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

RSA-7-OB for Tennessee Division of Rehabilitation Services - H177B170042 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 year636,572
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2636,572
A2. Total other federal1,528,539
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement1,528,539
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)98,221
A4. Third party0
A5. In-kind0
A6. Total Matching Funds98,221
A7. Total All Funds Expended2,263,332
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs328,768
C. Total expenditures and encumbrances for direct program services1,934,564

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 3.7500 28.0000 31.7500
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 3.7500 28.0000 31.7500

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 3 0.0540
2. Employees with Blindness Age 55 and Older 3 0.0540
3. Employees who are Racial/Ethnic Minorities 6 0.1081
4. Employees who are Women 32 0.5769
5. Employees Age 55 and Older 13 0.2343

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 FY193
2. Number of individuals who began receiving services in the reported FY671
3. Total individuals served during the reported fiscal year (A1 + A2) 864

B. Age

1. 55-5973
2. 60-6470
3. 65-6968
4. 70-7491
5. 75-79136
6. 80-84128
7. 85-89155
8. 90-94111
9. 95-9924
10. 100 & over8
11. Total (must agree with A3)864

C. Gender

1. Female618
2. Male246
3. Total (must agree with A3)864

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race9
2. American Indian or Alaska Native3
3. Asian0
4. Black or African American120
5. Native Hawaiian or Other Pacific Islander0
6. White728
7. Two or more races3
8. Race and ethnicity unknown (only if consumer refuses to identify)1
9. Total (must agree with A3)864

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)31
2. Legally Blind (excluding totally blind)351
3. Severe Visual Impairment482
4. Total (must agree with A3)864

F. Major Cause of Visual Impairment

1. Macular Degeneration472
2. Diabetic Retinopathy67
3. Glaucoma132
4. Cataracts19
5. Other174
6. Total (must agree with A3)864

G. Other Age-Related Impairments

1. Hearing Impairment160
2. Diabetes262
3. Cardiovascular Disease and Strokes432
4. Cancer49
5. Bone, Muscle, Skin, Joint, and Movement Disorders413
6. Alzheimer's Disease/Cognitive Impairment37
7. Depression/Mood Disorder53
8. Other Major Geriatric Concerns222

H. Type of Residence

1. Private residence (house or apartment)732
2. Senior Living/Retirement Community80
3. Assisted Living Facility33
4. Nursing Home/Long-term Care facility19
5. Homeless0
6. Total (must agree with A3)864

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)216
2. Physician/medical provider11
3. State VR agency57
4. Government or Social Service Agency88
5. Veterans Administration0
6. Senior Center27
7. Assisted Living Facility2
8. Nursing Home/Long-term Care facility10
9. Faith-based organization0
10. Independent Living center14
11. Family member or friend161
12. Self-referral196
13. Other82
14. Total (must agree with A3)864

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 665,490
1b. Total Cost from other funds 108,335
2. Vision screening / vision examination / low vision evaluation 668
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 499,118
1b. Total Cost from other funds 81,252
2. Provision of assistive technology devices and aids 753
3. Provision of assistive technology services 753

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 332,745
1b. Total Cost from other funds 54,168
2. Orientation and Mobility training 155
3. Communication skills 680
4. Daily living skills 732
5. Supportive services (reader services, transportation, personal 0
6. Advocacy training and support networks 0
7. Counseling (peer, individual and group) 575
8. Information, referral and community integration 178
. Other IL services 64

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 166,372
1b. Total Cost from other funds 27,084
2. Information and Referral 0
3. Community Awareness: Events/Activities 62 2,000

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) 543,199 1,934,564 1,391,365
2. Number of Individuals Served 822 864 42
3. Number of Minority Individuals Served 141 136 -5
4. Number of Community Awareness Activities 55 62 7
5. Number of Collaborating agencies and organizations 552 541 -11
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 753 100.00%
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) 671 89.11%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 82 10.89%
B1. Number of individuals who received orientation and mobility (O & M) services 155 100.00%
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) 67 43.23%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 88 56.77%
C1. Number of individuals who received communication skills training 680 100.00%
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) 488 71.76%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 192 28.24%
D1. Number of individuals who received daily living skills training 732 100.00%
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) 529 72.27%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 203 27.73%
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) 595 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) 3 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) 0 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 6 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

Tennessee would like to see RSA resume regular conference calls between states regarding the Older Blind program. This could be less frequent than the former meetings to a bi-annual calendar. We would also like to see an annual training session on how to complete the 7OB report for new program coordinators and any others who need a refresher. As the number of older adults with significant vision loss continues to rise but the level of federal funding does not Tennessee would also like some input on how to effectively serve all eligible individuals with current level funding.

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.

The Independent Living Services for Older Individuals who are Blind Program in the state of Tennessee is authorized under Title VII, Chapter 2 of the Rehabilitation Act of 1973, as amended. This program supports projects designed to serve persons who are fifty-five years of age or older and for whom, because of their blindness or severe visual impairments, gainful employment would be extremely difficult to attain, but individual living goals are feasible and attainable. In fiscal year 1994-95, Tennessee was awarded a five-year grant under the Title VII-Chapter 2 program. Funds were utilized to hire 10 Rehabilitation Teacher Assistants to work full time with older individuals who are severely visually impaired. The Rehabilitation Teacher Assistants work under the direct management of the Rehabilitation Teacher and are supervised by the Field Supervisor. The Rehabilitation Teacher makes the initial contact with the client, conducts the assessment and then, with the client’s input, develops the individualized Independent Living Services Plan (ILSP), from needs indicated during the assessment. At this point the case is referred to the Rehabilitation Teacher Assistant (RTA) to provide training services in independent living skills, as indicated by the ILSP. Rehabilitation Teacher Assistants may also be called upon to represent the Agency and Program in public educational activities. We feel the added bonus of referring an older blind client to the RTA for the individualized training helps us serve this ever growing population. In addition our Program Director works closely with the State Independent Living Council to make sure others working in the IL field statewide are aware of our program of services. Each RT is asked to identify the underserved or unserved populations in their service areas then schedule and participate in at least 3 outreach activities in those areas. Most staff reached their goal in conducting these outreach efforts. New staff follow our IL Program Training Outline with direct training provided by their direct supervisor and other qualified field staff.

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.

Statewide our staff continues to reach out to the community to provide education regarding services to meet the needs of persons’ with visual impairments and blindness. At the start of the reporting federal year we asked each RT to identify counties and or zip codes in their respective areas that were currently the most underserved. Then they were to complete at least (2) outreach activities in those identified areas. We are glad to report that all RTs met or exceeded this outreach goal. A total of 69 formal outreach activities took place during this reporting year. Our East Tennessee staff provided information about our program to various health centers, senior centers, doctors’ offices and other community groups. They attended the following events that were either held in or available to individuals and service providers in the identified unserved areas. Sullivan County - Home Instead Senior Care and Kingsport Senior Center Unicoi County - Unicoi Senior Center Upper East Counties - Blue Care — Health Care Provider Greene County - Roby Fitzgerald Adult Center Washington County - Bethel Housing/Fall Expo and Health Fair Carter County - Low Income Housing Multiple Counties - Eye Center of Oak Ridge Monroe County Health Council Claiborne County - Harrogate and Tazewell Senior Centers Union County Senior Center Cocke County Health Council Pickett County Health Department and Senior Center Clay County Health Department Fentress County Senior Department Macon County Senior Center Overton County Senior Center Jackson County - Fairview Community and Senior Center Putnam County Senior Center and Health Department Van Buren County Senior Center Plateau Mental Health Center and Heritage Senior Living — Putnam County Cannon County Senior Center Cumberland County Technology Day The Middle Tennessee staff attended outreach events at county senior centers, assisted living facilities, health centers, vision impairment support groups and other community agencies serving their unserved areas. We were asked once again to provide a workshop for Physical Therapy students at Belmont University in Nashville. One of our Rehabilitation Teachers conducts the “show and tell” portion of the presentation to educate the rising PT students about adaptive techniques and devices. Some outreach opportunities for our Middle Tennessee staff included such organizations as: Trousdale County Senior Center Springfield Heights Assisted Living Susan Walker Senior Expo Cheatham County Vantage Point Village Houston County Health Department DHS Houston County Remote Area Medical Clinic Signal Center — Technology Polk County Health Council Sequachee Valley Electric Cooperative Senior Expo NFB Cleveland TN Support Group Perry County Senior Center Wayne County Housing The West Tennessee staff met their goal of attending and presenting at (2) outreach activities per staff member in their underserved areas. They attended the following events: Lake County Senior Center Morning Side Assisted Living —Henry County Tennessee Disability Pathfinder with TN Healthcare Lauderdale County Commission on Aging Amerigroup Behavioral Health Initiatives Heritage Assisted Living Facility Mid-South Access Center University of Tennessee Scotts Hill Lion’s Club of Decatur County Scotts Hill Senior Center Savannah Senior Center Hardin County Health and Rehab Center Brookdale Germantown Senior Living Solutions Jk Lewis Senior Center Bells Assisted Care Living and Retirement Village Overall these statewide community events and presentations reached approximately 2000 individuals. We conduct outreach in an effort to raise awareness and referrals. To provide quality services staff collaborate with local, regional and national vendors and agencies that assist individuals with vision loss. Below is a list of the most frequent: Various Adaptive Equipment Vendors Tennessee Library for the Blind & Visually Impaired Home Health Agencies Area Agencies on Aging Senior Citizen Centers VI Support Groups Assistive Technology Centers Ophthalmologists Local Nursing Homes Braille Bible Institute American Foundation for the Blind Local Transportation Programs National Federation of the Blind Community Health Agencies Directory Assistance

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.

As is customary, our Chapter 2 Program Coordinator sends a list of individual cases that were closed in the previous month to the Office of Learning and Professional Development (OLPD) staff. The surveyors contact each client by phone to conduct a brief survey to reflect the customer’s satisfaction level and perception regarding the services they received. The survey results are compiled into a monthly report that is sent to the Coordinator who then passes this information onto our field staff. Two hundred and seventy-eight (278) individuals who participated in the Chapter 2 Program were surveyed. One hundred percent (100%) of those were closed successfully. Participants were very positive in their overall evaluation of the program, with 94% of the participants rating the program either Excellent or Good. Overall this year there was a 97% client satisfaction rate with the services they received. Ninety-three percent (93%) of the participants said they felt more independent “most of the time” as the result of the Rehabilitation Teacher program services. Percentages continued high with (98%) of the participants who said that their RT and/or RTA clearly explained the services, treated them with courtesy and respect and included them in the development of their plan of services. A majority of respondents (98%) felt like their RT and/or RTA tried to understand and help them solve their problems related to their vision loss and that their monthly meetings were helpful. Illuminated magnifiers, time keeping devices and cane training were noted in the surveys by consumers as helping them the most along with markings of appliances, books on disc and glare filtering devices coming in as a strong second as the most helpful. As we have been able to offer more opportunities for clients to learn Orientation and Mobility training from certified professionals, cane training has continued to increase as training clients found most helpful.

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).

A is a 70 year old individual with Macular Degeneration who lives in Middle Tennessee. His best corrected visual acuity had diminished to 20/400 in both eyes. A continues as part owner of an antiques business and due to his vision loss was unable to measure, label and view items at work. After a functional vision evaluation, the Rehabilitation Teacher identified that A could successfully use a 7 X magnifier and with the added assistance of a talking tape measure he could accomplish his goals. He found he could also read his mail, the local newspaper, medication labels and perform other short term reading task. Tactual bump dots were also placed on A’s thermostat so he could adjust the temperature in his home independently and he utilized the same tactile technique on the thermostat in his store. He and his family were introduced to proper sighted guide techniques and the Tennessee Library for the Blind. A can now listen to books and order any books that he likes from this free service. He says this has helped him pass the time during the day. A was provided with solar shields for inside and outside of the home, improving contrast and cutting glare. He continues using all his techniques and his equipment daily. He has expressed his gratitude for the support and encouragement provided by his teachers and says he feels he is a productive member of society again as a result of the Independent Living Services. B is a 77 year old man who grew up on a farm and was use to hard work and heavy lifting. B shared with his Rehabilitation Teachers that he played 5 seasons in the NBA during the late 60s and early 70s. He graduated from college with a degree in Engineering and worked for many years doing electrical and engineering work. B was diagnosed with both Macular Degeneration and Glaucoma. He was having problems with write lists and notes, keeping track of appointments, making and receiving phone calls and other reading tasks. B shared that he has always loved to cook but was having trouble using his stove and oven and accessing recipes. He was also a little afraid of using a knife to slice various foods and having problems with walking outside because of glare. Because of the Independent Living Skills training that he received and his great attitude B reported that he is now enjoying camping, working around the house and helping others with special projects. B confesses that he gets discouraged from time to time about his loss of vision, but staying busy and being with family and friends who understand his problems and concerns is most helpful with his emotional outlook on everything. B expressed his excitement in being able to read the date from his large print calendar and view large print recipes. He can now place and receive phone calls and to make notes for himself with a bold line pen and paper. He can now slice foods with more confidence using his cut resistant glove and walk outside with a lot less glare when wearing the sunshields he was provided! He is reading most things with the 6X magnifier he found helpful during the assessment. He expressed interest in being able to read for longer periods of time which prompted his Rehabilitation Teacher to refer him to the local Technology Access center for an evaluation for other low vision devices that should enhance his visual reading and duration. With the adaptive techniques and equipment that B was provided and his positive view of life, he will continue to be an independent, confident, productive and well-adjusted individual. C is a 76 year old individual who lives in an apartment complex with other older adults in West Tennessee. She has had a progressive visual condition for many years. She is a widow, who live alone and her adult son checks on her weekly. Prior to receiving Rehabilitation Teaching Services C states she only left her apartment for appointments and had given up on being able to perform daily tasks independently. She loves reading and wanted to be able to see well enough to read cookbooks, mail and her medicine bottles. A functional vision assessment was conducted by the Rehabilitation Teacher who found that a portable electronic magnifier allowed C, who could only see to count fingers at 3 feet, to obtain her reading goal. Once C became familiar with the device and practiced she was able to reach her reading goal of reading books, menus, correspondence, medicine bottle directions and even view photos. She was so excited that she said “I feel human again. I feel like I can live and enjoy life again!” C also wanted to be able to read package directions and cook simple meals in her microwave and toaster oven. The Rehabilitation Teaching Assistant placed tactile markings on these two kitchen appliances and after training C could complete the entire task of reading the package directions, set her kitchen appliance to fix a simple meal independently. She is so excited about her new found freedom and confidence!

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

For several years Tennessee has supplement the Older Blind Program with SSA reimbursement funds and additional state dollars as reflected in Part I: Funding Sources and Expenditures of this report. The supplemental funding has been included this year in our 7OB report to accurately reflect our funding sources, expenditures and encumbrances. This explains the increase in Total Direct Services Expenditures from what was reported in FY2016 report. Which we feel better reflects program costs. The need for additional federal funding is apparent as continue as our aging population grows, along with individual requests for high end technology. Tennessee would like to see an increase in funding to ensure all eligible individuals can be served.

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 byPaula Knisley
TitleVR Director
Telephone615-837-5049
Date signed12/20/2017