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

RSA-7-OB for Arizona Rehabilitation Services Administration - H177B180003 report through September 30, 2018

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 year672,603
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year474,337
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2649,853
A2. Total other federal718,513
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement379,710
(c) Title XX - Social Security Act338,803
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)113,216
A4. Third party0
A5. In-kind0
A6. Total Matching Funds113,216
A7. Total All Funds Expended1,481,582
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs907,301
C. Total expenditures and encumbrances for direct program services574,281

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 4.7000 5.4500 10.1500
2. FTE Contractors 3.3700 7.6100 10.9800
3. Total FTE 8.0700 13.0600 21.1300

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 16 6.6500
2. Employees with Blindness Age 55 and Older 7 2.7800
3. Employees who are Racial/Ethnic Minorities 13 4.7700
4. Employees who are Women 36 18.4300
5. Employees Age 55 and Older 14 7.1400

C. Volunteers

0.00

Part III: Data on Individuals Served

Provide data in each of the categories below related to the number of individuals for whom one or more services were provided during the reported fiscal year.

A. Individuals Served

1. Number of individuals who began receiving services in the previous FY and continued to receive services in the reported FY270
2. Number of individuals who began receiving services in the reported FY301
3. Total individuals served during the reported fiscal year (A1 + A2) 571

B. Age

1. 55-5947
2. 60-6459
3. 65-6958
4. 70-7470
5. 75-7983
6. 80-8482
7. 85-8989
8. 90-9458
9. 95-9921
10. 100 & over4
11. Total (must agree with A3)571

C. Gender

1. Female416
2. Male155
3. Total (must agree with A3)571

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race41
2. American Indian or Alaska Native15
3. Asian3
4. Black or African American33
5. Native Hawaiian or Other Pacific Islander2
6. White475
7. Two or more races1
8. Race and ethnicity unknown (only if consumer refuses to identify)1
9. Total (must agree with A3)571

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)63
2. Legally Blind (excluding totally blind)308
3. Severe Visual Impairment200
4. Total (must agree with A3)571

F. Major Cause of Visual Impairment

1. Macular Degeneration258
2. Diabetic Retinopathy32
3. Glaucoma105
4. Cataracts4
5. Other172
6. Total (must agree with A3)571

G. Other Age-Related Impairments

1. Hearing Impairment94
2. Diabetes91
3. Cardiovascular Disease and Strokes124
4. Cancer28
5. Bone, Muscle, Skin, Joint, and Movement Disorders153
6. Alzheimer's Disease/Cognitive Impairment18
7. Depression/Mood Disorder29
8. Other Major Geriatric Concerns85

H. Type of Residence

1. Private residence (house or apartment)420
2. Senior Living/Retirement Community78
3. Assisted Living Facility62
4. Nursing Home/Long-term Care facility10
5. Homeless1
6. Total (must agree with A3)571

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)12
2. Physician/medical provider16
3. State VR agency3
4. Government or Social Service Agency20
5. Veterans Administration0
6. Senior Center3
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization1
10. Independent Living center13
11. Family member or friend30
12. Self-referral454
13. Other19
14. Total (must agree with A3)571

Part IV: Types of Services Provided and Resources Allocated

Provide data related to the number of older individuals who are blind receiving each type of service and resources committed to each type of service.

A. Clinical/functional vision assessments and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 0
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 269,064
1b. Total Cost from other funds 50,458
2. Provision of assistive technology devices and aids 332
3. Provision of assistive technology services 352

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 193,749
1b. Total Cost from other funds 3,234
2. Orientation and Mobility training 441
3. Communication skills 513
4. Daily living skills 327
5. Supportive services (reader services, transportation, personal 0
6. Advocacy training and support networks 350
7. Counseling (peer, individual and group) 6
8. Information, referral and community integration 327
. Other IL services 37

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 0
3. Community Awareness: Events/Activities 0 0

Part V: Comparison of Prior Year Activities to Current Reported Year

A. Activity

a) Prior Year b) Reported FY c) Change ( + / - )
1. Program Cost (all sources) 1,831,408 1,481,583 -349,825
2. Number of Individuals Served 695 571 -124
3. Number of Minority Individuals Served 122 95 -27
4. Number of Community Awareness Activities 23 28 5
5. Number of Collaborating agencies and organizations 58 55 -3
6. Number of Sub-grantees 8 5

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 352 100.00%
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) 24 6.82%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 328 93.18%
B1. Number of individuals who received orientation and mobility (O & M) services 441 100.00%
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) 36 8.16%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 405 91.84%
C1. Number of individuals who received communication skills training 513 100.00%
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) 139 27.10%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 374 72.90%
D1. Number of individuals who received daily living skills training 327 100.00%
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) 135 41.28%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 192 58.72%
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) 170 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) 13 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) 12 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) 4 n/a

Part VII: Training and Technical Assistance Needs

During the 2018 Federal fiscal year, the Arizona OIB program finish working with Mississippi State University Technical Assistance Center. As a result of this collaboration, ILB was able to develop and implement meaningful metrics, create and implement the new Arizona Client Satisfaction Survey, developed curriculum and guidelines for group training, and revised and developed improved client case management forms that will reduce the duplication of information collected which will increase accountability once we migrate into a new case management system. All needs have been addressed at this point.

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 Arizona Rehabilitation Services Administration (AZRSA) Independent Living Blind Program (ILB) employs staff directly with the state agency; Arizona Independent Living Blind (ILB) Program, as well as individuals and agencies who contract to provide local and itinerant services, to administer the Title VII, Chapter II Independent Living Older Blind Program. During this reporting period, the Arizona ILB Program had thirteen internal staff, three contractors, and two agencies with thirty-three direct and indirect service employees, for a total of forty-six individuals who provided services statewide to our elderly blind citizens of Arizona. The services provided helped our 571 clients served live as safely and independently as possible in their homes or communities. Their service was delivered either in one-on-one basis or in a group setting, and training was provided either at their own home, or at the provider’s facility. AGENCY/ORGANIZATION PROVIDERS: AZRSA Independent Living Blind providers consist of thirteen state agency employees and five providers (including two agencies) as follows: State Agency Employees: 1. Bones, Nataly (Certified Orientation and Mobility Specialist 2. Garcia, Vasant (Certified Vision Rehabilitation Therapist) 3. Gunn, Suzi (Certified Orientation and Mobility Specialist and Certified Teacher for the Visually Impaired) 4. Lindley, Pam (Certified Vision Rehabilitation Therapist) 5. Miller, Anna (Certified Vision Rehabilitation Therapist/Certified Rehabilitation Counselor) 6. Sanchez, Eve (Certified Rehabilitation Teacher) 7. Byllesby, Amanda (Vision Rehabilitation Therapist) 8. Crist, Lanelle (Vision Rehabilitation Therapist) 9. Shapiro, Beatrice (Assistive Technology Specialist) Four Administrative Support Staff Provider Agencies: 1. Arizona Center for the Blind and Visually Impaired (ACBVI) 2. Southern Arizona Association for the Visually Impaired (SAAVI) Individual Providers: 1. Bishop-Amavillah, Tamara (Certified Orientation and Mobility Specialist) 2. Hanna, Georgeanne (Certified Vision Rehabilitation Therapist and Certified Low Vision Therapist) 3. Copado, Hector (Certified Orientation and Mobility Specialist, certified Low Vision Therapist, and Assistive Technology Specialist)

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 AZ OIB Vision Rehabilitation Therapists and managers provide community outreach through in-service presentations to local health fairs, senior centers, nursing homes, retirement communities, medical facilities, hospitals, Veterans Special Needs events, and Assistive Technology Events. The focus of these outreach efforts is to educate interested individuals about the needs of seniors who are blind or visually impaired, including providing information on accessing RSA and community blindness related services. The RSA ILB staff and contractors completed twenty eight in-service presentations throughout Arizona, and one thousand two hundred thirty two potential clients, friends, family members, and service providers were given information about vision-related services. Some of the organizations we collaborated during FFY 2018 include, but are not limited to the following: 1. American Foundation for the Blind (AFB) 2. Ability 360 3. Area Agency on Aging 4. Arizona Council of the Blind (ACB) 5. Arizona State Pioneers’ Home, 6. Arizona Technology Assistance Program 7. Arizona Telecommunications Equipment Distribution Program 8. Association for Education and Rehabilitation of the Blind and Visually Impaired (AER) 9. Backway’s Physical Therapy, PLLC, 10. Beattitudes Low Vision Support Group, 11. Braille and Talking Book Library 12. Brookdale Prescott (senior & assisted living residence) 13. Cascades of Tucson Assisted Living 14. Center for Disability Law 15. Chaparral Winds community support group 16. City of Phoenix 17. Connecting Tucson Community expo 18. Dependable Health Fair 19. Desert Low Vision Center 20. Digital Apex 21 DUET — Parish Nurse Training 22. East Valley Dial a Ride 23. Eschenbach 24. Fellowship Square health and wellness expo 25. Foundation for Blind Children —Low Vision Optometrist and social worker 26. Governor’s Council on Blindness and Visual Impairment 27. Guide Dogs for the Blind 28. Hadley Institute for the Blind 29. La Sienna Low Support group, 30. Las Fuentes Senior Living 31. Low Vision Plus 32. LS & S Low Vision Products 33. Maricopa County Public Library (large Print materials) 34. Mississippi State University Rehabilitation Research Training Center 35. National Blind Diabetes Group 36. National Federation of the Blind 37. Parish Nurses East 38. Parish Nurses West 39. Phoenix Dial a Ride 40. Pima Council on Aging: 41. Regional Dial a Ride 42. Sedona Winds Low Vision Support group, 43. Spofit Disability Sport Fitness Center 44. Sun Sounds of Arizona 45. Sun City Grand Low Vision Support Group 46. The Bureau of Engraving and Printing 47. Tucson Society for the Blind (TSB) 48. Tucson Sun Van Transit 49. University of Mass Boston 50. University of Arizona TVI Introduction to Blindness Summer Class 51 U.S. Med 52. Veterans Affairs 53. ViewFinder Low Vision 54. Vision Rehabilitation and Assistive Technology Expo (VRATE) 55. White Cane Day Some of the activities completed with these agencies are as follows: 1. Arizona Technology Assistance Program Working together regarding the most appropriate and beneficial technology for older clients with multiple disabilities. That would best meet their special needs. Collaboration for blind clients included special access for cell phones for people with limited dexterity, information on cell phones for people with limited dexterity, computer access for people with limited dexterity, special walkers for people severely disabled from Parkinson’s disease and other equipment available for persons with vision loss. This collaboration was in the form of discussions, resources, consultation, brainstorming and actual loan of equipment. 2. Hadley Institute for the Blind Collaboration included quarterly Hadley Ambassador meetings on new curriculum and programs at Hadley and distribution of information on the Low Vision Focus program for older persons with vision loss. Information about this program has been given to low vision support groups for information, education and discussion. Plus, it has been used with our clients for reference as a follow up after blind rehabilitation services. 3. Area Agencies on Aging Collaboration included resource information and referrals for our older persons with vision loss who face other life issues in addition to their vision loss. These issues could include but is not limited to housing, financial, physical, mental and cognitive issues. 4. National Blind Diabetes Group Collaboration with experts in the field of blindness and diabetes in conjunction with U.S. Med to provide accessible glucometers for persons with vision loss and diabetes, plus education on living successfully with diabetes and weekly peer support meetings. 5. Mississippi State University Technical Assistance Collaboration with MSU to improve the Arizona OIB program. 6. Arizona Telecommunication Equipment Distribution Program Collaboration included the provision of amplified phones for persons with combined hearing and vision loss, plus consultation. 7. Ability 360 Consultation for older blind clients needing resources for other life issues including housing, financial, hearing, cognitive, mental and physical; plus, involvement in the peer mentoring program. People with vision loss can become a mentor for others with vision loss or can receive a mentor to help in their adjustment to vision loss. 8. American Foundation for the Blind Collaboration included the use and distribution of the new 19 Independent Living lessons for older persons with vision loss prepared by Vision Aware.

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.

For this evaluation reporting period we continue using the new Client Satisfaction Survey developed in 2017 and improved upon feedback received from the Mississippi State University Technical Support. During this fiscal year approximately 200 closed clients were contacted, and 76 surveys were completed which is 38% of all attempts. The survey has 7 questions and 5 of them measure responses on a scale of 1 to 5 as follows: 5 = strongly agree 4 = agree 3 = neutral, neither agree or disagree 2 = disagree 1 = strongly disagree The last two questions are open, so client can express anything they need. The results of the surveys are shown below: 1. My teacher was attentative and interested in my well-being and listened and sympathized with my feelings and concerns. 1 2 3 4 5 0 0 1 15 60 0 0 1% 19% 79% 2. My teacher was knowledgeable regarding techniques, aids/ devices and resources used by people who are blind or visually impaired. 1 2 3 4 5 0 0 1 17 58 0 0 1% 23% 76% 3. I received information regarding other services available related to other health issues and personal concerns which was helpful to me. 1 2 3 4 5 1 3 20 11 40 1% 4% 27% 15% 53% 4. The services and the aids/ devices I received addressed the needs I expressed when I first contacted the program. 1 2 3 4 5 0 1 9 8 57 0% 1% 12% 11% 76% 5. After receiving the blind rehabilitation services I am more confident and better able to complete my desired daily living tasks and less dependent on others. 1 2 3 4 5 2 5 10 12 46 3% 7% 13% 16% 61% 6. What is one thing you would change to improve blind rehabilitation services for you and future consumers? No changes, everything was good, and I cannot think of anything that can be different. 50 67% More hours of training and more frequent visits are needed 10 13% Cannot perform activities independently yet, different and more powerful devices easier to use are needed. 9 12% The wait time to receive services is too long. 2 3% Follow up calls ones a year are needed to make sure we are OK 2 3% more O&M instructors, she always seemed so booked 1 1% A group of friends after training is done is needed. 1 1% 7. What is the greatest impact Independent Living Blind services has made in your life? The OIB program impacted our elderly blind community in different ways. Some of the comments received are as follows: • “Sewing and threading needles made me happy” • “helped me to see, read, magnifying glasses helped, worked great!” • “more confident” • “remaining independent with a disability” • “getting around easier” • “ott lite lighting helped so much” • “seeing to read again” • “Be able to use my phone!” • “I am able to function a lot better” • “learning about resources available to the blind” • “handling my business as usual” • “reading and moving on my own again” • “freedom of getting around without worrying” • “now I have something to take up my day, life has substance” • “Getting around with visual impairment. My mobility is great” • “knowing about groups and services available to me if I needed them” • “knowing I’m not the only blind guy with a cane” • “independence, I’m more sure of myself” • “getting around in my room by myself” • “seeing things again. Easier life” • “trying to be my own person and do my own things” • “changed my life. Introduced me to things I didn’t know existed like Netflix descriptive videos” • “she made me confident in being okay with losing my vision but still be able to be independent” • “being able to go look at magazines and go shopping and see prices”” • “doing more things by myself, a lot easier” • “able to read books and the bible and listen to the radio and use the computer again” • “labeling and doing things on my own” • “being comfortable with being completely blind” • “very helpful it was a great service” • “little things that made little irritations go away” • “much more independent than before”

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).

Success Stories submitted by state agency staff members and contractors: Vasant Garcia, state employed Certified Vision Rehabilitation Therapist: Mrs. V is a 77-year-old woman with glaucoma. She was having a very difficult time with reading her mail and preparing meals for herself and her daughter. The OIB services provided her with a 5x handheld magnifier and proper training to be able to read standard sized print. This device allowed her to independently read her mail, bills, and different types of paperwork. She also received a George Foreman grill, an electric skillet with tactile settings, and her oven dials were marked so she would be able to set her temperature independently. A proper training to safely used and care for these cooking devices was provided and she was so excited when she was able to cook her favorite meal again. She now feels that her blindness was not stopping her from living and being independent in her home. Now that she had overcome two big obstacles in her life, she is looking to start learning how to confront her last obstacle, which is getting around safely. She is now waiting for Orientation and Mobility. Mr. A is an 80-year-old man with macular degeneration and diabetic neuropathy. His main reason for calling for services was to be able to read printed material. When I saw him, he stated that he wanted to continue to do the family’s tax documents and read his mail. His vision was too poor to benefit from a handheld magnifier and his eyes tired easily so the OIB program gave him the Merlin Elite desktop video magnifier which has OCR capability for when his eyes tire. After he was given this device and a couple of lessons were completed, he was very motivated and began using it between lessons. Now he reports that he can work on tax documents and other important paperwork independently which makes him very happy. He also did not have a way to identify his medications or know his blood sugar levels. He received assistance to sign up with Scrip talk and learned how to use the device. He was surprised at how much information he was missing regarding his medication and even felt good that he could re-order medication on his own and provide the medication number that has been inaccessible since he lost his vision. Regarding a talking glucometer to control his glucose, he struggles with his doctor’s office because they were not cooperative with him. However, he was introduced to the Walmart talking glucometer and he found it easy to use and affordable, so he obtained one on his own and now he can independently monitor his glucose numbers. The service provided gave him back his self—esteem and confidence. Anna Miller, Certified Vision Rehabilitation Therapist and Certified Rehabilitation Counselor: Mrs. A is a ninety-six-year-old woman who currently resides in an assisted living facility on the eastside of Tucson. At the time of her assessment, she stated that she had been diagnosed with macular degeneration about ten years ago, but that she had noticed a significant change in vision over the last year and a half. While her daughter lived near her and would have been able to assist her in completing daily activities, Mrs. A desired to be as independent as possible. During her assessment, Mrs. A indicated that she was having difficulty in several areas of daily life. Within the area of communication, she stated she was having trouble with performing handwriting tasks and with telling time. In the area of home management, Mrs. A stated that she was having difficulty in seeing the settings on her microwave, and often had some trouble in identifying keys for checking her mail. Lastly, in the area of low vision, she indicated that she was having trouble reading items such as the menu for her facility and the journals she kept over nine separate trips she took to Europe with her husband over the years of their marriage. In order to address her needs within the area of communication, Mrs. A was provided instruction in the use of adaptive handwriting templates, and also in techniques she can use for signing her name such as the use of a signature guide or folding the paper on the signing line. Additionally, she was also provided training in the use of a talking clock she could easily move from room to room in her apartment. In the area of home management, she was provided instruction in the use of adaptive materials she can use for marking a variety of appliances such as the microwave, taking care to use concepts such as shape, color, and size when marking specific controls. Additionally, she was also shown how to use the materials for marking a variety of items such as medications and keys. Lastly, in the area of personal management, Mrs. A was provided instruction in several concepts relating to low vision. Due to her limited vision and the fact that hand held magnifiers would not work to allow her to read items such as her past journals, mail, or the menu from her facility dining room, Mrs. A was provided instruction in the use of a desktop video magnifier. Additionally, through assessment of her visual functioning, Mrs. A indicated that she was experiencing issues with glare when eating in the dining room. Therefore, she was also provided adaptive tints, which she reported significantly decreased the level of glare while eating. As a result of receiving services and training, Mrs. A reported that she felt greater independence and confidence. As she also possesses a significant hearing loss, she reported that she was especially thankful for her clock, which was very loud, and which also allowed her to check the time at night without having to get up and use her walker to go check the time. Most notably though, was the fact that Mrs. A’s joy she expressed with being able to reread her journals she kept about her trips to Europe, a task she was unsure she would ever be able to do again. Ms. O is a sixty-two-year-old woman who currently resides alone in a house in the central Tucson. At the time of her assessment, she indicated that she had been diagnosed with glaucoma twenty-five years ago, but also indicated that she was diabetic, and may have begun to develop complications from diabetic retinopathy for her remaining functional vision. At the time of her assessment, Ms. O’s visual functioning was limited to a visual acuity in the left eye of counts fingers, according to medical documentation. At the time of her assessment, Ms. O indicated that she was having difficulty in completing daily activities in several areas. In the area of communication, she was having difficulty in tracking information and records, in knowing the time, and in appointment management. In the area of home management, she stated she was having trouble in seeing appliance settings, and in identifying food packages. Finally, in the area of personal management, Ms. O indicated that she was having difficulty in activities to include identifying clothing colors for pairing outfits together and laundering clothing, as well as in reading and organizing paperwork. In order to address Ms. O’s ability to track important information such as lists, appointments, and individuals’ contact information, she was provided instruction in the use of a digital recorder. Additionally, as she knows Braille, she was also provided with materials such as Braille paper and assistance to get her Braille writer cleaned, which enabled her to use this medium more effectively for record management. Lastly, to address her ability to tell time, Ms. O was provided instruction in the use of a talking clock. In the area of home management, Ms. O was provided instruction in adaptive methods she can use to identify and organize food packages to include identifying them by their size, shape, or consistency of the products. Additionally, she was provided training in the use of a talking label wand, which she can use to create labels for food packages, but also to create an appointment book to address her need to manage appointments in the area of communication. Furthermore, to address Ms. O’s ability to safely use her appliances, she was also provided instruction in adaptive methods and materials she can use for labeling appliance settings. Within the area of personal management, Ms. O was provided training in adaptive methods to identify clothing color and organize outfits using a talking color identifier, but also through adaptive techniques such as marking clothing with safety pins to denote their color, placing different clothing colors in different sections, or in identifying clothing fabric texture or other specific characteristics. To address her need to read her mail and other documents, Ms. O was provided instruction in the use of a desktop video magnifier with speech capability, which enables her to have a choice of using her functional vision or having type written text converted in to speech to be listened to audibly. As a result of receiving instruction in the areas discussed above, Ms. O reported that she felt greater confidence and ability to complete daily activities. From managing her time to identifying foods and reading mail, Ms. O indicated she feels a sense of increased independence. While her children live near her and she sees them often, Ms. O indicated that she is thankful that she does not have to ask them to assist her with many of the areas covered within her training. Amanda Byllesby, State Employed Vision Rehabilitation Therapist: FM is a 91-year-old lady with macular degeneration who lives by herself in an independent living community in Sun City Arizona. Some of the problems identified during the assessment were telling time, reading her mail and different types of printed materials, and identifying colors. After giving the proper aids and devices and training, she was able to overcome all the issues identified. Without the OIB services she said she would be sitting around going crazy with nothing to do. With the aids and training services she reports she knows what time is at any decided moment, she shares it with others, wakes up on time, and gets to her appointments on time. She now also can read her mail again as well as other materials like magazines, advertisements, etc. She was especially proud to have read a special book one of her friends had written that she had been pining to read for over a year, afraid she would never get to read it. She is looking forward to reading the second book in the series. MF is a 72-year-old lady with macular degeneration living alone at an independent living facility in Sun City West, Arizona. Her family lives overseas and previous friends who had helped her did not support her when trying to be independent, and one had taken advantage of her finances. After moving into a better environment, the client learned about the OIB services and called. The client did not have much confidence to do anything and believed she would never cook or sew again. Some of the problems identified during the assessment were reading her mail, keep her calendar, cooking, telling time, and sewing. After aids/devices and training were given, the client was able to overcome these issues. When asked how the OIB program has helped her she replied, “I can write a check- I don’t depend on anybody any more. I Know how to cook now. After electric went out, I could set up the microwave timer again. I make veggie juice and I can read! I was lost completely for 2 years and depressed until now… I’m not waiting to die any more, I am living my life!” Suzi Gunn, State Employed Certified Orientation and Mobility and Teacher for the Visually Impaired: MC is a retired, 99-year-old widow living in a rural area, recently moved from her residence of over 40 years to an assisted living facility. She was previously very social, going golfing, attending the local country club activities and other community social activities prior to the loss of her husband some many years ago. Gradually her circle of friends diminished due to most passing away. She has no family in the state. She left her home filled with memories, personally decorated to her taste down to the wallpaper, and neighborhood familiarity, substantially changing her independent lifestyle. At her home of 40 years. She always handled her finances sitting at her meticulously, well organized desk. So along with her major lifestyle change she felt she was facing giving up control of this important, meaningful task that provided self-esteem. All these overwhelming changes caused her depression and put her emotional wellbeing at risk in general. During OIB instruction, her low vision and communication skills were evaluated as well as her learning style. She was issued a CCTV with simple controls and related training. She became engaged, meeting with the instructor, she looked forward to all sessions. She was stimulated and excited to learn to use the new buttons and ultimately to regain access to her important print documents and once again handle her financial affairs. She successfully learned to operate the new machine and delighted in the larger screen with improved clarity. She had thought she was not able to see her paperwork anymore due to her eye condition. She was also able to read the instruction manual if the instructor was not available to remind herself of the devices’ features. She could fill out her own checks. She now continues to manage her finances; paying her own bills with a return to independence and control of her life. She can now read her own personal birthday cards rather than ask someone to read them to her. Seeing the handwriting of old friends is an additional reminder that she is not alone. She uses the machine to view photos of family and friends now too; satisfactorily dimming the glare to see photos more clearly. It gives her great satisfaction that although she has had to change her lifestyle substantially, she can still manage her life. She also received an accessible phone with amplifier that accommodated her hearing loss. She now can communicate with family and friends. She no longer feels isolated and is quite sociable. Her sense of humor has returned. The accessible phone allows her to be connected to those she loves. Because she developed belief in herself again, she questioned the status quo. The instructor was also able to connect her to a case manager/social worker from the council on aging in the area to support ongoing additional assistance towards improving the quality of life at the assisted living facility. M is just beginning to work with this manager to explore options for change. Her depression has substantially reduced, and she thinks she can make a difference in her environment. She demonstrates that no matter your age, or your condition, quality of life remains important. She now revels in her increased independence, her skill at using adaptive devices; instruction, education and connections have made for a smoother lifestyle transition to an assisted living facility and adjustment to additional vision reduction. OIB services have given her greater sense of control over her daily activities and she can leave the assisted living facility to go to other environments, see other people and longtime business relationships that uplift her. LH a retired Los Angeles police officer, 83 years old, recently widowed in the last year, is also new to vision loss related to AMD. He is a self-starter, strongly self-reliant gentleman with a dry humor accustomed to serving and protecting others and not accustomed to asking for help. He is also a bit of a curmudgeon coping with his newly reduced vision. He had no previous rehabilitation training. And with both the recent loss of his longtime partner and his vision, at start of instruction he was isolated in his rural home, mainly only attending church whenever he could find a ride; angry, bitter, lonely but not wanting to bother others too much. He loves to play the guitar but is unable to see the music any longer. He was not able to read his mail, manage phone contacts, keep a calendar, read labels on food items for cooking instructions, or clean his house, etc. His son, who lives over two hours away is only able to see his father about once a month due to his other family and work commitments. He tried to assist LH by buying and setting up a voice operated phone dialer system, but his son was not accustomed to dealing with visual impairment nor a father that was more dependent; he was not able to instruct LH on how to independently operate the device. Although the device was helpful, LH felt helpless because neither he nor his son felt that he could operate the device. LH had to wait for infrequent visits to update new numbers in the system. This frustrated him and increased his sense of helplessness. The first order of business was to provide LH a sense of control over his life. He was issued and instructed in a method to store and retrieve new phone numbers using a simple digital recorder. Through several training sessions which included learning how to more successfully and systematically use and rely on tactile and auditory skills, he developed ability to retain and retrieve new phone numbers, as well as to take note of medical appointments, and instructional appointments, etc. He was also able to provide his son with a list of new numbers for his voice dialer device. He was very happy to be able to resume his fatherly position directing his son instead of feeling like a dependent child. Now that he is developing his new tactile emphasis and has had success at learning a new task with his vision change, he is able to consider a new goal; to learn how to operate the voice dialer independently. Through OIB services, LH first, reluctantly because he felt it made him vulnerable to walk with a cane, started to use a white cane to increase his mobility safety while living alone so he could manage to take care of his two dogs, safely letting them out for relief and increase his mobility efficiency, confidence and grace. He does have some balance issues and has some step-down areas in his home. He already has grab bars at these locations but learning how to detect drop offs with a white cane provided him time to react; this new tool was enlightening for him. He was introduced to use of the long cane also for identification purposes in public settings. He had been pretending to be able to see and it took so much energy to remain on top of social settings when he participated that he began to prefer staying home. It took some convincing for him to accept use of a cane by practicing safety techniques in his home and yard first and then with supervision, going out in public with the cane to understand the value of being identified with visual impairment in public while adjusting to his vision loss and being skilled at managing his own safety. While in O&M training he was provided an opportunity to attend a local Low Vision (LV) group which was thought could support his adjustment to reduced vision. The LV group of about 30 members has existed in his area for about 15 years, yet he was not aware of it until working with AZ ILB vision rehabilitation services. Prior to attending the meeting, he learned basic cane techniques that allowed him to move independently about the unknown building, ask for directions to the room and enter the room, find a seat in a dignified manner with ease and safety. He was enabled to meet several other people with different vision issues and hear how they cope, learn about their areas of interest, their complaints/needs and began to expand his world and share his own experience beyond the confines of his home. He quickly forgot the issue of carrying the cane in public because he mastered the techniques as if breathing and was no longer as self-conscious. Besides he was in a room with others that had canes too! He felt confident to mingle with the group, find a place to sit down and participate due to his newly acquired basic cane skills. He said it was like finding your own Cheers bar! Something he would not have considered just three months prior. LH stated he was quite impacted meeting so many people that were dealing with somewhat similar issues. He had no idea there were “so many” other people dealing with similar issues. It helped him adjust to his own situation to be among others that were also using a white cane. This experience has started his development of a network for him to talk to others, reach out, problem solve and continue learning even after OIB instruction is completed. Interacting with others with similar and different issues is affecting a positive adjustment. He only recently learned during instruction information about curb to curb transportation and other transportation options in his area that were previously unknown to him. He is delighted now to consider that he does not to have to wait for someone to offer him a ride to church! Opinionated and not sure of the newfangled ideas, suggestions or devices his instructor presented, he gradually is becoming educated about options in activities. His strong sense of independence motivates him now when he is frustrated rather than shutting the door and staying home. Lanelle Crist, State Employed Vision Rehabilitation Therapist: 60-year-old R’s life was dramatically and permanently changed in 2014, when he was in a near-fatal motorcycle accident. After waking from a 6-week long coma, it was discovered that the trauma R experienced resulted in optic nerve damage and left him with severe visual impairment. When he woke, R’s vision loss was not his only significant challenge. It appeared he hardly had a bone that had not been broken. His breaks included his ankle, leg, pelvis, his left arm in 32 places with a 4-inch piece of bone missing, his right arm in 15 places, his collar bone, neck…and his face/skull was shattered into 38 pieces. He woke to casts on both arms and one leg in addition to severe vision loss. Robert’s immense love of racing and his ownership of multiple race cars and business of custom auto body painting all needed to be set aside. Upon meeting R’s strength, determination and optimism were evidenced by the fact that he lives alone and had only one low vision aid-a self-purchased portable video magnifier. None of his appliances were marked, he uses an old flip phone and the solitary ceiling fan light and glare in his primary living area made it a challenge to see without vision loss. R had a goal unlike any I had previously encountered; to restore the antique car he recovered from a river approximately 45 years ago. R is the epitome of the term “gearhead.” He has a passion for mechanics and cars and said mechanical work keeps him sane. R was issued a desktop video magnifier with speech, which he said is enormously helpful for reading his mail and doing paperwork, but small devices made a big difference for him. Green tints, for indoors, were incredibly helpful. When R put them on, he exclaimed, “I can see your face!” Knowing hands-free magnification would be helpful, he was provided with an Opti visor. During our next meeting he said the Opti visor and tints he was provided were working great. He said he went to the races (which he does nearly every weekend) and excitedly said he had been able to see into the pits! Task lighting and kitchen appliance marking were also helpful, and the last time I spoke with R he said he was about to cook buttermilk biscuits and pork. When our training began, R had some individual pieces from his antique car that he’d had chromed. By the time our rehabilitation training concluded R proudly showed me his shiny “38 Special,” his 1938 Plymouth Coupe. He also said the desktop video magnifier was very helpful for him when doing his charity work and projects for the American Legion, where he serves as chairman. The training and devices R received from his vision rehabilitation services afforded R confidence and enthusiasm to continue living independently and pursue the things he enjoys. Natally Bones, Certified Orientation and Mobility Instructor and Vision Rehabilitation Therapist: A is a 101-year-old woman who lives alone in a tiered support apartment complex. Her vision loss is due to macular degeneration and she experiences very low vision. She was interested in receiving orientation and mobility services for the identification the long cane provides to the community and to be able to walk around her apartment complex and the community more safely. A received instruction in the areas of basic concept development, pre-cane techniques, cane techniques, and residential skills. She enjoyed the review of concepts and vocabulary of the basic concepts along with learning a few new things. Pre-cane techniques taught her how to safely trail surfaces using her hands and how to use a guide safely and efficiently. Cane techniques helped her to identify terrain changes, find obstacles in her way, and communicate to the community that she is a visually impaired traveler. Also, she reports feeling more confident walking in the halls of her apartment complex and picking up her mail while using her long cane. “A” plans her outings ahead of time and can use a combination of her long cane or walker, depending upon where she is going and what she is doing, to help keep her safe while traveling and feeling confident. She even has had her walker legs marked with red tape to identify to the community that she is a visually impaired traveler. “A” reports that she has enjoyed orientation and mobility instruction and feels more safe and confident when she leaves her apartment. R is a 66-year-old man who had received ILB orientation and mobility services many years ago, but recently experienced additional life changes. He experienced more vision loss and is now functionally blind and his mother died whom he lived with. R was continually bumping his head while walking around inside his home and was concerned about getting out of his home in case of an emergency. He made it very clear he wants to live independently in his home for as long as he can. Because of this desire, R was very motivated to move around his home safely and efficiently be able to escape in case of emergency. Training areas included basic concept development, pre-cane skills, and cane techniques. R reports enjoying review and learning new skills have been very helpful to him, especially since he now has no vision and has learned how to reach his goals with new skills. Some of the skills practiced were hand trailing, good posture, proper gait, and time/distance. He was also provided with a new cane and special tip, which he utilizes while walking around his home. With his new cane, instruction on its variety of uses, and practice with good posture and proper gait, he is no longer bumping his head on the wall corners. Additionally, routes were practiced and timed from three areas in his home to the front door in case he needed to get out quickly due to an emergency. Each next lesson showed a marked improvement in his timing and confidence. R is very thankful for OIB services. He feels more safe and confident living independently in his home for a long time. ACBVI: TG is a 78-year-old man who recently came to the Arizona Center for the Blind and Visually Impaired (ACBVI). He and his wife are from Jamaica and moved to the U.S. to be closer to their children. Soon after moving to our country, TG learned that he has glaucoma and that his vision is failing. Not knowing where else to turn, he contacted us for information about our programs and services. TG learned about Orientation and Adjustment to Disability services as we have support groups that are specifically designed for individuals who are new to vision loss. These individuals are given opportunities to learn about their eye conditions, to better understand vision loss, to recognize that there is a grieving process when adjusting to vision loss, and to understand what they can expect from themselves. TG quickly learned that his situation is not as unique as he had previously thought. He indicated that he was afraid about his future and living with the vision loss. Also, TG participated in some training in adaptive daily living skills. He learned about organizing medications, food, and other household items. He learned how to work safely in the kitchen and to prepare his own meals. TG also learned about resources that would help him as he resumes normal activities of life. Finally, TG took advantage of an opportunity to undergo some Orientation and Mobility training. Through this process, he learned how to use a white cane to navigate safely and effectively throughout the community although he could no longer see traffic and landmarks. Although TG has been coming to ACBVI for only a few months, his outlook has improved markedly. The fear he had is replaced with hope and optimism. He is very quick to encourage others and has become further involved in activities that are available to him. He especially enjoys our wood turning program wherein he can turn wood on a lathe and make very nice products such as pens and pepper mills that are true works of art. TG is very proud of his craftsmanship and of the reactions of his friends and relatives. The others in TG’s life are impressed with more than the crafts he can create. Since participating in our services that are funded by the Independent Living for the Blind program, TG has improved markedly in his outlook on his present life and his prospects. He is an active participant at his church and he very much enjoys’ traveling to visit relatives who live in other states. SAAVI: Ms. E.B has been a client of SAAVI for a couple of years. She has taken just about every Rehabilitation Teaching class offered. She has gone through several drops in vision but struggled for a long time accepting the fact that she would not regain vision. She also struggled with implementing the skills she was learning in each of her classes here at SAAVI. Ms. E.B. seemed timid and shy. Some might say she was embarrassed to need the skills she was learning. In the past year she experienced a dramatic drop in vision which left her with no functional vision. When this occurred Ms. E.B. once again reached out for help from SAAVI. She attended counseling sessions, could be seen taking cane technique advice from her Assistive Technology instructor. She moved from a retirement community where her meals were made for her and transportation was arranged for her to a standard apartment complex. Here she had to cook for herself, navigate along sidewalks, and arrange transportation. Over a period of about six months the SAAVI staff noticed an increase in her ability to use her cane effectively to navigate the SAAVI main building. She decided she no longer needed to participate in counseling as she was using the skills she had learned in her sessions and from her teachers. The client began to exude confidence. Recently Ms. E.B. called SAAVI to thank us for all the services she had participated in. She stated that she had experienced a very upsetting life change when she lost her vision however she has learned that becoming blind didn’t mean that she could no longer have a positive outlook on life. She wanted us to know that she was moving out of state and would always remember and be thankful for the kindness she received here at SAAVI. Ms. E.B. persevered her vision loss and worked through her adjustment to blindness and has come out the other side; truly successful. Mr. R.A. lives in a community just outside of Yuma, AZ. He had relied heavily on his ability to see his computer in order to maintain communication with family out of state, obtain news and for personal interest researching. He contacted SAAVI for assistance in obtaining software that would allow him to utilize his computer and internet again. He had used Zoom Text Screen Magnification software in the past, but his older version of the software did not work on his new computer. The client was provided with the newest version of the software and was given training on how to use the new functions the software offered. The client reviewed how to write and edit documents, browse the Internet, and how to write and send emails. The client is now back in operation; contacting his friends and family through social media and emails, reading the news on the internet and researching his favorite topics.

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

During this reporting period, AZRSA continues having several staff vacancies and we also continue losing more individual contractors due to the high cost of insurance requested by the state. During this reporting period Arizona went into a hiring freeze so ILB continues struggling to fill vacancies. These issues contributed to the increase in the number of people waiting for services, and the time frame to initiate services from when they are determined eligible.

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 byKristen Mackey
TitleAdministrator
Telephone602-364-2907
Date signed12/26/2018