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

RSA-7-OB for Montana Disability Employment and Transitions Division - H177B160026 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 year225,000
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2225,000
A2. Total other federal0
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)25,000
A4. Third party8,398
A5. In-kind0
A6. Total Matching Funds33,398
A7. Total All Funds Expended258,398
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs224,844
C. Total expenditures and encumbrances for direct program services33,554

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 0.1000 2.6600 2.7600
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 0.1000 2.6600 2.7600

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 5 0.6800
2. Employees with Blindness Age 55 and Older 1 0.4000
3. Employees who are Racial/Ethnic Minorities 1 0.1000
4. Employees who are Women 11 1.9000
5. Employees Age 55 and Older 5 0.4900

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 FY262
2. Number of individuals who began receiving services in the reported FY314
3. Total individuals served during the reported fiscal year (A1 + A2) 576

B. Age

1. 55-5925
2. 60-6418
3. 65-6940
4. 70-7442
5. 75-7972
6. 80-84124
7. 85-89130
8. 90-9492
9. 95-9930
10. 100 & over3
11. Total (must agree with A3)576

C. Gender

1. Female417
2. Male159
3. Total (must agree with A3)576

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaska Native20
3. Asian0
4. Black or African American0
5. Native Hawaiian or Other Pacific Islander0
6. White552
7. Two or more races3
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)576

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)10
2. Legally Blind (excluding totally blind)221
3. Severe Visual Impairment345
4. Total (must agree with A3)576

F. Major Cause of Visual Impairment

1. Macular Degeneration402
2. Diabetic Retinopathy20
3. Glaucoma36
4. Cataracts12
5. Other106
6. Total (must agree with A3)576

G. Other Age-Related Impairments

1. Hearing Impairment285
2. Diabetes126
3. Cardiovascular Disease and Strokes194
4. Cancer129
5. Bone, Muscle, Skin, Joint, and Movement Disorders293
6. Alzheimer's Disease/Cognitive Impairment76
7. Depression/Mood Disorder65
8. Other Major Geriatric Concerns111

H. Type of Residence

1. Private residence (house or apartment)438
2. Senior Living/Retirement Community86
3. Assisted Living Facility34
4. Nursing Home/Long-term Care facility16
5. Homeless2
6. Total (must agree with A3)576

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)151
2. Physician/medical provider19
3. State VR agency4
4. Government or Social Service Agency13
5. Veterans Administration29
6. Senior Center11
7. Assisted Living Facility4
8. Nursing Home/Long-term Care facility16
9. Faith-based organization0
10. Independent Living center3
11. Family member or friend134
12. Self-referral102
13. Other90
14. Total (must agree with A3)576

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 5,070
1b. Total Cost from other funds 563
2. Vision screening / vision examination / low vision evaluation 234
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 7,332
1b. Total Cost from other funds 92,123
2. Provision of assistive technology devices and aids 255
3. Provision of assistive technology services 39

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 2,100
1b. Total Cost from other funds 449
2. Orientation and Mobility training 53
3. Communication skills 223
4. Daily living skills 468
5. Supportive services (reader services, transportation, personal 32
6. Advocacy training and support networks 2
7. Counseling (peer, individual and group) 4
8. Information, referral and community integration 1
. Other IL services 2

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 3,673
1b. Total Cost from other funds 408
2. Information and Referral 230
3. Community Awareness: Events/Activities 58 113

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) 253,995 258,398 4,403
2. Number of Individuals Served 659 576 -83
3. Number of Minority Individuals Served 30 24 -6
4. Number of Community Awareness Activities 78 58 -20
5. Number of Collaborating agencies and organizations 2 2 0
6. Number of Sub-grantees 0 0

Part VI: Program Outcomes/Performance Measures

Provide the following data for each of the performance measures below. This will assist RSA in reporting results and outcomes related to the program.

Number of persons Percent of persons
A1. Number of individuals receiving AT (assistive technology) services and training 39 100.00%
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) 39 100.00%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 128 328.21%
B1. Number of individuals who received orientation and mobility (O & M) services 53 100.00%
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) 53 100.00%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 29 54.72%
C1. Number of individuals who received communication skills training 223 100.00%
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) 223 100.00%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 124 55.61%
D1. Number of individuals who received daily living skills training 468 100.00%
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) 293 62.61%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 293 62.61%
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) 237 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) 1 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) 3 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 8 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) 2 n/a

Part VII: Training and Technical Assistance Needs

On the management side of the Older Blind Program Montana’s program would benefit from assistance • Developing methods to measure the effectiveness and client satisfaction for the Older Blind Program. Previously surveys were sent to every closed case, but the last couple years this was done the response rate was too low to be effective (less than 1%). • How to make our case management system provide the information needed for both completing the 7-OB report and using it for measuring staff effectiveness • Finding resources to bolster or enhance the Older Independent blind services • Where to find and how to use statistics on blindness for the planning Older Blind Services in three to five years from now • How to better maintain the budget so we are not running out of funds before the end of the fiscal year Training and technical needs for the staff who provide direct services for the Older Blind program are • Low vision technology, assessments, etc. • Working with individuals with dual sensory loss • Techniques and assistive devices for medical management, i.e. insulin drawing • Basic techniques for Apple accessibility as well as Android devices • Case management issues, i.e. case closure when services completed but client doesn’t want to “let go”, referring clients to services that the OB program doesn’t provide • Computer technology—resources for clients who haven’t used technology through advanced resources for clients who are familiar with technology but need adaptive programs and devices • How to do outreach more effectively

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.

Montana provides Older Blind Services in-house with no sub-grantees or contractors. Direct services and case management are provided by four orientation and mobility specialists, five vision rehabilitation therapists and an assistive computer specialist. The staff work from regional offices and one sub-office and they travel to communities within their territory. Counties covered by each office are based on population so the geographic area covered varies. The offices on the western side of the state have larger population bases and fewer counties. Each office also contains a low vision lab where Older Blind consumers can be evaluated for and work with a variety of low vision equipment before it is dispensed or recommended for their purchase. Most low vision aids and assistive technology which are dispensed are purchased through bulk orders from distributors. This saves significantly on the cost items as shipping is less and often the vendors will give discounts for larger orders. Less equipment is purchased for clients as staff are spending more time providing training. Underserved populations in Montana consist mostly of Native Americans, people who reside in rural communities and Deaf-Blind individuals. Montana has seven reservations. Outreach activities consist of participating in community health fairs sponsored by senior centers, medical providers and community partners. Staff members contact the optometric clinics and senior centers on the Native American reservations in Montana. In an effort to reach more consumers BLVS entered into an agreement with iCanConnect to work with individuals with deaf/blindness to improve their telecommunications abilities. The BLVS staff meet with the applicants, do assessments, order equipment and provide training to iCanConnect clients. In return iCanConnect reimburses costs for working with their deaf/blind clients. Most of the iCanConnect clients also qualify for the Older Blind Program and this gives us the opportunity to provide them with Older Blind Services as well. Montana staff collaborates closely with the staff of the VIST and low vision clinic Veterans Affairs programs. Referrals go both directions. This arrangement allows the veterans to receive equipment the Older Blind program cannot afford to purchase for them and also training the VIST and low vision programs cannot provide. The staff also assists the Older Blind clients with completing applications for the Montana State Library Talking Book Program, Montana Assistive Telecommunications Program, Newsline, and the Montana Association for the Blind (M.A.B.) Summer Orientation Program. If individuals require financial assistance to purchase assistive technology they are referred to the M.A.B. loan/lease program.

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.

Blind and Low Vision has entered into an agreement with Perkins to provide services to iCanConnect patrons. iCanConnect couldn’t find a provider to work with the patroons for their program and the majority of individuals with deaf-blindness are over 55 years of age so would qualify the Older Blind Program as well. This collaboration provides referrals to the Older Blind Program and also allows our trained staff to provide additional services for the Older Blind participants. In addition, the funds provided by iCanConnect for providing services through their program are put into the Older Blind Program budget which increases our ability to provide services. We continue to work closely with the Veteran’s Administration VIST program both through giving and receiving referrals. Our staff provides assessments to Older Blind Individuals who are veterans, makes referrals to their program and also makes recommendations for equipment they need. In turn the VA provides magnification and other equipment the veterans are entitled to receive and our staff follows up with training in their homes both for the equipment they obtain at the VA clinics and the equipment recommended by our staff. The staff working with Older Blind individuals leads several support groups. They lead groups in Great Falls, Kalispell, Missoula, Hamilton, and Butte and have done presentations at support groups in Havre, Billings and Lewistown. Staff at the Missoula office worked with an Older Blind Client and the Independent Living Centers to get a statewide peer support network set up for individuals with blindness. Staff works closely with the vendors of low vision equipment in the state. They make and receive referrals, assist older blind individuals in choosing the equipment that works best for their needs. If the Older Blind individual requires financial assistance with purchasing equipment, they will help with referring to the Montana Association for the Blind Equipment loan/lease program or assist with finding used equipment. Blind and Low Vision Services also accepts used equipment like electronic magnifiers as donations and then gives the items to Older Blind individuals who can use it.

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.

No evaluations or satisfaction surveys were conducted in FY 2016.

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).

Many of the people served through the Older Blind program are happy just to find low vision aids so they can read again. Montana has very few options for individuals to find magnification that will work for them given the long distances between cities where ophthalmologists and optometrists practice. In many counties, the staff that provides services through the Older Blind Program are the only options for residents to find assistance in dealing with blindness and low vision. They lack transportation to get to the few medical professionals that do low vision (often more than 100 miles away). Low vision assessments, magnifiers and recommendations for equipment are the major services requested and provided. Those who request other services really benefit by the independence and purpose they regain. Loss of sight for some individuals means they stop activities in the community and may isolate themselves fearing what others think or how they can perform everyday activities in public. Through training and encouragement individuals can thrive. Words really cannot describe this woman--you just plain have to meet her. Mary Rose continues to live alone at the age of 92 ½ even though glaucoma and age related macular degeneration are taking all of her sight. She impacts others and the world around her due to her personality, vitality and tools such as adaptive equipment, instruction and support she has received from the Older Blind (OB) program. She is so unique she had a documentary movie made about her. Mary Rose never misses a support group meeting stating that church and this meeting is “just something she just does”. Mary Rose has attended the monthly support group since 2011 and often brings homemade cookies which are always a hit. Mary Rose brought up that she doesn’t like to eat out anymore and an appointment was scheduled to assist with this fear. Cutting and eating techniques were addressed and Mary Rose stated this provided the self-confidence needed to dine out and feel less judgmental about her eating skills. Thanks to a donated CCTV, talking blood pressure monitor and calculator Mary Rose continues to be able to read her mail, pay her bills, and monitor her health. Mary Rose is proud to announce that she doesn’t own a TV and is one of those people that doesn’t believe in being idle. Mary Rose helps with the family business that takes a home and turns it around to sell by assisting with the cleaning. Besides this effort Mary Rose fills her days reading her devotions using her large print bible with the CCTV, gardening, traveling independently on the city bus and can be found out and about picking up garbage in the ditches around her home. Services can assist with staying in the home by allowing the person to cook and care for themselves and also improve communication access to family and friends. Hetty is 95 and lives independently in her own home. Hetty was referred by her ophthalmologist. She was contemplating selling her home and moving into assisted living because she had trouble caring for herself due to vision loss. During the first meeting she received assessments on magnification and lighting and was given a magnifier. She also has some hearing loss and was referred to the Montana Telecommunications Program for amplified phone equipment. Letty with her son’s help changed all the lightbulbs in her kitchen, dining room, and bathroom to LED’s as recommended. She says that just with this change she is able to prepare meals for herself and take care of personal hygiene. Her appliances were marked to make using them safer and easier. MTAP provided her with an amplified phone and answering machine. Facebook is one of Hetty’s major connections to her extended family who live out-of-state so training was provided on easier ways to use her iPad. She now accesses messages and pictures of grandchildren with ease. She is no longer contemplating moving to assisted living. Margaret is an 81 year old woman with macular degeneration and a hearing impairment living alone. She wanted assistance with using kitchen appliances and being able to read the newspaper. In June she was given magnifiers, a large print calendar, talking alarm clock, liquid level indicator, measuring spoon set, 20/20 pens, check writing guide and signature guide. We also marked kitchen appliances for her. Follow up contacts indicate that she is more independent in the kitchen and with magnifiers reads the paper and other small print items. Jane, an 81 year old with legal blindness, was by a social services agency. Jane’s visual loss is from dry macular degeneration O.D., and retinal issues O.S. Jane resides alone in her own apartment and receives PCA (Personal Care Assistance) services five days a week. Jane reports other age-related impairments of hearing impairment, cardiovascular disease, stroke, bone, muscle, skin, joint and movement disorders, depression, hardening of the arteries and lupus. Jane’s visual expectations were, “To find out what you people do to help someone in my condition to continue reading and write. I write short stories and I still write to people in my family.” A comprehensive low vision evaluation was completed with Jane. Various types of magnification, including both illuminated and non-illuminated hand-held and fixed-focus magnifiers; spectacles; Luxo and daylight lamps; table and floor lamps; portable video magnification devices and CCTV’s were explored with Jane. What best suited for her current low vision needs included: a 3X hand-held bright white power magnifier; and a 3X Mensalux magnifier. These magnifiers were provided to Jane. Non-optically 20/20 pens, bold line paper, a bold line notepad, a large print calendar and a lap desk were dispensed to Jane. She explored a variety of makes/models of electronic magnifiers, all of which were beneficial to Jane. She was excited that she would receive a donated Clearview C with Speech CCTV and she was instructed in its utilization. In hopes of continuing to write short stories a computer evaluation was completed. A desktop computer with Windows 7 would best benefit Jane for writing. We worked with Jane’s payee to collaborate purchase financing for Zoomtext magnifier/reader software and a Zoomtext large print W/B keyboard which she also needed to successfully use the computer. Due to recent medical issues involving her neck and hip, the pursuit of the purchase of the Zoomtext software and keyboard was postponed. She was referred to the telecommunications for deaf and hard of hearing program and the talking book library for additional services. Jane enjoys her new found freedom with her Clearview C with Speech CCTV. Jane is able to read her mail and verses out of her favorite Biblical books, identify her jewelry and various prescriptions. Jane stated that just as important is the fact that she can continue to write letters to her family with the acquisition of her new CCTV. Charlene phoned our office complaining that she was unable to set her thermostat due to her visual impairment. Charlene has macular degeneration and received ocular injections for several years but opted to discontinue these treatments due to the pain and little value she felt they provided. She was a frail woman with who lived alone in her home and felt trapped due to her vision. She thought she could not go out or manage most tasks in her home and was very discouraged. She had discontinued cooking and relied on Meals on Wheels for her one meal a day. At this first meeting, we provided a magnifier and marked her thermostat so that she felt confident in setting it again. We discussed other difficulties she was experiencing, such as cooking, using her remote, seeing her clock, going out with friends, reading menus, enjoying books, and finding all her food freezer burned. Over the next few months she was provided a large button remote, a talking watch, a colossal kitchen timer, an Ahmed Video Magnifier, and a Luxo-lamp. Her stove, microwave and freezer were marked. She received instruction on low vision cooking techniques, using contrast and safe cutting techniques. She also received counseling about adjustment to vision loss, the attitudes of others and her own attitude about blindness and tips for eating out such as how to use the video magnifier to read a menu. Charlene subscribed to Montana Talking Book Library and now enjoys books daily. A free money identifier from the Bureau of Engraving was ordered to provide her independence with her money. Four months after starting services Charlene is a happy, independent, confident woman who is less frail. She cooks, enjoys lunches with friends, and enjoys her spare time. She feels the Older Blind Program gave her life back. In Montana we collaborate closely with the Veteran’s Administration VIST Program. This is a good match as the VA is able to provide more equipment the older veterans need and the Older Blind program is able to provide the training at the veteran’s homes. The veterans win with this partnership. Ben is an 81-year old widower with vision loss due to macular degeneration. His wife died approximately two years, and he lives by himself in his own residence. He has a great support system in place consisting of three daughters and numerous friends. He was referred for services by a family member. The Older Blind Program assisted him with identifying the magnifiers that would help him, assistive technology for cooking, training and tools for doing his banking, a white support cane for identification and a monocular to watch wildlife outside his window. He was excited that he could now see what wildlife others were talking about. The VIST program provided a closed-circuit television (electronic magnifier) and portable digital magnifier so he can read easier and remain an active board member. Tom, a Korean veteran with diabetic retinopathy, a heart condition, diabetes, depression, and amputated right leg lives in his own home with his two sons. He was referred by the VIST coordinator to work on adaptive cooking skills. The vision rehabilitation therapist completed an evaluation and provided training on cooking skills, handwriting, leisure skills, communication skills, personal management and money management. Both the Older Blind Program and the VIST program provided assistive technology devices to increase his independence. He was opened into the Older Blind Program on October 23, 2015 and when asked what brought him into see BLVS he commented “Have a hard time seeing and stuff like that”. The services provided by BLVS included; a low vision evaluation, Assistive Technology Devices and Aids, Assistive Technology Services and Training, Time Management, Peer or Family Support Group, Leisure Skills, Transportation, Adaptive Cooking, Handwriting, Telephone Management, Personal Management, Computer Training, and Money Management. He now can read his prescriptions, cook meals himself and perform many other tasks around the home. He has been able to improve his nutrition so the diabetes is better controlled. The services also provided him with methods for accessing leisure activities so he days don’t seem so long. In addition, he attends local support group meetings. These examples show that the person’s whole life improves with the provision of training and assistive technology. The numbers in section VI give a quantitative information but these examples show how affecting one aspect of a person’s independence affects other aspects of their lives.

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

The case management/data collection software used by Blind and Low Vision Services became active in the summer of 2015. FY 2016 is the first year we are fully under this management software and many bugs are still being worked on including getting accurate information for the 7-OB report. The numbers in Section VI of this report are incorrect. Until the case management software company can correct the information in this section, it will not be accurate. A total of 246 Older Blind cases were closed in this fiscal year. BLVS currently uses an Excel spread sheet which staff completes in half-hour intervals to identify the time they spend on low vision assessments, assistive technology services, independent living and community services to show the cost allocation for direct services in section IV. They all find this cumbersome and would like a simpler method to report their time usage. The current outreach to underserved populations like Native Americans isn’t working. The number of minorities who receive Older Blind services has declined while the information from statistics and articles indicate the number of individuals with vision loss continues to increase at a higher rate on the Native American Reservations of which Montana has seven. Three other underserved populations include people of Asian descent, individuals with dual sensory disabilities and rural populations. Part of the issue may be that staff are so busy seeing individuals in communities where the offices are located that they do not have time to make regular personal contacts on the Native American Reservations or in the sparsely populated rural areas. Funding for assistive technology and low vision aids continues to be an issue. Since most of the people served through the OB program survive on fixed incomes, they are not able to purchase the assistive technology and low vision aids they need, especially the electronic magnifiers (CC-tv’s) and other high end technology like screen reading and screen enlarge software. While technology that assists people with vision impairment and blindness increases the resources to fund these devices remains limited. Having access to a no-interest loan program helps, but its funds are also limited. Other funding sources are needed. BLVS needs technical assistance on developing methods to measure the effectiveness and client satisfaction for the Older Blind Program. Previously surveys were sent to every closed case, but the last couple years this was done the response rate was too low to be effective (less than 1%). One trend we have noticed is the number of older blind individuals who request more training and information about computer technology increases each year. Ten years ago very few Older Blind clients wanted to know about or used computer technology. Now we are seeing more who either use or want to use computer technology. Some are conversant with computer technology and need to know about adaptive techniques and programs or devices while others have never used the computer technology but want to start so they can maintain better communication with younger generations. The staff members who provide direct services for the Older Blind program have identified needs for training relating to • Low vision technology, assessments, etc. • Working with individuals with dual sensory loss • Techniques and assistive devices for medical management, i.e. insulin drawing • Basic techniques for Apple accessibility as well as Android devices As a final problematic area to be mentioned is the lack of sufficient resources for the Older Blind Program. This includes funding that has not changed since the program became a formula grant (due to being a minimally funded state). Yearly inflation increases costs for providing services through the Older Blind program.

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 byBeverly Berg
TitleProgram Administrator
Telephone406-454-6081
Date signed12/29/2016