skills that I really needed to do things I used to --I was ashamed of my blindness; now I am confident --It felt like family; they made sure I had vegetarian meals; like traveling airport --Every instructor went above and beyond their duty for students --Staff cares deeply about serving and providing learning; wanted us to progress --This was the greatest adventure of my life—a game changer --I received everything needed to carry on, work hard, serve others and myself --I was encouraged to address my challenges; deeply rewarding experience!

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

We are financially committed and mission-driven to provide quality services to the senior blind population who may be in jeopardy of losing their place of residence, mismanaging personal needs, and becoming unable to manage everyday tasks and responsibilities of daily living. This year we continue to experience many of the same challenges as in previous years. These issues include: • Transportation! Need for affordable, dependable, safe, & efficient rides. • Need for housing options for blind seniors with additional disabilities. • Need for availability of technology for seniors motivated to learn. • Seniors not ready to face vision loss reluctant to seek training and assistance. • Additional disabilities & medical concerns are obstacles to training & safety. • Funding -- Training for blind senior consumers is costly in terms of staff time required as training is often presented in a one-to-one format of staff to senior. Limited funding can limit program design. There are growing numbers of seniors needing services. • Professionals who are not trained in the unique service needs of the older blind population -- diabetes educators, senior center and senior housing staff, medical professionals, teachers of the blind. • Need for additional funding for expansion of ILOB program services. • Loss of expert staff through retirement or other means that are knowledgeable about the ILOB program and senior services. • Seniors motivated to learn modern technology, but technology can be costly. • Seniors losing vision often reluctant to admit need for services & assistance. • Seniors may not be willing to face vision loss and seek training. • The geography of the state makes it a challenge to provide the consistent on-going support many seniors need and desire.

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 byTandra Hunter-Payne
TitleProgram Manager
Telephone410-554-9107
Date signed12/28/2016