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

RSA-7-OB for Nebraska Commission for the Blind and Visually Impaired - H177B180027 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 year225,000
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year86,366
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 20
A2. Total other federal46,345
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement46,345
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)146,929
A4. Third party0
A5. In-kind0
A6. Total Matching Funds146,929
A7. Total All Funds Expended193,274
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs74,889
C. Total expenditures and encumbrances for direct program services118,385

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 0.2300 2.1000 2.3300
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 0.2300 2.1000 2.3300

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 13 0.8600
2. Employees with Blindness Age 55 and Older 5 0.0200
3. Employees who are Racial/Ethnic Minorities 8 0.1200
4. Employees who are Women 28 1.3500
5. Employees Age 55 and Older 20 1.9200

C. Volunteers

0.00

Part III: Data on Individuals Served

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

A. Individuals Served

1. Number of individuals who began receiving services in the previous FY and continued to receive services in the reported FY181
2. Number of individuals who began receiving services in the reported FY259
3. Total individuals served during the reported fiscal year (A1 + A2) 440

B. Age

1. 55-5921
2. 60-6427
3. 65-6936
4. 70-7436
5. 75-7938
6. 80-8487
7. 85-8985
8. 90-9481
9. 95-9927
10. 100 & over2
11. Total (must agree with A3)440

C. Gender

1. Female315
2. Male125
3. Total (must agree with A3)440

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race9
2. American Indian or Alaska Native5
3. Asian1
4. Black or African American9
5. Native Hawaiian or Other Pacific Islander1
6. White415
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)440

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)10
2. Legally Blind (excluding totally blind)275
3. Severe Visual Impairment155
4. Total (must agree with A3)440

F. Major Cause of Visual Impairment

1. Macular Degeneration288
2. Diabetic Retinopathy25
3. Glaucoma25
4. Cataracts0
5. Other102
6. Total (must agree with A3)440

G. Other Age-Related Impairments

1. Hearing Impairment88
2. Diabetes54
3. Cardiovascular Disease and Strokes61
4. Cancer9
5. Bone, Muscle, Skin, Joint, and Movement Disorders79
6. Alzheimer's Disease/Cognitive Impairment8
7. Depression/Mood Disorder7
8. Other Major Geriatric Concerns23

H. Type of Residence

1. Private residence (house or apartment)309
2. Senior Living/Retirement Community45
3. Assisted Living Facility54
4. Nursing Home/Long-term Care facility32
5. Homeless0
6. Total (must agree with A3)440

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)43
2. Physician/medical provider44
3. State VR agency3
4. Government or Social Service Agency33
5. Veterans Administration6
6. Senior Center1
7. Assisted Living Facility8
8. Nursing Home/Long-term Care facility13
9. Faith-based organization1
10. Independent Living center1
11. Family member or friend124
12. Self-referral144
13. Other19
14. Total (must agree with A3)440

Part IV: Types of Services Provided and Resources Allocated

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

A. Clinical/functional vision assessments and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 4
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 0

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 16,761
2. Provision of assistive technology devices and aids 437
3. Provision of assistive technology services 368

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 2,219
2. Orientation and Mobility training 91
3. Communication skills 158
4. Daily living skills 210
5. Supportive services (reader services, transportation, personal 10
6. Advocacy training and support networks 22
7. Counseling (peer, individual and group) 159
8. Information, referral and community integration 424
. Other IL services 158

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Information and Referral 99
3. Community Awareness: Events/Activities 197 4,980

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) 537,406 309,891 -227,515
2. Number of Individuals Served 708 440 -268
3. Number of Minority Individuals Served 42 25 -17
4. Number of Community Awareness Activities 13 197 184
5. Number of Collaborating agencies and organizations 38 48 10
6. Number of Sub-grantees 0 0

Part VI: Program Outcomes/Performance Measures

Provide the following data for each of the performance measures below. This will assist RSA in reporting results and outcomes related to the program.

Number of persons Percent of persons
A1. Number of individuals receiving AT (assistive technology) services and training 368 100.00%
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) 251 68.21%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 98 26.63%
B1. Number of individuals who received orientation and mobility (O & M) services 91 100.00%
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) 46 50.55%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 22 24.18%
C1. Number of individuals who received communication skills training 158 100.00%
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) 118 74.68%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 31 19.62%
D1. Number of individuals who received daily living skills training 210 100.00%
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) 140 66.67%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 49 23.33%
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) 281 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) 1 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) 55 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 85 n/a
E5. Number of individuals served who died before achieving functional gain or experiencing changes in lifestyle as a result of services they received. (closed/inactive cases only) 4 n/a

Part VII: Training and Technical Assistance Needs

It is important to continue some form of the Older Blind Program Managers meeting to allow experienced and new Program Managers to come together to learn from each other. It would be helpful if there were more financial incentives or assistance to help states send their OIB Program Managers to the meeting. In the past, there have been conference calls to share what is happening in state programs and to answer questions about the 7OB report.

Part VIII: Narrative

A. Briefly describe the agency's method of implementation for the Title VII-Chapter 2 program (i.e. in-house, through sub-grantees/contractors, or a combination) incorporating outreach efforts to reach underserved and/or unserved populations. Please list all sub-grantees/contractors.

Nebraska Commission for the Blind and Visually Impaired (NCBVI) implements the Title VII Chapter 2 program by providing one on one services to individuals in their homes. Counselors from our 6 field offices work directly with individuals on a plan that is created to address the unique needs of each person. Counselors network with other agencies through boards, committees, health fairs and in-services. NCBVI does not subcontract services through other vendors. Agency counselors network with other agencies and organizations who provide services to minority and underserved groups so that our services can be made available to all people, including those in un-served and underserved populations. During FY 2017-2018, NCBVI provided active Independent Living services to four hundred forty (440) older individuals who are blind. Eligibility determination is based on a visual impairment limiting the individual's ability to perform the activities of daily living and the availability of services offered by NCBVI to help the individual to be more independent in their home and community, without regard to race, color, national origin, gender, religion, or disabling condition. Counselors provide services in the areas of: daily living skills (i.e. cooking, telling time, identifying money, cleaning, mending, color identification, grooming. home maintenance, organizing medications); communication skills, (braille, keyboarding, handwriting, access to large print, recorded formats, audio books, telephone access to newspapers, use of readers, using telephones and cell phones); use of assistive technology and low vision services; family and peer counseling services; and support in self-advocacy so individuals can become or remain involved in their communities and organizations. Individuals are also referred to other agencies and given resources that they may want to contact. Referrals are made to NCBVI by the individual themselves, family, friends, doctors, other agencies and other clients. After a referral is received a counselor calls the referral and then meets with them to explain NCBVI services and discuss other agencies that might have needed services. (i.e. Talking Book and Braille Services -TBBS, radio reading services, NFB Newsline, low vision evaluations, transportation programs, telephone directory assistance waivers, Area Agency on Aging, programs to access religious material). New referrals are often given writing guides, a bold marker pen, a bold line tablet and other large print and low cost items. Staff can sign up the new referral for TBBS, Newsline, an audio Bible, free directory assistance and other free services. Dials and buttons on microwaves, stoves, thermostats, washers, dryers, etc, can be marked. If the new referral 55 years of age or older applies for independent living services they will be moved into an active status. If the individual also experiences hearing loss, they can be referred to the Nebraska Public Services Commission for a free phone that is accessible to people who experience vision and hearing loss. Those who choose not to pursue active independent living services are closed from evaluative services. If there is a low vision provider close by, individuals are given that information. In rural area, counselors will take a low vision kit to show people different types of magnification aids available.

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.

Counselors sit on various boards. In the Kearney office, counselors are part of the Kearney Area Aging Coalition, Elder Issues, the South Central Nebraska Area Agency on Aging (ADRC) Advisory Committee and Community Connections. The counselor from the Scottsbuff office sits on the Tri-City Action Council (which has been instrumental in helping with the accessible crosswalk projects in Scottsbluff), the Panhandle WIOA Partnership committee, the ADA compliance board for the local Midwest Theater and is certified with the Nebraska Behavioral Health Emergency Response Team. In Lincoln, counselors sit on the Brain Injury Advisory Board and Partners in Aging, Aging Disability Resource Center (ADRC) Advisory Committee. In Omaha, counselors sit on the Partners in Aging Committee, Mayor’s Commission for Citizens with Disabilities and the Senior Companion/Foster Grandparent Advisory Board. The Enrichment Foundation, a private, not-for-profit organization serving people with disabilities, awarded NCBVI a grant in the amount of $10,000 in support of Promoting Independent Living for the Blind of Omaha (PILBO).The target population served by PILBO includes blind and visually impaired persons 21 years of age or older living in the greater Omaha metropolitan area with independent living rather than vocational goals. A large part of the group benefiting from this grant are people 55 and older. This partnership has continued for 12 years. These funds help buy assistive technology, IL devices, and some interpreters for deaf blind activities. NCBVI continues to work with Assistive Technology Partnership (ATP). ATP is the state program that provides information about assistive technology for people with disabilities and resources for acquiring technology. NCBVI participates in a web based inventory-lending program coordinated by ATP. Through their web site www.at4all.com, people can find assistive technology for blind and visually impaired consumers and are encouraged to contact NCBVI for a demonstration or short-term loan of the equipment. ATP also administers "I Can Connect", a deaf-blind equipment distribution program benefiting NCBVI clients with dual sensory loss, many of whom are 55 years of age and older. NCBVI clients who have some functional vision can be referred to the Low Vision Clinic, University of NE Medical Center, for a low vision evaluation to help identify devices and equipment that may help the person effectively use their remaining vision. Individuals in more rural areas of the state will be referred to local eye care professionals for a low vision exam. When equipment is identified that will help the client, NCBVI can provide a few low vision aides and devices. Counselors are part of the presenters at the Fall Prevention Program put on statewide. NCBVI counselors routinely refer consumers to services offered by other agencies including: Talking Book and Braille Services, NFB NEWSLINE, Radio Talking Book, subsidized taxi coupon programs (Share a Fare in Omaha and Give a Lift in Lincoln, both coordinated by the American Council of the Blind of Nebraska), Braille Bibles International, Aurora Ministries and so on. NCBVI also works with Area Agencies on Aging, the Nebraska Commission for the Deaf and Hard of Hearing, centers for independent living, the League of Human Dignity, Vocational Rehabilitation and other philanthropic organizations serving people with disabilities.

C. Briefly summarize results from any of the most recent evaluations or satisfaction surveys conducted for your program and attach a copy of applicable reports.

Four hundred forty (440) active independent living clients were served by the Nebraska Older Blind Project in FY 2017. Three hundred nine (309) clients were closed from active services. Four (4) additional individuals were closed from application status without becoming active clients. Thirty one (31) were closed unsuccessfully. State of Nebraska Nebraska Commission for the Blind and Visually Impaired [Over 55] Program Participant Survey October 1, 2017 — September 30, 2018 Number of Surveys Mailed: 343 Number of Completed Surveys Returned: 102 (30%) 1... I feel more confident in my ability to perform activities I had given up because of my vision loss. 4 Strongly Agree 25 (27%) 3 Agree 45 (48%) 2 Disagree 8 (9%) 1 Strongly Disagree 00 (00%) 0 Not Applicable 15 (16%) Comments (if any): 1. Magnifier has helped. Taking books are great. 2. I feel I can get places on busses. 3. With decline did not utilize phone or talking books. 4. Would like something that would help to see to play cards. 5. Now I can read thanks to magnifying reader brought to me by Jon. 6. Visual aid allowed me to stay in my home for 10 years after becoming legally bind. 7. I love talking book, magnifier, large calendar. 8. They are very helpful. 9. Had not given up anything. 10. The Aladdin has been a great help for the purpose of reading. 11. The buttons and dots were very helpful 12. Having a hard time adjusting to loss of sight. 13. I haven’t totally lost all my sight yet. She gave me so many ways to do things like cook and other things that I know I will be able to use them later if my sights gets worse. 14. She was showing me how to use my phone with the voiceover and finger gestures 15. My eyes sight has deteriorated significantly. Making most daily activities more difficult. 16. The only activity I had I gave up reading. 17. Have not participated in NCBVI since I have lived here. 18. I now live in a nursing home because I am totally blind. 19. The person that came to visit was lovely, but there wasn't a significant amount of follow-up. The only service they provided was just a few buttons on her phone. I think they tried to offer her an idea of how to handle her plate in the dining room, but I was under the impression that there would be a plate with contrast on it. There was not that follow-up. Also, my mom is 91, so, there are other impairments, so that makes it difficult to accurately assess the situation. 2... Overall, I am less dependent on others. 4 Strongly Agree 19 (22%) 3 Agree 47 (53%) 2 Disagree 12 (14%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 09 (10%) Comments (if any): 1. If some things - not others 2. total care 3. While in my own home the aid of friends and family help me. 4. Marked cans of fruit & vegetable 5. Not your fault but I am more dependent. 6. The Aladdin has been a great help & joy to me. 7. As my eyes tight gets worse - I am more dependent on others. 8. Need help with paperwork because my eyesight is poor. 9. Nothing has changed 10. My cane helps me greatly and I really appreciate it. Plus all the other things. I use my tape recorders & watch every day. 11. Not much difference 12. I have also been diagnosed with Parkinson’s as wells as dementia, so things are very difficult without help. 13. The magnifying glass does this. 14. No real change 15. I now live in a nursing home because I am totally blind. 16. She still requires full nursing care. 17. I'm just as dependent as always. They weren't able to help me see any better. 3... I am better able to move confidently around my house, apartment, or yard. 4 Strongly Agree 19 (21%) 3 Agree 38 (42%) 2 Disagree 06 (07%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 26 (29%) Comments (if any): 1. Becoming better at this. Husband not babying me as much. 2. total care 3. no different 4. I am able to get around without any help so far 5. I haven’t fallen since I had her help me. 6. am getting a 4 wheeler I seat to assist 7. My peripheral vision does a great job. 8. No real change 9. I have had no service from NCBVI. 10. she gets around pretty well in her room. Now that this visual impairment is more severe for this length of time, she’s adjusting more to her environment. 11. The services I received didn't enhance my vision any, so how could it have helped? 12. I can still do that on my own. 13. I'm quadriplegic and bed bound. 4... I am better able to prepare meals for myself 4 Strongly Agree 15 (17%) 3 Agree 34 (37%) 2 Disagree 11 (13%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 27 (31%) Comments (if any): 1. Although husband does most of cooking. 2. Didn’t get much help on this part 3. Total care 4. I can read recipes with help of magnifier. 5. The red plastic tab that I have to show me microwave and stove! 6. I can even use to read recipes 7. I also haven’t burnt myself anymore. 8. Make less meals 9. I have never cooked much. Wife does. 10. Again my glass helps with recipes. I have writing in large print. 11. No real change 12. Have had no problem with this. 13. Have received help from NCBVI & prepare my own breakfast. 14. If I'm making something, I can read the recipe better because I can use the machine. Much of the food that comes in boxes and bags, the print is very small. I can put that on my machine and read that. 15. Someone else does this for him. 16. I have an aid provided by the VA that comes twice a week to prepare meals and do housekeeping. They prepare meals for me. 17. She lives in a nursing home, so all of her meals are prepared. 18. I have care aids who come in four times a day and cook for me since I'm stuck in bed. 5... I can better manage my house keeping tasks. 4 Strongly Agree 10 (11%) 3 Agree 39 (44%) 2 Disagree 07 (08%) 1 Strongly Disagree 01 (01%) 0 Not Applicable 31 (35%) Comments (if any): 1. Although husband does most of cooking. 2. Magnifier helps with bookwork. 3. total care. 4. Have a housekeeping (Caregiver) to clean once a week. 5. Same. 6. Can't do it. 7. I can’t do much now because of 2 hernias and falling. 8. Have a housekeeper assist 1-2X a month. 9. Have.Assistance with housekeeping is furnished. 10. I love to cook. After I lost my eyesight, I couldn't make a box of brownies. I can use that machine to read those kind of things. My cooking and meal making has been helped because of this reading machine. 11. I can see enough that I have not had to have any help with that yet. 12. Someone else handles this. 13. My wife does all of that. 14. She is in a nursing home. 15. I have care aids for this. 6... I am better able to manage my paperwork (such as mail, correspondence, and writing checks). 4 Strongly Agree 19 (21%) 3 Agree 33 (36%) 2 Disagree 14 (15%) 1 Strongly Disagree 08 (9%) 0 Not Applicable 17 (19%) Comments (if any): 1. ditto 2. Am presently using a magnifying projector to manage correspondence. This was suggested by Trulsen Eye Clinic in Omaha and a used color unit was fortunately found on a garage sale. 3. total care 4. not able read a lot but the smartlux does help 5. Because of magnifying reader thanks to Jon for bringing it by. 6. yes - black line on tablet - very good for me 7. My son takes care of paperwork for me 8. Not able to see very good anymore even with the Smartlux digital handheld magnifier. 9. need help 10. Not able to see them. Don’t write anymore & sign my name as needed with assistance 11. Glass helps me do credit card bills which I couldn’t do. 12. my daughters handle most of my paperwork 13. With machine to read. 14. Help with my computer! 15. They gave him a signature thing. 16. I got this machine, and I can write checks better now. 17. They helped me learn to use the computer, and I can use it to learn about the election, and I could use my computer to find information about it. Before all that, I couldn't even find that information. 18. They did a couple of things that helped with that. There was a magnifying instrument that helped. 19. I have someone that helps me do that. 20. My aid helps me with this. 7... I am better able to enjoy reading materials such as books, newspapers, magazines (whether with magnifiers, large print, Braille, or on tape). 4 Strongly Agree 31 (34%) 3 Agree 32 (36%) 2 Disagree 10 (11%) 1 Strongly Disagree 06 (07%) 0 Not Applicable 11 (12%) Comments (if any): 1. Love, love, love talking books 2. I enjoy the books. 3. hospice 4. Thank you so much for the magnifying reader brought to me by Jon. 5. The big screen magnifier was a great aid as it continues to be. The tapes from the library for the blind is a Godsend. 6. I had Kindle & large print 7. love the books, pocket clock & newspaper 8. I don’t do much reading, just some news & obituaries. 9. Not able to see better 10. Love my books & Bible tapes. Thank you greatly. 11. only on tape 12. Use my TV Type magnifier for this or talking books. 13. Enjoy reading materials on tape. Is reluctant to use the reading maching for fear of "Breaking" it. 14. Love the talking books 15. This is the best service I got. I enjoy it. I couldn't read at all without it. I can suffer through reading, but it's pretty hard. I have magazines and books I can listen to now. I like it. It's the best thing they have done for me. 16. I have that tape recorder. It is wonderful! It has entirely changed my life. I was a veracious reader all of my life. I had a huge collection of authors. I could have opened a library. I'm picky about the books I would buy. When I first went blind, I had to give up on ever reading Danielle Steel or Mary Higgins Clark. But I do it all the time now. It has opened up my life. 17. We take full advantage of books on tape program. She is the most veracious reader I've ever known. These are recordings we send through the mail through the commission. That gets my highest marks. 18. I've always been slightly nerdy. Now I can get back on the internet and use the program that gets stuff off of the screen to read stuff. They also recommended a program called JAWS which can read books. I'm definitely back into reading again. 19. I cannot read any newspaper or anything. I can’t read printed matter any longer. I listen to books. My listening skills are more keen. 20. I have not received services for reading. 21. I still can't read anything. 22. I don't use any of these services. I should, but I just don't have time. 23. I'm not good at reading materials other than listening to the recording. When I get mail, I can't read a lot of it. So, I don't know how to answer that. 24. I order my own books, and I read a lot. I always have. I already have braille skills. 8... I am better able to participate in the life of my family, friends, or community. 4 Strongly Agree 14 (16%) 3 Agree 40 (44%) 2 Disagree 12 (13%) 1 Strongly Disagree 02 (02%) 0 Not Applicable 22 (24%) Comments (if any): 1. Not driving is something you can’t help me with. 2. I am not afraid of falling anymore. 3. hospice 4. same 5. Am having to stop going to places (u shop, groceries) & playing cards 6. I didn’t quit being a social person. 7. Need help from my family. 8. Just because the books are so helpful in keeping her mind active. 9. I don't have no family but my wife. 10. I still see well enough. So, this did not apply. 11. The machine I got did not help me with my family. 12. My health keeps me homebound accept for going to the doctor. That's not due to the blindness . 13. I'm the last living member of my family. 9... I feel more in control in making decisions that are important in my life. 4 Strongly Agree 21 (23%) 3 Agree 46 (49%) 2 Disagree 11 (12%) 1 Strongly Disagree 00 (00%) 0 Not Applicable 15 (16%) Comments (if any): 1. I feel better in control. 2. hospice 3. At age 90 (as of Oct. 2018) of 2 kids behind me, I feel it is prudent to run business decisions by my sons before acting. I feel it is important I am in control of my own decisions, don't drive out of town, don’t drive at night 4. with the help of my 2 sons 5. depends on situation 6. I’m the same. 7. If nothing else, just being able to find out more about voting. There have been other things where I am able to use my computer again. There are so many things that I can do now. With the computer, it's just so wonderful to be able to read things and find information. Getting in touch with colleagues that I haven’t been able to talk with for over a decade now.” 8. Some of these things involve reading, and the machine does help in that way. 9. she is not able to make those sorts of decisions. Nothing about these services. I share power of attorney with my brother. 10. What was the greatest difference this program made in your life? (Please comment in the space below or over.) 1. If my hubby will let me. :) 2. I feel more comfortable with people. I get out and try to do things. Thank you very much 3. The talking clock and talking books program improved life the most. Written by her son who lives nearby. 4. To be able to function better because of dots and the cane. I feel I have a life again. 5. Things the program have provided make it a little easier to see with my magnifying device. 6. Meeting john & he is really trying to help me with continuing to play cards - the think I miss the most. 7. I am still able to be independent, with the help of the equipment given to me. 8. Helping me with technology 9. It was such a help to be able to read ingredients of medications, and anything small print. Also, support group means a lot to me. 10. The talking books are the greatest help. 11. Listening to books. I really enjoy it. Thank you. 12. Having the Magnifier reading. The one I have quit working within a few weeks and would not charge anymore. Got a replacement but it did not work either. And it was returned. Have not heard back on that. So I am without my magnifiers. I am hoping to hear back from my counselor on when I will l get a new one... (Requested counselor contact - AM 09/19/2018) 13. Someone to talk to about my problem. 14. Support, referrals & books 15. it help me 50% 16. Enjoyment of the tapes. 17. allows her to get door open with key, use microwave, use lighted magnifier a lot to read mail, fill out daily menus, etc. 18. Little or none. The equipment isn't workable for me. I don’t use it. 19. Being able to read my mail & magazines. I love my talking books! 20. Enjoy listening to stories & I use the magnifying glass. 21. I use the Acrobat magnifier all the time. I can read everything now. 22. Experience of the workshop. Meeting other people with similar disability. 23. Being able to manage daily chores and a new hobby of wood crafting. Everyone was knowledgeable and helpful giving me the confidence. 24. I can call you if a problem 25. listening to newspaper books on tape - love being able to listen to her favorite authors 26. I received material that helped me see well enough to do my job and everyday tasks. 27. I can read the daily paper now - I enjoy talking book now. Paying bills is a lot easier — Thank you for these. 28. I cannot read!!! 29. My greatest problem has been in reading all form of print. I’m so pleased to know there is help available in all areas of sight when & if that time comes. The large print calendar is so helpful along with the wide spaced writing paper and bold line - dark black writing pens not to mention the magnifying glass. I appreciated being shown different items especially for poorly sighted persons. Just knowing they are available is a big plus. Deanna was a big help in getting me information & showing support in all I was interested in. Keep up the good work. 30. The magnifier helps me see some material I would not be able to see. 31. I was listed that I have been dropped from your program 32. Being able to read & see things of interest, like pictures, mail, etc. 33. Made me realize I can see as well as I used to. 34. Passed away. Please remove her from mailing list. 35. The small handheld device worked for a very short time. Would be better to have a floor lamp w/ magnifier. But stronger magnifier. 36. Check writing devices - she feels needs better lighting - filled out by sister with patient input. 37. Read bills - book word with magnifying glass 38. Learned difficult things by the coming to home to teach me things. I still am waiting for you to give me a folding cane. Are there places to go to meet with other people with low vision? (Requested counselor to contact 09/19/2018 AM) 39. Talking with Angie, she was very encouraging. All the items she game me helps me so much. I think this is a wonderful program to help people who need it desperately. 40. My macular degeneration isn’t as advances as some people! Fritz Nuffer was faithful to call on me. My mother had advanced macular desecration so visiting with Fritz helped me by suggesting some of the helps out there. He also got me started on talking books. Fritz did what he could to help me. I get shots in both eyes - so scary. 41. I sent the book recorder back because I found I did not have the mobility enough to to use the recorder. 42. I can text message my kids; get emails on my phone, and read them! The voiceover feature is wonderful! 43. As my vision loss progresses, I don’t feel the despair that I previously had. Better coping and adjusting to my new reality is what it is. You program has helped a lot. Thank you! 44. very little 45. able to relax at night listening to book tapes & get a good rest 46. is in Madonna St. Jane long term care. Is not able to do much of anything. I'm not sure what program this refers to. 47. I could read newspapers and magazines using the magnifiers and do my bills. 48. I was surprise at the equipment supplied to me, & how it helped when I could still see better. 49. to be independent 50. I am able to read without the assistance of other people 51. I can use my reading machine. I can tell time with my talking clock 52. Confidence. Read material 53. Help me to read, they provided a magnifier to enlarge print. 54. For some time I have been looking for a better mag glass. This one helps as my eyes don’t always focus together. I sometimes need to use 2 mag glasses. Numbers are challenge for me. I need a glass that enlarges the letters. I still appreciate the glass you provided me. Thanks for you service. 55. Being able to read what she wants with less difficulty. 56. It has shown me have to mark things and provided me to the purchase of my DeVanci. I could not get alone without it. If there is help with cell phones and computer screens, I would appreciate that. 57. Introduced me to the great digital glass, TV Type magnifier, large calendar, special no bleed pens. 58. Having the talking watch and clock allows her to tell time and date. My daughters are completing this form on my behalf. 59. Being able to read with this eye machine is wonderful. 60. She passed away. Please take her name off your list. 61. I am sorry that the name of the gentleman who helped my mother escapes me. (Possibly, it is Larry). Anyway, he did his best to find things that would be helpful in making her life more enjoyable and easier. 62. Does not apply 63. I did not participate in this program. 64. Enjoyed the one on one he received & also enjoyed the time spent in North Platte at the conference. Thank you so much for all that you did for him. 65. Ability to listen to books. Loved to read so they are SO helpful. 66. I have had no help from NCBVI. 67. Read & keep up with news etc. better. Books on tape are great for me; the lighted magnifying glass helps a lot. 68. Mainly it was getting books to read and getting books on tape. Also, I got some magnifying glasses from them that were really good. 69. They gave me more confidence to try things and do things like cooking, how to use a knife when chopping things, and different ideas of how to do things. I feel more comfortable when I'm out with others, and I'm not afraid to ask for help when I need it. I really appreciate the talking books as well. 70. The audio books. 71. Getting the adaptive equipment that he needed. The signature thing and the audio books. 72. I got these things to help. I got a watch where I can press a button to get the time. I got another clock where I can just press it to get the time and date. They gave me little things to put on my microwave and washing machine, so I know how to choose what I want. They also gave me a big calendar and the reading machine. 73. The best thing that you did for me was get me a telephone that automatically dials the numbers. I just speak the name into the phone and it dials their number. I recently had a stove in a kitchen that was condemned. You sent some people over here and trained me how to use it. I am now able to prepare my coffee on top of the oven and cook my TV dinners inside of the stove. 74. They helped me with the stove, washer and drier and microwave. They helped me find the temperature and everything. I also like the talking books. That's just been so helpful. 75. The only thing that we got from the commission was a watch that told the date and time. That was helpful. The lady that came, they said he was only allotted so much money for a phone for him. I found a push button phone at Walmart. It cost $34, and they said they would not pay part of it but would have to pay all of it or none of it. I'm waiting to hear from the commission about the options about the phone. I also have not called her back. Whenever she meets with Dad, I try to be here. I think she's been here only once or twice. 78. ”When they gave me the CCTV and they set me up with the talking books. I can now read the newspaper through my phone.” 79. The talking books, absolutely. Even things like just the simple little dots. I can now operate the dishwasher, microwave and washing machine. These are things I could never do before. Even the template that you put over your checkbook is a wonderful thing. I couldn't write checks anymore, and now I can. I have one for an envelope as well. It's wonderful! 80. They put a button on her phone for one-touch dialing so she can call me. And the books also made a huge difference. 81. Getting me to a place where I can use a computer again and learning all the things that it does. My computer is set up to do more than what a normal computer does. I can control the temperature in my house, for example. They're trying to get a little camera to mount near or in the refrigerator, so I can choose what I want to eat when the aids are here. 82. I got a better understanding of my situation. Also, her being so friendly to me. 83. They gave me a reader that plays tapes. 84. They helped me set up my phone and computer. 85. Just that I was able to read, and I enjoy by listening to tapes. They gave me books to listen to at my house. They helped me with some things on the iPad, and they helped me with how to do it like orally asking for phone numbers. 86. They were just helpful. They understood what I am dealing with. 87. How to get along better in the kitchen with cooking skills. I learned to use plug-ins better by touch. There were different things that were taught to me that were better, such as using measuring spoons and cups, pouring dark liquids into light cups, and vice versa. These are all wonderful helps to me. This makes me not so dependent for help because I use these. 88. Just by using the stuff they gave me. The magnifier and the clock thing. I really like that, too. Also, the big calendar. 89. The watch and the reading machine, I use them all the time. I appreciate having these. 90. I learned a lot more back when I was going through the center program. More with the computer at that point than I have in a while. 91. The use of this machine. I find that it helps in reading newspapers. I can even work my crossword puzzles again. And also, in my bookkeeping. It involves quite a bit of reading. This has been the biggest help. Reading with this is definitely a plus.

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).

Carol is an 86 year old female who experiences vision loss due to Retinitis Pigmentosa and diabetes. When we first met years ago she lived on the family ranch with her husband and was very active in the day to day ranch operations, bookkeeping and cooking. She had also been an avid reader and enjoyed crafts. She felt with her deteriorating vision she was going to have to give those things up. She attended the FYI program in North Platte where she learned cane travel and many other daily living skills. Through her initial training program she was able to regain her confidence in continuing all of her daily activities and duties. Recently Carol contacted NCBVI again as she experienced a significant decrease in her vision. Her husband has passed away so she now lives with her daughter but absolutely does not want to be dependent on her. Carol has taken an interest in technology and is now using an iPhone through which she accesses a constant digital blood sugar monitor, reads books, does her shopping, uses as a magnifier, and stays in contact with friends and family. She is also using an OCR digital magnification device to maintain her own records and bookkeeping. With a bit more cane travel and daily living skills she is a great help to her daughter and still produces and loves her crafts.

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

Funding will probably always be the most problematic area. Nebraska is minimally funded and sometimes we've had to cut counselor time, programs or items we can provide because we have to stretch the budget. If we could get additional funding through state or federal means we would be able to have a much fuller program for our older clients. Counselor focus on transition, and employment is very important but that is leaving a growing number of older Nebraskans without the training and guidance that can help them remain independent and in their own homes. Based on the 2010 Census and the 2014 American Community Survey, Nebraska is projected to have 22,517 individuals 55 and older who will experience significant vision loss by 2020. We really need help funding the types of services this group needs.

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 byCarol Jenkins
TitleDeputy Director
Telephone402-440-8120
Date signed12/18/2018