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

RSA-7-OB for Pennsylvania Office of Vocational Rehabilitation - H177B170038 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 year1,355,890
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year2,532,980
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 21,355,890
A2. Total other federal3,623,121
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement1,090,141
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other2,532,980
A3. State (excluding in-kind)150,654
A4. Third party0
A5. In-kind0
A6. Total Matching Funds150,654
A7. Total All Funds Expended5,129,665
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs3,915,762
C. Total expenditures and encumbrances for direct program services1,213,903

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 7.1400 21.9000 29.0400
2. FTE Contractors 0.0000 0.3900 0.3900
3. Total FTE 7.1400 22.2900 29.4300

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 14 4.8800
2. Employees with Blindness Age 55 and Older 1 0.2600
3. Employees who are Racial/Ethnic Minorities 8 2.8200
4. Employees who are Women 80 22.3300
5. Employees Age 55 and Older 34 8.8500

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 FY2,440
2. Number of individuals who began receiving services in the reported FY1,014
3. Total individuals served during the reported fiscal year (A1 + A2) 3,454

B. Age

1. 55-59220
2. 60-64297
3. 65-69309
4. 70-74379
5. 75-79405
6. 80-84581
7. 85-89696
8. 90-94430
9. 95-99118
10. 100 & over19
11. Total (must agree with A3)3,454

C. Gender

1. Female2,504
2. Male950
3. Total (must agree with A3)3,454

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race86
2. American Indian or Alaska Native2
3. Asian15
4. Black or African American406
5. Native Hawaiian or Other Pacific Islander4
6. White2,798
7. Two or more races9
8. Race and ethnicity unknown (only if consumer refuses to identify)134
9. Total (must agree with A3)3,454

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)109
2. Legally Blind (excluding totally blind)1,437
3. Severe Visual Impairment1,908
4. Total (must agree with A3)3,454

F. Major Cause of Visual Impairment

1. Macular Degeneration2,030
2. Diabetic Retinopathy291
3. Glaucoma526
4. Cataracts45
5. Other562
6. Total (must agree with A3)3,454

G. Other Age-Related Impairments

1. Hearing Impairment462
2. Diabetes933
3. Cardiovascular Disease and Strokes1,136
4. Cancer342
5. Bone, Muscle, Skin, Joint, and Movement Disorders1,185
6. Alzheimer's Disease/Cognitive Impairment447
7. Depression/Mood Disorder128
8. Other Major Geriatric Concerns3,728

H. Type of Residence

1. Private residence (house or apartment)3,263
2. Senior Living/Retirement Community91
3. Assisted Living Facility95
4. Nursing Home/Long-term Care facility5
5. Homeless0
6. Total (must agree with A3)3,454

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)1,112
2. Physician/medical provider75
3. State VR agency93
4. Government or Social Service Agency550
5. Veterans Administration31
6. Senior Center14
7. Assisted Living Facility11
8. Nursing Home/Long-term Care facility5
9. Faith-based organization2
10. Independent Living center325
11. Family member or friend399
12. Self-referral565
13. Other272
14. Total (must agree with A3)3,454

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 73,737
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 658
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 221

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 386,176
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 1,345
3. Provision of assistive technology services 297

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 179,275
1b. Total Cost from other funds 0
2. Orientation and Mobility training 450
3. Communication skills 151
4. Daily living skills 309
5. Supportive services (reader services, transportation, personal 80
6. Advocacy training and support networks 289
7. Counseling (peer, individual and group) 1,411
8. Information, referral and community integration 1,804
. Other IL services 958

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 36
3. Community Awareness: Events/Activities 517 8,314

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) 5,161,930 5,129,665 -32,265
2. Number of Individuals Served 3,761 3,454 -307
3. Number of Minority Individuals Served 557 656 99
4. Number of Community Awareness Activities 634 517 -117
5. Number of Collaborating agencies and organizations 902 604 -298
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 297 100.00%
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) 5,413 1,822.56%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 137 46.13%
B1. Number of individuals who received orientation and mobility (O & M) services 450 100.00%
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) 161 35.78%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 156 34.67%
C1. Number of individuals who received communication skills training 151 100.00%
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) 87 57.62%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 59 39.07%
D1. Number of individuals who received daily living skills training 309 100.00%
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) 161 52.10%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 137 44.34%
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) 80 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) 57 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) 47 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 199 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) 80 n/a

Part VII: Training and Technical Assistance Needs

During FFY 2017 Pennsylvania received technical assistance from OIB-TAC regarding methods to determine which service delivery method has the best Return On Investment (ROI): a group instruction only model; an individual instruction model; or a combination group/individual instruction model. As a result, it has been determined that a combination group/individual instruction model is the best service model for meeting the needs of Pennsylvania customers and maximizing the available resources. Technical Assistance will continue into 2018 with a focus on strategic planning to improve efficiency and reduce staffing costs. Pennsylvania would also benefit from learning about and sharing ideas from other states regarding the following: Collaborations and capacity-building with aging and disability-related agencies; Cost-saving measures such as device lending and reclaim programs; Diabetes management; Current medical treatment for eye diseases; Processes for low vision evaluations; Low vision devices; Services that are offered for aged deaf-blind individuals; Themes used for expositions and outreach events; Dollar spending limits for ILOB cases; Group AT, VRT and O&M instruction; Recruitment and retention of staff; Overcoming transportation barriers; Low Vision devices and Access Technology offered to ILOB customers and; Improvements to the case review process. In response to requests from field staff, Pennsylvania continues to provide in-house technical assistance to field staff to strengthen knowledge regarding the following would enhance our ability to provide the best customer service in the ILOB program: Adjusting to vision loss; Effective counseling methods for individuals with visual impairments, dementia and Alzheimer’s disease; Common age-related eye conditions; Working with individuals with dual sensory impairments; Hearing loss; Reading an audiology report; Adult Protective Services and the criteria for reporting abuse; and other topics pertinent to the aging population. Many of the training sessions have been provided through the OIB-TAC grant and were very well-received by field staff and administrators.

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.

*Note: Part I, Funding Sources Other Federal Grant Carryover from Previous Year is SSA reimbursement carryover form FFY 2016. Independent Living for Older Individuals who are Blind (ILOB) program funds are used by Pennsylvania’s Bureau of Blindness and Visual Services (BBVS) to provide independent living services for individuals over the age of 55 who are blind and visually impaired, conduct activities that will improve or expand services for these individuals and conduct activities to improve public understanding of the problems of these individuals. BBVS one-on-one direct services are provided in our customers’ homes and within their communities to optimize their ability to gain independence and maintain community inclusion. In order to efficiently and effectively provide high-quality services to as many customers as possible, BBVS uses a case management model to provide services. BBVS teaches techniques and skills that enable the customer to reach his/her goals of safety and independence and to maintain that safety and independence through the long term. Outreach and educational activities are conducted through BBVS’s central office and its six district offices to inform the public of available services, to cultivate referrals to and from other agencies and professionals, and to improve public understanding of the issues surrounding vision loss and blindness. The direct services in our program are provided through in-house district office professional staff. However, contractors are utilized to provide direct services to customers when the district offices are experiencing a shortage in staff or an unusually high demand for services. The direct services provided through BBVS’s ILOB program include in-home assessments; Orientation and Mobility (O&M) instruction; Vision Rehabilitation Therapy (VRT); training in activities of daily living and access technology; adjustment to blindness counseling; provision of adaptive aids and access technology; advocacy training; individual and family counseling; communication skills; referrals for low vision exams, aids and training; referrals to other agencies; and facilitating community inclusion and the management of secondary disabilities. BBVS’s district offices promote awareness of the ILOB program through informational presentations and providing educational material and demonstrations of low vision devices and VRT teaching tools to hospitals; physicians; nurses; optometrists and ophthalmologists; audiology providers; nursing homes; health and wellness fairs; expos sponsored by local State Legislators; senior expos; senior centers; Area Agencies on Aging; sight-loss support groups; independent living facilities; schools, colleges and universities; disability advocacy groups; senior apartment buildings; shopping centers; personal care homes; faith-based organizations; physical and mental health managed care organizations and providers; physical therapists and occupational therapists; dialysis centers; social service agencies; and other agencies and advocacy groups related to the elderly, disabled or blind. BBVS’s ILOB staff strives to develop and maintain collaborative relationships with low vision doctors in an effort to better serve our mutual customers and encourage referrals. In addition, BBVS provides consultation services to optometrists in an effort to expand the availability of high-quality low vision evaluation services across the Commonwealth of Pennsylvania. BBVS staff provides outreach and in-service training to community agencies that provide direct services to the senior population to increase awareness about services provided by the Bureau of Blindness and Visual Services and also to educate individuals about the technology, aids and devices available to assist them in maintaining their independence. Pennsylvania also promotes awareness of our services through print and social media, the Pennsylvania Department of Labor and Industry’s website and by imprinting the Bureau’s telephone number and email address on brochures and promotional material such as Braille alphabet cards, signature guides, 20/20 high-visibility pens, and portable pocket magnifiers. These materials are given to customers and selectively distributed at outreach and educational events such as Senior Expositions, White Cane Safety Day Events, Blindness Awareness Expositions, Falls Prevention Awareness Events, Disability Awareness Day, and World Diabetes Day Events. These events are held at the PA State Capitol Building and across the commonwealth to increase customer referrals and public awareness and understanding. Orientation & Mobility Instructors, Vision Rehabilitation Therapists, Social Workers, and the Aging Services Specialist attend these events to provide education, sensory loss simulations, and demonstrations of high and low tech aids and devices to ensure individuals understand the available services and adaptive products. Coverage of these events through local television, radio, newspaper, websites, and social media also creates opportunities for expanding customer referrals and public awareness and understanding. Public meetings and Citizens Advisory Council meetings are held regularly in each district office to seek input and solicit feedback from customers, vendors, partner agencies, and other blindness agencies. BBVS is a member agency of the PA Link to Aging and Disability Resources, a service that easily connects consumers to local services/supports through any Link partner agency. It allows consumers to explore existing options to ensure a secure plan for independence; assists consumers with applications to determine funding eligibility; and helps consumers remain or return to their community because of a disability, an illness or accident, or to transition from an institution back to the community. These activities are part of Pennsylvania’s ongoing effort to reach out to underserved and unserved populations. During FFY 17, the Bureau of Blindness and Visual Services attended workshops sponsored by the Pennsylvania Emergency Management Agency regarding emergency preparedness for special populations. The Bureau of Blindness and Visual Services also partnered with Pennsylvania’s Department of Human Services and Department of Aging to conduct training for field staff regarding the Adult and Older Adult Protective Services law, how to identify signs of abuse, and how to file a report. As noted above, due to staff shortages or high demand for services, district offices are sometimes required to purchase services from contractors to meet customer demand in a timely manner. The services purchased in ILOB were limited to Orientation & Mobility instruction. Services were purchased from the following contractors in FFY 2017: Ann E. Bender-Brennan; Gary L. Davis; Jamie E. Sigel; Michele Marie Jones; and Amanda Prince.

B. Briefly describe any activities designed to expand or improve services including collaborative activities or community awareness; and efforts to incorporate new methods and approaches developed by the program into the State Plan for Independent Living (SPIL) under Section 704.

The Bureau of Blindness and Visual Services continues to increase efforts to become a more mobile workforce. Staff use secure “hot spot” connections that allow the use of laptop computers. Additional field staff has received iPhone and iPads, enabling them to send and receive emails; communicate with customers, colleagues, service providers and other professionals in the field; voice-dictate case progress notes; access and enter information into the electronic case management system (CWDS); review uploaded reports; and process purchase orders; and generate correspondence. Customer service and efficiency have improved due to the increased availability of BBVS staff and their expanded flexibility in completing necessary tasks while away from the district office. BBVS’s district offices continue to offer group instruction classes for ILOB customers, called JumpStart. These classes are designed to help seniors who are visually impaired understand that they can remain active and independent by introducing them to the different types of training and assistive technology devices available to them. JumpStart sessions address independent living skill needs such as food preparation, labeling, clothing care, writing skills, recording/listening devices, and cleaning. Classes also instruct customers on how to travel safely indoors/outdoors, using a cane, and how to navigate stairs, elevators, public transportation, if appropriate for the training building and area. Finally, many classes include group discussion sessions to allow participants to talk and learn about issues like adjusting to vision loss, medication management, community resources, elder abuse, and family interactions. The specific skills addressed at each group instruction program are based on the training needs of the ILOB customers attending the class and the professional judgment of the Vision Rehabilitation Therapists, Orientation & Mobility Instructors, and Social Workers. Feedback solicited from participants has been overwhelmingly positive, including specific examples of how their quality of life has improved; how much they learned from BBVS staff and from the other participants; and how much the participants value being connected to other people who have similar challenges. This year, BBVS has continued and expanded the bulk-ordering initiative for the ILOB program. This initiative has reduced the per case costs significantly in just the first few months. Bulk orders allow BBVS to realize free shipping and a discount on large orders and to provide instructional services and equipment essential to health and safety on a timelier basis. BBVS continues to seek methods to reduce costs while providing the best customer service to an ever-growing population. Since beginning the bulk ordering initiative last year, BBVS has reduced its average days open per case by over 180 days. BBVS District Offices also continue to collaborate with community groups and integrate new methods and strategies to provide the highest quality service to our customers. District Offices work closely with the twenty-six offices run by the non-profit organization, Pennsylvania Association for the Blind (PAB) and Philadelphia-based Associated Services for the Blind to coordinate referral and support services which include transportation, support groups, life skills education, grocery shopping assistance, and reading services provided by volunteers. PAB offices also provide low-vision screenings designed to detect potential vision problems for children/adults and conduct educational programs which stress the need for early detection, eye safety, and information about specific diseases Pennsylvania also continues to foster collaborations with local Consumer Advisory Committees (CAC), the Department of Aging, Department of Human Services, Department of Transportation, Associated Services for the Blind, Senior Centers, Area Agencies on Aging, Mature Worker Programs, Sight Loss Support groups, Senior Expos, Keystone Blind Association, community service organizations, home health agencies, and nursing homes. BBVS staff attended consumer conferences and statewide conferences for the National Federation of the Blind, Pennsylvania Council of the Blind, Pennsylvania Optometrist Association and the national AFB leadership conference. Informational materials are provided at doctor’s offices, faith-based facilities, and retirement homes. We also encourage customers to attend the Office of Vocational Rehabilitation annual public meetings to share their comments and suggestions on the ILOB Program. CAC meetings are also conducted via telephone conference, which allows customers to participate from home and provide direct input about the Independent Living Program. As part of a continuing effort to recruit high-quality instructional service staff, BBVS also works collaboratively with Salus University, Kutztown University, and The University of Pittsburgh to strengthen their respective curricula for VRT, O&M, and Teachers of the Visually Impaired and to facilitate internships for their students at BBVS’s six district offices. BBVS now offers opportunities for paid VRT and O&M internships. Pennsylvania Department of Labor & Industry’s Office of Vocational Rehabilitation, Bureau of Blindness and Visual Services and Office for the Deaf & Hard of Hearing continues its partnership with the PA Statewide Independent Living Council and the Center for Independent Living of Central PA to fund the first statewide program of Support Service Providers (SSPs) for individuals who are deaf-blind. This pilot grant, “Deaf Blind Living Well Services” (DBLWS), is a State Plan for Independent Living initiative funded with federal and state dollars with the goal of increasing outreach and services to persons who have a dual sensory loss of both vision and hearing. A very important key to greater independence and increased quality of life for persons who are deaf-blind includes the use of Support Service Providers. SSPs link individuals to their environment by providing relevant information and acting as a guide and communication facilitator to allow individuals who are deaf-blind to make informed decisions. The Center for Independent Living of Central PA will administer the program, recruit SSPs, and provide training to both SSPs and participants who are deaf-blind. DBLWS is a consumer-driven program that is committed to supporting the rights of the unserved and underserved population of persons who are deaf-blind in accessing their environment and community. During the grant’s third year, 48 individuals have used SSP services and 60 people have been trained and registered to provide SSP services. In FFY 2017 the Office of Vocational Rehabilitation continued its efforts in providing statewide staff development and technical training with the goal of improving customer service, ensuring statewide consistency and sharing and reinforcing best practices. BBVS central office staff conducted bi-monthly training sessions named “Feed Your Mind Thursdays” for Vision Rehabilitation Therapists, Orientation & Mobility Instructors, Social Work and Vocational Counselor staff. 2017 topics included: Assisting the Low Vision Customer (The emotional impact of vision loss, Hadley Low Vision Focus Program, AFB Vision Aware Program); Working with Older Individuals who are Blind/Visually Impaired with Hearing Loss; Update on the National Conversation on Aging and Vision Loss; Reading an Audiology Report; Reading a Low Vision Report; Introduction to Dementia and Alzheimer's; Introduction to Traumatic Brain Injury and Vision Loss & Interventions for Traumatic Brain Injury and Vision Loss; Low Vision for O&M/VRT; Adult and Older-Adult Protective Services; and Common Age Related Eye Diseases. Many of the training sessions have been provided through the OIB-TAC grant and were very well-received by field staff and administrators. Bureau of Blindness and Visual Services continues to collaborate with other state and federal agencies to coordinate services, build awareness, and expand capacity. BBVS continues to partner with vision professionals from the Veteran’s Administration to introduce staff, share information about respective agency services, and increase opportunities for collaboration and coordination of services for mutual customers. BBVS also works very closely with the PA Department of Aging in many facets, with plans to collaborate on a cross-department event to recognize Older Americans Month in May of 2018. In addition, BBVS partners with PA Department of Human Services regarding programs offered in the Office of Long Term Living to seek coordination of services for our mutual customers and to ensure that the needs of individuals with visual impairments, hearing impairments, or dual impairments are considered as part of their managed health care plan. BBVS also has initiated collaboration with the PA Department of Transportation concerning funding for transportation programs for seniors and individuals with disabilities. BBVS staff have also met with US Senator Bob Casey, the Ranking Member of the U.S. Senate Special Committee on Aging to discuss the needs of older Pennsylvanians with vision loss and provide information about vision and hearing loss in older adults. In September, BBVS participates in a Falls Prevention Awareness Event at the PA State Capitol Building sponsored by the PA Department of Health and the PA Department of Aging and provides information regarding falls prevention and visual impairments, available services for those with visual impairments, and assistive device demonstrations. In November, BBVS takes part in a World Diabetes Day Event at the PA State Capitol Building co-sponsored by the Diabetes Caucus of the PA General Assembly and the PA Department of Health. BBVS provides educational information about diabetic eye disease, details of Medicare vision benefits, brochures regarding available services and an opportunity for guests (seniors, general public, public officials, and legislators) to experience a sensory-loss simulation. BBVS persists in its efforts to educate public officials and members of the PA General Assembly of the prevalence of visual impairments in the commonwealth, the needs and concerns of PA citizens who are blind or visually impaired, and the barriers to employment and independence that they face.

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.

Customer satisfaction surveys are sent to ILOB clients after their case is closed successfully. Of those surveys, 69% of customers reported that they felt more confident to perform activities they had previously given up on; and 60% of customers reported that they are less dependent on others because of the services provided by the ILOB program. Thirty-three percent of respondents reported that they live alone and 65% customers reported that they are better able to prepare meals for themselves. In addition, 50% of customers reported that they are better able to enjoy reading materials (whether with magnifiers, large print, Braille, or on tape) and 67% reported that they are better able to participate in the life of family, friends, or the community. Consistent with surveys conducted in previous years, the main type of eye problem reported was macular degeneration (77%); followed by glaucoma (6%), diabetic retinopathy (2%), cataracts (2%), and other causes (4%). The results from our satisfaction survey follow: 01. I feel more confident 5. No Answer 2.08% 4. Strongly Agree 12.50% 3. Agree 56.25% 2. Disagree 12.50% 1. Strongly Disagree.33% 0. N/A 8.33% 02. I am less dependent 5. No Answer 4.17% 4. Strongly Agree 14.58% 3. Agree 45.83% 2. Disagree 25.00% 1. Strongly Disagree 25% 0. N/A 4.17% 03. I am better able to move 5. No Answer 4.17% 4. Strongly Agree 25.00% 3. Agree 52.08% 2. Disagree 6.25% 1. Strongly Disagree 2.08% 0. N/A 10.42% 04. I am better able to prepare meals 5. No Answer 8.33% 4. Strongly Agree 12.50% 3. Agree 52.08% 2. Disagree 6.25% 1. Strongly Disagree 4.17% 0. N/A 16.67% 05. I can better manage housekeeping 5. No Answer 8.33% 4. Strongly Agree 8.33% 3. Agree 52.08% 2. Disagree 12.50% 1. Strongly Disagree 4.17% 0. N/A 14.58% 06. I can better manage paperwork 5. No Answer 8.33% 4. Strongly Agree 8.33% 3. Agree 29.17% 2. Disagree 31.25% 1. Strongly Disagree 6.25% 0. N/A 16.67% 07. I am better able to read 5. No Answer 4.17% 4. Strongly Agree 25.00% 3. Agree 25.00% 2. Disagree 27.08% 1. Strongly Disagree 10.42% 0. N/A 8.33% 08. I am better able to participate 5. No Answer 4.17% 4. Strongly Agree 12.50% 3. Agree 54.17% 2. Disagree 18.75% 1. Strongly Disagree 2.08% 0. N/A 8.33% 09a. I feel more in control 5. No Answer 4.17% 4. Strongly Agree 16.67% 3. Agree 58.33% 2. Disagree 12.50% 0. N/A 8.33% 09b. I am better able to access community 5. No Answer 10.42% 4. Strongly Agree 8.33% 3. Agree 22.92% 2. Disagree 41.67% 1. Strongly Disagree 2.08% 0. N/A 7 14.58% 09c. I am better able to use library services 5. No Answer 12.50% 4. Strongly Agree 6.25% 3. Agree 16.67% 2. Disagree 31.25% 1. Strongly Disagree 4.17% 0. N/A 29.17% 09d. I feel I have more control and confidence in my ability to maintain my current living situation 5. No Answer 12.50% 4. Strongly Agree 18.75% 3. Agree 41.67% 2. Disagree 14.58% 1. Strongly Disagree 2.08% 0. N/A 10.42% 11.a. Have you experienced changes in your lifestyle that was not caused by your vision loss Yes 41.67% No 56.25% N/R 2.08% 11.b. Age 95 2.08% 93 2.08% 92 6.25% 90 6.25% 89 12.50% 88 2.08% 87 4.17% 86 2.08% 85 8.33% 83 4.17% 82 2.08% 81 2.08% 80 2.08% 79 2.08% 77 2.08% 76 4.17% 75 10.42% 74 2.08% 73 4.17% 70 6.25% 69 2.08% 63 2.08% 0 8.33% 12. I am Male/Female U 6.25% M 33.33% F 60.42% 13. Live Alone/Spouse/etc. With Spouse 39.58% With Relatives 12.50% With Non-relatives 4.17% No Answer 10.42% Live Alone 33.33% 14a. Type of Eye Problem Other 4.17% No Answer 4 8.33% Macular Degeneration 77.08% Glaucoma 6.25% Diabetic Retinopathy 2.08% Cataracts 2.08% 14b. Vision Loss Time No Answer 6.25% Less than 1 year 39.58% 7-9 years 25.00% 4-6 years 18.75% 1-3 years10.42% 15a. Cardiac / Circulatory Yes 35.42% No 64.58% 15b. Stroke Yes 6.25% No 93.75% 15c. Hearing Yes 37.50% No 62.50% 15d. Muscular / Skeletal Yes 22.92% No 77.08% 15e. Cancer Yes 4.17% No 95.83% 15f. Pulmonary Yes 12.50% No 87.50% 15g. Renal Disease Yes 2.08% No 97.92% 15h. Diabetes Yes 22.92% No 77.08% 15i. Other Yes 14.58% No 85.42% 15j. None Yes 16.67% No 83.33% 16. Considered Nursing Home Seriously considered 2.08% No answer 12.50% Never needed 58.33% Briefly considered 18.75% Already live in one 8.33%

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).

Services provided through BBVS’s ILOB program have helped individuals over 55 who are blind or visually impaired across the commonwealth of Pennsylvania to gain independence in their daily living, remain in their own homes, increase involvement in and connection to their local communities, reduce their feelings of isolation, and improve their overall quality of life. Below is an individual case example from each of the six BBVS district offices: 1) Linda lost her vision and some of her hearing due to cobalt toxicity from a hip replacement. Linda’s worked with a BBVS Social Worker, VRT, and an O&M contract provider. She was experiencing the grief process due to her sudden vision loss and faced difficulties during the initial VRT visits. After cultivating a strong relationship with Linda, the BBVS VRT introduced VoiceOver and other accessibility features on her iPad. She can now access news, email, the internet, and reading material. Over the span of the VRT services, Linda was encouraged to participate in the Central PA Sight Loss Support Group. Linda and her husband attend meetings on a regular basis and have met others with vision loss. In April of 2017, Linda attended Jump Start group instruction for ILOB customers which played a vital role for her to network and socialize. Linda was exposed to O&M training at Jump Start and subsequently amended her IL plan to include individual O&M training. Using a cane has greatly improved her mobility and her quality of life. 2) Mary was referred to BBVS by the local PA Association for the Blind, The Sight Center, due to her visual impairment. She had a low vision exam at the Sight Center upon referral by her Ophthalmologist. According to the customer’s eye records, she has been diagnosed with age related macular degeneration with acuities of 20/125 right eye and 20/100 left eye. Mary lives by herself in the home she owns so her goal was to remain independent in her home despite her visual impairment. With financial assistance from BBVS, she was able to obtain the hand-held magnification device to read print, including recipes, mail, financial information and household communication. She also received a distance viewing device to assist her with reading signs when in the community and to view her property for home maintenance. The customer reports that these devices have assisted her with maintaining her independence by being able to read print materials and distance viewing. Mary participated in Visual Rehabilitation Therapy and reports that she feels better able to maintain her independence with the devices and strategies she learned from her therapist. She learned to trim her nails safely, mark her clothing to distinguish colors, is able to tell time with a talking watch and a talking clock, is able to keep track of appointments by using a large print calendar, uses a large print check register to keep track of finances, uses writing templates, bold line paper, bold pens, dark lead pencil to write and fill out forms, uses markings to identify appliance settings, uses safe, non-visual ways to cut, measure, pour, bake safely, flip food, and determine doneness, learned techniques for ironing safely, and learned non-visual techniques for sewing and mending. Mary also uses adaptations and task lighting with her magnification devices to read mail, books, and other items with a reading stand, typoscope and acetate sheets. Her BBVS social worker assisted her in completing an application for NLS talking books as she was an avid reader before her visual impairment. She reports she is doing well with them. As a result of the assistance that the customer received from BBVS, she indicates that she feels more independent and better equipped to do her everyday tasks. She is relieved that she does not have to depend on family members as she once did to complete her activities of daily living and reading print materials. Mary knows she may contact BBVS services in the future should her vision change. 3) Four years ago an IL customer, Selah, went through an experience which proved to be life-changing. After a major stroke and needing to work tirelessly during an intensive rehabilitation therapy to regain the ability to walk and talk, coming to term with the resulting vision loss and partial paralyses was her final step to regaining her independence she believed to be permanently lost. Selah received services from BBVS that she called “transformational”. An application for Talking Books was completed. This enabled her to read her mystery books again and opened her to the possibility of rejoining a book club for socialization. Along with her vision loss, she also experienced arthritis, weakness and paralysis from the stroke. She received a low vision evaluation to determine the most suitable device to meet her needs for reading and writing. The use of this device gave her the confidence to handle household tasks on her own again. Selah is now able to independently manage her diabetes medications, read recipes, and manage her finances. She stated that the most valuable service she received from BBVS was VRT instruction and its related aids and devices. She specifically praised the liquid level indicator, which allows her to help her husband with cooking and allows to pour herself a beverage despite her paralysis and vision challenges. 4) Connie is visually impaired due to Primary Open Angle Glaucoma. Connie traveled only using human guide prior to her having an open case with BBVS’s IL program. Connie received O&M training using an adaptive cane. She reports that she can safely and independently use the stairs in her home and walk around her city community. Connie also received VRT instruction and its related access technology and devices. Connie has been able to return to volunteering at her church and fully participating in her grandchildren’s lives. She credits BBVS for helping her regain her independence and returning to her active, involved life. 5) Diane has a longstanding history of Diabetic Retinopathy in both eyes. Together with her BBVS social worker, an independent living plan was developed to assist her achieving goals of independence and address her limitations due to vision loss. After a low vision evaluation, she received an illuminated hand-held magnifier and a CCTV from reclaimed stock. Through BBVS VRT instruction, Diane has reported an increase in independence with everyday reading and writing tasks such as reading her mail, writing checks, and reading her insulin pen. She stated that the VRT adaptive techniques and aids like the large print computer keyboard and handheld magnification mirror have been crucial in her regaining the ability to complete daily tasks. Diane was enrolled with NLS and can access talking books program through Carnegie Library for the Blind and Physically Handicapped. The BBVS social worker provided counseling, guidance, education and support services throughout the life of her ILOB case. Due to the services she received from BBVS, Diane has reported better quality of life and increased independence living in her own home. 6) Lane’s vision has gradually deteriorated over the past 5 years. He can no longer drive and was having difficulty with ADL’s especially reading the newspaper, mail, writing checks, cooking safely and traveling independently. Lane received a low vision evaluation as part of his IL plan and he received the recommended magnifiers. He received VRT instruction with adaptive aids in his home that included marking of appliances, cooking instruction, clothing organization, and using a talking blood pressure monitor. Lane also attended the BBVS JumpStart program where he connected with new friends who were also experiencing vision loss. He received O&M instruction that has further increased his ability to complete daily activities and travel independently. Lane has expressed gratitude for BBVS services and reports having a more positive outlook on life and has become very active in attending programs and activities in his apartment complex.

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

Pennsylvania ranks fifth in the nation in terms of residents aged 55 and above. By 2020, it is projected that one in five Pennsylvanians will be 55 and older; and one in three will be 65 and older. This presents challenges for the Social Workers, Vision Rehabilitation Therapists, and Orientation and Mobility Instructors to provide timely services to the ever increasing referral base for the eligible ILOB population. We strive to provide the highest quality services to our customers and to develop strong relationships with our local, state and federal partners. Forty-eight of Pennsylvania’s sixty-seven counties are rural; the rural elderly is the fastest growing segment of our population. These rural counties often have very limited resources and services for the elderly. Lack of public transportation in rural areas continues to be a major obstacle for the elderly in our state. Elderly residents of Pennsylvania who are visually impaired or blind find it difficult to access community and medical services due to transportation issues. Our district offices attempt to work with local agencies to obtain transportation for these individuals, but funding limitations often limit the number of individuals these agencies can serve and the territories and distances they can reach. We have insufficient funds to contract services such as residential Personal Adjustment to Blindness Training or other complimentary services where special needs exist due to an absence of natural supports and multiple disabilities. Delays, sometimes for months at a time, in federal Title VII-Chapter 2 funding allotments also result in a substantial delay in services provided to our ILOB customers. Static Title VII-Chapter 2 funding allotment amounts over several years has required Pennsylvania to reduce per case spending in order to reconcile increasing costs. The poverty rate among PA seniors continues to rise in rural, suburban, and urban areas alike. Along with the growing senior population and rising poverty rates is an increase in the prevalence of diabetes and its related health conditions, which include diabetic eye disease, creating a greater demand for ILOB services. Social Security and Medicare do not provide low vision and hard-of-hearing health care services that are so vital to the overall well-being and independence of PA’s senior population. Over the last 3 FFYs, OVR has spent over $14 million providing 13,000+ hearing aids and devices to customers and over $3.6 million providing 12,000+ low vision devices and services. These services were provided to enable OVR customers, including ILOB customers, to achieve their independence and employment goals. These services are critical for ILOB participants to achieve the goals of securing and maintaining independence. ILOB customers who receive hearing aids and devices, low vision aids, and low vision rehabilitation therapy are able to conduct many functions of daily living at a more independent level thus reducing the need for costly attendant and personal care services. These costly but necessary hearing and vision services are difficult to provide with static or reduced ILOB funding. Pennsylvania continues to experience difficulty in recruiting and maintaining qualified staff based on shortage of qualified Social Workers, Vision Rehabilitation Therapists, and Orientation and Mobility instructors. There is considerable competition for these individuals among employers who can offer higher salaries. There is an increasing need for our ILOB customers regarding Assistive Technology, both high and low tech. The evaluation and training for these services is extremely expensive and although our customers can greatly benefit from AT evaluations and training the funding is not available to offer it as a standard service.

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 bySusan Neff
TitleAging Services Specialist
Telephone717-783-8398
Date signed12/28/2017