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

RSA-7-OB for Nebraska Commission for the Blind and Visually Impaired - H177B170027 report through September 30, 2017

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 year201,712
Other federal grant carryover from previous year4,850
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2353,321
A2. Total other federal65,531
(a) Title VII-Chapter 1-Part B4,850
(b) SSA reimbursement60,681
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)118,554
A4. Third party0
A5. In-kind0
A6. Total Matching Funds118,554
A7. Total All Funds Expended537,406
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs376,667
C. Total expenditures and encumbrances for direct program services160,739

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 0.6200 3.1100 3.7300
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 0.6200 3.1100 3.7300

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 16 1.6500
2. Employees with Blindness Age 55 and Older 6 1.4400
3. Employees who are Racial/Ethnic Minorities 8 0.0600
4. Employees who are Women 25 2.2500
5. Employees Age 55 and Older 20 3.1400

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 FY232
2. Number of individuals who began receiving services in the reported FY476
3. Total individuals served during the reported fiscal year (A1 + A2) 708

B. Age

1. 55-5936
2. 60-6440
3. 65-6961
4. 70-7467
5. 75-7961
6. 80-84116
7. 85-89167
8. 90-94113
9. 95-9942
10. 100 & over5
11. Total (must agree with A3)708

C. Gender

1. Female537
2. Male171
3. Total (must agree with A3)708

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race8
2. American Indian or Alaska Native15
3. Asian2
4. Black or African American15
5. Native Hawaiian or Other Pacific Islander1
6. White664
7. Two or more races1
8. Race and ethnicity unknown (only if consumer refuses to identify)2
9. Total (must agree with A3)708

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)22
2. Legally Blind (excluding totally blind)469
3. Severe Visual Impairment217
4. Total (must agree with A3)708

F. Major Cause of Visual Impairment

1. Macular Degeneration436
2. Diabetic Retinopathy58
3. Glaucoma58
4. Cataracts11
5. Other145
6. Total (must agree with A3)708

G. Other Age-Related Impairments

1. Hearing Impairment181
2. Diabetes139
3. Cardiovascular Disease and Strokes182
4. Cancer49
5. Bone, Muscle, Skin, Joint, and Movement Disorders257
6. Alzheimer's Disease/Cognitive Impairment33
7. Depression/Mood Disorder44
8. Other Major Geriatric Concerns73

H. Type of Residence

1. Private residence (house or apartment)472
2. Senior Living/Retirement Community88
3. Assisted Living Facility101
4. Nursing Home/Long-term Care facility46
5. Homeless1
6. Total (must agree with A3)708

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)44
2. Physician/medical provider38
3. State VR agency2
4. Government or Social Service Agency32
5. Veterans Administration4
6. Senior Center1
7. Assisted Living Facility44
8. Nursing Home/Long-term Care facility9
9. Faith-based organization1
10. Independent Living center1
11. Family member or friend154
12. Self-referral346
13. Other32
14. Total (must agree with A3)708

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 9
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 94,701
1b. Total Cost from other funds 60,702
2. Provision of assistive technology devices and aids 689
3. Provision of assistive technology services 430

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 1,229
1b. Total Cost from other funds 1,156
2. Orientation and Mobility training 191
3. Communication skills 283
4. Daily living skills 405
5. Supportive services (reader services, transportation, personal 224
6. Advocacy training and support networks 31
7. Counseling (peer, individual and group) 302
8. Information, referral and community integration 532
. Other IL services 248

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 61
3. Community Awareness: Events/Activities 38 950

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) 403,810 537,406 133,596
2. Number of Individuals Served 443 708 265
3. Number of Minority Individuals Served 34 42 8
4. Number of Community Awareness Activities 12 13 1
5. Number of Collaborating agencies and organizations 20 38 18
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 430 100.00%
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) 158 36.74%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 240 55.81%
B1. Number of individuals who received orientation and mobility (O & M) services 191 100.00%
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) 55 28.80%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 114 59.69%
C1. Number of individuals who received communication skills training 283 100.00%
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) 85 30.04%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 170 60.07%
D1. Number of individuals who received daily living skills training 405 100.00%
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) 130 32.10%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 235 58.02%
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) 236 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) 6 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) 68 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 57 n/a
E5. Number of individuals served who died before achieving functional gain or experiencing changes in lifestyle as a result of services they received. (closed/inactive cases only) 9 n/a

Part VII: Training and Technical Assistance Needs

OIB Program Managers breakout sessions at the AFB Leadership Conference this year were very helpful in answering questions about the 7OB report and providing a time to share information about our programs. We need to maintain some venue for bringing together the Program Managers. We also need some assistance in helping states get their staff to those meetings. Last year we did several conference calls where we went over the 7OB report. This was mainly to suggest changes to the report. It might be helpful to have those calls and focus on how people are filling out the report, to help those new to the report. We can always use training for our new counselors regarding working with older individuals.

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.

Nebraska Commission for the Blind and Visually Impaired (NCBVI) implements the Title VII Chapter 2 program by providing direct services to individuals by counselors in our 6 field offices. NCBVI does not subcontract services through other vendors. Agency counselors network with other agencies and organizations who provide services to minority and underserved groups so that our services can be made available to all people, including those in un-served and underserved populations. During FY 2016-2017, NCBVI provided active Independent Living services to seven hundred and eight (708) older individuals who are blind. Eligibility determination is based on a visual impairment limiting the individual's ability to perform the activities of daily living and the availability of services offered by NCBVI to help the individual to be more independent in their home and community, without regard to race, color, national origin, gender, religion, or disabling condition. Services available include: daily living skills (i.e. cooking, telling time, identifying money, cleaning, mending, color identification, grooming. home maintenance, organizing medications); communication skills, (braille, keyboarding, handwriting, access to large print, recorded formats, audio books, telephone access to newspapers, use of readers, using telephones and cell phones); use of assistive technology and low vision services; family and peer counseling services; and support in self-advocacy so individuals can become or remain involved in their communities and organizations. Individuals are also helped to understand and access other available resource. Referrals are made to NCBVI by many other organizations and agencies. Once a referral comes in, a counselor meets with the new referral and explains NCBVI services and services available from other organizations and agencies (i.e. Talking Book and Braille Services -TBBS, radio reading services, NFB Newsline, low vision evaluations, transportation programs, telephone directory assistance waivers, Area Agency on Aging, programs to access religious material). New referrals are often given writing guides, a bold marker pen, a bold line tablet and other large print and low cost items. Staff can sign up the new referral for TBBS, Newsline, an audio Bible, free directory assistance and other free services. Dials and buttons on microwaves, stoves, thermostats, washers, dryers, etc, can be marked. If the new referral 55 years of age or older applies for independent living services they will be moved into an active status. If the individual also experiences hearing loss, they can be referred to the Nebraska Public Services Commission for a free phone that is accessible to people who experience vision and hearing loss. Those who choose not to pursue active independent living services are closed from evaluative services. Those individuals who are accepted for active independent living services may be referred to a low vision clinic for an assessment of what devices might work most effectively. In rural area, counselors will take a low vision kit to show people different types of magnification aids available. Many people will work with a counselor on blindness skills so they can remain independent in their homes. Some offices offer group teaching programs, giving clients an opportunity to network with others and learn alternative skills in blindness and use those skills in a setting away from home.

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.

Across the state there are 2 group teaching programs for older blind clients. For Your Independence (FYI) occurs once a year and will accommodate 10 people in each program for a 4 day program. Another day long group teaching program occurs several times a year in the eastern part of the state. Both older blind clients and VR clients are eligible to attend these programs. During these programs counselors teach blindness skills, offer opportunities for people to talk about blindness issues, and help people make connections with other blind people. Additionally counselors sit on various boards. In the Kearney office counselors are part of the Kearney Area Aging Coalition, Elder Issues, the Brain Injury Advisory Board, Partners in Aging, Aging Disability Resource Center (ADRC) Advisory Committee, the South Central Nebraska Area Agency on Aging (ADRC) Advisory Committee and Community Connections. In Omaha, one counselor sits on the Partners in Aging Committee and the Senior Companion/Foster Grandparent Advisory Board. The Enrichment Foundation, a private, not-for-profit organization serving people with disabilities, awarded NCBVI a grant in the amount of $10,000 in support of Promoting Independent Living for the Blind of Omaha (PILBO).The target population served by PILBO includes blind and visually impaired persons 21 years of age or older living in the greater Omaha metropolitan area with independent living rather than vocational goals. A large part of the group benefiting from this grant are people 55 and older. This partnership has continued for 11 years. These funds help buy assistive technology, IL devices, and some interpreters for deaf blind activities. NCBVI continues to work with Assistive Technology Partnership (ATP). ATP is the state program that provides information about assistive technology for people with disabilities and resources for acquiring technology. NCBVI participates in a web based inventory lending program coordinated by ATP. Through their web site www.at4all.com, people can find assistive technology for blind and visually impaired consumers and are encouraged to contact NCBVI for a demonstration or short term loan of the equipment. ATP also administers "I Can Connect", a deaf-blind equipment distribution program benefiting NCBVI clients with dual sensory loss, many of whom are 55 years of age and older. NCBVI clients who have some functional vision can be referred to the Low Vision Clinic, University of NE Medical Center, for a low vision evaluation to help identify devices and equipment that may help the person effectively use their remaining vision. Individuals in more rural areas of the state will be referred to local eye care professionals for a low vision exam. When equipment is identified that will help the client, NCBVI can provide a few low vision aides and devices. Counselors are part of the presenters at the Fall Prevention Program put on state wide. NCBVI counselors routinely refer consumers to services offered by other agencies including: Talking Book and Braille Services, NFB NEWSLINE, Radio Talking Book, subsidized taxi coupon programs (Share a Fare in Omaha and Give a Lift in Lincoln, both coordinated by the American Council of the Blind of Nebraska), Braille Bibles International, Aurora Ministries and so on. NCBVI also works with Area Agencies on Aging, the Nebraska Commission for the Deaf and Hard of Hearing, centers for independent living, the League of Human Dignity, Vocational Rehabilitation and other philanthropic organizations serving people with disabilities.

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.

Seven hundred and eight (708) active independent living clients were served by the Nebraska Older Blind Project in FY 2016. Three hundred twenty nine (329) clients were closed from active services, three hundred and one (301) successful and twenty eight (28) unsuccessful. Three hundred twenty seven (327) surveys were mailed to those closed from active services (minus those deceased or otherwise unavailable). One hundred thirty one (131) surveys (40%) were returned. The data compiled from those surveys follows immediately. State of Nebraska Nebraska Commission for the Blind and Visually Impaired [Over 55] Program Participant Survey Sent out (2017) Number of Surveys Mailed: 327 Number of Completed Surveys Returned: 131 (40%) Number of Surveys Returned as Undeliverable: 16 (5%) Number of surveys not filled out: 180 (55%) 1... I feel more confident in my ability to perform activities I had given up because of my vision loss. 4 Strongly Agree 43 (33%) 3 Agree 62 (47%) 2 Disagree 06 (05%) 1 Strongly Disagree 00 (00%) 0 Not Applicable 16 (12%) - Unanswered 04 (03%) Comments (if any): 1) I manage but with your help it is somewhat better. 2) I can now see 5x7 cards. 3) No rehab given. 4) I have looked over the survey and don’t really know how to answer so I am giving comments. I had to give up driving, still have to depend on family or handi-bus for appointments. I don’t go much. 5) I use the large magnifier all day long. I would be lost without it!! 6) I could not live independently without most of the aids you have loaned me. 7) I can read ordinary directions and labels. 8) Education was minimal because of my age. 9) Getting macular D in left eye. 10) In assisted living at Eastmont and do not have housekeeping responsibility. We are using your "talking books" service and are every happy with it. Thank you. 11) I am so blessed to receive the magnification that I received. 12) I can thread a needle without help. (Sounds insignificant but is important to me.) 13) I have had a machine for over 15 years. 14) I was really down until Larry was here. He help me so much. I can't thank him & everyone enough. 15) I was spending more time outside doing yardwork. As I could see better. Deanna gave be confidence. One of the projects I didn't do well was trying to thread the needle on sewing machine. 16) It made very little difference. 17) My vision continued to diminish after becoming a client, lost one eye, husband died. Needs varied for me as years passed. Needle threaders so great. 18) The Nebraska Commission in Omaha came to my apartment to inquire what helps I needed - they visited me several times. 19) Yes I do, reading all my mail. 2... Overall, I am less dependent on others. 4 Strongly Agree 26 (20%) 3 Agree 77 (59%) 2 Disagree 13 (10%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 09 (07%) - Unanswered 05 (04%) Comments (if any): 1) Don’t depend on others too much. 2) My family and friends are always helping but I do a lot on my own. 3) Most of the time. 4) Crippled also in wheelchair. 5) I have to use my magnifier glass with light for checking phone calls seems like a lot of screens. I accidentally answered a scam. Still wondering what I got into. Also grocery shopping need family to help or use glass which helps. 6) I have had considerably more vision loss since working with NCBVI. I am more challenged and the helps are necessary for independent living. 7) My neighbors help with yard work and winter snow removal. 8) I asked for a magnifying glass for my TV. Denied…because of my age. 9) I have laundry done for me, meals cooked for me and help with baths. 10) Dependency is due to transportation need living in a rural area. 11) I am able to read my mail. 12) I don't ask my son from Grand Island to always help me. The watch & calendar are so great for me. Also, the clock on table is okay in the morning. The social part & have Deanna come was great. I miss the time we spent together. 13) I have macular degeneration. My main problem is discomfort in the eyes. The main help I get from NCBVI is distraction and a change to enjoy something new and give my eyes a rest. I am most grateful. 14) I have my vision by cant read small writing. 15) Larry has been so very kind & helpful. 16) Not able to drive anymore or go shopping alone. 17) The blind went & got me a card for my Merlin. Now I can read my mail & do so much more. 18) Things are the same. 3... I am better able to move confidently around my house, apartment, or yard. 4 Strongly Agree 26 (20%) 3 Agree 68 (52%) 2 Disagree 05 (04%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 25 (19%) - Unanswered 06 (05%) Comments (if any): 1) Yes I do what I can. 2) Learned on my own with help from family. 3) I use my blind cane when I leave the house. It really helps. Seems like people notice, opening doors for me ect. 4) It is not better, it is not worse. 5) Does not apply. 6) I can do so many more things for the Blind has help me so much. I have books I can listen to. They give me sun glasses I can see so much better in the sun. 7) I know and can see things in home. 8) I try to do chores more slowly; so as not to trip. I did learn to ask for some help. 9) I use the cane outside and for longer distances. 10) Lives in nursing home. 11) My problem - can't remember where I place things. 12) No, change as I have not changed place / home location. Without hard contacts (which I can no longer wear.) I was visually disabled for many years. 13) Not confident outside 14) Only because of myself, not what the program has done. 15) Yes. 4... I am better able to prepare meals for myself 4 Strongly Agree 19 (15%) 3 Agree 56 (43%) 2 Disagree 16 (12%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 33 (25%) - Unanswered 06 (05%) Comments (if any): 1) Lives in assisted living. 2) Yes, always have. 3) Reside in a nursing home. 4) I struggle with cooking. 5) Yes the little red dots on my stove, washer, and radio have helped. 6) Absolutely not. 7) Meals at my assisted living. 8) Caregivers. 9) Does no cooking. 10) Does not apply. 11) Doesn't cook. 12) Hands have arthritis in and hard to handle thing, and hard to read recipes and hard to wash dishes. 13) Home health comes and helps make meals. 14) I can cook & bake & in the summer time I can plant flowers a little at the time 15) I live in assisted living. 16) I must use a lighted magnifier to read enlarged recipe. 17) I use the cookbooks all the time. I do cook more and use the ways that Deanna showed me in cutlery, slicing, using stove. She helped me to use my pitcher cup to measure. 18) Raised dots allow me to locate implants landmarks on appliances. Feeling size of pan is proportion of burner aids me. Learning of can openers, magnetic knife strip is valuable. 19) Sometimes I need to read instructions and my reading has improved. 5... I can better manage my house keeping tasks. 4 Strongly Agree 19 (15%) 3 Agree 52 (40%) 2 Disagree 10 (08%) 1 - Strongly Disagree 02 (02%) 0 - Not Applicable 39 (30%) - Unanswered 09 (07%) Comments (if any): 1) I manage to do all. 2) I have help. 3) I have a housekeeper part-time. 4) I am CEO of my own LLC 5) Somewhat…doing laundry is better. 6) Caregivers. 7) Does no housekeeping. 8) Have trouble doing the scrubbing of the floors. Also, the ceiling fan, I just can't reach it. 9) Home health helps 10) I can clean the floor & clear the kitchen. I can write my checks & do my bills. Thank you for the magnifying glass. 11) I can't tell if anything is clean. I just clean at it. 12) I still do my own housework but not as often. (At least every 2-3 weeks). 13) My biggest problem was reading. They went out on the limb helping me read. 14) So far, I was able to do my windows & curtains. I did ask for help in hang curtains. 15) Thank you so much for your help! 16) The same: more good. 17) With help. 18) Yes. 6... I am better able to manage my paperwork (such as mail, correspondence, and writing checks). 4 Strongly Agree 36 (27%) 3 Agree 45 (34%) 2 Disagree 23 (18%) 1 Strongly Disagree 06 (05%) 0 Not Applicable 13 (10%) - Unanswered 08 (06%) Comments (if any): 1) Still have trouble sometimes reading and writing things. But I have 2 or 3 problems with my eyes. 2) Having to use readers and magnifiers help a lot. 3) Unable to do close work such as this survey without assistance. 4) I am not able to do any paperwork. 5) Cannot see to write. 6) My husband does this. 7) The magnifier glass with light helps. My biggest problem is I lay something down, it vanishes, I can’t see to pick it up again, even in plain sight and look and look for it sometimes not finding it for a week or so later. 8) The electronic magnifier CCTV is absolutely essential for my independence. 9) No. 10) Shaking. 11) Be given magnifiers / machine is a life saver. 12) Does none. 13) home health helps 14) I can't read anything, but I can write a little. 15) I do manage mail if it isn't detailed - some with correspondence. There are priorities - my checking account. I cannot read magazines or newspaper. 16) I don't write checks nor write to family. I use the computer. 17) I have some help & can do most of these things. 18) I have someone that does the paperwork for me. 19) I still have to have help in understand some of my mail, but I do better on advocacy. The tablet was a God send as I can better write. I use the reader now for even reading. Most all cooking & reading mail. 20) I use the magnifiers almost every day. 21) It helps, but not enough that I feel comfortable doing it by myself. 22) My son does my mail. 23) No different. 24) Thanks to NCBVI for all they have done. They give me a watch that tells the time & date. 25) The machine I have is the best help I could ever hope to have. I love it! 26) The same. She writes the same. I (the provider) help. 27) With help. 28) Would appreciate a big number calendar the beginning of each new year. 29) Yes. 30) You make this possible for me. 7... I am better able to enjoy reading materials such as books, newspapers, magazines (whether with magnifiers, large print, Braille, or on tape). 4 Strongly Agree 50 (38%) 3 Agree 52 (40%) 2 Disagree 11 (08%) 1 Strongly Disagree 05 (04%) 0 Not Applicable 04 (03%) - Unanswered 09 (07%) Comments (if any): 1) Talking books are great! 2) I was misreading recipes but have no problem now. 3) The tapes are wonderful. 4) He enjoys the vision screen, like a TV on a table. 5) Using magnifier. 6) I was given a video magnifier that I use all day and books on tape. 7) I have I-pad. 8) I have really enjoyed the books. 9) I use a large magnifier for the newspaper, and my I-pad for reading books. Sometimes tapes! 10) I so enjoy the cassettes and would be lost without them. I listen to quite a few each month. 11) A good friend of mine found me a great magnifying glass with lights around the circle. 12) Love my Freedom Scientific Topaz and Eschenbach magnifier! 13) I enjoy the books on tape. 14) Denied because of my age! 15) No magnifier has shown up. 16) Tapes 17) Books on tape. 18) Continue to be OK. 19) I enjoy all of the books. Little Women, Little Men, Gone with Wind & so many more. 20) I read digital books. 21) I use the magnifiers almost every day for my mail. 22) Large print doesn't help me. I use tapes from Lincoln both nonfiction and fiction. Only talking book. 23) She enjoys the books on tape. 24) Talking Books are wonderful. 25) The magnifier has been a tremendous help for so many things. I keep them close by at all times. The book recordings are so enjoyable, and I have enjoyed so many without the strain of reading on my eyes. THANK YOU. 26) This has kept my life manageable but better yet enjoyable. 27) Works the same as my old machine. 28) Yes. 8... I am better able to participate in the life of my family, friends, or community. 4 Strongly Agree 25 (19%) 3 Agree 64 (49%) 2 Disagree 11 (08%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 22 (17%) - Unanswered 08 (06%) Comments (if any): 1) Depends on what it is. 2) Hasn’t made any difference in this area. 3) I use my cane when I leave the house. So far I don’t use it as much in the house. 4) I do not think this is better. 5) Family only 6) gives me confidence 7) I am home bound. 8) I do very little reading to family, friends, or community. 9) I feel so much better now than before. Larry has helped me with putting all the things together. So I will know how to do it myself. 10) I join anything I'm interested in. 11) no change 12) No family close by 13) The NFB local chapter we have started here has been a good source of support and also learning and friendship in dealing with my changing lifestyle due to the profession of the macular degeneration. 14) Visually disabled persons are still avoided by population. My family involvement is minimal due to my family's choice. Beneficial would be seminar program involving family members especially children in understanding blind / visually disabled. Family members are still independent not a burden. 15) With age and disability life changes. I am not included in some functions like working in the kitchen at church. 16) yes 9... I feel more in control in making decisions that are important in my life. 4 Strongly Agree 35 (27%) 3 Agree 63 (48%) 2 Disagree 05 (04%) 1 - Strongly Disagree 01 (01%) 0 - Not Applicable 19 (15%) - Unanswered 08 (06%) Comments (if any): 1) For now yes. 2) I still have a strong mind. 3) No Change. 4) It is great to ask for help. 5) What I have learned does help to a degree. I appreciate the time and information. I need to convince myself that I am capable of controlling my life as it is. 6) The most important decision is phone calls, I had to put caller ID on the phone, I goofed one day and answered a scam. 7) My sister helps me out if I have any questions or get her opinion. 8) Not sure how to feel. 9) Never changed. 10) Better able to see correspondence / manage bills / determine when outside help is needed. 11) I love the talking book machine! 12) I went to see my daughter in N.C. for 3 weeks & I see my niece in Tenn. I want to thank Larry for the 2017 large print calendar. 13) No difference 14) Somewhat. I ask for advice or help when I know I might not bake the right decision. 15) Yes 10. What was the greatest difference this program made in your life? (Please comment in the space below or over.) 1) Many thanks for the business services. Have a nice day! Keep up the good work. Years back I started with Shane B. and he was super. Now I have a kind, understanding and very helpful gentleman Larry Mackey. He is wonderful and always helps me with my vision when I need him. With old age my vision is not getting better. I am 94. 2) No comment 3) I especially love my counselor in Omaha. She is very helpful to teach me things I can do and in getting me things that make life easier. She also gives me confidence. 4) No comment 5) Yes it has helped in some ways. 6) Paid for my readers, thank you so much. The service is awesome, but most of my life I learn to cope and enjoy what sight I have, I’m blessed, as for this survey I am not really sure how you want me to answer these questions. Again thank you so much. 7) The book reader and the OCR reader and the assistance from the case worker. 8) No comment. 9) Many things came to my mind, some are cooking for my family, reading my mail, keeping my budget without help. 10) The ability to enjoy books again. 11) I am able to listen to books and use my monitor. 12) I am able to read better with the magnifying glass. 13) Providing tools to perform activities of daily living. 14) Gave me bigger phone numbers to call my kids. Thanks. 15) Being able to read. 16) I reside in a nursing home. I enjoy the machine that reads books and the large machine that magnifies. 17) Helping me out so that I am more independent. 18) I can read some things that I couldn’t read before. 19) To start with beginning to have books read to me, also starting back with small sewing project. Thank you for all the help. 20) I am 89, live alone, do all things I have to do. I ask my family for rides to store or church. 21) I can just see better. 22) The CCTV helps me keep independent control of myself. 23) Just to help me realize I am not alone in this and others are not as fortunate as I am. Being thankful for what I have. 24) I did not rehab. I learned on my own. I was given a magnifier that I could not live without. 25) The positive support I was given by all staff members. 26) I do very good. 27) The lighted magnifying glass helps me read small print and large print for longer like recipes and my bible. Before my eyes would get tired and foggy. 28) Confidence in self. 29) I have learned that I can ask for help, we all need assistance at times and need to accept what I can do and don’t stay away from reaching out for help. Need to be aware that my age is part of my loss of independence. I thank Deanna for her time and patience. 30) I think it is coming with the new head librarian in Washington DC. 31) The cane is very helpful when I leave the house. Phone with window, although the phone needs more volume tone, or answers for messages. I can’t see out of my right eye to read anything, I get injections in my left eye every two months. Would like to say the most helpful is the cane, phone, red buttons, and magnifying glass. Love the books and recorder. The red buttons on the washer, dryer, stove and radio are most helpful, although I appreciate everything I have used. I have used the 411 number several times. I think this is a good program, I have enjoyed the program. Keep it going, this helps. 32) More confident. 33) Being able to manage my checkbook, letters, do some reading, though I find it more difficult to read than when my loss first appeared. The med bottle marker, magnifier and cassette player are a real blessing. 34) This just got to me because I have moved and you do not have my new address. The program was a big help to me. I got a clock and a wrist watch but I can’t get them reset when the time changes. I also got a small light magnifier. I would like to know where I can get a larger one with a brighter light. I don’t know if there is anything to help with the computer. I did buy a device that I am writing with. I would like to have some information about the tape or cd books. The bible especially in the new living translation. I would have liked for them to have marked my appliances, but I use a flashlight so I am doing fine. Lord willing I will be good. Thank you for helping me as much as you have. 35) It has allowed me to read mail that I couldn’t read before. 36) Feeling someone could give me good advice on how to handle new challenges. My reader helps me with so many things and I am able to use it more with practice. 37) I am able to read much better because of the magnifiers you furnished. An automobile accident six months ago damaged some of my vision and impedes my mobility. Continuous therapy is helping me continue to move about. Thank you everyone. 38) I can do things that I could not do before. 39) The presentation by Deanna. She is a super person. Bless her and many thanks! 40) The equipment really helps. The advice and counseling was very helpful as well. I am thankful for this agency! 41) I am able to take care of myself. Thank you for your help and especially Larry Roos for his help. 42) The help I received during the visits. 43) Being able to turn oven on without help. 44) Meeting Cheryl and experiencing her positive outlook on life. Getting my oven marked with dots has helped a lot. 45) I discovered I could do things that I didn’t think that I could. 46) The books bring pleasure. 47) Ability to read. 48) Very-very minimal. I got denied because of my age- that is what I was told. Older people are screwed. 49) Building my confidence in learning to prepare fool, do simple household tasks and working in unfamiliar places. 50) None because no magnifier received. 51) Can do more things & participate without total dependence on others. 52) able to listen to books 53) Able to read the newspaper, etc. The counselor was Super. He was exceptional!!! So appreciate all he has done for me. Made my life much better. 54) At the time it helped, but it has been awhile since we have seen or heard from anyone. His health has detreated since this time! 55) Became more independent. 56) Before I could only read headlines. Now I can read newspapers with the magnifiers, even fine print on prescriptions. 57) Being able to continue my alterations and making sure numbers are right. Thank you & God Bless. 58) Being able to read my mail. 59) Enabled me to read printed materials. (Closed Circuit TV). Taught me proper use of the white cane. 60) Eye sign improved after cataract surgery. I am able to read without the magnifier. The magnifier was a "miracle worker" when I was unable to read without it. Thanks to Mr. Mackey :) 61) Eyes were too far advanced. Age was biggest problem - too old. Would recommend the machine. Thanks. 62) Having things available for my situation. 63) Helped me to become more independent. 64) I a more independent. 65) I am able to do everything myself. I am 87 years young. 66) I am able to read & do close work that I had to give up before and am grateful for the big calendar. A big help. 67) I am able to read the newspaper with less difficulty. 68) I am able to read things I could not see before. Makes a lot of things easier. I love my Davinci magnifier. 69) I am fortunate to have a very supporting family. Thank the NCBVI for their support. 70) I can do more for myself, read, understand, and the help of my caregiver and feel comfortable with help. 71) I can hear my magazines. I can't read anymore. 72) I cannot read without by Toyag reader! No paper work or etc. - prescription labels etc. I am still independent with most other tasks - Except writing :) 73) I do a lot of crocheting and the magnifying glasses I got are a big help! 74) I felt that mag equipment helped greatly, but they referred me to other programs which are helping me greatly too. 75) I had been independently functional except for writing legibly. So I avoid this task - I use cash or debit card. All my bills (utility) are on auto pay from my bank. So is my mortgage payment. (I do not use credit cards). The Tech support is very important to me and I am very thankful to Jan Brandt for her kindness and patience! I had been managing my life very well so far. Perhaps a time will come when i will need the other programs offered. 76) I have learned how to cope or manage my life since disabilities have come along. I believe this has kept me motivated to do the best that I can. But my independence is becoming more of a struggle. 77) I really enjoy my clock, large number calendar, my magnifiers, diabetic meter. Thank you for the help! 78) I really like the books on tape and my talking watch necklace. 79) I was a lover of books & then I got books on tape. It is wonderful & I am not so alone. Also, I am cooking again. Thanks for everything. 80) it enables me to read in very strong light and read until my eyes tire. 81) It has made our life much more enjoyable because Howard cannot read & my reading is limited. 82) Just to know that there are other people in the same or similar situations, and that there are no obstacles that cannot be overcome. It has made it much easier for me to accept my situation and feel confident that I can handle whatever happens. 83) Larry did a great job explaining the different adaptations and items we could use as Ken's vision declined. Thank you for the Support that you provided. 84) Larry Roos has helped me a great deal. I am 87 and retired still have some sight. When I first went to our NCBVI, I didn’t know what to expect. I hoped they could have classes to help me maneuver. I am very independent but am at a loss, but I’ll manage. Sorry not much help to you. 85) Larry's interest in my condition. He's given me some hope for the future. 86) Learning to walk better with cane. I'm working on learning Braille. 87) Merlin HD made difference in my life. 88) More confidence in all the tasks I perform. I recently moved in with a roommate and perform my parts of household duties. Thank you so for all the help. I appreciate it all so very much. 89) More confidence. 90) No comments. I did not attend 91) Opened way for more activity. 92) Provided a Da Vinci machine so I could read letters & mail. This helps me keep up with friends & family. 93) Put things on oven. Measuring. Got a watch I can see better. Help with magnifying glass. Recipes. 94) Reading all my mail. Can watch T.V. now so much better. Also, tell time (with the clock I got). Made a BIG DIFFERENCDE in my life. Thank you so much. 95) Some time I sit & listen to my books for hours at a time & it has made me so much more happy & I feel so it has help me so much. 96) Talking clock is good. Marking the stove & microwave was great. Magnifier works good too. 97) Telling time 98) That I could read my paper, and keep up on my local news. 99) the clock & talking books 100) The clock and light helpful way much. I appreciate them. 101) The Davinci has made such a difference in my life. It’s wonderful! Talking Books, also. 102) The fact that they have helped me and continue to check on me. The telephone has been a Godsend. 103) The machine that helps me read better because every word is Big! So much help. Thank you for this wonderful machine. 104) The magnification to be able to do my bills & the ability to read me Bible & manage my finances. Been very happy to be able to be independent shopper. 105) the magnifiers and the talking books 106) The new camera for my eye machine. Thank you so much. 107) The realization that there is help and the numerous ways / tools available to me. 108) The time / interest shown by counselors on a one to one basis. Knowing I was not isolated - understood. Being involved with NCBVI, I learned new developments / equipment available to visually disabled. Meeting clients, counselors such as Amy & Shane who live full productive lives. - And find JOY. I wish i had been able to attend academy & become proficient on computer / smart phone etc. I do feel as my vision continues to diminish, I have been and will continue to be "Left behind" by technology. Living in rural area still concerned about transportation modes such as Lyft, Uber. I am afraid to be as independent as I would like to be. A big thank you to everyone @ NCBVI for time, consideration, good humor, friendship. I miss involvement tremendously. 109) There is no change in her situation. She deals with the fact that she cannot read. Her biggest difficulty medically is trying to get her blood sugar reading. Is there enough blood? Getting the lance changed? 110) To just keep doing! 111) Was given magnify glasses & reading list to a certain extent. Not really doing the best with those things. 112) With the magnifier, I can read newspaper. Read my bills! And other reading materials.

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).

1. Mr. D is a 77 year old man who lost vision due to a stroke. He came into our office to inquire about services and decided to sign up for services. He is retired but still very involved in service organizations. He is a member of the Lions and the Kiwani’s and had decided he could not be actively involved any more. He worked with a long white cane to help him get around independently. He worked with his note taker and phone to be able to keep up to date on the news and read books. We provided him with an audio dialer so he could store his large number of contacts for each organization. He attended our group teaching program called For Your Independence. He learned a lot from the program and made some important connections to other blind and visually impaired people. He assisted with a presentation to his district Lions Club group, talking with them about his journey with vision loss and the skills that help him remain independent. He still struggles but shows up at all his meetings and has input into the business of the organization. 2. Kat is a 64 year old woman who experiences vision loss due to diabetic retinopathy. When we first met Kat, she was having difficulty reading her mail, reading her papers, reading her prescriptions, and reading her glucometer. She found it hard to use her microwave because she couldn’t see the buttons. Her walking was aided by the use of a walker. Even with the walker she had great fear of falling. Kat had given up sewing completely because she could not thread a needle or make a stitch. Kat’s blood sugars were dangerously high. Her medical providers and family were extremely concerned about her health issues. Kat complained of depression and a great loss of independence. We introduced Kat to several types of magnification devices and the Amigo Reader turned out to be her favorite. With the Amigo she could once again read her papers, read her mail, and read her prescriptions. Kat told us that this gave her a regained sense of independence. Kat spent time working with MD on diabetic alternatives. She learned to take her own blood and use a talking glucometer. In a short period of time after, her blood sugars began to stabilize, she had fewer surprise reactions, she began to get stronger, she began exercising, and even lost a little weight. Kat started with physical therapy and worked on orientation and mobility with an NCBVI staff person. She learned to walk without the walker. She used a white support cane for a while. Eventually she stopped using that cane and she took instruction on how to use the long white cane. This gave her more confidence and she began walking with the white cane whenever she left her apartment. She is now able to walk four blocks outside with little assistance or walk the entire length of a Walmart Store. Kat’s Grandson is also blind. He was so proud of his Grandmother Kat that he bought her a brand new white cane. Kat and her Grandson are great encouragement to each other. NCBVI marked Kat’s microwave with raised dots and she started cooking simple meals with her microwave again. Kat also attended a group home teaching where she did a little cooking, worked on Braille, cane travel, and techniques of daily living. Another counselor worked with Kat and showed her how to thread a needle with needle threaders and make a stitch. Kat got so much from this training she began sewing again. She really enjoys making “Crazy Quilts.” Kat tells us she is healthier, happier, and more confident about her future thanks to the services, devices, and training she receiver from the Nebraska Commission for the Blind and Visually Impaired. 3. We have been working with a woman who is 84 years old. She and her husband live together in their own home. They have no children that live within the state to provide support. We have provided independent living skills previously. Within the last few months we were re-contacted by her to say she is caring for a husband with dementia and is struggling with reading print material. Her husband use to handle the finances and assist with reading bills, recipes etc. Low vision is not a good option and technology is not one of her strengths. We discussed a smart phone and apps and how they can aid her with her remaining independent. We downloaded and did training on Seeing AI and she is able to read bills, directions on boxed products, etc.She is also using a bar code scanner app for other items around her home. She has worked with her banking institution to have an app to open her checking account to check her balance, using voice over with her IPHONE. We discussed the Lyft and UBER app to use for transportation as they do not live anywhere close to a bus line and her husband is giving up driving. We discussed prescription reminder app to remind and track medications. She is so excited and found it unbelievable that one device could help her in so many ways. We have marked and labeled items around her home. We connected her with case management with ENOA and made a referral for a senior companion. The companion could support both as it would afford the client to do things and have someone visiting with her husband while she is busy or the companion could be for her to assist with shopping and medical appointments. She is feeling so much more confident about remaining independent in her home and caring for her husband.

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

Funding continues to be a concern. With continued focus on transition it shifts attention away from our older visually impaired Nebraskans. While focus on transition and developing job skills are very important, we have a growing number of older blind and visually impaired individuals who need guidance and training so they can remain in their homes. When applying the percentages of individuals with vision loss, captured during the 2010 to 2014 American Community Survey, Nebraska is projected to have 22,517 individuals 55 and older who will experience significant vision loss by 2020. This is a large number of individuals who do not want to live in assisted living or nursing homes. But without the proper training it is likely that many of them will not be able to take care of themselves. Every year we see funding as the problem, but without proper funding, and at some point additional funding, we cannot meet the needs of our older Nebraskans.

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 byCarlos Servan
TitleExecutive Director
Telephone402.471.8104
Date signed12/14/2017