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

RSA-7-OB for North Carolina Division of Services for the Blind - H177B160033 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 year946,121
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 2978,441
A2. Total other federal978,441
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other978,441
A3. State (excluding in-kind)258,697
A4. Third party0
A5. In-kind0
A6. Total Matching Funds258,697
A7. Total All Funds Expended2,215,579
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs45,886
C. Total expenditures and encumbrances for direct program services2,169,693

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 7.4450 19.7000 27.1450
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 7.4450 19.7000 27.1450

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 18 16.6000
2. Employees with Blindness Age 55 and Older 7 6.5000
3. Employees who are Racial/Ethnic Minorities 84 77.5000
4. Employees who are Women 193 178.1500
5. Employees Age 55 and Older 133 122.7700

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 FY382
2. Number of individuals who began receiving services in the reported FY275
3. Total individuals served during the reported fiscal year (A1 + A2) 657

B. Age

1. 55-59106
2. 60-64109
3. 65-6983
4. 70-7473
5. 75-7979
6. 80-8496
7. 85-8974
8. 90-9428
9. 95-999
10. 100 & over0
11. Total (must agree with A3)657

C. Gender

1. Female475
2. Male182
3. Total (must agree with A3)657

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race15
2. American Indian or Alaska Native2
3. Asian1
4. Black or African American205
5. Native Hawaiian or Other Pacific Islander0
6. White427
7. Two or more races2
8. Race and ethnicity unknown (only if consumer refuses to identify)5
9. Total (must agree with A3)657

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)55
2. Legally Blind (excluding totally blind)330
3. Severe Visual Impairment272
4. Total (must agree with A3)657

F. Major Cause of Visual Impairment

1. Macular Degeneration245
2. Diabetic Retinopathy80
3. Glaucoma132
4. Cataracts8
5. Other192
6. Total (must agree with A3)657

G. Other Age-Related Impairments

1. Hearing Impairment157
2. Diabetes196
3. Cardiovascular Disease and Strokes231
4. Cancer70
5. Bone, Muscle, Skin, Joint, and Movement Disorders222
6. Alzheimer's Disease/Cognitive Impairment12
7. Depression/Mood Disorder77
8. Other Major Geriatric Concerns130

H. Type of Residence

1. Private residence (house or apartment)580
2. Senior Living/Retirement Community65
3. Assisted Living Facility4
4. Nursing Home/Long-term Care facility5
5. Homeless3
6. Total (must agree with A3)657

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)12
2. Physician/medical provider12
3. State VR agency66
4. Government or Social Service Agency292
5. Veterans Administration0
6. Senior Center8
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization1
10. Independent Living center0
11. Family member or friend25
12. Self-referral222
13. Other19
14. Total (must agree with A3)657

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 0
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 77
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 1

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 135,165
2. Provision of assistive technology devices and aids 537
3. Provision of assistive technology services 306

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 118,132
2. Orientation and Mobility training 135
3. Communication skills 292
4. Daily living skills 486
5. Supportive services (reader services, transportation, personal 253
6. Advocacy training and support networks 128
7. Counseling (peer, individual and group) 345
8. Information, referral and community integration 298
. Other IL services 194

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Information and Referral 1
3. Community Awareness: Events/Activities 0 64

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) 1,374,737 0 -1,374,737
2. Number of Individuals Served 636 657 21
3. Number of Minority Individuals Served 197 225 28
4. Number of Community Awareness Activities 111 107 -4
5. Number of Collaborating agencies and organizations 0 0 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 306 100.00%
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) 76 24.84%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 183 59.80%
B1. Number of individuals who received orientation and mobility (O & M) services 135 100.00%
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) 43 31.85%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 79 58.52%
C1. Number of individuals who received communication skills training 292 100.00%
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) 102 34.93%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 182 62.33%
D1. Number of individuals who received daily living skills training 486 100.00%
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) 195 40.12%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 285 58.64%
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) 247 n/a
E2. Number of individuals served who reported feeling that they have less control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 0 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 2 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 5 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) 11 n/a

Part VII: Training and Technical Assistance Needs

As a program specialist having ongoing training and support on trending needs of our consumers would be useful in improving implementation of the program. A technical assistance train the trainer series can provide staff the additional resources needed for AT service delivery. Having access to additional trained staff would minimizes cost escalation and outsourcing. Technical Assistance training would enhance DSB staff’s resources to continue serving 100 counties with in-house programming. Our consumers benefit and enjoy our community learning classes at the IPad/I Device Mini Centers. We would like to do more to keep up with the learning request. It would be helpful if each counselor could learn to teach iPad/iOS devices in the classes and in the home. Some additional training needs to improve the performance of our Title VII- Chapter 2 program is working with substance use and visually impaired, mental health issues, co-occurring disorders, new treatments for eye disorders, and diabetic education.

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.

Direct services are provided by Independent Living Rehabilitation Counselors (ILRC’s) who serve as case managers and give hands-on instruction. ILRC’s serve all 100 of North Carolina’s counties. Services are provided in consumer homes and at Mini Centers which are community-based group trainings. As case managers, ILRC’s refer and coordinate other needed services including referrals to in-house Orientation & Mobility Specialists, Nursing Eye Care Consultants who provide low vision evaluations, Deaf-Blind Specialists, Assistive Technology Consultants and Assistive Technology Instructors. ILRC’s also refer to other DSB case managers including Vocational Rehabilitation Counselors and Social Workers for the Blind. In-home services may include instruction in kitchen safety and adaptive cooking techniques, safe travel techniques, communication skills, labeling and home management, adjustment counseling and hands-on instruction with a variety of low and high-tech devices. Mini Centers provide instruction in the same areas as in-home training but also provide peer support and may forge lasting connections with other local people who are blind or visually impaired. As community-based trainings, Mini Centers also increase the confidence of participants by allowing older people who are blind or visually impaired to realize they are capable of participating in novel activities outside the home. Mini Centers typically provide at least 36 hours of instruction. Some specialized Mini Centers may also be provided. Specialized Mini Centers may include cooking-only Mini Centers, iPad/idevice Mini Centers, Braille Mini Centers and Self-Advocacy Mini Centers. Many community partners and resources are used for Mini Centers to maximize available funding as well as to educate consumers on community resources. A few of DSB’s many partners include local transportation providers, Lions Clubs and other civic groups, churches, fire departments, local law enforcement, senior centers, pharmacies and local health departments. EDTAP or other transportation funding sources are used wherever possible.

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.

This year 107 outreach events were held by DSB staff targeting specific services available to individuals through the Older Blind Independent Living program. DSB Community outreach activities are aimed at informing individuals and organizations in effort to increase awareness and find people that need our services. Building collaborative relationships with community organizations in different counties strengthens are ties to increase the number of people served. Our collaborations connect community resources and activities that can benefit consumers and families we serve. Community outreach continues in all areas of the state, with the ILRC’s making presentations for assisted living communities, senior centers, for medical professionals, senior assistance organizations, camps, and other service providers. The Older Blind Program coordinates assistance for consumers with Social Workers for the Blind, Orientation and Mobility Specialists, Nursing Eye Care Consultants, Deaf/Blind Specialists, and Assistive Technology Specialists, to provide a variety of services to empower individuals to reach their independent living goals. ILRC’ s is provided with training opportunities and professional service delivery practices. We also review information to determine best practices/techniques that may be beneficial to the ILRC’s as they work with our senior consumers. Collaborative efforts are made in the mini center classes with various community resources who provided information to the mini center participants about various programs in the community. DSB/DVR Conference/Youth Mini Center and Sciworks Camp presentation to PETS about vision impairments and independent living services. In August, 2016, the NC Division of Services for the Deaf partnered with the Duke Eye Clinic to coordinate the biennial Medical Update. Duke Medical Center hosted the event, providing the auditorium and most of the presenters. The training was open to all NC DSB employees, regardless of position or program, with 124 employees attending. The purpose of this training is to keep staff abreast of medical advances and treatments for common eye diseases that impact the consumers with whom DSB staff work. Of particular interest were updates about low vision devices. As Diabetes is particularly prevalent, DSB coordinated a presentation by a Certified Diabetes Educator regarding updates, resources and impact of diabetes on vision. Representatives from the Helen Keller National Center and the NC Division of Services for the Deaf and the Hard of Hearing also presented an overview of Haptic Communication techniques and how this technique may be beneficial in working with consumers who are blind and visually impaired in addition to those who are Deaf-Blind.

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.

NC Division of Services for the Blind’s ILOB Satisfaction Survey consists of 11 questions which address customer service, consumer choice in program planning, outcomes and performance measures as well as participant’s overall satisfaction with services. Surveys are mailed to all consumers closed each quarter. ILR Older Blind Program Status 26 Satisfaction Survey Results FY 2015-2016 Number Surveys Received Q1 Q2 Q3 Q4 FY Total Q1 October 2015 - December 2015 21 34 30 18 103 Q2 January 2016 - March 2016 Q3 April 2016 - June 2016 Question 1 - Were staff of the Division of Services for the Blind office polite to you? Q4 July 2016 - September 2016 Q1 Q2 Q3 Q4 FY Total % All the time 19 30 27 15 91 91% Most of the time 2 2 2 2 8 8% Some of the time 0 0 0 1 1 1% None of the time 0 0 0 0 0 0% Hardly ever 0 0 0 0 0 0% Adjusted Total 21 32 29 18 100 100% Question 2 - Were your phone calls to the Division of Services for the Blind office returned to you in a timely manner? Q1 Q2 Q3 Q4 FY Total % All the time 18 25 23 15 81 84% Most of the time 1 4 3 3 11 11% Some of the time 0 1 1 0 2 2% None of the time 0 0 1 0 1 1% Hardly ever 1 0 0 0 1 1% Adjusted Total 20 30 28 18 96 100% Question 3 - Did your Independent Living Rehabilitation Counselor schedule appointments as soon as you thought he/she should? Q1 Q2 Q3 Q4 FY Total % All the time 18 24 22 16 80 86% Most of the time 1 5 3 0 9 10% Some of the time 0 0 1 1 2 2% None of the time 0 0 1 0 1 1% Hardly ever 0 0 1 0 1 1% Adjusted Total 19 29 28 17 93 100% Question 4 - Who made decisions about your rehabilitation goals? Q1 Q2 Q3 Q4 FY Total % You and counselor together 15 28 25 14 82 85% You, alone 2 3 2 1 8 8% Counselor, alone 2 0 1 2 5 5% I don’t know 1 1 0 0 2 2% Adjusted Total 20 32 28 17 97 100% Question 5 - Who made decisions about which services you received from the Division of Services for the Blind? Q1 Q2 Q3 Q4 FY Total % You and counselor together 16 26 24 13 79 81% You, alone 0 2 2 1 5 5% Counselor, alone 3 2 2 2 9 9% I don’t know 1 2 0 1 4 4% Adjusted Total 20 32 28 17 97 100% Question 6 - Was a description of the Independent Living Rehabilitation Program and an explanation of your rights as a consumer discussed with you? Q1 Q2 Q3 Q4 FY Total % Yes 16 24 22 16 78 82% No 2 2 1 0 5 5% Not sure 2 5 4 1 12 13% Adjusted Total 20 31 27 17 95 100% Question 7 - How satisfied are you with the instruction that your received in your home? Q1 Q2 Q3 Q4 FY Total % Very satisfied 17 24 24 17 82 84% Somewhat satisfied 1 3 4 1 9 9% Very dissatisfied 0 0 0 0 0 0% Somewhat dissatisfied 0 0 1 0 1 1% Did not receive 3 3 0 0 6 6% Adjusted Total 21 30 29 18 98 100% Question 8 - How satisfied are you with instruction that your received in the Mini Center? Q1 Q2 Q3 Q4 FY Total % Very satisfied 13 23 18 13 67 65% Somewhat satisfied 3 2 3 1 9 9% Very dissatisfied 1 0 1 0 2 2% Somewhat dissatisfied 0 0 0 0 0 0% Did not receive 4 9 8 4 25 24% No Response 0 0 0 0 0 0% Adjusted Total 21 34 30 18 103 100% Question 9 - How beneficial was the Independent Living Rehabilitation Program in helping you improve your ability to perform the following activities of daily living? A) Move confidently around your home, yard and community Q1 Q2 Q3 Q4 FY Total % Very helpful 14 24 16 14 68 76% Moderately helpful 4 3 7 1 15 17% Somewhat helpful 0 2 1 0 3 3% Neutral 1 0 1 0 2 2% Not helpful 1 0 1 0 2 2% Adjusted Total 20 29 26 15 90 100% B) Prepare simple meals for yourself Q1 Q2 Q3 Q4 FY Total % Very helpful 12 18 16 14 60 70% Moderately helpful 1 1 6 2 10 12% Somewhat helpful 1 4 3 0 8 9% Neutral 1 1 0 0 2 2% Not helpful 3 2 1 0 6 7% Adjusted Total 18 26 26 16 86 100% C) Read materials whether with magnifiers, large print, recorded on tape or Braille Q1 Q2 Q3 Q4 FY Total % Very helpful 13 21 19 16 69 74% Moderately helpful 1 2 4 1 8 9% Somewhat helpful 2 4 2 0 8 9% Neutral 1 0 1 0 2 2% Not helpful 1 2 3 0 6 6% Adjusted Total 18 29 29 17 93 100% D) Manage your mail, correspondence and check writing Q1 Q2 Q3 Q4 FY Total % Very helpful 11 18 11 11 51 59% Moderately helpful 1 1 7 1 10 11% Somewhat helpful 2 3 1 0 6 7% Neutral 2 1 3 1 7 8% Not helpful 3 3 5 2 13 15% Adjusted Total 19 26 27 15 87 100% Question 10 - Overall, would you say your experience with the Division of Services for the Blind was good? Q1 Q2 Q3 Q4 FY Total % All the time 19 26 20 15 80 84% Most of the time 1 3 6 3 13 14% Some of the time 0 0 0 0 0 0% None of the time 0 0 0 0 0 0% Hardly ever 1 0 1 0 2 2% Adjusted Total 21 29 27 18 95 100% Question 11 - Based on your experiences, would you recommend services from the Division of Services for the Blind to others? Q1 Q2 Q3 Q4 FY Total % Definitely would 19 28 26 18 91 94% Probably would 0 2 2 0 4 4% Maybe would 1 0 0 0 1 1% Definitely would not 0 0 0 0 0 0% Probably would not 0 0 1 0 1 1% Maybe would not 0 0 0 0 0 0% Adjusted Total 20 30 29 18 97 100% ILR Older Blind Program Status 28 Satisfaction Survey Results FY 2015-2016 Number Surveys Received Q1 Q2 Q3 Q4 FY Total Q1 October 2015 - December 2015 2 0 0 0 2 Q2 January 2016 - March 2016 Q3 April 2016 - June 2016 Question 1 - Were staff of the Division of Services for the Blind office polite to you? Q4 July 2016 - September 2016 Q1 Q2 Q3 Q4 FY Total % All the time 2 0 0 0 2 100% Most of the time 0 0 0 0 0 0% Some of the time 0 0 0 0 0 0% None of the time 0 0 0 0 0 0% Hardly ever 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 2 - Were your phone calls to the Division of Services for the Blind office returned to you in a timely manner? Q1 Q2 Q3 Q4 FY Total % All the time 2 0 0 0 2 100% Most of the time 0 0 0 0 0 0% Some of the time 0 0 0 0 0 0% None of the time 0 0 0 0 0 0% Hardly ever 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 3 - Did your Independent Living Rehabilitation Counselor schedule appointments as soon as you thought he/she should? Q1 Q2 Q3 Q4 FY Total % All the time 2 0 0 0 2 100% Most of the time 0 0 0 0 0 0% Some of the time 0 0 0 0 0 0% None of the time 0 0 0 0 0 0% Hardly ever 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 4 - Who made decisions about your rehabilitation goals? Q1 Q2 Q3 Q4 FY Total % You and counselor together 2 0 0 0 2 100% You, alone 0 0 0 0 0 0% Counselor, alone 0 0 0 0 0 0% I don’t know 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 5 - Who made decisions about which services you received from the Division of Services for the Blind? Q1 Q2 Q3 Q4 FY Total % You and counselor together 1 0 0 0 1 50% You, alone 1 0 0 0 1 50% Counselor, alone 0 0 0 0 0 0% I don’t know 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 6 - Was a description of the Independent Living Rehabilitation Program and an explanation of your rights as a consumer discussed with you? Q1 Q2 Q3 Q4 FY Total % Yes 2 0 0 0 2 100% No 0 0 0 0 0 0% Not sure 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 7 - How satisfied are you with the instruction that your received in your home? Q1 Q2 Q3 Q4 FY Total % Very satisfied 2 0 0 0 2 100% Somewhat satisfied 0 0 0 0 0 0% Very dissatisfied 0 0 0 0 0 0% Somewhat dissatisfied 0 0 0 0 0 0% Did not receive 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 8 - How satisfied are you with instruction that your received in the Mini Center? Q1 Q2 Q3 Q4 FY Total % Very satisfied 0 0 0 0 0 0% Somewhat satisfied 0 0 0 0 0 0% Very dissatisfied 0 0 0 0 0 0% Somewhat dissatisfied 0 0 0 0 0 0% Did not receive 2 0 0 0 2 100% Adjusted Total 2 0 0 0 2 100% Question 9 - How beneficial was the Independent Living Rehabilitation Program in helping you improve your ability to perform the following activities of daily living? A) Move confidently around your home, yard and community Q1 Q2 Q3 Q4 FY Total % Very helpful 1 0 0 0 1 100% Moderately helpful 0 0 0 0 0 0% Somewhat helpful 0 0 0 0 0 0% Neutral 0 0 0 0 0 0% Not helpful 0 0 0 0 0 0% Adjusted Total 1 0 0 0 1 100% B) Prepare simple meals for yourself Q1 Q2 Q3 Q4 FY Total % Very helpful 0 0 0 0 0 0% Moderately helpful 0 0 0 0 0 0% Somewhat helpful 1 0 0 0 1 100% Neutral 0 0 0 0 0 0% Not helpful 0 0 0 0 0 0% Adjusted Total 1 0 0 0 1 100% C) Read materials whether with magnifiers, large print, recorded on tape or Braille Q1 Q2 Q3 Q4 FY Total % Very helpful 1 0 0 0 1 100% Moderately helpful 0 0 0 0 0 0% Somewhat helpful 0 0 0 0 0 0% Neutral 0 0 0 0 0 0% Not helpful 0 0 0 0 0 0% Adjusted Total 1 0 0 0 1 100% D) Manage your mail, correspondence and check writing Q1 Q2 Q3 Q4 FY Total % Very helpful 1 0 0 0 1 100% Moderately helpful 0 0 0 0 0 0% Somewhat helpful 0 0 0 0 0 0% Neutral 0 0 0 0 0 0% Not helpful 0 0 0 0 0 0% Adjusted Total 1 0 0 0 1 100% Question 10 - Overall, would you say your experience with the Division of Services for the Blind was good? Q1 Q2 Q3 Q4 FY Total % All the time 2 0 0 0 2 100% Most of the time 0 0 0 0 0 0% Some of the time 0 0 0 0 0 0% None of the time 0 0 0 0 0 0% Hardly ever 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100% Question 11 - Based on your experiences, would you recommend services from the Division of Services for the Blind to others? Q1 Q2 Q3 Q4 FY Total % Definitely would 2 0 0 0 2 100% Probably would 0 0 0 0 0 0% Maybe would 0 0 0 0 0 0% Definitely would not 0 0 0 0 0 0% Probably would not 0 0 0 0 0 0% Adjusted Total 2 0 0 0 2 100%

D. Briefly describe the impact of the Title VII-Chapter 2 program, citing examples from individual cases (without identifying information) in which services contributed significantly to increasing independence and quality of life for the individual(s).

Case 1: L.H. LH was not new to vision loss as he witnessed his brother lose vision many years ago. Now, LH himself was going blind. He was already aware of NC Division of Services for the Blind because his brother had utilized services from our agency. LH referred himself to us and at that point, he began his personal success story. The Social Worker for the Blind who served LH’s county assessed his needs, opened his case and provided services. Some services provided were inclusion in a support group, referrals to the Independent Living Older Blind program, the Nursing Eye Care Consultant, and the Orientation and Mobility Specialist. Through DSB services, he learned how to use a variety low vision and blindness assistive devices, how to use a long cane for travel purposes, travel techniques for local travel as well as on public transportation and was connected to the NC Library for the Blind and Physically Handicapped. LH voiced the desire to go even further so assistive technology training on the computer was provided and his computer skills flourished. LH participated in a full Mini Center and in a Braille-specific mini center. During this time, he was elected by his peers at the local VIP support group to become the president, which he gladly accepted and served in this role. LH still wanted to be more active so he connected to Vocational Rehabilitation services. Through that program, he attended the DSB Rehabilitation Center for the Blind in Raleigh. At the Rehabilitation Center, his Braille skills advanced and he went on to learn how to repair Braillewriters, which are Braille typewriters. He now has a part-time business repairing Braillewriters. His most recent accomplishment has been acceptance as a Mini Center Instructor. He began his first Mini Center in the fall of 2016. LH exemplifies what feats can be accomplished in the face of adversity and was, therefore, selected as this year’s Case of the Year for the ILR and ILOB programs. Case 2: J.C. JC is a 51 year old man with visual impairment due to Retinitis Pigmentosa. His best corrected visual acuity is LP OD and HM OS. Other health conditions that he is dealing with include Schizophrenia, depression, high blood pressure, high cholesterol, tachycardia, peripheral arterial disease, neuropathy, COPD, asthma, GERD. JC has been living in a 60 bed assisted living facility for persons with mental illness for almost 15 years. There was a plan for him to move into his own apartment as part of a Department of Justice mandate to transition individuals from long term care facilities into the community. Initially JC was ambivalent about this move. Even though it is very institutional, he is familiar with his current setting where meals, laundry, medications are provided for him and he has never lived on his own. He has been using a wheelchair for the past 15 years, mostly out of convenience and to avoid collisions with other residents in the hallway. He did not know how to use a travel cane or have the strength in his legs to walk. JC was unable to ambulate/navigate safely,keep track of the time/date/appointments, identify his medications, use the telephone, prepare meals, do laundry, or other household chores. JC receives mental health services from A Caring Alternative. Staff meet with him several times/week and have been key in helping him to make his transition to independent living. JC attended a mini center where he really came out of his shell and was loved by all the ladies in the class. He has been able to learn to do things that he had previously insisted that were impossible for him such as identify his money, pour liquids, measure ingredients, slice and peel vegetables, use a microwave, dial a phone, use a digital recorder, label and organize his belongings, identify his medications. He received O&M training, increased his strength to walk with his travel cane whenever he leaves the facility. He went from going down stairs on his bottom, to being able to descend using the railing and his cane. JC, his case manager and ILRC looked at an apartment that hopefully he will be approved to move into next month. He is excited to have his own place, where he can have his own space, listen to his music, make his own decisions. He still has a lot to learn, but will have plenty of support doing so. It has been amazing to watch him become more confident and able. Case 3 : B.D. This consumer was first accepted for Independent Living Rehabilitation, in July, 2013. Her partner of 19 years had recently passed away. She expressed a strong desire to regain proficiency in using her computer. Legally blind, for many years, this consumer also reported difficulty seeing the controls to set her washer/dryer. She also acknowledged bumping into corners of her home while navigating from room to room. This consumer had been using a 5X lighted magnifier but diminishing vision led her to think that a follow up evaluation with Nurse Eye Care Consultant could prove beneficial. She was also particularly sensitive to glare. Prior to opening her case, she had some basic cane skills, but did not use it regularly and did not have access to public transportation. When she moved to a new location, the need for O&M became quite apparent. This consumer also expressed interest in attending the local Mini Center program. During the Mini Center, this consumer arranged her own transportation using public transportation. She maintained a journal of this learning experience, using bold lined paper and a 20/20 marker. She learned to sew with needle threader, to cook with a George Foreman Grill, and to pay her bills using bold lined checks and improved lighting. She worked with the O&M Specialist on about 5 different occasions. She learned to walk to several shopping centers, and a local community center (where a support group met). She also learned to travel by bus to a more expansive shopping center. She ultimately planned on taking her grandson to the movies there. Her ability to walk to common destinations and to take the public bus has been a big cost saver for her. Another acquisition that enabled consumer to get out and about were two specially fitted light filters for glare. After the Mini Center, consumer decided that an iPad would be more suitable to her needs than a traditional computer. She received an iPad and followed that up with some iPad training from one of our Mini Center instructors. Not only does she use it for traditional purposes, like sending emails and searching the web; she also uses it as a magnifier and is able to read her mail and even books. With increased access to public transportation, consumer was able to volunteer at her grandson’s third grade classroom where she read (using her lighted magnifier), for about a half hour, once a week, to the entire class, throughout the year. Finally, this consumer was one of three volunteers who accompanied this ILRC when he gave a presentation on Mini Centers at a state wide convention. During this presentation, this consumer shared with those in attendance how valuable the Mini Center program was for her in regaining her confidence and ability to get out and make a difference in the world. While this consumer was not newly blind, prior to beginning with this ILRC, the gains she made, even from that point, were so dramatic (with her increased mobility skills, increased technology skills, increased awareness of community resources, and increased involvement in her community) that I am proud to identify her as Outstanding Consumer of the Year.

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

The Independent Living Older Blind Program experienced several vacancies during the year that hindered program implementation of in some areas of the state. Those vacancies were primarliy due to staff retirements leaving resource challenges in various catchment areas. DSB strives to stay current of the everchanging landscape of Assistive Technology (AT), in efforts to keep up with the changes we need the resources necessary to do so. Currently there are 4 AT Specialist across the state, this limits ours consumers with the necessary follow up training they need to use their AT independently. ILRC’s are meeting the needs of our consumers as best they can however, with limited staff and unexpected vacancies limits the staff in meeting the AT needs of our consumers.

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 byCrystal Jackson Cheek
TitleIL Rehabilitation Program Specialist
Telephone9195276720
Date signed12/21/2016