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

RSA-7-OB for Georgia Vocational Rehabilitation Agency - H177B180058 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 year871,332
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year411
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2869,923
A2. Total other federal0
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)96,813
A4. Third party0
A5. In-kind0
A6. Total Matching Funds96,813
A7. Total All Funds Expended966,736
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs61,536
C. Total expenditures and encumbrances for direct program services905,200

Part II: Staffing

FTE (full time equivalent) is based upon a 40-hour workweek or 2080 hours per year.

A. Full-time Equivalent (FTE)

Program Staff a) Administrative and Support b) Direct Service c) Total
1. FTE State Agency 0.6100 0.0000 0.6100
2. FTE Contractors 12.1300 27.7000 39.8300
3. Total FTE 12.7400 27.7000 40.4400

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 21 8.9310
2. Employees with Blindness Age 55 and Older 8 2.1510
3. Employees who are Racial/Ethnic Minorities 26 11.8206
4. Employees who are Women 51 23.1451
5. Employees Age 55 and Older 23 13.8150

C. Volunteers

1.63

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 FY249
2. Number of individuals who began receiving services in the reported FY1,089
3. Total individuals served during the reported fiscal year (A1 + A2) 1,338

B. Age

1. 55-59126
2. 60-64144
3. 65-69162
4. 70-74168
5. 75-79192
6. 80-84174
7. 85-89181
8. 90-94128
9. 95-9953
10. 100 & over10
11. Total (must agree with A3)1,338

C. Gender

1. Female835
2. Male503
3. Total (must agree with A3)1,338

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race16
2. American Indian or Alaska Native15
3. Asian9
4. Black or African American386
5. Native Hawaiian or Other Pacific Islander3
6. White859
7. Two or more races28
8. Race and ethnicity unknown (only if consumer refuses to identify)22
9. Total (must agree with A3)1,338

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)131
2. Legally Blind (excluding totally blind)589
3. Severe Visual Impairment618
4. Total (must agree with A3)1,338

F. Major Cause of Visual Impairment

1. Macular Degeneration395
2. Diabetic Retinopathy104
3. Glaucoma283
4. Cataracts36
5. Other520
6. Total (must agree with A3)1,338

G. Other Age-Related Impairments

1. Hearing Impairment480
2. Diabetes337
3. Cardiovascular Disease and Strokes288
4. Cancer73
5. Bone, Muscle, Skin, Joint, and Movement Disorders226
6. Alzheimer's Disease/Cognitive Impairment41
7. Depression/Mood Disorder28
8. Other Major Geriatric Concerns50

H. Type of Residence

1. Private residence (house or apartment)1,198
2. Senior Living/Retirement Community68
3. Assisted Living Facility59
4. Nursing Home/Long-term Care facility12
5. Homeless1
6. Total (must agree with A3)1,338

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)952
2. Physician/medical provider29
3. State VR agency23
4. Government or Social Service Agency5
5. Veterans Administration8
6. Senior Center10
7. Assisted Living Facility16
8. Nursing Home/Long-term Care facility4
9. Faith-based organization0
10. Independent Living center2
11. Family member or friend114
12. Self-referral85
13. Other90
14. Total (must agree with A3)1,338

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 420,153
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 928
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 2

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 155,766
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 522
3. Provision of assistive technology services 823

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 324,946
1b. Total Cost from other funds 0
2. Orientation and Mobility training 250
3. Communication skills 379
4. Daily living skills 253
5. Supportive services (reader services, transportation, personal 41
6. Advocacy training and support networks 452
7. Counseling (peer, individual and group) 197
8. Information, referral and community integration 1,112
. Other IL services 22

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 4,335
1b. Total Cost from other funds 0
2. Information and Referral 19,022
3. Community Awareness: Events/Activities 157 21,785

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) 951,503 966,736 15,233
2. Number of Individuals Served 1,372 1,338 -34
3. Number of Minority Individuals Served 426 457 31
4. Number of Community Awareness Activities 137 157 20
5. Number of Collaborating agencies and organizations 266 271 5
6. Number of Sub-grantees 7 7

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 823 100.00%
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) 846 102.79%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 24 2.92%
B1. Number of individuals who received orientation and mobility (O & M) services 250 100.00%
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) 169 67.60%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 22 8.80%
C1. Number of individuals who received communication skills training 379 100.00%
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) 261 68.87%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 55 14.51%
D1. Number of individuals who received daily living skills training 253 100.00%
D2. Number of individuals that experienced functional gains or successfully restored or maintained their functional ability to engage in their customary daily life activities as a result of services or training in personal management and daily living skills. (closed/inactive cases only) 195 77.08%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 41 16.21%
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) 93 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) 20 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) 49 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 19 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) 29 n/a

Part VII: Training and Technical Assistance Needs

A reasonably priced database system for tracking the 7OB information. Data management continues to be a difficult task for some of the providers. Many providers are left to “hand count” if they cannot afford one of the larger databases available that larger centers can access. Training resources for the Older Blind Program (OBP) providers and instructors in Georgia to attend state and national training conferences in order to learn firsthand about the latest aids, devices and products for the visually impaired along with the newest teaching techniques and current information about services and activities. Training for staff on the current technology programs to benefit seniors unfamiliar with the technology. More seniors are wanting devices and don't know how to use them. The staff needs to be up to date on the most recent technology. Maybe a webinar can be developed that our program can access at no charge. Staying abreast of advances in the accessibility of technology, the software required, and the hardware needed to best serve our clients remains an ongoing challenge. Funds to enable each of the Georgia providers to purchase the most updated technology to enable them to demonstrate and train staff who in turn can demonstrate and train our seniors.

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.

Project Independence: Georgia Vision Program for Adults Age 55 and Over (also referred to as the Older Blind Program — OBP) implements the 34 CFR part 367 program through seven main sub-grantees. Many of our sub-grantees further subcontract with various vision specialists throughout Georgia. The sub-grantees in Georgia are: • Center for the Visually Impaired (CVI) • Vision Rehabilitation Services ((VRS) • Visually Impaired Foundation of Georgia (VIFGA) • Savannah Center for Blind and Low Vision (SCBLV) • Visually Impaired Specialized Training and Advocacy Services (VISTAS) • Walton Options for Independent Living (WO) Project Independence (PI) contracts with a seventh provider, Mississippi State University (MSU) - The National Research and Training Center on Blindness and Low Vision. MSU conducts program evaluations and serves as consultant to Project Independence. Mississippi State University continues to provide a yearly detailed program evaluation and assists with measuring customer satisfaction. The six main PI providers send names and phone numbers on a quarterly basis of closed cases to MSU who, in turn, contact the seniors to conduct the customer satisfaction survey. MSU does not provide direct services to seniors. IN FFY 18, we maintained and cultivated working relations with the following entities that increased our outreach efforts in order to reach the underserved and unserved older blind in Georgia: • Helen Keller National Center • Georgia Division of Aging Services • Georgia Radio Reading Services • National Federation of the Blind of Georgia • Georgia Council of the Blind • Business Enterprise Program • Native American Representative • Statewide Independent Living Council • Georgia Library for Accessible Services • Older Driver Task Force • Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults • Alternative Media Access Center (AMAC) Accessibility Solutions, Georgia Institute of Technology, College of Architecture • Georgia Gerontology Society • Department of Veterans Affairs • Lions Lighthouse • Lions Club • The Coalition of Advocates for Georgia's Elderly (CO-AGE) • Prevent Blindness Georgia Our main initiatives to reach underserved and/or unserved populations in Georgia continued to be: 1) increasing outreach efforts through involvement with the various components of the Division of Aging Services, 2) increasing support of our peer support groups throughout the state by a. conducting a statewide peer meeting via phone and b. continuing to provide the groups with program and resource information e.g. webinars so they have a wide variety of topics to offer their groups, and 3) maintaining and expanding our relationship with the Statewide Independent Living Council and Independent Living Centers. Our primary subcontractors’ implementation process and outreach efforts to reach underserved and/or unserved populations are listed as follows. Visually Impaired Specialized Training and Advocacy Services (VISTAS) VISTAS information is sent to persons interested in our services. After receiving medical information, it is sent to the low vision specialist. The low vision specialist notifies us whether he/she qualifies for the program or needs a low vision exam, as well as recommendations regarding training. VISTAS continues to work closely with the local optometrist, ophthalmologist and physicians in the area for referrals. VISTAS participates in as many community outreach programs for seniors as possible. Our services are continuous from last year: collaborating with local senior agencies, spreading the word about our services, providing transportation (when needed) and training in advocacy. Low vision is provided by our local optometrist and daily living services are provided by our four sub-contractors. Clients receive services in technology, orientation & mobility, vision rehabilitation therapy, counseling and braille. We have a certified peer support leader who leads a monthly group. Training is held primarily in the senior’s home because most of our seniors do not want to leave their homes and transportation is a problem. Walton Options for Independent Living (WO) Referral process: Referrals are made by eye care providers, self-referrals, medical professionals, social workers, low vision clinics, Area Agencies on Aging, family/friends, and through other Walton Options programs. NOTE: WO provides information and referral (I&R) services to many individuals who are 55 and older with vision impairment who are referred to other grant funded programs within the Independent Living organization. The referral is based on the request of the senior e.g. need a battery for a watch as opposed to comprehensive vision services. If comprehensive vision services are deemed appropriate from the I&R discussion, that senior is referred to the OBP. Referrals can be submitted through fax, email, walk-ins, taken over the phone by our intake person or through our website referral link. When an eye care provider makes the referral they normally send the eye report with the referral. Once the Older Blind Program (OBP) staff receives the referral — they call and collect demographic information on the phone and inform the senior we need a current eye report in order to provide services. We offer to mail them a Release of Information (ROI) form to sign and mail back to us. When we receive their signed ROI — we fax it to the eye care provider requesting a current eye report. Eye Report: When the eye report is received in our office and we determine eligibility, we proceed to assign the senior to one of our instructors for an assessment. Based on the assessment results, we determine what services the senior will need. Service delivery: WO subcontracts with an Orientation and Mobility Specialist (OM), Vision Rehabilitation Therapist (VRT) and Occupational Therapist (OT) — all of whom are either certified or licensed professionals to provide VRT, OM, Low Vision and other daily living skills services. Documentation: Upon completion of each visit with the senior, the instructor submits to the OBP staff all completed documents, a signed appointment log, and a summary of what activities were conducted during the visit. Also recorded on the summary are recommendations for other services, what aids and devices were provided or if assistance is needed to help provide the device(s). Aids and Devices/Training: Once the equipment arrives at the office, the requesting instructor is notified, and he/she will schedule a time to deliver the device (s) to the senior and provide training. The consumer signs a delivery statement when they receive equipment and the instructor notes the delivery and training on their summary report. This is all recorded in the agency database and forms placed in consumer file. Follow-up: A follow up call is provided to the seniors receiving devices to ensure they are using the device and it is functioning properly. Consumers are reminded they may be getting a phone call from Mississippi State University (MSU) to talk about their satisfaction of services. Outreach Efforts: Following is a sampling of outreach efforts to reach under and unserved populations with vision loss. Information was provided on the services by Walton Options that included Project Independence at the following venues: several senior center wellness fairs, various community resource and health fairs, National Federation of the Blind of Georgia senior division possibilities fair and six rural eye screening clinics. WO exhibited at several conferences and also at information fairs through local schools and colleges. WO was involved with various local advisory boards and networking clubs. A one day Confident Living Program taught by the senior representative from Helen Keller National Center was sponsored by WO via Project Independence. Savannah Center for Blind and Low Vision (SCBLV) Savannah Center for Blind and Low Vision (SCBLV) incorporates the Title VII-chapter 2, Older Blind (OB) program, into our overall service delivery model so that (OB) seniors receive essentially identical services as clients in other service categories. The general service delivery model follows the chronological progression of: intake/eligibility, low vision examination, functional assessments in vision rehabilitation therapy/orientation and mobility/assistive technology/social services, service plan development, skills training, plan reviews/closure, and finally, follow-up case management. Training can be center- or home-based, depending on the senior’s individual needs and current living situation. The type, duration, and location of services delivered are determined and recorded in the evaluation and service plan. Most seniors receive a full range of compensatory skills training, while others may receive short term services aimed at an immediate need or needs. Many times, the latter is appropriate for seniors who have immediate safety concerns or require only a few basic skills to maintain or regain their independence and quality of life. All direct services are provided by SCBLV’s professional staff, as well as our two contracted Optometrists specializing in Low Vision. SCBLV utilizes staff members certified in Orientation & Mobility and Vision Rehabilitation Therapy to implement home-based services. SCBLV continues to furnish traditional outreach activities and in-service trainings through office visits with medical professionals, service agencies, and senior residential facilities. Also, SCBLV staff is proudly represented at community events, health/medical conferences, and resource fairs throughout Georgia. Finally, additional outreach is provided through our website and social media outlets. Visually Impaired Foundation of Georgia (VIFGA) VIFGA is not a “brick and mortar” facility. Since we serve rural South Georgia, we go to communities to work with the clients instead of the seniors coming to our facility. We work with eleven different doctors throughout the state, subcontract with COMS, CVRT and Computer Technology Specialists, and support four peer support group leaders. • Referrals: Eye care professionals, family members, friends, rehabilitation counselors, etc. refer a senior with low vision to VIFGA. A copy of the senior’s eye medical is faxed by the doctor to VIFGA or to the clinic where the senior will be seen. The senior is called, and if appropriate, is scheduled in one of our nine clinics in South Georgia closest to the senior’s home. • Low Vision (LV) Exams: At the clinic, the doctor checks the refraction and makes suggestions about LV products or services. The LV Specialist discusses services, resources, and advocacy with the senior. Products that are matched to the seniors needs are demonstrated and recommended. A typed summary of the exam is given to the senior and attending doctor at the time of the exam along with a host of resources e.g. the Client Assistant Program brochure, the Project Independence resource brochure, list of peer support groups, resource lists, library application, the Helen Keller registry application, business card, and VIFGA blurb. Additional services are recommended at this time as well. The recommended products are listed on the exam summary that is given to the senior at the end of the exam. If special services are needed, the appropriate teacher is contacted and he/she contacts the senior. Additional devices may be recommended by the CVRT, computer technologist and/or COMS teachers and sent to the client. The senior with both hearing and vision loss may also choose to attend the Confident Living Program (CLP) to receive daily living, orientation and mobility, adjustment to blindness, and/or computer skills services over a two or three day period. Feedback from CLP program participants indicated that their experience was “life changing”. At four month intervals a staff member from VIFGA calls all clients that have received services to inquire: 1) if they did indeed receive the products recommended; 2) if they are able to use the products; 3) whether or not they need additional help from the program; 4) if the devices helped, 5) if they know how to contact us, and 6) to remind them that Mississippi State will be calling to ask about the program. Vision Rehabilitation Services of Georgia (VRS) VRS implements the Title VII-Chapter 2 program via community and center based services. Low vision clinics, serviced by three contracted optometrists who specialize in low vision, are provided in our center and in remote locations throughout a 30+ county service area in north Georgia. We typically offer one clinic per week. The majority of new clients began their program with a Low Vision Evaluation (LVE). Most VRS seniors purchase their own prescribed devices. All LVE clients received a follow up phone call to gauge their satisfaction in our service delivery. Many seniors received at least one follow up visit from an instructor to review the use and care of the device. The instructors also provided instruction to clients in other skill areas based on the needs identified from the initial intake and the client’s time with the doctor during the LVE process. An Individualized Service Plan (ISP) was created at the time of the LVE or during an initial visit from a VRS staff member. Clients typically receive weekly training until their ISP goals are met. Our vision rehabilitation and orientation and mobility instructors are university trained and Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) certified. Our technology instructors are university training in computing sciences. Staff provided instruction in activities of daily living, orientation and mobility, and access technology. An independent contractor provided adjustment to blindness counseling. Our core instruction staff consisted of four full time and three part time employees, as well as two contractors. Although we encouraged clients to come to centralized training sites or to our main office, we continued a robust community-based model. Center for the Visually Impaired (CVI) CVI implements Title VII-Chapter 2 programming both in-house and in the community. CVI’s Florence Maxwell Low Vision Clinic provides two to three clinics per week in-house and satellite clinic in Suwanee. Additional satellite clinics are scheduled in the community, public schools and our Drive for Sight rural areas. The Florence Maxwell Low Vision Clinic has three part-time sub-contracted optometrists in the Atlanta Low Vision Clinic, one of whom is also available to conduct Suwanee clinic. We are currently working to bring on another contract Optometrist to add another clinic day to our Midtown location and assist with satellite clinics. The Florence Maxwell Low Vision Clinic staff has had some changes during this OBP fiscal year. During FFY 18 the Low Vision Clinic consisted of the Director of Low Vision, the Medical Office Specialist, and the Occupational Therapist (OT). However, the OT, planned to resign in October 2018 — the beginning of FFY19. CVI will be actively searching to fill the full-time OT position. CVI's Title VII- Chapter service model is a mixture of group and one on one service provision. The low vision clinic service model is one on one service provision. All participants receive a low vision examination from an Optometrist. Following the assessment, the client receives individualized therapy with an Occupational Therapist trained in low vision to address all aspects of daily living and to provide further training of the doctor’s recommendations. Often clients require follow-up services in the clinic or the client’s home to address all the clients’ challenges and to ensure that the client has been able to use devices successfully and to apply modifications and compensatory strategies. Accepting several insurances for both the Optometrist and the Occupational Therapist have allowed the Low Vision Clinic to make OBP funds serve as many individuals as possible. Low Vision Clinic is currently in the process of credentialing to accept more insurances including all Medicaid CMO’s. Referrals are made to the New View Facility Based program and/or the New View Community Based Services programs when O&M instruction, technology, or additional services are requested. All clients served by CVI’s Community Based Services (CBS) team received one on one assessments by case manager or instructor followed individualized instruction. Group class instruction was provided by CBS staff when a group is identified in a community facility. Assignment to group classes was case by case and occurred only if appropriate for the particular senior.

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 project manager conducted presentations and presented details of our program both as a collaborative and community awareness effort at the conventions of the Georgia Council of the Blind, the National Federation of the Blind of Georgia, and the Business Enterprise Program; at meetings of the Georgia Statewide Independent Living Council, Vocational Rehabilitation, the Georgia Library for Accessible Services, providers of blind services, peer groups, the Older Driver’s Task Force, various components of the Division of Aging Services, Lions Club, Georgia Gerontology Society and the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults. Contact was maintained with the Department of Veterans Affairs, Lions Camp, Georgia Industries for the Blind, the Coalition of Advocates for Georgia's Elderly (CO-AGE) and Prevent Blindness Georgia. In March 2018, the project manager participated in the Annual Statewide Association for Education and Rehabilitation of the Blind and Visually Impaired conference in Atlanta. Information was shared to the audience on Project Independence (PI). This year, our program provided to different statewide Division of Aging conferences a very nice flyer on Project Independence (PI) to be placed in the registration bags. PI also developed a clever ad that was placed in a statewide Gerontology Conference. The use of the flyers and ad was a cost effective way to help expand community awareness of PI, especially when it was not possible for a representative of the program to attend or present at these various conferences. Assistive listening devices (ALD’s) were brought to state meetings for use with those having a dual sensory loss and were a major hit in the presentations throughout Georgia. Demonstrations were conducted with people without hearing loss to aid in community awareness so they would understand the impact of the ALD’s on someone with a hearing loss. More and more seniors who are blind and low vision are letting it be known they are having hearing difficulties. The use of ALD’s aided other entities in the benefit of this technology and enhanced further awareness in the community of a needed resource. It was vitally important that Project Independence maintain a collaborative relationship with the IL system. One of our six service providers is Walton Options, an Independent Living Center located in Augusta, Georgia. The Project Manager participated in the IL meetings and sent training and other pertinent information to the IL groups in GA. As part of Project Independence collaborative activities, two contractor meetings were held this fiscal year. We had a face to face meeting in March 2018. Our final meeting for FFY18 was via phone with the contractors in August 2018. Both meetings enhanced our collaborative activities and increased community awareness of various programs. As a group, participants were able to share concerns, ask questions, highlight Project Independence events, share new methods and provide partner updates. The participants also provided feedback from training attended, shared resource information and discussed program services for seniors. The spring meeting was devoted to adult protective services, mental health, brain injury, independent living and aging services, staffing and funding concerns, recommendations of the MSU evaluation and overall PI program recommendations. The fall phone meeting focused on the FFY19 contract deliverables and budget concerns, 7OB report, upcoming confident living training, proposed staff qualifications, technology training, program processes and provider issues and concerns. In 2018, we conducted two statewide Peer Support Group Leader conference calls geared toward group training. The peer leaders shared ideas and innovations in their groups. The February 2018 training meeting focused on Adult Protective Services and the August 2018 training meeting dealt with Advocacy. Georgia Radio Reading Service (GARRS) continued dissemination of the updated 30 and 60 second public service announcements (PSA) regarding our program. These PSA’s aired several times per week and reached an audience of approximately 16,000. Activities of the Project Independence Manager continued further collaborative activities and community awareness: 1. Increased community awareness and greatly enhanced visibility of our program through our up to date Project Independence website https://gvs.georgia.gov. The MSU customer satisfaction survey is included in the website. 2. Distributed information on numerous training webinars and informational resources from various entities to our partners, interested community persons and the IL system so as to increase private and public awareness of services to seniors. In turn, these various groups send informational resources to Project Independence — we have a very good information and resource network setup. 3. Conducted in depth program reviews of all seven contractors. These reviews helped ensure uniformity and standardization of services throughout the state. The reviews consist of a summary of discussions with Project Independence staff and consumers, a review of service processes, case files, observations of various lessons, groups, and low vision exams. The process pinpointed any problems/issues that needed addressing and proposed recommendations that would improve our program and expand our services in Georgia. The focus was on services, finances and implementation of previous fiscal year recommendations. 4. Used FFY17 carryover funds to purchase training services, training items and supplies for the Confident Living Program; registration, travel, and lodging for contractors’ meeting/training; and PI flyers and an ad for conferences. These funds allowed Project Independence to conduct critical training activities that would help improve services as well as incorporate new approaches for seniors and staff we would not have been able to do otherwise. 5. Continued to make small inroads with the Lions Clubs and Lions Camp in GA. While this effort has been slow to develop, we continue to persevere. 6. Initiated a relationship with the GA Department of Public Health - Behavioral Risk Factor Surveillance System (BRFSS), to aid our program with updated statistics. This mapping will show vision loss in the regions of our Project Independence providers - in addition to a statewide total. We hope these specific numbers will aid in a more efficient and effective use of our limited resources where most needed. This contact began toward the end of FFY18. More to come with our new friends in Public Health with the BRFSS. Our primary subcontractors collaborated and incorporated new methods and approaches in various ways. Highlights are noted in the providers’ words: Visually Impaired Specialized Training and Advocacy Services (VISTAS) The Occupational Therapist we partnered with last year continues to refer clients to our program who have had a stroke or been in an accident that resulted in severe visual impairment or blindness. This has been a very productive collaboration. We continue our relationship with the local Center for Independent Living based in our area; we refer clients to each other. Because we serve seniors 55 years and older we refer those that are younger to them and vice versa. If they are younger and are interested in employment services we provide them with information to contact the local Georgia Vocational Rehabilitation Agency Counselor for the Blind. We have worked with the Athens Heritage Lions Club, the Athens Council of The Blind, the Georgia Council of The Blind and the Georgia Library for Accessible Statewide Services that is based in our local library. This year we were fortunate to receive grant money again from Georgia Council of the Blind to help those clients who were not financially able to pay for a low vision aid or exam. VISTAS’ has a special relationship with a low vision vendor. Whenever he gets equipment returned from his consumers and it can still be used, he donates the items to us to use with our seniors. This partnership has helped us save several hundred dollars that we didn’t have to spend. Walton Options for Independent Living (WO) WO is an Independent Living Center. The WO SPIL Goal is to elevate access for individuals with disabilities to healthcare services and supports. Walton Options efforts that align with the SPIL are to: • Partnered with Area Agencies on Aging and GA Prevent Blindness to provide free eye screenings in rural areas. Some seniors haven’t seen an eye care provider in many years. Walton Options’ staff participated in six screenings this fiscal year that allowed over 100 seniors the opportunity for eye care. The majority of these screenings were held in rural areas of the state. • Provided ongoing support with peer groups. The groups bring in guest speakers to educate their members of services and products and to mentor each other in advocacy issues. • Provided an internship opportunity for a student in Social Work from Augusta University. Student received hands on experiences with field work, research, data collection and input. The intern was able to learn about various technology solutions and why it is important to think outside the box when traditional options are not working. Savannah Center for Blind and Low Vision (SCBLV) SCBLV continues to help increase the knowledge base of the field of vision loss by hosting the annual Vision Conference for local and surrounding area Ophthalmologists, Optometrists, Ophthalmology Technicians, and Vocational Rehabilitation Counselors. This conference, aimed at vision specialists, trains professionals to identify vision loss, provides various information on accommodations and provides referrals to patients who could benefit from our services. In addition, SCBLV has officially established a working relationship with Dr. Joshua Parmelee to help open a Brunswick, GA location for low vision services. Dr. Parmelee has been providing Low Vision evaluations in his office as part of comprehensive rehabilitation services. The Low Vision Coordinator refers these seniors to the appropriate therapist(s) for further services, as needed. SCBLV also using its main fundraising event Dining in the Dark to increase awareness and need of vision rehabilitation in our community. This past year 130 residents attended the event. While they ate in the dark, they listened to former and current students share their rehabilitation experiences with our staff. SCBLV continues to succeed in its’ family rehabilitation program. This program is provided to clients’ families twice a year and gives them the opportunity to step into their loved one’s shoes, simulate their vision loss, and experience the skills training they receive at the center. From this experience, family members gain a new respect and understanding for the client’s vision loss; it serves as a necessary support for family members. Other activities that we feel expand and improve community awareness: • Staff and students’ participating in White Cane Day activities with Savannah Coalition of the Blind and National Federation of the Blind of GA members; • Executive Director sitting on Council of Aging’s Yellow Dot Design team that focuses on Disaster Preparedness; • Staff and former students assisting United Way campaign by presenting at various businesses and agencies about the Center and SCBLV’s support to the community; • Presenting to local Nursing Homes, Assistive Living Centers and Medical Center staff; • Participating at various conferences and Health Fairs; • Coordinating various Blind Ambition Outings with current students and Peer Support members that allows the community to observe functioning blind members in action; and, • Collaborating with the Telfair museum an upcoming art project that will create a tactual mural at Savannah/Hilton Head airport! Visually Impaired Foundation of Georgia (VIFGA) The Visually Impaired Foundation of GA, Inc. attends consumer group conferences, teacher, counselor, and library conferences, and meetings involving the visually impaired or elderly throughout the state to promote awareness of Project Independence (PI). We also provide workshops on low vision aids to senior centers, libraries, doctors’ offices, universities, and school systems. We call ophthalmologists throughout the state on a monthly basis reminding them of the services available in their area. VIFGA maintains a website (vifga.org) and a toll free number (1-877-778-4342) to help people find the Georgia resources available to them. As a special project, VIFGA provides eye exams and glasses twice a year at the Native American Reservation in Whigham, GA. Activities that aid in expanding and improving services: • Support Groups and Support Group List: This is an essential piece of the vision rehabilitation process. We supported five support groups this year: two in Albany, one in Douglas, one in Macon and one in Bainbridge. There are four other groups to which we send seniors in our area, three in Columbus and one in Milledgeville. At the end of the fiscal year, VIFGA sends all seniors the Support Group List to remind them again of this service. • The Confident Living Program (CLP): This collaborative event between Project Independence and Helen Keller National Center is for participants with dual sensory loss (both vision and hearing impairments). The CLP training introduces visual and hearing devices available, teaches home safety, explains how to prepare for emergencies, and most of all, encourages the bonding of new friends through shared experiences, laughter, and fun. They reported that the experience was “life changing”. CLP training was provided to the Douglas Low Vision Support Group this FFY year. It was a huge success. • Helen Keller Registry: VIFGA has incorporated into the Low Vision Exam the distribution of the Helen Keller Registry for those with dual sensory loss. Nearly 60% of VIFGA clients have a dual sensory loss. • Assistive Listening Devices: We use the “Pocket Talker” in 60% of the exams to enable seniors to communicate with ease. • Presentations: As Director of VIFGA, I enjoy presenting in inter-active workshops at doctor’s offices, support groups, civic clubs, Libraries and the Georgia Vocational Rehabilitation Agency. • Brochures and Resource Guides: These guides are an invaluable tool! • The Columbus Vision Rehabilitation House: This is a new project VIFGA is working on. We have been given the opportunity to renovate a house for rural South Georgia to use for daily group programs, projects, and classes for the visually impaired. We are currently looking for funding and community involvement to realize this project. When completed, it will be the only facility in South Georgia specifically for the blind and visually impaired. A building grant of $50,000 would enable us to begin renovating the Columbus Vision Rehabilitation House. We would be able to offer daily group cooking classes, computer classes, gardening classes, mobility classes and independent living classes in this non-residential program. Vision Rehabilitation Services of Georgia (VRS) VRS has expanded their outreach efforts by hiring a Business Development Coordinator with a focus on growing collaborations between VRS and the business community, community groups, medical and eye health providers. Additionally, this position served to host a VRS booth/table at a variety of health fairs and senior events. VRS strived to present Project Independence (PI) and our services in a way that benefited the senior. Case and vision notes are closely reviewed to determine the best course of action. Seniors that may not qualify for a low vision evaluation are given a home visit where the instructor will visit the senior in their home to explore the nature of their vision loss and identify their needs. Seniors and their families have access to support groups in various areas. The goal of these groups is to provide current and topical information, socialization, training, and sharing of challenges. We continued to collaborate with community organizations to present the topic of vision loss and vision rehabilitation to clients, their families and staff, in which we always touch on the impact that hearing loss has on those who have low vision as well. We continued to seek out effective ways of presenting our services in remote locations with sessions consisting of a full day of access technology, vision rehab therapies and orientation and mobility training. Some sessions are group breakouts with others teaching one-on-one. Community awareness events: • Presentations to practice managers, technical staff and front office personnel to educate eye care providers on vision rehabilitation steps and procedures. • Incorporated social media and blog posting for general awareness which resulted in inquiries from the public for more information, referral, services and education. This led to a new relationship with a Retina Specialist. • Active in the Smyrna Business Exchange — a closed networking organization — which has resulted in donations of money and opportunities for education presentations. • Active member of the Cobb Chamber, Smyrna Business Association, and South Cobb Business Association. • Participated in a National Aging in Place Society meeting. • Visited various assisted living facilities and spoke at senior gatherings, such as Cobb Senior Services Annual Fall Prevention Expo and Dalton-Whitfield annual Senior Health Fair & Expo. Presented to a local Ministries and Cobb Workforce on access technology solutions for the visually impaired. • Our Eye2i support group, along with a couple of instructors, collaborated with the Cobb Safety Village (CSV) for emergency safety training for the client. This collaboration allowed the CSV trainers to better enact their rescue/service efforts to the visually impaired. Feedback from the leadership of the CSV was invaluable and led to changes in some of their procedures. • The support group visited Portrait on a Plate for hands-on preparation of a healthy meal and nutritional information. Speakers were hosted on Non-24, a circadian rhythm disorder, and guide dogs. • One of our deaf-blind clients became qualified as a Community Emergency Rescue Team member. The Community Emergency Response Team (CERT) program educate volunteers about disaster preparedness for the hazards that may impact their area and trains them in basic disaster response skills, such as fire safety, light search and rescue, team organization, and disaster medical operations. Recent feedback from their leadership sites this person as an invaluable member of their team who is active in training new recruits. Continued collaborations: • United Way of Metro Atlanta: Provided Diabetic Education for those who have experienced vision loss. • University programs/interns: Supported four TVI’s seeking O&M internships. Multiple one-day observations were provided for college students pursuing related careers such as Certified Rehabilitation Counselor or Occupational Therapist. • Hosted Low Vision interns: Our doctors host several interns per year, who visit, observe, and assist in our clinics. • Cobb Senior Services (CSS): An ongoing relationship with CSS for referral, staff training and volunteer opportunities. • Georgia Vocational Rehabilitation Agency (GVRA): Some seniors are referred to VR for additional training and employment placement. • Veterans Affairs (VA): Continued to serve a few VA clients within their home. • Dual sensory loss: Continue to refer eligible seniors to the ICanConnect program to help with purchase of technology for communication tasks and the Georgia Council of the Deaf and Hard of Hearing for help with their amplified phone programs. VRS hosted DeafBlind meetings at our facility. • Referred clients to the Lion’s Lighthouse for low cost hearing aids. • Worked closely with Helen Keller National Center (HKNC) in consultation regarding our clients who have dual-sensory loss. We continue to discuss the need for our own Confident Living Program training that we hope will be held later this year. Center for the Visually Impaired (CVI) In response to increased demand resulting from the vacant VRT position in the Community-Based program, CVI’s New View facility-based program has been providing instruction to program participants, particularly in the areas of Assistive technology (mainly iOS and Android accessibility), braille and Orientation and Mobility. The Program Marketing Manager is actively contacting and networking with our various constituencies and traditional referral sources, including eye care practices, senior centers and other social services organizations, assisted living facilities, health fairs, etc. In addition, this marketing professional is contacting less traditional referral sources, such as dialysis clinics, diabetes clinics and diabetes professionals, and falls prevention initiatives. While the impact of this concerted outreach campaign will certainly be more of a long-term strategy, we have already seen a gradual increase in referrals as a result of these efforts. In order to facilitate access to services by Spanish-speaking adults, CVI maintains a dedicated telephone line where inquiries for information and services can be left. These messages are retrieved each day and are then processed through CVI’s normal intake process with the assistance of interpreters when needed.

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.

GA contracts with The National Research and Training Center (NRTC) on Blindness and Low Vision at Mississippi State University to provide a program evaluation of the Project Independence program. As part of the evaluation, consumers are interviewed about their experiences with the program. The six contractors providing direct services send the NRTC names of closed consumers on a quarterly basis. An experienced telephone interviewer then contacts consumers to complete surveys. Each year the NRTC prepares a program evaluation report that includes consumers' feedback regarding satisfaction with services and how services have impacted their ability to live independently. In addition, demographic and service data from the annual 7-OB report and findings from site reviews of contractors are included in this report. This comprehensive report will be available in early 2019. The GA program has contractual agreements with six regional agencies for provision of direct services to eligible seniors. A regional service delivery approach enhances the ability of project staff to be sensitive to and familiar with the needs of local consumers. Depending upon the contractor and/or individual consumer's needs, an itinerant, center-based, or combination of itinerant/center-based model is used in providing services. An itinerant model is generally used to serve consumers in outlying rural areas who might not otherwise be able to participate in such a program. During this project year, 162 consumers participated in telephone interviews. Just over half of participants (54%) were aged 75 and older. Almost two-thirds (61%) were female. About 88% of participants reported living in a private residence; the others living in senior living/retirement communities, assistive living facilities, or nursing homes. The most reported reason for vision loss was macular degeneration (48%), with the second most reported reason being glaucoma (23%). Consumer satisfaction levels among those participating in the survey were very high. In responding to satisfaction questions regarding delivery of services, i.e., manner of service delivery, types of services provided, and perceived outcomes of services—almost all of the participants expressed satisfaction. Participants were most satisfied with the attentiveness, concern, and interest of staff (97%); followed by the overall quality of services (96%), and timeliness in which those services were received (95%). Consumer ratings of functioning after receiving different types of independent living service areas follow: • 91% reported that they were better able or had maintained their ability to travel independently having received travel services • 86% reported that they were better able or had maintained their ability to function more independently having received assistive technology devices • 96% reported that they were better able or had maintained their ability to function more independently having received communication skills training • 100% reported that they were better able or had maintained their ability to function more independently having received daily living skills training • 57% reported that they had greater control and confidence in their ability to maintain their current living situation; 30% indicated no change; and 12% indicated less control and confidence Program participants were asked what was the biggest difference the program had made in their lives. Typical comments include the following quotes: • Being able to use the phone and see things, I wasn’t able to see with the magnifying glass. • Being around people with similar situations. The cane has been most helpful. • I am more independent about everything. • I can go to the grocery store and see what I am getting. Just being able to read again. • I thought that somebody cared. The clocks helped and the canes. • It busted my fear of computers. I am no longer totally afraid of them. • It enabled me to utilize computer technology to send and receive e-mail, and access to everyone I might need. • It has given him some security and the fact that there is a source for future needs. • It has given me more confidence to do what I want to do. • It has given me the sense of more security. The help with the cane was very informative. • It has helped me to keep check on my diabetes. • Marking my appliances where I can cook and wash my clothes. • The books on tape have made a wonderful assistance to my quality of life. • They built me up, and they let me know that I am not the only one in this shape. They helped my depression.

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).

Senior 1 Ms. Selena D. initially came to the Center to receive services for her decreasing vision due to optic atrophy. The doctor prescribed 6x magnification to increase her ability for near reading. She was also encouraged to make an appointment with a doctor that specialized in prisms. There was a possibility that increasing her visual fields might enable her to return to driving. Finally, the low vision doctor referred her to comprehensive rehabilitation therapy 1) to increase her awareness of vision concerns, and 2) to increase her independence through training using adaptive techniques and equipment. All the training and equipment she received are allowing Ms. D. to remain safely and independently in her home. She states that she is now more confident in living with her vision loss since receiving the training. In addition, since her training commenced, and her skills and confidence have increased, she has decided that she wants to return to work. Her previous employer of 15 years has expressed interest in rehiring her now that she has received training and was able to use adaptive skills to complete her job tasks. Ms. D. also recently participated in a “Walk A Mile” fundraiser that current and former students of the Center put on. She became part of the programs executive committee by helping to coordinate and track donations and activities. Her increased confidence and skills really shined through during this event. Senior 2 A couple residing in rural Georgia were having difficulty continuing to live independently when their grandchildren moved out of their house. Both husband and wife are totally blind and the wife is also totally deaf. With Project Independence funds we were able to purchase the husband with an Optical Character Recognition (OCR) device, which enabled him to read the mail, product labels, and any printed matter. Project Independence also provided them with a vision rehabilitation therapist who checked in on them to help with household concerns they may encounter. These services enabled them to continue living in their own home together and independently. Senior 3 RH lives in an apartment complex with his wife. He completed a Braille course through the Hadley Institute. RH was trained and used several aids and devices to help him live as independently as possible. He is a local entrepreneur who is currently working to re-learn email management for his marketing business. He wants 1) to bring to market a medical device for testing the extent of neurological damage, and 2) to bring together the developer of the device with numerous medical practices and sports organizations. To manage his correspondence, RH’s long-term goal is to correspond independently with others by using the NonVisual Desktop Access (NVDA) screen reader on his PC. He expressed deep gratitude for services provided throughout the year to aid him in his quest. Senior 4 Ms. B. is a 73 year old woman who lives in her home with family rotating in and out to offer her support. Family members have offered to relocate her to their homes, but her goal is to continue to live in her home. She has lost significant vision from posterior uveitis. Ms. B. was referred to the program by her local ophthalmologist. She attended the Low Vision Clinic, but no optical devices were helpful due to the extent of her vision loss. Adaptations using non-optical devices were provided by Low Vision as well as resource information including agency sponsored activities, e.g. support groups, book club, audio described movies, and Toastmaster’s. Her goal was to be able to travel more independently, so she was referred for orientation and mobility (O&M) instruction. At the time of her referral she did not leave home without an escort. The O&M instructor provided instruction for client to use a long cane to navigate stairs and drop offs and for limited travel in the community. Sighted guide instruction for Ms. B. and her family was provided for them to be able to travel together safely. Ms. B. is now able to teach sighted guide to others who offer to assist her. The O&M instructor taught her to enter and exit the paratransit van. She received further O&M instruction at the facility. When she completed her O&M, she began attending activities using paratransit. The first time she attended the Living with Vision Loss support group she was escorted by her grandson. The next time she attended she was alone. She said she gained courage by listening to the stories of other group members. She began exploring other locations independently. The O&M instructor oriented her to a local senior center where she enrolled to attend some of the activities. She then began attending classes at a local gym with the goal of losing weight. She has lost over 50 pounds. She went on a cruise for the first time and has been indoor skydiving. She continues to participate in activities, especially support group meetings where she freely expresses her gratitude. “I’m doing things I never would have done when I could see.”

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

Staffing Staffing issues were even more pronounced this year. In addition to pay concerns, we are now dealing with staff retiring. Our funding cannot compete with the Department of Veterans Affairs and the Department of Education. We lose staff to those entities. Several of our long term instructors retired or will retire this upcoming fiscal year. The certified teachers need to be better financially compensated for the time they put into their jobs. Providers are finding it harder and harder to obtain and keep qualified instructors and difficult to provide services to all those in need due to their budget constraints. Certified Vision Rehabilitation Therapists have been especially difficult to find. Once we find staff who can deliver Certified Orientation and Mobility, Certified Vision Rehabilitation Therapy services or Technology Access Training, the challenge remains to keep these individuals. Finding qualified professionals who are willing to accept the pay and travel long distances to spend time with seniors in some of the more remote rural areas in Georgia has proven to be a difficult task. Contractors spend a great deal of funds on transportation in order to serve seniors in the remote areas of Georgia. Funding GA continued to struggle to serve all eligible seniors for the full fiscal year. Our funds simply ran out, in spite of the fact that providers sought (and sometimes obtained) other funding to help with the program. Several contractors were only able to provide information and referral services the last couple of contract months as they had no more funds. Some of the subcontractors did not receive funds from other grants this year that they had been accustomed to receiving previously. The availability of funds for assisting with the purchase of devices for seniors is limited. Although the typical cost for the equipment needed is in the $45 - $60 range, seniors seem reticent about purchasing it. Some individual clients truly do not have the funds available. In that situation the Social Coordinator/Low Vision Coordinator works with them to help identify local resources. Others have the funds available but are so accustomed to government programs covering the cost, they withhold purchasing the equipment. One provider has implemented a “lay away” program for those seniors who are interested; however, this process takes additional staff time of the Low Vision Coordinator and the Accountant. Outreach can be a double edged sword; we let the community know of the program and then, depending on when they apply, we might not have the funds for direct services until the next fiscal year. However, funds for continuous outreach is very much needed. Providing services to individuals in the rural service areas continues to be a challenge. Our seniors in rural areas are stranded by a lack of available transportation, and oftentimes, require completely home-based services. Due to the extensive miles traveled to cover the entire rural areas of Georgia and the growing visually impaired aging population some of the providers run out of funds prior to the end of the fiscal year. Additional funds would enable the program to provide more seniors in the rural areas with the services they need. These services include orientation and mobility, computer and technology skills, vision rehabilitation therapy, and adaptive aids/devices. The limited funding also restricts the ability to make frequent visits to the same person in order to fully provide their needed services. With funds already limited, it is impossible to make a decision to send a therapist two hours away from a Center for an up to two hour session (this is the longest most of our elderly tend to be able to focus) while we could serve five individuals on-site in the same time frame. In addition, the thought of putting a senior citizen on regional coaches for undetermined lengths of time, often with no air-conditioning and unreliability for pick up or drop off times, is just too much to ask of our seniors. So we struggle with providing home based vs. center based services. While certified professionals receive over 95% of the reimbursement, the program does not allow full cost of administrative fees for the providers’ services. The lack of a reasonable reimbursement for administrative costs is an ongoing issue. Based on the training GA has provided, the Confident Living Program has been hugely successful in aiding the seniors in their adjustment to their dual sensory loss by teaching them skills to help in their independence. As our program serves more seniors with the dual loss, additional funding is needed to provide this specialized training for the seniors throughout the state to aid them in their independence. Training The ever-changing technology is challenging us to keep abreast of all the latest developments. Those seniors who are accustomed to using technology in their home and work life expect to continue to do so. Technology upgrades are expensive. Once a senior learns that the I-Phone for example has a myriad of assistive capabilities, the request flows in for more and more training. It may sound prudent to say to the client that you have mastered the basics and now you are on your own. Those living in urban areas have access to technology classes and support if they can get transportation to same. Those living in rural areas do not have those resources and again, there is the transportation issue. Database Our work is very paper intensive; we are still expected to keep paper files and to store them for many years. This is a costly burden in space, supplies expense, and in human resources. It would be prudent to consider an electronic system that all agencies serving Project Independence could use and access. Additional comment: This has been one of the most difficult years regarding funding and staffing for the GA program. The program manager is very proud of the fact that we were able to provide services to almost the same numbers of seniors as we did last year in spite of running out of funds and losing staff prior to the end of the FFY.

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 byKay McGill/Paul Raymond
TitleGA OIB Prg. Mgr/Ga Blindness Services Coordinator
Telephone770-414-3006
Date signed12/06/2018