Georgia Vocational Rehabilitation Agency · · 2017-06-01Georgia Vocational Rehabilitation Agency...
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Georgia Vocational Rehabilitation Agency Project Independence: Georgia Vision Program for Seniors Title VII-Chapter 2 Program Evaluation Report Federal Fiscal Year 2016
Transcript of Georgia Vocational Rehabilitation Agency · · 2017-06-01Georgia Vocational Rehabilitation Agency...
Georgia Vocational Rehabilitation Agency
Project Independence: Georgia Vision Program for Seniors
Title VII-Chapter 2 Program Evaluation Report
Federal Fiscal Year 2016
Project Independence
Georgia Vision Program for Seniors
Title VII – Chapter 2 Program Evaluation Report
Federal Fiscal Year 2016
Prepared by:
Karla B. Antonelli, Ph.D. Anne Steverson, M.S.
Don Golembiewski, M.Ed.
The National Research and Training Center on Blindness and Low Vision Mississippi State University
P.O. Box 6189 Mississippi State, MS 39762
www.blind.msstate.edu
Mississippi State University does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information,
sexual orientation, group affiliation, or veteran status.
Table of Contents
INTRODUCTION ............................................................................................................. 1
Background ................................................................................................................. 1
Population and Prevalence Rates Estimates ............................................................... 3
Project Independence Service Delivery Model ............................................................ 4
Purpose and Organization of Report ........................................................................... 7
METHOD ......................................................................................................................... 9
Instruments .................................................................................................................. 9
Procedures ................................................................................................................ 11
RESULTS ...................................................................................................................... 12
I. Annual 7-OB Report .............................................................................................. 12
II. Interviews with Consumers (Program Participant Survey) ..................................... 19
III: Site Visits ............................................................................................................. 42
IV: Project Independence Contractor Meetings ........................................................ 44
Demographics All Consumers Served (7-OB report) ................................................. 45
Satisfaction/Outcome Data (Program Participant Survey) ......................................... 46
RECOMMENDATIONS, COMMENDATIONS, & CONCLUSIONS ............................... 50
REFERENCES .............................................................................................................. 59
Appendix A: ................................................................................................................... 61
Appendix B: ................................................................................................................... 73
Appendix C: ................................................................................................................. 113
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State of Georgia
Program Evaluation Report
FFY 2016
Project Independence Georgia Vision Program for Seniors
Title VII - Chapter 2
INTRODUCTION
Background
The Georgia Vocational Rehabilitation Agency (GVRA) is the designated
state agency that provides rehabilitation services for individuals with disabilities,
including those with visual impairments. (Previous to July 1, 2012, GVRA was
housed in the Georgia Department of Labor.) GVRA receives funding under Title
VII, Chapter 2 of the Rehabilitation Act of 1973, as amended, to provide
independent living (IL) services to blind and visually impaired individuals 55 and
older in the state of Georgia. Administered by the Rehabilitation Services
Administration (RSA) in the U.S. Department of Education, Title VII, Chapter 2
program funding is provided to state-federal vocational rehabilitation (VR)
agencies to support IL services to persons age 55 or older whose severe visual
impairment makes competitive employment difficult to obtain but for whom IL
goals are feasible. Within GVRA, Project Independence: Georgia Vision Program
for Seniors, also referred to as the Older Blind Program (OBP), provides these
services. In federal fiscal year (FFY) 1995, the Project Independence program
first received 7-OB funding in the amount of $250,000 to serve approximately
250 consumers. It is now one of the largest in the country with an annual budget
of approximately $845,000 in FFY 2016 and serving approximately 1,400
consumers annually. A brief history of independent living services to older blind
individuals in the U.S. follows.
Federal funding for blindness-specific IL services under the civilian VR
program was first authorized under the Rehabilitation Act of 1973. This allowed
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state VR agencies to conduct 3-year demonstration projects for purposes of
providing IL services to older blind persons (American Foundation for the Blind,
1999). In response to the success of these early projects, the 1978 Rehabilitation
Act Amendments to Title VII - Part C (now Title VII - Chapter 2) authorized
discretionary grants to state VR programs to provide IL services for individuals
age 55 or older who are blind or visually impaired. Funding for these services did
not begin until congressional appropriations were allocated in 1986.
Subsequently, state VR agencies were invited to compete for available dollars,
and in 1989, 28 IL programs were funded (Stephens, 1998).
In FFY 2000, the Chapter 2 Older Blind program reached a major
milestone when it was funded at $15 million (a 34% increase) and was thus
moved from a discretionary grant program to a formula grant program. (The
Rehabilitation Act of 1973, as amended, provides for formula grants in any fiscal
year for which the amount appropriated under section 753 is equal to or greater
than $13 million.) These formula grants assure that all states, the District of
Columbia, and the Commonwealth of Puerto Rico receive a minimum award of
$225,000. Guam, American Samoa, the United States Virgin Islands, and the
Commonwealth of the Northern Mariana Islands are assured a minimum
allotment of $40,000. Specific allotments are based on the greater of (a) the
minimum allotment or (b) a percentage of the total amount appropriated under
section 753. This percentage is computed by dividing the number of individuals
55 and older residing in the state by the number of individuals 55 and older living
in the United States (Rehabilitation Act Amendments of 1998).
The overall purpose of the Title VII, Chapter 2 program is to provide IL
services to individuals who are age 55 and older whose significant visual
impairment makes competitive employment extremely difficult to attain but for
whom independent living goals are feasible. IL programs are established in all 50
states, the District of Columbia, and the territories. These programs help older
blind persons adjust to blindness and to live more independently in their homes
and communities.
Under federal regulations (Rehabilitation Act of 1973, as amended, Rule,
7-1-99), IL services for older individuals for purposes of subsection (d)(1) include-
1. services to help correct blindness, such as—
A. outreach services;
B. visual screening;
C. surgical or therapeutic treatment to prevent, correct, or modify disabling
eye conditions; and
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D. hospitalization related to such services;
2. the provision of eyeglasses and other visual aids;
3. the provision of services and equipment to assist an older individual who is
blind to become more mobile and more self-sufficient;
4. mobility training, braille instruction, and other services and equipment to help
an older individual who is blind adjust to blindness;
5. guide services, reader services, and transportation;
6. any other appropriate service designed to assist an older individual who is
blind in coping with daily living activities, including supportive services and
rehabilitation teaching services;
7. independent living skills training, information and referral services, peer
counseling, and individual advocacy; and
8. other independent living services.
State IL programs generally provide blindness-specific services, such as
training in orientation and mobility, communications, and daily living skills;
purchase of assistive aids and devices; provision of low vision services; peer and
family counseling; and community integration services.
Population and Prevalence Rates Estimates
Population estimates from the U.S. Census Bureau (2016) indicate that
there are approximately 2,268,400 individuals age 55 and above in Georgia,
145,789 of whom are visually impaired. The American Community Survey
collects prevalence rates on visual impairment among individuals and reports
numbers by ethnicities, but only distinguishes among the ages of 18 through 65
and 65 and older. As a result, prevalence estimates by ethnicity could not be
obtained for ages 55 and above; estimated rates and numbers for individuals 65
and above are reported in Table 1 (Erickson & von Schrader, 2017). The overall
prevalence rate of visual impairment is higher for individuals age 65 and older
residing in Georgia compared with the overall rate in the U.S. population. This
higher rate may be due to differences in socioeconomic factors and higher
incidence of blindness among minority groups in comparison to white people.
Rate of visual impairment for Georgians age 65 and above across all races
regardless of ethnicity is 8.2%, compared with 6.4% for individuals nationwide.
This higher rate of visual impairment for Georgians is also true for white people
(7.4% vs. 5.8%) and black or African American people (11.0% vs. 9.0% U.S.).
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The state prevalence rates and numbers for American Indian or Alaska Natives
with visual impairments are not included because the small sample size of this
minority group results in a large margin of error relative to the estimate.
Table 1: Georgia and U.S. Prevalence Rates of Visual Impairment
by Race/Ethnicity, Age 65 & Above, 2015 ACS
Race/Ethnicity Georgia U.S % Number %
White, non-Hispanic/Latino 7.4% 67,900 5.8%
Black or African American, non-Hispanic/Latino
11.0% 30,200 9.0%
American Indian or Alaska Native, non-Hispanic/Latino*
11.8%
Asian, non-Hispanic/Latino 4.1% 1,200 5.1%
Other, non-Hispanic/Latino 10.4% 1,100 8.9%
Hispanic/Latino, any race 8.0% 2,300 9.6%
Total, all races/ethnicity 8.2% 103,300 6.4%
*Margin of Error relative to sample size precludes making reliable estimates of percentages and
numbers.
Project Independence Service Delivery Model
To be eligible for Project Independence services, a person must be 55
years of age or older and have a visual acuity of 20/70 or worse with best
correction in the better eye, or significant field restriction or a significant
functional visual impairment that impacts independent daily living activities. This
includes a senior with a dual sensory loss, i.e. deaf-blindness, and any other
disability in addition to vision loss. Documentation of vision impairment from an
ophthalmologist or optometrist is required for eligibility, except for someone who
has little light perception or no light perception, in which case a certified blind
rehabilitation professional can attest for program eligibility.
The primary goal of the program is to facilitate the acquisition and
maintenance of IL skills that allow individuals with visual impairments to carry out
activities of daily living. Individuals who participate in the program are among a
growing number of Americans with access to IL programs designed to assist and
empower them to maintain independent lives regardless of vision loss. The
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program is designed to assist older persons who are blind and visually impaired
to age in place – to continue to live in their own homes and communities.
State agency staffing. GVRA employs a part-time (approximately 3 days
per week) Program Manager to oversee Project Independence. The current
Manager had previously retired from the agency with considerable experience in
administration of blindness rehabilitation and independent living programs. She
has served as Program Manager since January 2010. Although part-time, the
Program Manager's sole responsibility is overall management of Project
Independence. The program has benefited from her attention to overall and day-
to-day activities. The OIB Program Manager consults closely with the MSU
Project Director in developing policies and procedures to enhance the statewide
program.
Service providers. The state agency contracts with six direct service
agencies to provide independent living services to older individuals throughout
the state. These contracted agencies include:
Center for the Visually Impaired (CVI), serving Northeast and Central
Georgia;
Vision Rehabilitation Services (VRS) of Georgia, serving Northwest
Georgia;
Visually Impaired Foundation of Georgia (VIFGA), serving Southwest
Georgia;
Savannah Center for Blind and Low Vision (SCBLV), serving Southeast
Georgia;
Walton Options (WO) for Independent Living, serving East Georgia
Visually Impaired Specialized Training and Advocacy Services (VISTAS),
serving Northeast Georgia.
Each of the six contractors utilize a wide variety of professionals representing
many disciplines. These include Certified Vision Rehabilitation Therapists
(CVRT), Certified Orientation and Mobility (O&M) specialists, low vision
specialists/coordinators (including optometrists), assistive technology specialists,
etc. Other professionals are utilized as needed to obtain specialty examinations
or specific services needed for individual clients.
Contractors provide a number of services to assist eligible consumers to
maximize their functional independence. Examples of services include:
Skills training in the home community by certified rehabilitation specialists so seniors can keep on doing the daily tasks they like and stay active
Mobility training by certified instructors so seniors can travel safely
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Support groups that offer opportunities so seniors can learn from and interact with peers who also have visual loss
Comprehensive low vision evaluations by qualified professionals to assess practical and useful ways to access information with magnification
Assistive aids/devices such as talking watches and clocks, lighting, big button phones, various household and kitchen aids
The provision of comprehensive IL services enables consumers to better
access relevant community resources and services, and thus, enhances their
capacities to remain in their homes and communities with maximum self-direction
and, in some cases, assists in avoiding premature and unnecessary moves to
assisted living facilities or nursing home placements.
Table 2 shows the number of individuals served by the six Project
Independence contractors during the last eight fiscal years. The number of
individuals served has held relatively steady for the past four years.
Table 2: Number of Consumers Served
IL Contractor 2009 2010 2011 2012 2013 2014 2015 2016
CVI 303 327 432 739 693 667 570 670
VRS 226 220 278 232 191 228 226 310
VIFGA 240 227 315 314 239 264 299 248
Savannah 100 118 133 135 100 77 121 105
Walton Options 78 91 76 109 112 117 72 62
VISTAS 45 43 80 77 83 37 56 65
TOTAL 992 1,026 1,314 1,606 1,418 1,390 1,344 1,460
Outreach and collaborative activities. In addition to the six main service providers, GVRA worked with The Helen Keller National Center; Georgia Radio Reading Services; National Federation of the Blind of Georgia; Georgia Council of the Blind; Business Enterprise Program; Native American Representative and the Business Enterprise Program; the Georgia Statewide Independent Living Council, the Georgia Vision Collaborative, Alternative Media Access Center (AMAC) Accessibility Solutions, Georgia Institute of Technology, College of Architecture; Vocational Rehabilitation, the Georgia Library for Accessible Services, the Older Driver’s Task Force, the Division of Aging Services, the
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Georgia Gerontology Society and the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults.
Outreach and collaborative activities with these entities and activities
implemented by the six contractors are detailed in the narrative section of FFY
2016 7-OB report submitted to RSA (see Appendix C).
Purpose and Organization of Report
The purpose of this evaluation report is to review the Project
Independence Program in relation to how well services have enabled consumers
to meet their goals for independence during FFY 2016 (October 1, 2015 through
September 30, 2016). Further, evaluation data is used to identify and implement
evidenced-based policies and interventions resulting in increased quality of IL
services delivered to consumers. The external evaluation process included the
following major activities:
implementation of external evaluation activities, including review and
revision of the primary data collection instrument (Program Participant
Survey);
analysis and interpretation of secondary data including consumer disability,
demographic, and service data from the annual RSA 7-OB report to
identify statewide consumer characteristics and trends within the
population served;
collection, analysis, and interpretation of responses from program
participants regarding their functioning on independent living tasks and the
service delivery process;
compilation of information from participation in contractor meetings and
from on-site reviews of service delivery contractors; and
preparation of the program evaluation report.
In addition to this introductory section, this report includes method, results,
summary/discussion, and recommendations/conclusion sections. The method
section provides information regarding selection of study participants,
instruments used for collection of service, satisfaction, and outcome data,
procedures used to collect data, and the techniques used for data analysis. The
results section provides aggregate data on consumer demographics for all
consumers served by the program in FFY 2016. Also included are consumer
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demographics and findings regarding consumer functioning on specific IL tasks
or domains for a sample of consumers closed during FFY 2016. Demographic
data elements include age, gender, race, living arrangement, reported eye
conditions, and reported other health conditions. Information from site visits to
two contractors is also reported in the results section. The summary section
includes a brief review of evaluation data. The final section provides a list of
program recommendations and conclusions.
The National Research and Training Center (NRTC) on Blindness and Low
Vision at Mississippi State University staff assigned to this project include Dr.
Karla B. Antonelli, Postdoctoral Associate and Project Director; Ms. Anne
Steverson, Research Associate II; and Mr. Don Golembiewski, External
Consultant, and administrative support staff.
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METHOD
This study used a mixed-method research design to collect program
evaluation information from a variety of sources. Information from the
Independent Living Services 7-OB annual report for FFY 2016 was used to
describe demographic and disability characteristics of all consumers receiving
Title VII - Chapter 2 services in Georgia. In addition, the Program Participant
Survey (see Appendix A) was used to collect demographic, satisfaction, and
outcome data from consumers closed by the Project Independence program in
FY 2016. These sources of data are further described in the “Instruments”
subsection below. Finally, the MSU external consultant conducted an on-site
review of two service delivery contractors to supplement program information.
Instruments
Annual 7-OB Report. All state IL programs receiving Title VII - Chapter 2
funding must submit a completed 7-OB report to RSA approximately three
months after the close of each fiscal year. Information reported on the 7-OB
includes funding sources and amounts, staff composition and numbers, and
consumer demographic, disability, services, and outcome data. Demographic
and disability data from the Georgia FFY 2016 7-OB report are summarized in
this report, and when appropriate, aggregate demographic data are compared to
similar data from the Program Participant Survey.
Program Participant Survey. The Program Participant Survey (see
Appendix A) was administered to determine the degree to which Project
Independence consumers were satisfied with their program of independent living
services and the extent to which they perceived that their level of functioning
improved in various activities of daily living. The survey was developed by NRTC
on Blindness and Low Vision staff in consultation with the state agency
administrative staff and contractor administrative and service delivery staff. The
goal was to develop a consumer-friendly survey that would assess consumers'
satisfaction with services and the impact of services on their independent living
functioning. NRTC interviewers completed 279 surveys. The Program Participant
Survey was divided into four sections, which focused on the following areas of
inquiry:
The first section contained three questions which quantified respondents’
level of agreement with statements related to the manner in which services
were delivered (i.e., timeliness of services; attentiveness, concern, and
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interest of staff; and overall quality of services). A five-point Likert-type
scale (strongly agree, agree, neutral, disagree, strongly disagree) was
used to assess the level of agreement. Respondents were also provided
opportunity to comment on each item.
The second section contained four multi-part questions which focused on
broad service areas typically provided by the Project Independence
Program (i.e., orientation and mobility, assistive technology,
communication skills, and other activities of daily living). The OIB program
must report outcome data on these four services in its annual RSA-7-OB
report. Respondents were first asked if they had received each service,
and if they had not, was this a service they would have liked to receive. If
respondents indicated that they would have liked to receive a service, they
were asked whether this service was recommended to them by their
service provider. Respondents indicating they had received a service were
asked to provide feedback regarding their functioning (i.e., service had
resulted in improved functioning, maintenance of functioning, or loss of
functioning) and their satisfaction with each service (very satisfied,
satisfied, neutral, unsatisfied, and very unsatisfied). Again, respondents
were invited to comment on questions. Note that participants may not have
received all four services, given that IL plans are individually developed to
address consumers' particular needs and interests.
In the third section, respondents were asked how services may have
helped them maintain their current living situations; what other services
they needed to become more independent in their home and community;
and if they needed services, whether they knew how to contact their
service provider. The telephone interviewer was instructed to provide
respondents with providers’ contact information, as appropriate. In two
open-ended questions, respondents were asked "In your opinion, what
was the greatest difference this program has made in your life?" and “How
could your experience have been improved?”
The last section included questions related to respondents' demographic
and disability characteristics. Included were questions regarding age,
gender, living situation, reason for visual impairment, presence of hearing
loss, and race/ethnicity. Finally, respondents were asked if they had
experienced any life-style changes in the last few months that had resulted
in their becoming less independent.
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Procedures
Contact information on all cases closed by Project Independence
contractors was requested quarterly. Telephone interviews of consumers were
conducted by the NRTC interviewer beginning the second quarter and continued
until early January 2017. Attempts were made to contact each consumer on at
least three occasions. The telephone survey was reviewed and exempted from
oversight by the Institutional Review Board (IRB) for the protection of human
subjects at Mississippi State University. The Project Independence Program
Manager completed the RSA 7-OB report at the close of the fiscal year and
provided MSU staff with a copy to use in writing the annual evaluation report. Site
visits to two contractors were made in July of 2016.
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RESULTS
Findings from four major data sources--the program's RSA-7-OB report,
telephone interviews with program participants, on-site reviews of two of the six
service contractors, and participation in joint meetings with contractors--are
included in the results section.
I. Annual 7-OB Report
Consumer demographics. During FFY 2016 (October 1, 2015 through
September 30, 2016), 1,460 individuals were served by the Georgia Project
Independence program. Fifty-eight percent (n = 840) of consumers were age 75
and over. Most were female (63%, n = 918). Consumers were asked to self-
report their race and ethnicity. The majority of consumers reported being white,
not Hispanic/Latino (65%, n = 942) or black/African American, not
Hispanic/Latino (29%, n = 419). Approximately 7% reported being other races or
ethnic groups or race unknown: American Indian/Alaska Native, not
Hispanic/Latino (n = 27), Hispanic/Latino of any race (n = 24), Asian, not
Hispanic/Latino (n = 16), two or more races (n = 2), or unknown (n = 29). The
vast majority of consumers lived in private residences (n = 1,297, 89%); 97
consumers (7%) lived in senior living/retirement community settings, 49 (3%) in
assisted living facilities, and 14 (1%) in nursing homes or long-term care facilities.
Approximately 48% (n = 700) were legally blind (includes totally blind), and
the leading cause of visual impairment was macular degeneration (45%, n =
650). Consumers also reported having a number of other age-related
impairments/health conditions. The number one condition was cardiovascular-
related issues and strokes (50%); followed by hearing impairment (35%);
diabetes (28%); and bone, muscle, skin, joint, and movement (20%).
Demographic and disability information on all consumers served by the
Project Independence contractors are provided in the following figures. Please
note that due to rounding or when multiple responses were allowed, percentages
may not add up to exactly 100%.
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55-6421.6%
65-7420.9%
75-8426.0%
85+31.5%
Consumers by Age
Female62.9%
Male37.1%
Gender
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White64.5%
Black28.7%
Other6.8%
Race/Ethnicity
Private Home89.0%
Senior Living Community
6.6%
Assisted Living3.4%
Nursing Home1.0%
Type of Residence
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Totally Blind4.8%
Legally Blind43.2%
Visually Impaired
52.1%
Degree of Visual Impairment
Macular Degeneration
44.5%
Diabetic Retinopathy
9.1%
Glaucoma18.9%
Cataracts4.2%
Other 23.3%
Major Cause of Visual Impairment
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Figure 7 presents the number of consumers reporting health conditions in
addition to visual impairment. The most frequently reported nonvisual conditions
were cardiovascular-related issues and strokes (n = 727, 50%); hearing
impairment (n = 507, 35%); diabetes (n = 408, 28%); bone, muscle, skin, joint,
and movement disorders (n = 291, 20%); cancer (n = 74, 5%); depression and
mood (n = 42, 3%); and Alzheimer’s/cognitive (n = 33, 2%). Twenty percent (n =
294) of consumers had age-related health conditions not included in the major
categories on the RSA 7-OB.
Source of referral. The primary source of referral of consumers (n = 913,
63%) was an eye care provider, followed by family member of friend (n = 156,
11%); other sources not specified in the 7-OB (n = 143, 10%); and self-referral (n
= 71, 5%).
Staffing. Program FTE positions reported in the FFY 2016 7-OB report
included 8.10 administrative and support staff and 15.99 direct service staff for a
total of 24.09 FTEs. These numbers included 0.60 administrative and support
staff from the Georgia state agency.
49.8%
34.7%
27.9%
19.9%
5.1%
2.9%
2.3%
20.1%
0% 20% 40% 60% 80% 100%
Cardiovascular/Strokes
Hearing Impairment
Diabetes
Bone, Muscle, Skin,…
Cancer
Depression/Mood
Alzheimer's/Cognitive
Other
Non-Visual Health Conditions
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Funding. For FFY 2016, total federal grant money available was
$845,343. The program expended $950,679: $856,663 from Title VII-Chapter 2
monies and $94,016 from state monies. Of the total, $67,851 (7.1%) was
expended for administrative, support staff, and general overhead costs.
Services. Table 3 lists types of services and number and percentages of
consumers receiving each service for FFY 2016. A total of 1,460 consumers
(non-duplicated count) served received one or more of the following services. In
comparison, 1,344 consumers received one or more of these services in FFY
2015.
Table 3: Services by Number and Percentage
Number Percentage
Clinical/functional vision assessment and services
Vision screening 976 66.8% Surgical or therapeutic treatment 24 1.6% Assistive technology devices and services
Provision of assistive technology devices/aids 566 38.8% Provision of assistive technology services 927 63.5% Independent living and adjustment training and services
Orientation and Mobility training 215 14.7% Communication skills 928 63.6% Daily living skills 307 21.0% Supportive services 21 1.4% Advocacy training and support networks 232 15.9% Counseling 438 30.0% Information, referral and community integration 1,404 96.2% Other IL services 27 1.8%
Program outcomes/performance measures. Data on the number of
individuals served in FFY 2016 who gained or maintained functioning in key
independent living outcome areas by the time of their closure are reported in the
following bullets. Note that IL functioning is measured when consumers' cases
are closed from the Project Independence program and that a large number of
consumers would still be receiving services at the close of the reporting period.
Of the 927 consumers receiving assistive technology services, 777 (84%)
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either maintained or improved functional abilities that were previously lost
or diminished as a result of vision loss. Functioning had not been
determined for 55 individuals (6%) (open cases still receiving services).
Of the 215 consumers receiving O&M services, 173 (75%) either gained or
maintained their ability to travel safely and independently in their residence
and/or community environment as a result of services. Functioning had not
been determined for 31 individuals (14%) (open cases still receiving
services).
Of the 928 consumers receiving services communication skills training, 697 (75%) either gained or maintained their functional abilities as a result
of services received. Functioning had not been determined for 151
individuals (16%) (open cases still receiving services).
Of the 307 consumers receiving services daily living skills training, 205
(67%) either gained or maintained their functional abilities as a result of
services received. Functioning had not been determined for 125 individuals
(41%) (open cases still receiving services).
Overall, 139 consumers reported that they are more in control and more confident as a result of receiving services. Twenty-two consumers reported less control and confidence, and 70 individuals reported no change in their feelings of control or confidence after receiving services.
Thirty consumers reported experiencing changes in lifestyle for reasons unrelated to vision loss, and 47 individuals died before achieving functional gain or experiencing changes in lifestyle as a result of services they received.
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II. Interviews with Consumers (Program Participant Survey)
Project Independence service delivery contractors were requested to
provide contact information for consumers closed from services at the end of
each quarter and at closure, and to alert consumers that an interviewer from
Mississippi State University (MSU) would be calling them regarding services they
had received. Names and telephone numbers for 977 consumers were provided
to NRTC project staff during the fiscal year and through December 2016. All
telephone interviews with consumers were completed by early January 2017.
Attempts were made to contact each consumer on at least three occasions.
Telephone calls were made at different times of the day and on weekends. A
subset of 536 of the 977 consumer names received were selected for contact,
based on contract hours available to complete consumer surveys and the relative
percentages of consumers served per agency. The interviewer was able to speak
to 314 individuals, 305 of whom were viable participants (excluding those
consumers who were deceased); 279 individuals consented to the interview,
yielding a 91% response rate among those individuals contacted.
Table 4 lists, by Project Independence service delivery contractor, the
number of consumers served, names received from closed cases, number of
consumers contacted, and completed interviews with consumers for FFY 2016.
Table 4: Consumers Served, Contacted, and Interviewed
IL Contractor Consumers
Served
No. of Contacts Received
No. Contacted
No. of Contacts
Interviewed
CVI 670 556 137 123
VRS 310 125 30 27
VIFGA 248 204 108 96
Savannah 105 68 25 19
Walton Options 62 5 3 3
VISTAS 65 19 11 11
TOTAL 1,460 977 314 279
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Data on demographic and disability characteristics of survey participants
and their perceptions regarding the manner in which services were provided,
their satisfaction with specific services, and the impact of services on their
functioning are provided in the following figures and narrative. Please note that
due to rounding or when multiple responses were allowed, percentages may not
add up to exactly 100%.
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Demographic and Disability Characteristics
Age. Of the survey respondents who reported their age, consumers ranged
from 55 to 98 years of age. Almost 20 percent of respondents were between 55
and 64 years old; approximately 21% were between 65 and 74 years old. Thirty-
one percent were between the ages of 75 and 84, and 28% of responding
participants were 85 years old or older. Two participants chose not to disclose
their age in the survey. This data compares well with Georgia’s 7-OB Report
data, with percentages in age categories of consumers interviewed fairly well
matched to age categories of those served.
55-6419.9%
65-7420.9%
75-8431.0%
85+28.2%
Age
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Gender. Approximately 36% of survey respondents were males and 64%
were females. Four respondents did not provide their gender in the survey. Data
from the annual 7-OB report indicated that 63% of consumers served during the
fiscal year were female, for only an approximate 1% difference between the
percent of females interviewed and the percent of females actually served during
the fiscal year. This data compares well with Georgia’s 7-OB Report data, with
interviewed percentages of consumers by gender fairly well matched to gender
percentages of those served.
Male36.0%
Female64.0%
Gender
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Living arrangement. Eighty-five percent of the consumers who responded
to the question of living arrangements (n=235) indicated they live in a private
residence (e.g., house or apartment). Additionally, approximately 11% of
respondents indicated they lived in a senior living/retirement community. Two
percent indicated they lived in an assisted living facility. Two participants (less
than 1%) indicated that they resided in a nursing home or long-term care facility.
Two participants (less than 1%) indicated that they had other living
arrangements. Three respondents did not provide living arrangement information.
Senior Living/ Retirement Community
11.2%
Private Residence
85.1%
Assisted Living Facility
2.2%
Nursing Home/Long-Term Care
0.7%
Other
0.7%
Living Arrangement
24
Primary cause of vision loss. The most frequently reported primary cause
of vision loss among survey respondents was macular degeneration at 54%. This
finding is not surprising, given that macular degeneration is the leading cause of
vision impairment among older persons in the United States (Lighthouse
International, 2016). Other causes of vision loss indicated by respondents were
glaucoma, 15%; diabetic retinopathy, 9%; cataracts, 6%; and retinitis
pigmentosa, 4%. Seventeen percent of respondents reported other or additional
causes for their vision loss.
53.6%
15.2%
8.7%
6.2%
4.0%
17.0%
0% 10% 20% 30% 40% 50% 60%
Macular Degeneration
Glaucoma
Diabetic Retinopathy
Cataracts
Retinitis Pigmentosa
Other
Cause of Vision Loss
25
Non-visual health conditions. Seventy-three (26%) of the survey
respondents reported having one medical condition in addition to vision loss; 67
(24%) reported two additional medical conditions; and 60 (22%) reported three
additional medical conditions. Nineteen respondents (7%) reported no additional
medical conditions, and the remaining respondents reported having four or more
additional medical conditions. Fifty-four percent of individuals responding
reported having musculoskeletal problems; 48% indicated hearing impairment;
and 36% indicated cardiovascular-related issues. Other impairments were
reported as follows: diabetes, over 33%; depression/mood problem, 26%;
cancer, 15%; and Alzheimer's/cognitive change, 9%. Eighteen percent reported
having some “other” health condition. Note that these percentages for rates of
non-visual health conditions are much higher than those indicated in the 7-OB
data, for most categories. Possible reasons for this difference in percentages
between survey results and 7-OB data include that it could be characteristics of
the survey sample, or an indication that methods of inquiry about non-visual
health conditions for 7-OB data may not be adequately capturing this information
(i.e., consumers may need to be specifically asked about each condition, as is
done in the survey, for more accurate reports).
54.1%
48.0%
35.5%
33.7%
25.8%
15.1%
9.3%
17.9%
0% 10% 20% 30% 40% 50% 60%
Bone/Muscle/Skin/Joint/Movement
Hearing Impairment
Cardiovascular/Stroke
Diabetes
Depression/Mood
Cancer
Alzheimer's/Cognitive
Other
Other Health Conditions
26
Prevalence of hearing loss. When asked specifically about hearing loss,
50.4% (n = 137) of those responding indicated that they had experienced some
degree of hearing loss. Seven respondents did not provide information about
whether they had hearing loss. Among those respondents reporting hearing loss,
28.5% rated the loss as mild, 34.3% rated the loss as moderate, and 37.2% rated
the loss as severe.
50.4% 49.6%
0%
20%
40%
60%
80%
100%
Yes No
Hearing Loss
27
Race and ethnic background. The majority (70%; n = 194) of the 276
participants who responded to the survey question on race indicated that they
were white, and 24% (n = 66) reported as black or African American. Of the
remaining respondents, four (1%) indicated American Indian or Alaskan Native,
three reported Hispanic/Latino, one reported Asian, and four identified as being
of two or more races. Four were recorded as race and ethnicity unknown.
70.3%
23.9%
1.4%
1.1%
0.4%
1.4%
1.4%
0% 20% 40% 60% 80%
White
Black or African American
American Indian/Alaska Native
Hispanic/Latino of Any Race
Asian
Two or More Races
Race/Ethnicity Unknown
Race
28
Changes in living situation. Of the 269 individuals responding, thirty-four
(13%) indicated that they had recently experienced a change in living situation.
Of those respondents providing details, one reported having moved to a
retirement community for health concerns, six had moved to a new private
residence, and two moved in with family members. Four experienced a change in
the status of their previous caregiver, for reasons including illness, death, and
separation. Although not directly related to living situation, 14 respondents
indicated a change in medical/health issues, 2 indicated worsened eyesight, and
8 indicated no longer driving as having decreased their ability to live
independently.
12.6%
87.4%
0%
20%
40%
60%
80%
100%
Yes No
Changes in Living Situation
29
Manner in Which Services Were Provided
Respondents were asked three questions regarding the manner in which
services were provided: timeliness of services, concern and interest of the
service provider, and quality of the program. Respondents indicating
dissatisfaction with services were asked to provide further comment. A listing of
all comments is included in Appendix B.
Services were provided in a timely manner.
Participants were asked to rate their level of agreement with the above
statement. Responses to this query were quite positive: 63% of the 278
respondents strongly agreed that services were provided in a timely manner, with
an additional 33% generally agreeing. Six respondents neither agreed nor
disagreed that services were provided in a timely manner. Nine respondents
provided feedback on being neutral or dissatisfied: Seven indicated a long wait
for an initial appointment or contact back, with one citing known personnel
changes. Four indicated there was too long a wait on equipment or training
services. Only six respondents either disagreed or strongly disagreed.
62.6%
33.1%
2.2% 1.1% 1.1%0%
20%
40%
60%
80%
100%
StronglyAgree
Agree Neutral Disagree StronglyDisagree
Timeliness
30
Staff were attentive, concerned, and interested in my well-being.
Participants were asked to rate their level of agreement with the above
statement. Seventy-six percent of the 278 respondents strongly agreed that staff
were attentive, concerned, and interested in their well-being, with an additional
22% who generally agreed.
Four respondents disagreed with the above statement and an additional
two respondents neither agreed nor disagreed. One respondent reported feeling
that the staff were focused on selling products, one indicated they did not receive
new or helpful service, and another reported feeling the staff were disinterested.
75.5%
22.3%
0.7% 1.4% 0.0%0%
20%
40%
60%
80%
100%
StronglyAgree
Agree Neutral Disagree StronglyDisagree
Concerned and Interested
31
How satisfied were you with the quality of the services you received?
Participants were asked to rate their level of satisfaction with the quality of
services received. Almost 59% of the respondents were strongly satisfied with
the quality of services provided by the program, and 33% were generally
satisfied. Ten respondents were neither satisfied nor dissatisfied. Nine
respondents were dissatisfied and four were strongly dissatisfied. Comments
from respondents indicating dissatisfaction with services suggested that the
services were not thorough enough, or did not adequately correct issues. Issues
of lack of timeliness and efforts by staff to have respondents purchase products
appeared in these responses as well. Again, all comments are provided in
Appendix B.
58.6%
33.1%
3.6% 3.2% 1.4%0%
20%
40%
60%
80%
100%
StronglySatisfied
Satisfied Neutral Dissatisfied StronglyDissatisfied
Quality of Services
32
Functioning and Satisfaction with Services
Consumers were asked to provide feedback regarding their experiences in
receiving services in four broad areas: orientation and mobility/travel, assistive
technology, communication skills, and daily living skills.
Participants were first asked whether they had received services to help
them travel more safely and efficiently in their home and/or community. Fifty-five
(20%) of the 278 respondents to this question stated that they had received
these services. Eight (4%) respondents who had not received travel services
indicated that they would have liked to have received these services as part of
their program. Comments regarding why they did not receive these services
indicated generally either that they did not ask for or discuss it with the provider,
or that they were still awaiting these services. One respondent indicated having
been unaware that this was an offered service.
Regarding those participants who had received services, 67% (n = 37)
reported that they were now better able to travel independently in their home
and/or community; 31% (n = 17) had maintained their ability; and 1.8% (n = 1)
was less able to travel independently. The respondent who was less able to
travel independently indicated worsening vision as the reason.
67.3%
30.9%
1.8%0%
20%
40%
60%
80%
100%
Better Able Maintained Ability Less Able
Travel Functioning
33
Travel Services: 95% satisfaction rate!
Respondents who had received travel services were also asked their level
of satisfaction with services. Fifty-six percent (n = 31) indicated that they were
very satisfied with the services they had received. Thirty-eight percent (n = 21)
were generally satisfied. One respondent was neither satisfied nor unsatisfied,
and two respondents were unsatisfied with this service. Those respondents who
were unsatisfied indicated needing more service, and feeling that the sale of
equipment was the focus of services.
56.4%
38.2%
1.8% 3.6%0.0%
0%
20%
40%
60%
80%
100%
VerySatisfied
Satisfied Neutral Unsatisfied VeryUnsatisfied
Satisfaction with Travel Services
34
Participants were asked whether they had received or had purchased
devices or equipment (e.g., canes, insulin gauges, magnifiers, bump dots,
adaptive cooking items, writing guides, large button telephones) to help them
function more independently. Two hundred and thirty-six (85%) of the 277
respondents to this question stated that they had received or purchased some
sort of device or equipment through the program. Four (10%) of the respondents
who had not received devices indicated that they would have liked to receive this
service as part of their program. Comments regarding not receiving devices or
equipment included still awaiting this service, not being aware of the service, and
not being able to afford it.
Regarding those participants who had received devices/equipment, 49%
(n = 116) of respondents reported that these devices and/or equipment had
improved their ability to function independently; 40% (n = 94) had maintained
their ability; 3% (n = 7) reported that the devices/equipment had neither helped
nor maintained; and 8% (n = 19) reported that they were not using any of the
devices/equipment attained through their program. Examples of reasons why
respondents were not using devices/equipment included continued or worsening
eyesight that made the equipment/device ineffective, equipment/devices that
were not well designed or difficult to use (e.g., large magnifiers), and one report
of having lost the glasses received.
49.2%
39.8%
3.0%8.1%
0%
20%
40%
60%
80%
100%
ImprovedAbility
HelpedMaintainAbility
Neither Helpednor Maintained
Not UsingDevices
Functioning with Devices/Equipment
35
Respondents who had received or purchased equipment or devices were
also asked their level of satisfaction with these in helping them function more
independently. Fifty-four percent (n = 127) of respondents indicated that they
were very satisfied with the services they had received. Thirty-five percent (n =
83) were generally satisfied. Fifteen respondents (6%) were neither satisfied nor
dissatisfied. Eight (3%) individuals reported being unsatisfied, and three (1%)
individuals reported being very unsatisfied. Examples of reasons for
dissatisfaction included the device/equipment not helping due to visual
impairment being too bad for it to be helpful, the device/equipment being too
cumbersome or not working well for the desired task, and one report of the
device/equipment having broken.
53.8%
35.2%
6.4% 3.4% 1.3%0%
20%
40%
60%
80%
100%
VerySatisfied
Satisfied Neutral Unsatisfied VeryUnsatisfied
Satisfaction with Devices/Equipment
36
Participants were asked whether they had received training to help them
improve their communication skills. Examples included training using magnifiers
or other magnification devices; braille instruction; keyboarding or computer
training; using the telephone; using handwriting guides; telling time; or using
readers or audio equipment. Ninety-five (34%) of the 276 respondents stated that
they had received these services. Eight (4%) of the respondents who had not
received communication skills training indicated that they would have liked to
have received this service as part of their program. Responses regarding
communication services not being received included that they did not know the
service was provided or it was not discussed, that the respondent did not ask for
it, and that the respondent assumed the provider was understaffed.
Regarding those participants who had received communication skills
instruction, 47% (n = 45) of respondents reported that they were now able to
function more independently; and 53% (n = 50) had maintained their ability to
function independently. No consumers reported being less able to function
independently.
47.4%52.6%
0.0%0%
20%
40%
60%
80%
100%
Better Able Maintained Ability Less Able
Communication Skills Functioning
37
Communication Skills Training: 96% satisfaction rate
Respondents who had received communication skills training were also
asked their level of satisfaction with services. Sixty percent (n = 57) of the 95
respondents indicated that they were very satisfied with the services they had
received. Thirty-six percent (n = 34) were generally satisfied. Three respondents
(3%) were neither satisfied nor dissatisfied, and one respondent (1%) was
unsatisfied with services in this area. The respondent who reported being
unsatisfied indicated that he or she needed more training.
60.0%
35.8%
3.2% 1.1% 0.0%0%
20%
40%
60%
80%
100%
VerySatisfied
Satisfied Neutral Unsatisfied VeryUnsatisfied
Satisfaction with Communication Skills Training
38
Participants were asked whether they had received services to help them
with their daily living activities, such as food preparation, grooming and dressing,
household chores, medical management, or shopping. Thirty-four (12%) of the
277 respondents stated that they had received these services. Seven (3%) of the
respondents who had not received services to help with daily living activities
indicated that they would have liked to receive these services as part of their
program. Feedback on not receiving this service included not having discussed
or been made aware of the service, not having asked for it, and still waiting for
the service, with one respondent commenting that the provider was looking for
staff.
Regarding those participants who had received daily living skills training,
50% (n = 17) of respondents stated that these services had enabled them to
function more independently; and 44% (n = 15) had maintained their ability. Six
percent (n = 2) stated they were less able to function independently after
receiving services. Those reporting being less able to function independently
indicated declining visual ability and declining cognitive functioning as the
reasons.
50.0%44.1%
5.9%
0%
20%
40%
60%
80%
100%
Better Able Maintained Ability Less Able
Daily Living Skills Functioning
39
Daily Living Skills Training: 97% satisfaction rate
Respondents who had received services to help with daily living activities
were also asked their level of satisfaction with services. Almost sixty percent (n =
19) of the 34 respondents indicated that they were very satisfied with the
services they had received. Forty-one percent (n = 14) were generally satisfied
and 3% (n = 1) were neither satisfied nor unsatisfied with received services. No
respondents reported being unsatisfied with these services.
55.9%
41.2%
2.9% 0.0% 0.0%0%
20%
40%
60%
80%
100%
VerySatisfied
Satisfied Neutral Unsatisfied VeryUnsatisfied
Daily Living Skills Training Satisfaction
40
General Questions Regarding Services
Consumers were asked three general questions regarding services: how
services may have helped them in maintaining their current living situation;
additional service needs; and the greatest difference services had made in their
lives.
Participants were asked how services may have helped them maintain
their current living situation. Sixty-one percent (n = 170) of the 277 individuals
responding reported that they now had greater control and confidence in their
ability to maintain their current living situation. Thirty percent (n = 83) indicated
that there had been no change in their control and confidence in their ability to
maintain their living situation. Comments regarding this response included that
vision, health, or cognitive ability had declined, that services may not have been
helpful or that they needed other or additional services, or that vision was not bad
enough to need more services. Some comments appeared to indicate that “No
Change” was equated with maintaining their level of independence. Nine percent
(n = 24) stated that they had less control and confidence in their ability to
maintain their current living situation, most often due to declining health and
vision. Other respondents indicated less control and confidence relating to lost or
ineffective equipment/devices, or being unable to work.
61.4%
30.0%
8.7%
0%
20%
40%
60%
80%
100%
Greater Control &Confidence
No Change Less Control &Confidence
Confidence in Ability to Maintain Living Situation
41
Participants were asked what other services they needed in order become
more independent in their home and community. Forty-three (15%) of the 279
respondents reported a need for services to help with hearing loss; twenty-six
(9%) indicated a need for transportation services; and twenty-six (9%) indicated a
need for computer/software training. Twenty-two (8%) individuals reported the
need for other additional services. Common areas of need included needing
devices such as magnifiers, large button phones, and large print items. Other
needs mentioned included help with independent living support such as bump
dots and improved lighting, mobility training, and Braille training. Some
respondents also mentioned needing help with in-home services such as
cleaning, chores, and meals.
Following this question, participants were asked if they knew how to
contact their service provider in the event they needed additional services.
Twenty-six respondents (9%) indicated that they did not know how to contact
their service provider. For those persons not knowing how to contact providers,
the MSU interviewer was instructed to ask participants if they would like contact
information and to provide this information, if applicable.
15.4%
9.3%
9.3%
7.9%
0% 10% 20% 30% 40% 50%
Hearing Loss
Transportation
Computer/Software
Other
Additional Service Needs
42
Survey Comments from Consumers
The telephone survey included an opportunity for respondents to provide
additional comments following any question and at the end of the interview. These
comments are included in Appendix B. Consumers of services generally provided
positive feedback regarding their IL services. Efforts were made to capture participant
comments verbatim. Some of the typical responses include the following:
It turned my life around. I couldn't see to do anything. Now I can do for
myself. I can read for myself with my big scanner.
It got me going outside more. The training with the cane motivated me.
Just knowing someone is there if I need them.
I can see and read some now. It was great to be able to read again.
I could not read my mail and it really bothered me. Now, I can fill out forms
and read my mail again.
It has given me the information that they have that has encouraged me to
go even farther to put my life in order.
It has made it easier for me to read. It is great to know that someone cares
and is willing to help.
The various techniques and the tools that are available were very
enlightening. Things they showed me that will help me along the way.
The magnifiers help me to read menus in restaurants now.
Recognition of my vision problem. I has helped me to realize what is
happening to me.
The counseling was great. They helped me to accept and how to cope.
It gave her more time to maintain her independence a little bit longer.
They were able to keep me from being totally immobilized in my house, not
being able to do anything. They were able to take me out of my fear of
going blind and to find people that were able to help me and who wanted
to help me. I am able to walk and talk and cook. They saved my life.
III: Site Visits
The MSU outside project consultant conducted two site visits/reviews for
FFY 2016. The first visit was conducted at Walton Options for Independent Living
on July 12 and 13, 2016. The second site visit took place at VISTAS Center on
July 14 and 15, 2016. The major purpose of the site visits was to gain an
understanding of the service delivery process in its entirety, from initial
application by consumers to closure of their service in the program. A detailed
43
report of the site visits was provided to the Project independence program
manager shortly after the reviews. A brief summary of each of these visits is
included below.
Walton Options for Independent Living (WO)
The site reviewer visited Walton Options on July 12 and 13, 2016. The
reviewer met with the WO Executive Director for a review of their service provision program, and with other staff to facilitate the visit. The reviewer met with the Director of Assistive Technology and the Independent Living Advocate, who described the program’s process and operations in providing services. They discussed WO’s good working relationship with local agencies on aging, from whom they receive many referrals, and their need to contract for service providers due to recent staff retirement.
The reviewer interviewed three contracted direct services providers
regarding their roles at the agency; one CVRT, one COMS/VRT, and one OTR/L, who each explained their role in the service provision process with consumers. Staff were knowledgeable and qualified for their respective roles. The reviewer met one staff member at the Low Vision Rehabilitation clinic, and was provided an overview of their low vision devices and trial items, which included modules for practicing real life experiences in grocery shopping and banking.
The site reviewer observed direct services provision of an O&M lesson and
one home visit for an initial intake. Services observed were professionally and thoroughly conducted, and appropriate referrals for additional services were made.
Nine case files were reviewed for completeness and organization, and all
were found to be current, clearly documented and complete. In particular, WO had made strides in case processing standardization, justification of services, documentation of regular contact, and current eye report records. Staff also reported their system for providing assistance with devices and equipment, which was well organized and made good use of available resources.
In summary, all staff were devoted to providing quality services in a
professional manner to older consumers who are blind. With the inclusion of contracted service providers, WO is able to offer a broad base of necessary rehabilitation services for the older blind population in their service area.
44
VISTAS Center
The site reviewer visited VISTAS Center on July 14 and 15, 2016. The reviewer met with the Program Manager and was given a thorough overview of the program. The Program Manager described the agency’s process of providing services, including contracting out for service provision due to their being a smaller agency, and described a good relationship with local referral sources.
The reviewer interviewed three contracted service providers about their
roles at the agencies and services provided, including technical support, COMS/VRT, and technology instruction. The site reviewer also observed two events of direct services provision—an O&M lesson and technology instruction—and attended a peer support group. The individual services were professional and thorough, and the peer support group was welcoming and open to varied discussions.
Ten case files were reviewed for completeness and organization, and all
were found to be in good order. Service provision for needed devices and equipment was straightforward.
VISTAS Center has a positive commitment to providing quality,
comprehensive, professional services to the older blind population in their community. Staff are professional and empathetic service providers who make a positive difference in the lives of their consumers.
IV: Project Independence Contractor Meetings
The Older Blind Program Manager for Project Independence convenes two
meetings annually. Representatives from all direct service contractors, key
GVRA administrative and contract staff, the NRTC, and a variety of individuals
presenting on relevant IL topics are in attendance in meetings.
In FFY 2016, the spring meeting was held April 11 through 13, 2016, in
Macon, GA. The spring meeting focused on reviewing the Recommendations
from the FFY 2015 Program Evaluation report. A dynamic discussion of findings
and recommendations from the report followed, with recommendations for future
evaluations and service provision concerns addressed.
The second meeting was held in the fall of 2016 via conference call.
Contractors were allotted time to provide program overviews and to discuss any
program or policy concerns.
45
SUMMARY/DISCUSSION
GVRA was awarded $845,343 in Title VII, Chapter 2 monies for FFY 2016.
Total FFY 2016 expenditures for the Project Independence program were
$950,679: $856,663 from Title VII, Chapter 2 federal funding and $94,016 from
state funds. Only 7.1% of total expenditures were allocated to administrative,
support staff, and general overhead costs.
GVRA contracts with six service providers to help ensure that services are
available to eligible consumers across the state. In addition to receiving
traditional itinerant IL services, blind and visually impaired individuals have
opportunities to participate in center-based low vision services and blindness and
low vision training. During FFY 2016, 1,460 individuals received services through
a network of 15.99 full-time equivalent (FTE) direct service staff and 8.10 FTE
administrative and support staff, of which 0.60 administrative/support staff were
GVRA employees. This is an increase of 116 consumers served, a decrease of
0.23 FTE administrative/support staff, and an increase of 1.74 direct service staff
from the previous fiscal year.
Demographics All Consumers Served (7-OB report)
Project Independence staff reached out to the most significantly disabled
individuals who require more intensive (and costly) services to enable them to
regain IL functioning. Fifty-eight percent of all consumers served were age 75
and older and 48% were legally blind (includes totally blind). In addition,
consumers reported multiple health conditions in addition to visual impairment.
For example, approximately 50% had cardiovascular disease, 35% of consumers
had a hearing impairment, 28% had diabetes, 20% had musculoskeletal
conditions, and 5% had cancer. Project Independence services have the capacity
to moderate the effects of the majority of these health conditions by providing
individuals the skills and knowledge to improve health management and
implement healthier life styles.
Approximately 65% of consumers served in the Project Independence
program were white, 29% were black or African American, 2% were American
Indian or Alaska Native, 2% were Hispanic/Latino of any race, and 2% were
other races or unknown. Percentages of persons served by race and ethnicity
matched relatively well with estimates of prevalence of vision impairment from
the Georgia 2015 Census data (Erickson & von Schrader, 2017), suggesting that
GVRA contractors and collaborative partners are successfully incorporating
outreach efforts to reach underserved and/or unserved populations (see
46
Appendix C for details of these efforts). With respect to individuals with
Hispanic/Latino backgrounds, the number remains small but has, on average,
increased in the last five years (24 served in FFY 2016, 26 served in FFY 2015,
20 served in FFY 2014, 11 served in FFY 2013, and 16 served in FFY 2012).
In determining if racial/ethnic minorities are equitably served, differences in
prevalence of visual impairment among racial/ethnic groups and economic-
related data should be considered. For example, estimated rates of visual
impairment become higher for white people compared with other racial/ethnic
groups at around 80 years and continue to increase at a higher rate with age
(Prevent Blindness America, 2008). Further, these higher rates are associated
with a greater incidence of age-related macular degeneration among white
people. Thus among OIB consumers age 75 and above, we might expect to see
a slightly higher percentage of white consumers compared with other
racial/ethnic groups served in the program. Conversely, preexisting
socioeconomic differences may result in a greater need for IL services among
certain minority groups and therefore, higher numbers served.
Satisfaction/Outcome Data (Program Participant Survey)
The primary instrument employed for evaluating this program was a 38-
item Program Participant Survey. This instrument was a collaborative effort
among the NRTC Project Director, GVRA administrative staff, and
representatives from the six IL contractors with the goal of capturing feedback
from participants regarding the impact services had made on their day-to-day
functioning. A more detailed description of the Program Participant Survey is
found beginning on page nine of this report, and a copy of the instrument is
provided in Appendix A. Participants’ comments are contained in Appendix B.
Telephone interviews using the Program Participant Survey were
conducted with 279 consumers who had received services and were closed
during FFY 2016. Project Independence contractors provided contact information
for 977 individuals. The NRTC interviewer made telephone contact with 314
individuals, 305 of whom were viable participants, and 279 (91%) consented to
be interviewed. This represents about 29% of consumers closed and about
nineteen percent of the consumers served statewide (but not necessarily closed).
Further, survey respondents were similar to all consumers served on several
demographic and disability variables, supporting generalizability of survey
findings to the larger group.
47
One area that showed a marked divergence from information reported in
the 7-OB was when consumers were asked about non-visual health conditions.
Although percentages cannot be expected to match exactly, as survey
respondents are only a sample of the population of all consumers served, these
percentages for rates of non-visual health conditions were much higher in most
categories than those indicated in the 7-OB data. This difference in reported
rates of incidence for medical conditions may indicate that data is not being
accurately captured in 7-OB reports. As previously stated, Project Independence
commendably offers services that can moderate the effects of these health
conditions, and therefore accurate collection of this information is desirable. In
program evaluation from previous years, consumers have sometimes
underreported specific conditions such as hearing loss unless specifically queried
about that particular condition; this may be an advisable strategy for asking
consumers about their non-visual health conditions.
In the Program Participant Survey, the first section contained three Likert-
type scale items which quantified respondents’ level of agreement with
statements related to the manner in which services were delivered. Ninety-six
percent of respondents agreed that services were timely, ninety-eight percent
agreed that staff were attentive, and ninety-two percent agreed that they were
satisfied with the quality of services. The greatest level of agreement (98%) was
in response to the statement regarding attentiveness, concern, and interest
shown by the staff. High scores on these measures are indicative of an efficient
and effective service delivery system.
The second section contained four multi-part questions which focused on
broad service areas typically provided by the Project Independence program (i.e.,
orientation and mobility, assistive technology, communication skills, and other
activities of daily living). Respondents were first asked if they had received each
service, and if they had not, was this a service they would have liked to receive,
and if so, did they know a reason why they did not receive this service.
Respondents indicating they had received a service were asked to provide
feedback regarding their functioning (i.e., service had resulted in improved
functioning, maintenance of functioning, or loss of functioning) and their
satisfaction with each service (very satisfied, satisfied, neutral, unsatisfied, or
very unsatisfied).
Twenty percent of respondents reported having received orientation and
mobility services; 85% reported having received devices or equipment;
34% reported having received instruction in communication skills; and 12%
reported having received instruction in activities of daily living.
A moderate percentage of respondents reporting not receiving a specific
48
service indicated that they would have been interested in receiving the
service: 4% orientation and mobility; 10% devices/equipment; 4%
communication skills training; 3% daily living skills training. These numbers
are similar to those from last year’s report, except for a slight increase in
the percentage who would have liked to receive devices/equipment (from
7% in FFY 2015 to 10%).
Of those who indicated that they would have liked to receive a specific
service, but did not, percentages ranged widely of respondents who
indicated that they knew a reason why the service was not provided (50%
orientation and mobility; 75% devices/equipment; 13% communication
skills training; 29% daily living skills training). Comments on reasons why
services were not provided generally indicated that the service was not
discussed or requested by the consumer, with smaller percentages of
reasons given being that they were not informed the service was available,
that the service was not available or did not get scheduled, or because of
some other barrier such as cost. A small number of respondents indicated
known or assumed issues with lack of staffing with the provider. These
comments are included in the full list in Appendix B.
The overall average of respondent satisfaction was 94%. Training in travel
skills received 95% satisfaction rating, and assistance with daily living skills
received 97% satisfaction ratings. Ninety-six percent of those who received
communication skills reported being satisfied, and receiving equipment
and/or devices was rated at 89% satisfaction.
Overall, 95% of respondents who received services reported that services
had helped them to gain or maintain functioning in daily life activities. One
hundred percent of those who had received training in communication
skills reported that services had helped them to gain or maintain
functioning. This was followed by those who had received training in travel
skills (98%) and in daily living skills (94%). Those reporting a gain or
maintenance of function after receiving equipment or devices through the
program was 89%, an increase of 4% from that reported last year for this
service.
Overall, these reported rates of satisfaction with services and maintenance
or gain in IL functioning by consumers are quite high, and reflect the commitment
of service providers to offer comprehensive, life-changing IL services.
In the survey’s third section, respondents were asked: how services may
have helped them maintain their current living situation; to identify additional
services they may have needed to become more independent in their home and
49
community; in their opinion, what was the greatest difference the program had
made in their lives; and how their experience could have been improved.
The majority of respondents (61%) reported greater control and
confidence, and 30% reported no change. Nine percent of respondents
reported having less control and confidence to remain in their current living
situations.
About 15% of respondents reported needing help with their hearing loss;
9% needed help with transportation services; and 9% needed computer or
software training.
Respondents provided specific examples of how services had positively
enhanced their ability to function independently in their homes and
communities. Substantive responses are provided in Appendix B, question
11.
Consumer feedback. Although most questions in the Program Participant
Survey are closed-ended, respondents are invited to comment after each
question about services. Individuals generally provided positive comments
regarding services they had received. The few negative comments often related
to not receiving an adequate amount of services, having a long wait for services
or contact, or equipment and devices being expensive or not working correctly.
Some of the negative comments may be attributable to the staffing issues noted
for FFY 2016. The majority of comments were positive, and multiple consumers
reported increased confidence in their ability to function independently as a result
of receiving services. All substantive comments are provided in Appendix B.
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RECOMMENDATIONS, COMMENDATIONS, & CONCLUSIONS The following recommendations were developed based on data collected from
telephone interviews of consumers closed from services during FFY 2016
(Program Participant Survey), the annual RSA 7-OB report, two site visits to
Project Independence service providers, and participation in two contractors’
meetings.
Recommendations
1. Continue providing consumers with the appropriate services to meet their
IL goals, ensure consumers are informed about all appropriate resources
available through the OBP, and ensure consumers are informed about
alternative resources that can assist them with needs that are outside the
scope of the OBP.
Rationale: Numbers of consumers indicating that they did not receive a
particular service but would have liked to receive it have held
mostly steady, with percentages comparable to those from
FFY 2015. OBP contractors should be commended for this
effort in providing comprehensive services. For this minority of
consumers who indicated they would have liked to receive
particular services while they were in the program, some
stated that they were not aware the service was offered, while
others indicated that they could not afford a particular device
or piece of equipment. OBP contractors are encouraged to
ensure that consumers are well informed about all the
services that are available to them through the OBP program,
as well as to direct them to alternative resources for needed
services not offered through the OBP, and additional
resources that may help to cover costs of equipment, devices,
or other needed services. Finally, if consumers identify goals
or concerns that are outside the scope of the OBP, it is
encouraged that consumers are provided referral or
information to other appropriate resources whenever possible,
such as to vocational rehabilitation if a consumer expresses
the desire to work.
51
2. Continue to strive to offer comprehensive services that address the
appropriate scope and depth of needs of consumers, with particular
attention to the extent and amount of training needed, including training on
devices and equipment.
Rationale: As in reports from recent years, comments by many
consumers indicated that they needed more training in
general, and specific to performing tasks or operating devices
and equipment, in order to feel comfortable without the
presence of their instructor. Additionally, several consumers
claimed that a device or piece of equipment did not work well
for them for the desired task, or did not work properly; this
response may be, in part, due to the need for additional
training on operation and/or maintenance of such devices and
equipment. Because changes in consumers’ health or
functioning may impact their ability to independently complete
tasks after services have ended, it is important to establish
some consistent and reliable method of allowing the consumer
or their family member to refer back to helpful instructions or
to follow up with the service provider. Providing them with the
contact information for the manufacturer of their devices and
equipment may also help with operation and maintenance
questions and concerns the consumer may have after using a
device.
3. Consider implementing a systematic and comprehensive method of
recording contacts of consumers calling to obtain services or to have
questions answered, to ensure that consumers are not left waiting for
lengthy periods with no contact. Include in this system a direct policy that
specifies the intake process in a way that is both efficient for the service
provider and least obstructive as possible for consumers.
Rationale: A frequently noted comment was that consumers were left
waiting for lengths of time to have services begin, or waiting
for equipment or devices to be delivered. Additionally, some
consumers reported having been trying to reach their service
provider but not receiving a call back. Responses to the
survey question about overall timeliness were quite positive,
but the percentage of those choosing “Strongly Agree” fell this
year from 74% in FFY 2015 to 63%. In addition, the site
review consultant indicated a recommendation based on case
52
file reviews that a record of consistent and regular contacts be
observed in case files. Finally, a small number of consumers
commented that their intake for services was delayed or
postponed due to having problems or complications with
documentation and paperwork. A systematic policy on
frequency of contact with consumers both while enrolled in
services and while going through the intake process would
help to ensure that consumers are receiving timely service
and are informed of their status in regard to obtaining services
or equipment. It is duly noted that an ongoing concern for the
entire field of older blind service provision is chronic
understaffing, due to limited funding as well as a scarcity of
trained and knowledgeable blindness service providers. The
OBP contractors should be commended for their commitment
and dedication in providing services with limited resources and
staff. However, even if services are not immediately available
for consumers who make contact to request service, or if
intake processes require very methodical systems for fair and
manageable appointment systems, consumers would benefit
from being well informed. A policy of advising consumers of
both their own obligations for what is required for services
(e.g., with regard to paperwork or contact with providers) as
well as giving them a “status report” of when they may be able
to expect a call back, have a service scheduled, or have a
device delivered, will help to alleviate consumers’
experiencing frustrations or delays with receiving needed
services.
4. It is encouraged that contractors and OBP project personnel continue to
make every effort to develop creative staffing solutions to ensure
professional service providers are available for needed services.
Rationale: Based upon the general state of the field in service provision
for individuals with visual impairment and for OBP service
provision in particular, there is a well-known shortage of
trained and knowledgeable professionals in the field. This
shortage is also evidenced by reports from the consultant who
performed site reviews of the two provider facilities included
above, detailing staffing issues, as well as the appearance in
consumer comments to the survey about delays of service
being due to staffing shortages. While this ongoing shortage of
53
professionals is a nationwide issue that will not be solved
quickly, current providers are encouraged to creatively
problem-solve whenever possible to ensure that the most
comprehensive service delivery possible is still available to the
community. Current strides toward this goal with the use of
shared contracted service providers as well as itinerant
service delivery models and other methods are commendable
for all OBP personnel and contractors.
5. Consider devising a standardized follow up policy and procedure regarding
consumers receiving, using, and maintaining devices and equipment. If
equipment is no longer useful for a consumer, it is encouraged that
providers facilitate the option of having it sold or donated to a resource for
distribution to other consumers.
Rationale: Along with reports of consumers who were waiting to receive
devices, equipment, or aids, a number of consumers (n = 19)
reported no longer using devices or equipment because it did
not work, did not work well for them in particular, or was no
longer useful for them due to worsening vision or health.
Following up with consumers specifically on their receipt and
use of devices at designated intervals may help to
troubleshoot any issues with needed repair, maintenance, or
additional training. If the device is no longer useful,
assessment for some other solution for the consumer for the
intended task or activity could be conducted. In addition,
particularly for durable and/or more expensive equipment and
devices such as large magnifiers, consumers who have these
devices but are unable or uninterested in using them could sell
or donate them to a “loan closet” or other resource for use by
other consumers. This system could help to ensure that
consumers are benefitting from any equipment or devices they
have purchased, and also provide a potential source for
usable equipment that can be provided to other seniors. In
addition to ensuring consumer benefit, this plan could
supplement the effective strategies that are currently being
implemented by OBP contractors to address the issue of
providing consumers with resources to help secure needed
devices and equipment with limited funding.
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6. Ensure that closed consumers’ contact information is accurate and current
and provided to MSU staff no later than 30 days after the close of each
quarter.
Rationale: There were a number of closed consumers for whom the
contact information led to a wrong or disconnected number.
Approximately 5% (n = 29) of the 699 contact attempts led to
a bad number. Additionally, a number of consumers who
completed the survey indicated that they were at that time
waiting for services to begin. Consumers may not recall
services that were given at a time too far prior to the survey
call, and contact information could change over time. In order
to address this problem, contractors are encouraged to ensure
that accurate information for only closed OBP consumers is
provided to MSU within 30 days after the close of the quarter.
MSU staff will endeavor to implement a system of regular and
timely reminders for submission of information. OBP
contractors are also requested to provide a report even if no
OBP consumers were closed for that reporting quarter, to
assist MSU staff with monitoring the arrival of reports.
Implementing this system will help ensure that the consumers
are contacted within a reasonable time after services have
been delivered and allow less time for contact information to
become outdated or for consumers to forget or confuse one
service provision period with another.
7. Properly identifying non-visual health conditions in order to appropriately
plan needed services is an important component to achieving successful
independent living outcomes. It is recommended that contractors be
proactive and specific when enquiring about additional health issues that
may impact a consumer’s ability both to take advantage of OBP services
and to live independently. Consider implementing a program-wide
standardized medical condition questionnaire in order to capture accurate
reports of multiple health conditions as providers are working with
consumers. Contractors can then more appropriately provide additional
resources and information to assist consumers with health issues that may
impact their independent functioning.
55
Rationale: Percentages of health conditions reported in the consumer
survey for most categories were much higher than those
reflected in the 7-OB data. For example, Bone, Muscle, or
Skin conditions were reported at 20% in the 7-OB report, while
the participant survey rate for those conditions was 54%;
Hearing Impairment was reported at 35% in the 7-OB, but
48% in the survey; Depression/Mood disorders reported in the
7-OB were 3%, but 26% in the survey. While some variation
may be expected from the survey sample to the entire
population of consumers served, such large differences are
more likely to be indicative of health conditions being
underreported by consumers when they are receiving
services. Particular attention is warranted with identifying
hearing impairment, as consumers may be reluctant to report,
and a hearing impairment can have marked consequences on
response to services, as well as appropriate referrals and
registries that may be recommended. Making efforts to
adequately capture health information will ensure that service
planning is as appropriate and comprehensive as possible.
8. In communities away from main OBP facilities, encourage the
development of more peer support groups where none exist. Additionally,
utilize funds for transportation that can be provided to help consumers to
attend groups.
Rationale: This recommendation was indicated by the site review
consultant who performed site reviews of the two provider
facilities, included above. The consultant identified a need for
additional outreach for this service in outlying areas for
consumers for whom distance to providers may be a barrier to
access to services. The use of peer support groups is
encouraged as these can also supplement other OBP services
for consumers in areas that have a dearth of professional
service providers and may have long waits for other types of
services. Where group meetings are distant, consumers can
have transportation costs covered by the OBP in order to
attend, and this practice is encouraged in order to provide
outreach to more consumers in need of this support.
9. Consider developing a simplified “Eye Report” form for use project-wide in
consumer case files. The form would include the consumer’s signed
56
release, and information specific to the consumer’s eye condition including:
acuities in each eye, visual fields, diagnosis(es), prognosis, and space for
comment on additional medical or personal information of concern to IL
goals.
Rationale: This recommendation was indicated by the site review
consultant who performed site reviews of the two provider
facilities, included above. The consultant indicated that a
streamlined eye report form would be useful in more clearly
conveying information on an individual’s functional vision, as
well as facilitate easier eligibility determination. The consultant
remarked that the required “Eye Report” in case files is often
an overwhelming number of faxed pages with very limited
information on the actual visual condition, making determining
eligibility and functional vision difficult and laborious. This form
could also be used to relate pertinent medical and personal
information about the consumer that could impact IL goals,
such as living situation, family concerns, or other disabilities.
Commendations
The following commendations were developed based upon findings from
program evaluation activities, and are provided in an effort to support the positive
outcomes of the Project Independence program.
1. Consumers were asked, “How could your experience have been
improved?” Contractors should be commended on the positive feedback
received. When asked specifically about how their experience could be
improved, the feedback was markedly positive. Given the opportunity to
critique the program, most comments were positive about their experience,
and of those who offered ways to improve, many gave comments that
were related to issues outside the scope or control of the OBP, such as
transportation, location, and cost of devices and equipment. Additionally,
comments were requested of consumers with the question “In your
opinion, what was the greatest difference this program has made in your
life?” Responses to this question were overwhelmingly positive, with
consumers making statements of how services have improved not only
their ability to live independently, but also their quality of life. Contractors
should be commended on the overall very positive experiences consumers
reported having in the program.
57
2. Satisfaction was very high for all areas of service that were specifically
queried. The lowest satisfaction rate was 89%, for just one service area
(devices and equipment), and all others were 95% or higher. Contractors
should be commended on the high satisfaction rates given by consumers
for the program.
3. The ratio of visual impairment in Georgia’s population versus the ratio of
consumers served, based on race/ethnicity, are very similar, with
races/ethnicities having the highest prevalence rates of visual impairment
in Georgia receiving a higher percentage of care. The outreach to all
races/ethnicities by the OBP should be commended. Specifically, among
the visually impaired population in Georgia, 66% are white, 29% are black
or African American, 2% are Hispanic/Latino, and 1% are Asian.
Races/ethnicities served by the OBP are: white, 65%: black/African
American, 29%; Hispanic/Latino, 2%; and Asian, 1%. When comparing
these figures, it can be seen that most races/ethnicities in Georgia are
being appropriately reached. The Hispanic/Latino population has an 8%
prevalence rate of visual impairment in Georgia, yet only comprise 2% of
those being served by the Georgia OBP. Contractors may consider further
outreach to Hispanic/Latino communities in order to ensure that this
population is aware of services; however, it is acknowledged that with few
service providers who have Spanish-speaking staff, language barriers may
exist that could limit outreach and service provision to Hispanic/Latino
consumers.
4. The consultant for site reviews, who met with several staff members on his
reviews of the facilities as listed above, gave high commendations for staff
commitment to the program goals and to providing quality services to the
older blind consumer population.
5. In previous years, the recommendation was made to ensure that
consumers and their family members were provided with a way that they
could contact their service provider again after services had been received.
In FFY 2015, then percentage of consumers indicating they did not know
how to contact their provider was 14%; for FFY 2016, this percentage has
dropped to 9%. OBP providers should be commended on this effort to
ensure that consumers are informed and can reach providers again when
needed.
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Conclusions
The Project Independence program is a well-conceived, well-executed
program providing a full range of IL services to Georgia’s older blind and severely
visually impaired population. The majority of consumers receiving services are
age 75 and older with multiple health conditions, and some reside in nursing
homes. The GVRA has contractual agreements with six regional agencies for
provision of direct services to eligible seniors. These contractors generally use
both a center-based and an itinerant approach to service delivery. Provision of
itinerant services is crucial to serving consumers who might not otherwise be
able to participate in such a program, particularly individuals in outlying rural
areas. Further, a regional service delivery approach enhances the ability of
project staff to be sensitive to and familiar with the needs of local consumers.
Even with fluctuations in staffing and funding, the number of individuals
served has held relatively steady for the past four years. (From 1,418 in 2013, to
1,390 in 2014, 1344 in 2015, and 1460 in the current year). Staffing issues in
particular are of major concern, as industry-wide shortages of trained and
qualified staff in low vision services have become a nationwide concern. With
staffing shortages added to fluctuations in federal and other funding across
years, maintaining such high levels of individuals served will be a challenging
endeavor. The OBP will need to be vigilant in managing all available funding and
resources, and also engage in innovative and creative staffing solutions, in order
to ensure that consumers are served as comprehensively as possible.
In conclusion, the suggestions contained in the "Recommendations" section
of this report should be considered as a part of the ongoing program planning
process, and the commendations should be noted for the successes of Project
Independence in developing and providing of a comprehensive state model of
services for individuals age 55 and older with visual impairments.
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REFERENCES American Foundation for the Blind. (July, 1999). Independent living services for
older individuals who are blind program (Title VII, Chapter 2 of the Rehabilitation Act). Retrieved from: http://www.afb.org/afb/aging/advocacy_tools/
Erickson, W., Lee, C., von Schrader, S. (2017). Disability Statistics from the
American Community Survey (ACS). Ithaca, NY: Cornell University Yang-
Tan Institute (YTI). Retrieved on February 24, 2017 from Cornell University
Disability Statistics website: www.disabilitystatistics.org.
Lighthouse International. (March, 2016). Arlene R. Gordon Research Institute:
Causes of Vision Impairment. Retrieved March 8, 2016 from http://li129-
107.members.linode.com/research/statistics-on-vision-impairment/causes-
vision-impairment/
Prevent Blindness America (2008). Vision problems in the U.S.: Prevalence of
adult visual impairment and age-related eye disease in America. Retrieved
February 24, 2011, from http://www.preventblindness.org/
vpus/2008_update/VPUS_2008_update.pdf
Stephens, B. (1998). The relationship of age to levels of performance and
independence associated with rehabilitation interventions provided older
adults who are blind. Unpublished doctoral dissertation, Mississippi State
University.
U.S. Census Bureau. (2016). American Community Survey, PUMS Data, 2011-
2013 3-Year Averages. Data tabulated by National Strategic Planning and
Analysis Research Center, Mississippi State University.
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61
Appendix A: Program Participant Survey
62
63
Georgia Vocational Rehabilitation Agency FY 2016 Program Participant Survey
Consumer Number: Services Received: Instructions: The Georgia Rehabilitation Services has asked Mississippi State University to contact you to ask about the services you have received from (say name of service provider here). I assure you that this is not a sales call. We are interested in getting your feedback on the services you received from (service provider) in order to improve the program. Your participation in this survey is completely voluntary, and you may skip any questions that you do not wish to answer. This should take only about 10 minutes to complete. Your answers are confidential, so we do not need your name. Your responses are greatly appreciated and any comments you might have will also be appreciated. Can we complete the interview now? If the senior declines to participate: Mr./Mrs. (senior’s name), would you mind answering just one question? In your opinion, what was the greatest difference this program has made in your life? (record response) If the senior declines to answer the one question: Mr./Mrs. (senior’s name), is there a reason that you do not want participate in this satisfaction survey?
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First, I would like your opinion of the manner in which services were provided to you. In addition to answering the questions, if you have any comments, I would also like to hear those. (Interviewer, if respondent answers negatively, please ask him/her to comment.) 1. Do you (read options) that services were provided in a
timely manner (your program proceeded at a reasonable pace)?
Comments:
5 - Strongly Agree 4 - Agree 3 - Neutral 2 - Disagree 1 - Strongly Disagree
2. Do you (read options) that the staff were attentive, concerned, and interested in your well-being? Comments:
5 - Strongly Agree 4 - Agree 3 - Neutral 2 - Disagree 1 - Strongly Disagree
3. How satisfied were you with the quality of the services you received? Were you (read options) with the quality of services? Comments:
5 - Strongly Agree 4 - Agree 3 - Neutral 2 - Disagree 1 - Strongly Disagree
65
Next, I would like to know more about the different services you may have received. First, I will ask if you received a particular service. If you received the service, I will then ask how the service may have helped and if you were satisfied with the service. 4. You may have received services to help you travel more safely and efficiently in your home and/or community. For example, you may have been provided training in how to use a cane or a sighted guide to move around. Did you receive this service? _____Yes _____No 4a. (If did not receive service) During the time you were receiving services from (service provider) was this a service you would have liked to have received? _____Yes _____No Comments (Interviewer, ask for comments if “yes”):
4b. If “Yes,” do you know why you did not receive this service from (service provider)? _____Yes _____No Comments:
4c. (If received service) After receiving travel services, would you say that you …. ___are now better able to travel safely and independently in your home and/or community. ___have maintained your ability to travel safely and independently in your home/community. ___are now less able to travel safely and independently (ask respondent to comment). Comments: 4d. (If received service) How satisfied were you with services you received to help you travel more safely and independently in your home or community? Were you ___Very satisfied ___Satisfied ___Neutral ___Unsatisfied (ask respondent to comment) ___Very Unsatisfied (ask respondent to comment) Comments:
66
5. You may have received or purchased devices or equipment, such as canes, insulin gauges, magnifiers, bump dots, adaptive cooking items, writing guides, pocket talkers, or large button telephones to help you function more independently. Did you receive or purchase any of these devices or equipment? _____Yes _____No 5a. (If did not receive/purchase) During the time you were receiving services from (service provider) were you interested in receiving or purchasing any of these devices? _____Yes _____No Comments (Interviewer, ask for comments if “yes”):
5b. If “Yes,” do you know why you did not receive or purchase these devices? _____Yes _____No Comments:
5c. (If received/purchased) Can you give me some examples of the things you received or purchased that may have helped you become more independent? 5d. Would you say that these devices and/or equipment have…. ___improved your ability to function more independently? ___helped you maintain your ability to function more independently? OR ___I am not currently using any of these devices or equipment (ask respondent for comment). Comments: 5e. (If provided/purchased) How satisfied are you with the devices or equipment in helping you function more independently? Are you ___Very satisfied ___Satisfied ___Neutral ___Unsatisfied (ask respondent to comment) ___Very Unsatisfied (ask respondent to comment) Comments:
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6. You may have received training to help you improve your communication skills; for example, you may have received training using magnifiers or other magnification devices; braille instruction; keyboarding or computer training; using the telephone; using handwriting guides; telling time; using readers or audio equipment. Did you receive instruction or training in any of these areas? _____Yes _____No 6a. (If did not receive training) During the time you were receiving services from (service provider) was this a service you would have liked to have received? _____Yes _____No Comments (Interviewer, ask for comments if “yes”):
6b. If “Yes,” do you know why you did not receive this service from (service provider)? _____Yes _____No Comments:
6c. (If received training) After receiving this, would you say that you ….. ___are now able to function more independently? ___have maintained your ability to function more independently? ___are less able to function independently (ask respondent for comment)? Comments: 6d. (If received training) How satisfied were you with the training you received in helping you function more independently. Are you ___Very satisfied ___Satisfied ___Neutral ___Unsatisfied (ask respondent to comment) ___Very Unsatisfied (ask respondent to comment) Comments:
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7. You may have received services that helped you with your daily living activities, such as food preparation, grooming and dressing, household chores, medical management, or shopping. Did you receive services that may have helped you in any of these areas? _____Yes _____No 7a. (If did not receive services) During the time you were receiving services from (service provider) was this a service you would have liked to have received? _____Yes _____No Comments (Interviewer, ask for comments if “yes”):
7b. If “Yes,” do you know why you did not receive this service from (service provider)? _____Yes _____No Comments:
7c. (If received services) After receiving this service or services, would you say that you …. ___are now able to function more independently? ___have maintained your ability to function more independently? ___are less able to function independently (ask respondent to comment)? Comments: 7d. (If received services) How satisfied were you with the services you received in helping you function more independently. Are you ___Very satisfied ___Satisfied ___Neutral ___Unsatisfied (ask respondent to comment) ___Very Unsatisfied (ask respondent to comment) Comments:
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Next, I have a question about how any of the services may have helped you maintain your current living situation. 8. Compared with your functioning before services, would you say that ….
You now have greater control and confidence in your ability to maintain your current living situation.
There has been no change in your control and confidence in maintaining your current living situation.
You now have less control and confidence in your ability to maintain your current living situation. (ask respondent to comment).
Comments: 9. What other services do you need to become more independent in your home or community? Do you need (Interviewer, mark all that apply): ____ Services to help with your hearing loss ____ Transportation ____ Computer/application software training ____ Other (Interviewer, please specify) __________________________ 10. If you need additional services, do you or your family or friends know how to contact/reach (service provider)? _____Yes _____No 11. In your opinion, what was the greatest difference this program has made in your life? 12. How could your experience have been improved?
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Next, can you tell us a little about yourself. 13. What is your age? ______ 14. Are you ____Male _____Female 15. Do you _____? (check only one) ___Live in a private residence (home or apartment) ___Live in a senior living/retirement community ___Live in an assisted living facility ___Live in a nursing home/long-term care facility ___Other (Interviewer, ask for clarification) 16. What main type of eye problem do you have? ___Macular Degeneration ___Diabetic Retinopathy ___Glaucoma ___Cataracts ___Retinitis Pigmentosa ___Other (Interviewer, please specify) ___________________________ 17. Do you have another impairment or health problem besides your vision problem? (Please mark all that apply.) ___Hearing Impairment ___Diabetes ___Cardiovascular Disease and Strokes ___Cancer ___Bone, Muscle, Skin, Joint, and Movement Disorders ___Alzheimer’s Disease/Cognitive Impairment ___Depression/Mood Disorder ___Other Major Geriatric Concerns 18. Do you have a hearing loss? ____Yes ____No 18a. If yes, how would you rate its severity? (1) Mild (2) Moderate (3) Severe
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19. Could you tell me your race or ethnic background. Are you ___Hispanic/Latino of any race (For individuals who are not Hispanic/Latino only, check below) ___American Indian or Alaska Native ___Asian ___Black or African American ___Native Hawaiian or Other Pacific Islander ___White ___Two or more races ___Race & ethnicity unknown (Interviewer, mark if consumer refuses to answer question) 20. In the last few months have you experienced any changes in your living situation (for example, moving from your normal residence to another residence such as a senior living or assisted living facility) that has resulted in your becoming less independent?
Yes (Interviewer if yes, please provide details) No
Interviewer, ask for additional comments. Date of interview and interviewer’s initials: __________________
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73
Appendix B:
Consumer Comments
74
Georgia 2016 Comments
A special effort was made to capture participant comments verbatim; therefore, some deficiencies in grammar, syntax, and clarity of expression may be noted.
Manner in which services were provide:
1. Services were provided in a timely manner (your program proceeded at a reasonable pace)?
51-003 They told me they would call me back and they didn't. It has been three
weeks now.
11-041 It wasn't very timely. Someone had quit or was fired and they didn't have
anyone in place.
61-038 It was months before anyone contacted me.
32-021 The distance and time was not acceptable. No records were available
and not the right kind of equipment was available. The young girl's attitude was
very bad also.
12-210 It took too long to get an appointment.
12-108 They are just too slow. I am still waiting for glasses
12-170 Some were and some were not. So far, no one has visited me to teach
me how to use the white cane and other occupational therapy. I have called them
about 6 times. No one has ever called me back.
62-109 They were very good.
23-019 We have called them times and left messages. They have not returned
our calls. We want to buy another magnifier.
13-378 I still haven't received the thing that they were supposed to send out from
the Library in Washington to help you read.
2. Do you (read options) that the staff were attentive, concerned, and interested in your well-being?
11-083 The staff seemed to be fixated on selling products from their gift shop.
They really pushed them. They tried to sell her something for over $1,000.00. We
looked on the internet and they only cost $400.00.
11-021 They were better than I expected.
31-016 They were very professional.
12-137 They didn't tell me anything new and they didn't help me with anything.
12-165 I don't think they just did their job. Just going through the motions.
62-109 They were great.
75
24-014 They did a great job.
13-328 They were wonderful.
3. How satisfied were you with the quality of the services you received? Were you
(read options) with the quality of services?
11-037 I had hoped that she would come away with more resources than she
did.
31-006 The expensive magnifying glasses did not improve my abilities at all.
51-003 They have not returned my phone call.
11-046 I would like to find something that might enhance my health. Like
transplants, etc.
11-019 I didn't have transportation all the time therefore I did not finish getting my
services.
32-021 I was treated alright in the office, but it took 2-3 months to get my
equipment. I had to make several calls. They had lost my documentation.
12-101 Their attitudes were awful. They talked to me very poorly. The testing
was OK. But then, I didn't hear from them for a while. It was paperwork for
someone else that they wanted me to fill out. They were very rude to me when I
returned them. I still have not heard from them.
12-137 I will not go there again.
12-152 I didn't get what I thought I was going to get. First, the machine wasn't
working, then I was called back again, and the charts were not good. The doctor
did not help me at all. Also, items were way too expensive for me. They did not
help me at all financially.
12-146 I haven't received my glasses yet. I have talked with them several times.
12-180 I didn't know when I went that they were going to try to sell me some
stuff.
62-076 The glasses they sent me were not as strong as the ones I used at the
office. They didn't work.
63-154 We did not feel like his needs were addressed as basically as we were
led to believe they would be. We felt like we were misled as to what they were
going to be.
44-008 They didn't check my eyes or anything. The only thing they did was look
at my glasses and picked out some for me. They are not for my eyes. I cannot
see with them.
13-248 I was supposed to get some glasses, but I never did.
13-278 My eyesight is worse.
76
Services received:
You may have received services to help you travel more safely and efficiently in your home and/or community.
4a. (If did not receive service) During the time you were receiving services from (service provider) was this a service you would have liked to have received?
51-001 I am in a wheelchair.
21-002 I would have asked for it if I had known that it was available.
11-035 I think I am going to call and get it set up ASAP.
11-017 It is on the schedule to be done.
11-024 They are scheduling me for that now.
11-013 I will need this help later.
12-121 We did not discuss it.
12-170 We discussed it and someone was supposed to come. No one has come.
62-109 I needed training in the home.
63-154 He needs some follow-up mobility training.
4b. (If did not receive service) Do you know why you did not receive this service from
(service provider)?
21-002 I did not ask for it since I didn't know it was available.
11-017 It is going to be done later.
11-008 They did the evaluation and I am waiting for a call.
11-024 I am waiting to be scheduled.
12-170 I have just been waiting. I think they are understaffed.
62-109 I guess because he noticed that I can get around my home pretty well.
4c. (If received service) After receiving travel services, would you say that you are now
better able, have maintained your ability, or are now less able to travel safely and independently?
11-027 Because of my eyesight, it has worsened.
31-003 They gave me lots of tips. I am too sick and weak.
62-111 I do need more training.
13-443 I think I need some more training now. It has been a long time since I was
trained.
4d. (If received service) How satisfied were you with services you received to help you travel more safely and independently in your home or community?
11-027 I think I could have gotten a little more help.
11-083 I think it was a precursory leading up to buying expensive equipment.
77
You may have received or purchased devices or equipment, such as canes, insulin gauges, magnifiers, bump dots, adaptive cooking items, writing guides, pocket talkers, or large button telephones to help you function more independently.
5a. (If did not receive/purchase) During the time you were receiving services from
(service provider) were you interested in receiving or purchasing any of these
devices?
11-024 I am not able to purchase the magnifier.
12-101 I was not offered any of them. I needed kitchen items. Since the
paperwork was wrong, I never got anything so I could go down there.
12-121 I needed a magnifying glass. And cooking needs. Writing guides and
bump dots.
13-408 I got my things from the VA.
13-228 We are just in the beginning stages of my program.
5b. (If did not receive service) Do you know why you did not receive or purchase these
devices? 11-024 I cannot afford one.
12-101 Since the paperwork was sent to me wrong, I never got down there. They also told me I was eligible for a grant.
12-121 It was not mentioned. Only glasses were mentioned.
13-228 We haven't really started anything yet.
5d. (If received/purchased items) Would you say that these devices/equipment have
improved or helped you maintain your ability to function more independently, or are you not currently using any of these devices/equipment?
51-001 I am more independent now.
21-002 Greatly improved.
21-004 I would be lost without my watch.
11-074 I just have trouble with the batteries.
11-083 We are just dissatisfied. We came away with very little.
31-003 It was tremendous help.
11-018 He doesn't use it. I use it. He can't focus well enough to use it.
11-094 She doesn't want to hold it and she doesn't want to put things in her lap that will make it be at the right angle.
11-034 It is not designed very well. I cannot read an entire sentence and it is too big to use.
11-073 The magnifier helped me some, but the alarm clock had to go back.
31-016 He just didn't pursue the opportunity.
61-012 I have lost them.
61-022 It is hard to use. I don't get much use out of it. The BP machine helps me.
78
61-031 It doesn't do me any good.
32-018 They were helpful, but I just forget to put them on.
32-040 I need a stronger one now since I had a hemorrhage.
12-137 It doesn't help at all.
12-143 His abilities are difficult.
61-028 The magnifier did not help her. Her eyes got worse.
12-165 They did not help as we thought they would for her because of her blindness.
61-002 My eyes have gone down now, but I can't see with it.
62-060 They were not very helpful.
62-076 It has partially helped, but not a whole lot.
62-080 It does help, but my sight is going fast.
62-061 It helped me in the beginning. Now, I need a larger one, I cannot read well with this one now.
62-071 They are great when I am wearing them.
62-096 I need a stronger magnifier now.
62-107 My sight has gotten worse.
62-116 Her eyesight has gotten worse.
63-159 I could not use the bingo cards where I go.
63-152 Because she is completely totally blind.
63-173 He just uses a better light like they suggested. He just doesn't read much anymore.
44-022 I cannot see through them. They are not right for me.
44-028 She just didn't want to use it.
44-029 They don't do any good.
63-188 When they came in the Rx was not right or someone did them wrong. They are not quite right and I can't use them.
13-438 Because I still have some issues with my eyesight.
13-443 My vision has declined. I need upgrades.
5e. (If received/purchased items) How satisfied are you with the devices/equipment?
11-026 I am sure that there is something better that is not so cumbersome.
11-094 She doesn't want to hold it or put it in her lap.
51-003 The clock has broken and they won't return my calls.
11-034 You should be able to read a complete sentence. Same as above
statement. It should be lighter.
61-009 I think my eyes are such that the magnifier does not help.
61-023 They don't help me much.
32-021 I needed a larger magnifier.
32-034 It is not what I thought it would be.
61-025 I wish I could read better with the table magnifier.
12-137 It only shows a word at a time.
79
61-002 I was perfectly satisfied with it, but now I can't use it.
62-060 The glasses were OK, but he could not see any better with them.
62-106 I do not have the one for my head yet.
44-029 Because they are not for my eyes.
24-013 The magnifiers are not what I would like. I need stronger ones and larger
ones.
63-188 They are not right for me.
13-418 I was very satisfied until my eyesight got so bad, it doesn't do me any
good anymore.
You may have received training to help you improve your communication skills.
6a. (If did not receive service) During the time you were receiving services from (service
provider) was this a service you would have liked to have received? 11-035 I didn't ask for it at the time.
31-008 I don't need this now, but I will need some of it in the future.
61-027 I would like to have the audio equipment and readers.
12-121 Computer training.
61-028 With a talking watch, she could keep up with time.
12-170 Since they did not respond, I have gone to the low vision of the VA.
6b. (If did not receive service) Do you know why you did not receive this service from
(service provider)? 11-035 I didn't ask for it at that time.
61-027 I don't remember asking for it.
12-102 We did not discuss it.
61-028 This was not mentioned to us.
12-170 They are probably understaffed. That was part of the call that I have
been waiting for.
6c. (If received service) After receiving communication services, would say that you are now better able, have maintained your ability, or are now less able to function independently? NO COMMENTS
6d. (If received service) How satisfied were you with the training you received?
11-027 I needed more training.
80
You may have received services that helped you with your daily living activities. 7a. (If did not receive services) During the time you were receiving services from
(service provider) was this a service you would have liked to have received? 11-035 I didn't ask for it.
11-024 I needed help with household needs and shopping.
61-050 I did not discuss it with them.
12-128 They didn't ask about that.
12-170 Same as before. I am still waiting.
12-182 He could have used that service.
13-308 I needed to be with people that had some problems like I did.
13-388 They were looking for a new employee.
7b. (If did not receive services) Do you know why you did not receive this service from
(service provider)?
11-035 I did not ask for it at that time.
11-024 I talked with them about this, but I don't know why I have not gotten it
yet. I live alone and need help.
61-050 Because I did not ask for it.
12-145 We didn't discuss it.
12-170 I am still waiting.
12-182 It was not offered to him.
7c. (If received services) After receiving this service(s), would you say that you are now
better able, have maintained your ability, or are now less able to function independently? 11-041 I think he has early dementia.
63-158 I am losing more sight every day.
13-443 I was getting help, but the person has quit coming. I don't know why.
7d. (If received services) How satisfied were you with the daily living service(s) received?
NO COMMENTS
8. Compared with your functioning before services, would you say that you now have greater control and confidence, there has been no change in control and confidence, or you have less control and confidence in your ability to maintain your current living situation?
11-027 My eyesight has gotten worse and I am older now.
81
11-037 She wasn't blind enough to require more assistance in the home to have
more assistance.
11-059 I have other things wrong with me that are reoccurring.
11-050 I only had shots in my eye. My eyesight is getting worse and I will need
more help soon.
11-061 He has Alzheimer and he only got a new pair of glasses.
11-071 Nothing has changed.
11-069 He has dementia and it is hard for him to use the glasses for anything
other than reading.
11-074 I think my eyesight is getting worse.
11-008 My vision is a lot worse. I haven't had new classes yet. They should be
scheduled.
11-083 Nothing helped her. It was just all sales pitches.
11-005 I have MS now and everything is the same. My eyesight is getting worse
now. I am starting a new medication now.
31-001 I still don't need much. The magnifier does help me to read magazines
better.
11-018 The magnifier did not help him. The one that he needed we could not
afford.
31-006 My biggest problem is reading. I need help with lighting and I don't know
how to improve that.
31-012 My eyesight has gotten worse.
31-008 Now I can read and pay my bills myself.
11-087 My vision has gotten worse.
11-094 Because there was limited opportunities for improvement.
51-003 My eyesight is getting worse.
11-029 I think my eyesight has gotten worse.
11-034 The magnifier is too bulky and heavy. You cannot comprehend what you
are reading because the design is bad.
11-068 I am just older. With the magnifiers, I cannot read much at a time and
then it is hard to remember what I have read.
31-016 His general physical condition has gotten worse.
11-036 Because I know where everything is and I know my limits.
11-066 I can still do everything that I did before.
61-009 Because my eyesight is worse.
61-012 I have lost my glasses and I need more to replace them.
61-016 I cannot see so I have less control.
61-017 There are things I cannot do.
61-018 Because they won't let me go back to work.
82
61-023 Nothing has helped much.
61-031 Because the equipment didn't help me.
61-038 I cannot do anything more than before.
61-057 What I needed, the indicator, I do not have. I need some dots or buttons
to mark my dials on my washer and appliances.
61-058 My eyes are getting worse.
32-023 It is just that I didn't need a lot of the things that were offered. I cannot
drive any more.
32-029 My eyes are no better now.
32-032 The program in [State Removed] was 10 times better than Georgia.
They didn't do much to help me at all. I have been very disappointed here.
32-034 It is too hard for me to use.
61-020 Other strengths have been drawn from other people and other sources.
32-044 My eyes have gotten worse.
12-196 My eyesight has deteriorated.
12-204 Her vision continues to diminish.
12-210 His eyes are worse now.
12-101 So far, nothing has been done.
12-108 I am getting help from my family.
12-116 I have just been able to maintain my situation.
12-121 Because it is about the same.
12-137 It simply does not help.
12-138 I had confidence before I went there.
12-142 The thing is that I really need something that is not hand held. The
hands free item was too expensive.
12-143 His abilities are going down in all areas.
12-147 I don't need anything. I function well.
12-157 My vision is not getting any better.
12-152 The items just didn't help at all.
12-146 Because I haven't gotten my glasses.
61-028 Because her eyesight has gotten worse.
12-100 So far nothing has been done through them.
12-173 Eyesight is getting worse.
12-176 My comfort keepers help me.
12-170 I haven't had any response yet.
12-182 He probably doesn't use them as much as he should.
12-186 She can only do so much. But it has helped her.
12-189 He got nothing special to help him.
12-188 My eyes are worse.
83
12-159 My vision is always smoky.
12-165 Her health has declined.
32-030 I only got information.
32-020 She didn't need anything. Nothing has changed.
32-025 Sometimes it is better and sometimes it is not.
61-002 My eyesight is so much worse.
12-195 She is 90 and nothing helped.
12-180 I just didn't benefit from it.
62-075 My eyesight is getting worse.
62-076 The equipment wasn't strong enough.
62-084 I did not get anything from them. I just looked at some equipment.
62-061 My eyesight is getting worse.
62-069 I don't use the cane often. No one came to my apartment so I didn't get
help there. I do use the magnifier constantly.
62-096 My eyesight has gotten worse.
62-107 The cane helps me a lot, but my eyesight has got a lot worse for the use
of the other items.
62-120 I am just too old.
62-116 Her eyes are worse now.
62-127 My eyesight is still the same.
62-135 I did not get help with housekeeping.
62-138 The training was, more like, to cook. I don't cook anymore.
63-164 The only change that I can see would be with the magnification device. I
cannot do anything else.
63-174 I have a lot of frustration because I can't see. I can't focus very well.
62-062 He is about the same.
62-124 The magnifier helps some, but there is no change in my daily living
routine.
63-152 She is totally blind now.
63-173 Because he doesn't read anymore.
63-154 He is older and his sight is worse.
63-158 Because my eyesight is getting worse.
44-009 It has helped tremendously.
44-008 Because the glasses did not help me at all.
44-010 Everything is all right now.
44-022 I still cannot see well. The help they gave me did not help me much at
all.
44-028 Because she won't use the item. It is not the fault of the item.
44-029 The glasses don't help me.
84
63-188 I cannot use the glasses.
13-258 I am a little bit better.
13-278 My eyes are not too good.
13-308 I was not quite ready for all this, I think it helped me to acknowledge that
I do have a problem.
13-328 I am getting old.
13-348 I only had an eye exam, but did not get glasses or anything.
13-378 There has been very little change, but some.
13-228 We haven't started yet.
44-007 The magnifying glasses do not help much.
13-438 I can move around with or without the items.
13-443 I am older and need new equipment from them.
13-418 Because my eyesight has gotten much worse.
11. In your opinion, what is the greatest difference this program has made in your life?
51-001 They made me independent. They are very good.
21-002 I could not read my mail and it really bothered me. Now, I can fill out
forms and read my mail again.
21-003 It has given me the ability to hear my books again.
21-004 The watch has given me the ability to know what day of the week it is
and the time of the day.
11-027 Just being aware that this program exists. Also the magnifiers helped me
a lot.
11-028 The devices that they showed me and the ones that I have selected
have helped me out. Also, the book-reading recorder.
11-030 I am able to read again.
11-033 I can see better now.
11-035 It has given me the information that they have that has encouraged me
to go even farther to put my life in order.
11-037 She felt like they were willing to help her in any way they can and that
they really were concerned. The bump dots have helped her most.
11-040 It has helped her to become more independent and it gave her more
confidence.
11-047 It helped me to adjust to a new area that I had just moved to. It made me
more independent.
11-048 Just being able to see something fine print.
11-051 I can read better now and the glasses have helped a lot.
11-052 It has helped me greatly to read my paperwork.
85
11-053 I am not so scared of losing my sight.
11-054 They provided me with the magnifier that I can read again. The
important stuff. Like my medicine bottles.
11-056 The CCTV has been just great.
11-059 The glasses have helped me the most.
11-026 Using the magnifier has helped me to be able to see my prescription
bottles and instructions better.
11-003 I have more confidence and they made me more aware of things that I
did not know. The teaching is great.
11-050 I have never been through any kind of program. This is the first I have
been told some of the things you are telling me.
11-060 The magnifier helped me to read and write now.
11-061 It is hard to say, but he cannot read anything without his glasses. Also,
his reading machine has helped a lot.
11-071 He can see and tell time now.
11-077 The magnifiers have helped me.
11-069 That he is able to see enough to be able to read.
11-074 I have the books on tape and they are nice.
11-075 Well, I can see better and I can see my computer better.
11-082 The books on tape have been very good for me. I just wish I didn't have
to wait so long for them to come in.
11-010 The magnifiers have helped me a lot.
11-012 The magnifier and the cane have helped me most.
11-017 The magnifier lets me read a little better.
11-008 It helped me to think about ideas that will improve your life.
11-016 The light helps her to see better for eating.
11-083 There were no differences. We thought it was two hours of wasted time.
11-004 They were willing to help.
11-005 Working with the man who helped me with my eyes. He was very
knowledgeable.
11-021 It has made it easier for me to read. It is great to know that someone
cares and is willing to help.
11-024 It has given me confidence.
31-001 I am able to read better and they also showed me more options if my
eyesight gets worse.
31-003 They were able to keep me from being totally immobilized in my house,
not being able to do anything. They were able to take me out of my fear of going
blind and to find people that were able to help me and who wanted to help me. I
am able to walk, talk, and cook. They saved my life.
86
31-004 The magnifiers have really helped me with my shopping and so forth.
31-005 It has enabled me to be able to read again. Also, finding out what was
available to me.
11-013 The various techniques and the tools that are available were very
enlightening. Things they showed me that will help me along the way.
11-018 It hasn't really helped him at all.
31-006 The audio reader has been nice. Not much else is different.
31-012 The magnifiers help me to read menus in restaurants now.
31-008 It lets me know that there is help when I need it. I will know when I need
more help and the type help that I need. The magnifier has helped me a lot.
11-087 My bifocals did help.
21-001 The watch meant everything to me.
11-094 As the caregiver, they have helped me to understand her situation
better.
51-003 The talking clock and the talking watch.
11-041 The watch and the phone are awesome.
11-062 It helped her with her independence.
11-045 The magnifiers have helped me a lot.
11-046 They allowed me to be able to ride on the mobility bus.
11-019 They highlighted the buttons on my telephone and that helped me to be
able to hang my phone up.
11-029 I don't know.
11-034 Recognition of my vision problem. It has helped me to realize what is
happening to me.
11-068 The magnifiers have helped me some.
11-073 The magnifier has helped me the most.
31-016 I think they made a significant effort to help him, but he just has no
interest to exert and effort to use it.
11-036 Just knowing that there is help for people out there who have eye
problems and that they are willing to help you.
11-066 I think the recommendation for the Amigo. It helps me read things that I
wouldn't be able to read without it.
61-003 The magnifier has helped some.
61-005 The magnifiers have been helpful.
61-009 I don't believe it made any, but it was not their fault. Just nothing could
be done.
61-012 The glasses helped me a lot.
61-014 It gave a better sense of control where her vision stands.
61-015 The magnifier is great.
87
61-016 It has helped me to hear my TV programs better.
61-017 My sunglasses have helped.
61-018 The magnifier helped me most.
61-019 I just got an eye exam.
61-022 My BP machine helps me a lot.
61-023 It really hasn't made any.
61-027 The magnifying glass has helped me out a lot.
61-031 It didn't make any difference.
61-037 The magnifier has helped.
61-038 I can just see bit better.
61-042 It afforded me to go to the school and it gave me more teaching on
independent living and training on cooking. Also, the exposure to being with
other blind people.
61-049 Actually, the glasses that I got helped me along with the magnifiers.
61-050 It has helped me to be able to sit down and write my own checks. I have
a timer for my kitchen that helps. Also, a mobility ride in my neighborhood and
sunglasses.
61-057 The magnifier has helped me the most. The video eye.
61-058 I don't know.
32-018 The glasses helped me.
32-023 The audio books have made things easier.
32-021 The magnifier helps me.
32-029 I don't know right now.
32-032 Nothing much at all.
32-033 The counseling was great. They helped me to accept and how to cope.
32-034 I can read my mail better.
61-020 The items that she got have helped her some. Some are better than
others for her.
61-025 Being able to read some things that I need to read that I couldn't read
before.
32-040 It gave me more input on what to look for and how to find things. The
magnifiers have helped also.
32-041 Knowing that I can go there for different things.
32-044 They put me on the right track to get the help that I needed. The
sunglasses have helped me a lot.
32-037 They told me about all the things I might need and where to find them.
Also, the catalogue to order things.
32-043 It would be able to see my letters and numbers greater.
32-047 It helped me with the magnifiers. I can read small things better.
88
32-048 Helping me understand more about vision loss and how to cope daily.
12-196 That there is someone willing to help you. It is a good morale booster.
12-198 It renewed my confidence in [Service Provider Removed].
12-201 I can read with this magnifying device now.
12-204 It gave her more time to maintain her independence a little bit longer.
12-208 I have the cane to walk around with.
12-210 At that point it made him feel like he was still OK. I guess peace of mind.
12-101 I do have the recorder that I can listen to the tapes at night.
12-108 They haven't helped me much.
12-111 It made things easier for me on a day to day basis.
12-114 Well, it really has helped me to have a better outlook in my life. It has
helped me to accept the fact that I can go on with my life. And the training has
helped me a lot. I now have a happy and successful life.
12-116 The fact that they do take interest in you and they try to help in any way
they can. Also, the devices that you need, they try to provide them for you.
12-121 The safety precautions.
12-122 It helped me with telling what time it is and everything like that. Also, my
glasses for the sun have helped me too.
12-124 The cane.
12-128 It has given me the ability to read the newspaper and keep up with
what's happening.
12-138 The magnifying glasses where I can continue to read my own mail and
stuff like that.
12-139 I am able to read items that I couldn't read before.
12-141 They have provided me with equipment and items that have helped me
greatly in my life. The software has made the biggest difference.
12-142 I enjoy the books on tape.
12-143 Nothing has helped him.
12-147 I didn't need much. The magnifier has helped some.
12-157 This program has helped me to live.
12-107 They trained me how to walk with a cane. It has helped me a lot.
12-112 I learned how to count change and stuff like that.
12-102 The cane and the magnifiers and the shades have helped me greatly.
12-145 They did have the light that I needed and some other things.
12-146 It hasn't made any.
61-028 She was able to read the newspaper in the beginning.
61-030 They have helped me with walking again. The magnifying glass has
helped me to see things better.
61-043 Being able to see clearly with my glasses.
89
22-008 The markers have helped me.
12-099 The magnifying glasses have helped me most.
12-100 They only suggested that I might need the magnifying glass and the
tented glasses. They haven't done anything else.
12-173 Some more self-confidence.
12-176 My DaVinci machine.
12-181 They helped me to read better and to see better.
12-183 Just the security that I have someone to call on. Knowing the store aids
are there.
12-187 I feel less stigmatized.
12-170 They helped me a number of magnifiers. The one I purchased has
helped me with my medications and vision reading.
12-182 It gave him some more confidence.
12-186 It helped her to be able to see better.
12-189 They helped us to understand more.
12-188 The magnifying glasses help some.
12-151 It has helped me to read my medicine bottles.
12-159 Reading better. I listen to the audio tapes.
12-165 It made her aware that there was just about nothing else they can do for
her.
32-030 I got information about what is offered.
32-020 It helped with her confidence just knowing that the program was
available to her and that she was stable.
32-025 The magnifying glasses have helped me the most.
32-042 I think the magnifiers and the training have been able to help her read
better. It has given her greater confidence.
61-002 [Name Removed] was exceptionally helpful. I got lessons learning how
to use an iPhone.
61-051 The glasses have helped. Also, a lot of friendship and knowing that there
is someone out there that actually cares for people who are blind.
61-053 It has helped me to be able to read labels on my medicine bottles.
12-104 They helped me to get a driver’s license once I got my glasses.
12-110 It has given me confidence with traveling.
12-169 The sunglasses have helped a lot.
12-172 Writing my checks and keeping my checkbook.
12-195 It did not help her, but it did help the caregivers.
12-153 The support they offered her. Also the demonstration they gave her.
12-209 Just knowing that someone is there. It was encouraging to her.
90
41-003 Being able to read both the computer and documents to me. I am more
in contact with my surroundings with being able to use these applications.
62-060 It made him aware that there are some things that will help him. If he
needs them, he can get help.
62-070 Being able to read more now.
62-075 Just knowing I can go back in the future.
62-076 I would say really not any.
62-080 The books on tape have been the best.
62-077 He can tell time now. They also gave him encouragement.
62-082 I think it was a good program and it gave me some insight as far as what
is offered to me to be able to see better and to get around.
62-084 Just some advice they gave me.
62-061 The magnifier helped me a lot in the beginning. Now, it is almost useless
to me.
62-066 I can't really tell you now. I had a stroke and I can't think right now.
62-069 The magnifying glass has helped me most.
62-078 The glasses have helped me to be able to read better.
62-089 It would have to be the encouragement they give me.
62-091 The watch is good and the dots on my phone are good.
62-068 They helped me with placing my furniture in my house. They taught me
how to move around. The glasses have helped me most. They are good.
62-071 The glasses have helped me a lot. I like them. They are good. I dropped
them once and they didn't break.
62-074 The magnifying glasses and sunglasses have given me more
confidence.
62-081 It has enabled me to maintain my lifestyle.
62-092 Helping me with the reading glasses.
62-095 It has made a great change. I am able to take care of myself now and do
for me.
62-096 It helped me to be able to read some more.
62-102 Just in understanding the condition I have itself and knowing that I am
not going to be blind. Just the knowledge.
62-104 She can see a little bit better now. Her glasses have helped her some.
62-106 It has helped me to see a little bit better.
62-107 Just them uplifting me and making sure that I understood there was help
there anytime I wanted it or asked for it. Other than that, the cane has helped
me the most.
91
62-094 To know that she has the support of an organization that are there for
her in her impairment. Also, the phone has helped a great bit. It gives her the
ability to reach out to friends and family.
62-111 Being able to maintain doing my checkbook and being able to walk
around in my yard. My mobility - going up and down stairs.
62-120 It helped me to be able to read better.
62-116 It made a great difference. She could still enjoy her TV, now she can't.
62-122 I think walking with the cane has helped her most. She is not afraid
anymore to walk.
62-126 It has made my life simpler. I can read much better now with the
magnifier.
62-127 There has not been much change.
63-141 It has given me some options to do. The cane is wonderful. I am able to
move around a whole lot more with confidence by myself. I can move more
freely and speedily.
63-147 It improved my ability to read some. The magnifiers helped
tremendously.
62-131 It helped him with the cane not to bump into stuff. The watch has helped
him keep up with the time.
62-135 My eyeglasses have helped me the most.
62-136 The walker has helped me most.
62-138 The glasses that I got. I am able to read without having to hold a
magnifying glass now.
63-159 I can see better with the equipment.
63-162 The glasses have helped me to see better now.
63-163 That I can read my Bible more each and every day.
63-170 I think the magnifier has helped me the most.
63-171 The books on tape have opened up a whole other world to me now since
I can no longer read.
63-164 The magnifier has helped me.
63-172 The glasses have helped a lot.
63-174 The magnifier has helped me more than anything.
63-180 It taught me a lot. They gave me a lot of support. The cane has helped
me a lot. The people took their time and trained me well.
62-087 It has helped him to read more again.
62-062 I think it helped with the magnifiers. He has enjoyed using both.
62-109 The talking clock and watch have helped me tremendously. I am
somewhat more independent and confident in doing things.
92
62-118 It has allowed me to be able to see better with the magnifier. Also, a
magnifier that I got from her 8 years ago.
62-124 The magnifier helps me to read a little bit better.
62-125 The magnifier has helped me to be able to read better.
63-142 She has more confidence and more independent.
62-132 I couldn't see how to thread a needle. The sewing kit helped me a lot.
Also the magnifying glass has helped me too. I listened to the talk. It was good.
63-146 The magnifier helps a lot. The light helps a lot.
63-148 The watch and a talking machine they helped me with has helped most.
63-150 Well, I am partial to the magnifying glass.
63-152 She tried hard to use the magnifier. I don't think there has been much
improvement. The clock has helped some.
63-173 It really hasn't done much for him. He doesn't use it much.
63-181 Knowing that people cared about her and were trying to help her. They
let her know that she is still important.
62-114 The watch and the clock have been a great help.
63-155 The clock and the blood pressure cuff have helped me most.
63-158 The caller ID and the clock have helped me most.
23-017 The mobility has helped me the most.
23-019 The cane has helped me most. I still need more help.
44-009 It has given me more confidence and just being able to use the
magnifying glass to see recipes and things like that.
44-012 The operation of her iPhone. Being able to use the phone again.
23-018 It really helped me to get around really good.
44-008 It didn't make nothing. None at all.
44-010 The magnifier helped me some.
44-022 The lamp helped me a little.
44-028 In the doctor’s office, her vision went up 100%. She just refuses to use it.
44-034 It has helped me to be able to read and watch TV again.
44-038 The glasses are helping.
44-020 I was having a lot of doubt in functioning. They have helped me to be
more confident out in public. I have more confidence in myself socializing.
44-024 I am able to see better and I have the talking books.
24-013 I am able to see better.
24-014 I would say teaching me with my cane, how to get about.
24-015 The telephone and seeing better.
63-188 I don't know how to answer that. The program itself has improved my
self-confidence.
63-193 A lot. By updating my glasses when I had surgery. I can see better now.
93
13-218 It helped me to move around and function better. I am not so afraid now.
I try to do things on my own.
13-248 I can get around in the house and outside better.
13-258 I really don't know. Learning how to use my cane and how to get from
places to places. How to get around.
13-278 They gave me my glasses.
13-288 It got me going outside more. The training with the cane motivated me.
13-298 How to use my microwave and move around my house.
13-308 I realized that I do have a problem and that I do need help.
13-328 The magnifier helps me a little bit.
13-348 Nothing -- I was switching my coverage to the VA at the same time.
13-368 I don't know.
53-004 The magnifier helped me the most.
13-378 My magnifier.
13-388 Venturing out independently.
13-408 It turned my life around. I couldn't see to do anything. Now I can do for
myself. I can read for myself with my big scanner.
13-428 Showed her how to do things in order to be independent. How to use the
cane and walk.
13-228 Nothing has been done yet.
44-031 It helped me to know how to deal with what I have. Knowing that there is
help out there.
44-007 The magnifying glasses have helped me the most.
44-013 Just knowing someone is there if I need them.
13-438 I don't know. The magnifier has helped a lot.
13-443 The fact that I have been able to get some visual aids to help me
function better.
13-318 I think he has more confidence to function on his own now.
13-418 The magnifier helped me a lot at first.
13-268 They helped me to be able to move around better.
44-014 I can see and read some now. It was great to be able to read again.
44-019 It helped me to be able to read now.
41-002 It made her at ease to be able to walk around without fear of falling.
12. How could your experience have been improved?
51-001 No way.
21-002 I don't know. I feel so blessed to have been given this opportunity. It has
improved my quality of life greatly.
94
21-003 It was good like it was. They are still supposed to come.
21-004 I was perfectly satisfied.
11-027 I don't know. Maybe if they came out more often. Not every 2-3 weeks,
but 2-3 months to check on me.
11-028 It was alright like it was.
11-030 I think it was good.
11-033 The class about the telephone could be better.
11-035 They have helped me in many ways already. They have given me
motivation to just get up and do what I need to do.
11-037 I don't think there was anything that could have been done. They might
have considered her other health conditions and considered other ways to help
more than her vision.
11-040 I don't think there is anything else.
11-047 I can't think of anything.
11-048 It was just fine.
11-051 They gave me satisfaction to take care of myself. It was good.
11-052 The time with them was good.
11-053 I don't know. I do know that I want to go back to them. I had a pretty
good experience.
11-054 It was good.
11-056 They did a wonderful job.
11-059 The people and the doctor were great.
11-026 I need more help with my computer. And more telephone information.
11-003 They could not be improved.
11-050 The visit was OK. The doctor checked my eyes and I got a magnifier.
11-060 It was good. It would have been better if I didn't have to go out.
11-061 I don't think anything.
11-071 I don't believe it could have been.
11-077 I don't think it could have been improved.
11-069 It was just an excellent experience. If the travel distance was a little
shorter would have been good.
11-074 I need larger print in things that I have to read.
11-075 Everything was good and they helped me a lot. It would have been
better if I didn't have to go so far.
11-082 They were very, very nice.
11-010 The experience was exceptional.
11-012 Everything was good.
11-017 I needed some more glasses and also the diabetic and mobility classes.
11-008 I need a closer location. It is 40 - 45 miles from where I live.
95
11-016 Nothing really.
11-083 Stop trying to sell expensive equipment. Find the cheapest equipment
and go more thoroughly into what people need.
11-004 I don't think it could have been changed.
11-005 It was very frustrating because he was only there on Thursdays and you
had to wait if anything else happened.
11-021 They all were very patient and I think they do a real good job.
11-024 It was alright.
31-001 I thought it was a great experience.
31-003 I can't think of anything that they could have made better.
31-004 I don't think they could have been any better.
31-005 I don't think it could have been better. I was pleased with them.
11-013 Give me some better sight.
11-018 Maybe some glasses so he might be able to see better.
31-006 If they had called me back in a timely manner.
31-012 None. It was a good experience.
31-008 It was wonderful.
11-087 Nothing could have been done better.
21-001 It was good.
11-094 It was a long wait and they need a magnifier that will sit flat on a book at
an angle.
51-003 Return my calls on time.
11-041 I can't think of a thing.
11-062 Everything was good.
11-045 If I could get into the typing program for the visually impaired.
11-046 I think I could have done better with an eye transplant.
11-019 Offered transportation to help me get downtown for keyboarding.
11-029 Everything was good.
11-034 If they had had something that would have helped me to read better.
Better magnifiers.
11-068 I really don't know.
11-073 Due to distance and I don't drive, I did not get a magnifier returned as
soon as they wanted. Therefore, they charged me for the magnifier even though
I had told them it didn't work for me and I was going to return it. I am not very
happy with that.
31-016 I think they made a very good effort to make the best out of his situation.
11-036 I really cannot think of anything.
11-066 Nothing that I know of.
61-003 It was alright like it was.
96
61-005 I think they did extremely well.
61-009 I believe they did all they could for me.
61-012 It was good.
61-014 I don't think anything. They were wonderful. Very kind, gentle, and
sensitive.
61-015 I think everything is good.
61-016 It was good.
61-017 It was good.
61-018 It was great.
61-019 Nothing.
61-022 It was good.
61-023 I don't know.
61-027 I cannot think of anything. Just some of the items were too costly.
61-031 I don't know, I don't know of anything they could have done better.
61-037 It was good.
61-038 It was good as it was. Just too expensive.
61-042 The internet went down at the home we were staying at. Other than that,
everything else was fine.
61-049 I don't think they could have improved anything.
61-050 I believe it was great.
61-057 It was good like it was.
61-058 They were very good. Very nice.
32-018 I don't know of anything. They were great.
32-023 I don't know that it could have been any better.
32-021 If the people had been nicer and more helpful.
32-029 It was OK.
32-032 They could have helped me with magnifiers more. I think I need a 6+6
now. They could also have spent a little more time with me.
32-033 They could offer counseling over the phone.
32-034 I don't think anything.
61-020 They were very nice and attentive. I think it was for people with worse
vision than she has.
61-025 Nothing that I know of.
32-040 Everything was very good.
32-041 It was perfect.
32-044 I don't know of anything. They did well.
32-037 It was all OK.
32-043 I made a phone call earlier to get something to help me with writing my
bills. I need a larger magnifier that is not hand held. They were not very helpful.
97
32-047 I don't think it could have been better.
32-048 I don't think they could have done anything better.
12-196 I can't think of anything.
12-198 It was alright like it was.
12-201 It helped me in every way. It was good.
12-204 It was just long for her at her age. It was a good experience.
12-208 Oh, I have no opinion on that.
12-210 Nothing. The location is a bit difficult to get in to.
12-101 They could have sent the right papers with the right name on it. They
should have followed up after that. They only contacted me after my Social
Security officer called them.
12-108 Been quicker and more helpful.
12-111 I can't think of anything.
12-114 I don't know. The keyboarding class could have been a little bit better.
The counselors have a lot of clients. They need more counselors to make sure
that the needs are really met.
12-116 I can't think of anything.
12-121 If they had told me about some of the items that were just mentioned.
12-122 It was good.
12-124 Nothing that I know of.
12-128 They could have gone over more of the devices in their store.
12-137 If the equipment was cheaper. I could not afford anything.
12-138 They did what I needed. It was good.
12-139 I don't think they could have done anything better.
12-141 It was the best.
12-142 Well, introduced me to something affordable to help me with doing my
checks and my checkbook.
12-143 I don't think there was anything.
12-147 I don't think it could have been.
12-157 Nothing.
12-152 Having the eye equipment functional. I was disappointed in the eye
exam and the quality of the glasses offered. All they were interested in was
selling the items out of their store.
12-107 I think they do a good job.
12-112 It was alright.
12-102 It was wonderful.
12-145 If their prices had been more reasonable.
12-146 If they had come through with my glasses.
98
61-028 I think they might have come out to our house and showed her more on
how to read and perform her daily activities.
61-030 It was alright.
61-043 They were very helpful.
22-008 Nothing.
12-099 Nothing.
12-100 It was alright.
12-173 It was alright.
12-176 It couldn't.
12-181 It was good.
12-183 Nothing.
12-187 I think they have answered most of my needs.
12-170 They could have followed up to help me with the cane and done the
services in my apartment with living needs.
12-182 If we had known everything that it offered.
12-186 It was alright.
12-189 Their simulation was not good.
12-188 It could have gone a little smoother.
12-151 Nothing.
12-159 I enjoyed it. They attended to me quickly and got me finished.
12-165 If the employees had had just a little bit better attitude. They were good,
but their personalities were flat.
32-030 I was very satisfied.
32-020 They did an excellent job.
32-025 They were all very nice and polite and they didn't seem to push me to do
anything. I did appreciate that.
32-042 It was wonderful. We were extremely impressed.
61-002 It was good.
61-051 They did a wonderful job.
61-053 It was alright. They were really nice to help me.
12-104 If they had someone more knowledgeable about the computers. If they
could have helped me to understand more about it.
12-110 Shown me more things that could help me with my situation.
12-169 I have no idea.
12-172 They were great.
12-195 It was very good.
12-153 I don't know. We wish the gift shop had been open.
12-180 I guess they did alright.
12-209 Nothing. It was good.
99
41-003 If I had gone there just a little bit longer. Maybe I could have gotten more
training.
62-060 Only if the glasses had helped him to be able to read and see better.
62-070 They were fine.
62-075 If the doctor could have helped me more. The PX just was not adequate.
62-076 If what they showed me had worked like they showed me in the office.
The glasses were too small. You have to be under the proper light to make out
what you are trying to read. It just wasn't any good.
62-080 It was alright.
62-077 It was good like it was.
62-082 I don't really know of anything that could have been any better than what
it was.
62-084 It was very good.
62-061 It was alright.
62-066 Everything was alright.
62-069 I don't know of anything.
62-078 I think they did everything just fine.
62-089 I don't know that they could have improved anything.
62-091 It was alright like it was.
62-068 They did all they could. It was good.
62-071 They could not have done anything better. They did all they could for
me. It was good.
62-074 I don't think they could have done anything better. I enjoyed my visits.
62-081 I can't think of anything. They were so nice and accommodating.
62-092 I don't know. Everything was over and above.
62-095 It was alright like it was. They did everything they could do for me.
62-096 Nothing, they did what they could.
62-102 I can't think of anything. They were very nice.
62-104 It was alright. Everyone was nice.
62-106 It was alright. Everyone was real nice to me.
62-107 I don't know of anything they could have done to make it better.
62-094 We are very satisfied with the program. I wish the magnifying machines
were not so high.
62-111 I don't think anything could have been better.
62-120 It was good like it was.
62-116 It was fine like it was.
62-122 If their magnifiers were larger so she could read a whole page at a time
would make everything much better for the blind.
62-126 I don't know. They were very nice.
100
62-127 They couldn't have done more.
63-141 I don't think they could have done anything.
63-147 I can't think of anything else they could have done.
62-131 Everything was done well. They were very helpful and informative.
62-135 I was well pleased.
62-136 It was alright.
62-138 They couldn't. They were great.
63-159 I think they were real good.
63-162 It was good. I really enjoyed it.
63-163 They were good.
63-170 I really don't know. They were very good.
63-171 They did a great job.
63-164 They were alright with what they did.
63-172 Nothing really. They did real good.
63-174 It was just good.
63-180 If we could have had more time it would have been great. I was very
pleased.
62-087 I can't think of anything.
62-062 I don't think they could have done better.
62-109 I don't know. Maybe some braille or computer training.
62-118 I don't know of anything.
62-124 I don't know. I guess I was expecting them to be able to have stronger
eyeglasses for me. I wasn't just expecting a magnifier, but I am thankful.
62-125 Everything was fine.
63-142 It was good just like it was.
62-132 They did a good job.
63-146 They let me know that they could help me when my vision gets worse.
63-148 They did an excellent job.
63-150 It was all nice.
63-152 I don't think there was anything. We didn't know about the service early
enough.
63-173 It was alright.
63-181 They were really good.
62-114 Everything was good.
63-154 If they could have helped him like we needed.
63-155 If they could have helped me with my grooming, and shopping, etc. I
also need a voice-activated phone.
63-158 I don't know.
23-017 Everything was good.
101
23-019 If they had given me some glasses so I could see better.
44-009 They were really good.
44-012 I don't know that there would have been anything.
23-018 They did it. Just to help me to use the cane and to get around.
44-008 I think they should have had someone give me an eye exam at least.
44-010 I don't know of anything else they could have done.
44-022 I was alright.
44-028 I don't think anything could have been any better.
44-029 If I had got the right glasses.
44-034 It was good.
44-038 It was good.
44-020 It was always pleasant and they tried to do the best they could do for
me. They gave me excellent service.
44-024 They treated me well.
24-013 I don't know of anything.
24-014 They were very good. I don't think they could have done anything.
24-015 Everything was alright.
63-188 Nothing. They are wonderful.
63-193 They couldn't have done anything.
13-218 They were good. I liked them.
13-248 They were alright.
13-258 They treated me alright.
13-278 It was O.K.
13-288 It couldn't be better.
13-298 It was good.
13-308 I don't think they could have done anything better.
13-328 They couldn't have done any more for me.
13-348 What they did was good.
13-368 It was alright.
53-004 I don't think they could have improved it.
13-378 There is really nothing.
13-388 More advanced scheduling.
13-408 They did everything possible. I couldn't ask them to do anything more.
13-428 I don't know.
44-031 It was alright.
44-007 I don't know. It was good.
44-013 They were alright.
13-438 I don't even know.
102
13-443 It has been better since seeing them.
13-318 He was very comfortable with them.
13-418 It was very good when we saw them.
13-268 They were very good.
44-014 Everyone was very nice and helpful.
44-019 It couldn't been better.
41-002 It was a good training.
Additional comments:
51-001 Everything was good.
21-002 I am grateful for the [Service Provider Removed] program and I would be
delighted to help in any way I can.
21-004 Everything was just wonderful.
11-027 I think they do very well with what they have. With the staff and
everything.
11-028 I think that the program is a good program overall, but I need to get into
it a little more before I can have a good opinion.
11-030 We thought it was just great. We were very proud to have found out
about it.
11-033 It has been a good program. I am in class now.
11-040 They are the best.
11-047 I would say that it is a lifesaver if you are trying to remain independent.
Also, I really enjoy the talking books. I could not function without them.
11-052 I am very satisfied with it.
11-054 I was very satisfied with it. Everything helped me.
11-056 We just really appreciate it and think it is a great and worthwhile
program.
11-059 I am really happy with everything.
11-026 I think the center is very helpful.
11-003 I have just enjoyed the program and everyone who is with the program. I
am having a good time learning from them how to live my life to the best of my
ability with the condition I have.
11-050 I need to see them again. I will probably need more help in the future
with transportation.
11-077 The program is great.
11-069 We just think it was a great process.
11-074 I think they have done a good job.
11-082 Georgia does a great job; however, I am interested in the books on tape.
My local library doesn't carry them, the main library is located downtown, and it
103
is very hard to drive there and find a parking spot. No one wants to go down
there. I have to wait too long to get books that I have to order. They need to do
something about that.
11-010 Everyone has been wonderful. I think I need more help especially with
my computer, but I don't want to be greedy and I have called them several times
asking questions.
11-012 Everything was good, but I didn't know that I could get a large button
telephone. I need one of those.
11-017 I am just trying to wait to get into more of the problem and I need help as
soon as possible. They haven't gotten back to me yet.
11-008 I just think it is an excellent program.
11-016 The people at the center were very accommodating and pleasant.
Because of her disease, they couldn't do much for her, but they took their time
helping me to understand her and helping me learn how to guide her and help
her better as her caregiver.
11-004 No, I hope to get back with them soon and see what else they can help
me with.
11-005 I just wish that the doctors who work there were available more than one
day a week.
11-021 They make your visit easy to handle. There was room for parking, with
no waiting time. Everyone was very respectful and supportive. Everyone helped
me through my stress and put me at ease.
11-024 I would like to have the CCTV, but I can't pay for it. The people need that
available to them even if it is on loan. When they pass on, they have to give it
back.
31-001 I just think it is a great program.
31-003 They were a blessing to my life and my family's life. They took away
fears that were there from everyone.
31-004 I was just glad I found out about it. I may need more in the future if my
vision gets worse.
31-005 They really did a good job. I am really happy about it. My doctor told me
about them and I am glad that I went.
11-013 They are doing a wonderful job and I hope they are able to help a lot of
people along the way.
11-018 I don't want anyone to think that the magnifier wasn't useful. Even
though he cannot use it, we both have trouble with our eyes, and I use it all the
time. It is very beneficial for me.
31-008 I think the program is wonderful. I have shared it with my church and
people that I see of how wonderful it is. The people that I saw were all
wonderful.
104
11-087 I think it is absolutely wonderful that they have programs for people like
me today.
11-094 I really appreciated the doctor. He was very good and told us things that
we haven't heard before.
11-041 They did a wonderful job. I just hope that when I have to go back I can
maybe get some help from them with transportation. I am 71 now and I don't
drive and traffic is real bad.
11-062 They do a real good job.
11-045 I guess they could get more classes for people who need it and are not
going back to work. They need it for personal reasons.
11-046 I want an eye transplant so I can be independent and not have to
depend on other people. If I can get one from any place I would appreciate it.
11-019 Basically, I enjoyed everything except I could not finish my program
because it was downtown and I was unable to get transportation there.
11-029 I do appreciate everything that they tried to do for me. I just think they
cannot help me now and my eyesight is worse. I wish they could do something
to help me drive again.
11-034 I would like to see them make a magnifier that will fit a page and allow
the reader to see a complete paragraph or more at a time. It needs to be on
telescopic legs or movable legs to use as you need it. I do appreciate their help
and everyone was very nice to work with.
11-073 I wish [Service Provider Removed] had locations other than downtown
[City Removed]. It is really inconvenient getting there from outlaying places.
Needing to buy things from them that I need, it is really hard getting there.
People have to take off a whole day just to take me there.
31-016 Everyone was just fine. They were courteous and helpful with our
situation. I would give them top marks.
11-036 It is a fantastic program.
61-003 I just think they did a fine job.
61-009 I thought they were good. There was just nothing that could be done for
me.
61-015 I think they were just great.
61-019 It is just great that you can do something like this.
61-022 It would be very nice if I could just get my BP monitor, and the talking
thermometer. I also need some special tweezers. [Name Removed] is supposed
to send them to me.
61-023 Nothing seems to help. I know it is not their fault, that's just the way it is.
61-027 I have always wondered if, when or where, you should start learning
Braille or other things I might need to know in the future.
105
61-031 It is a good program for someone they can help. With my problem there
wasn't anything they could do. They tried.
61-042 The program has been very helpful to me over the years and helped me
to afford the equipment to maintain my independence here in my home. I am
very grateful to them.
61-049 It was very good and they were very professional.
61-050 I am grateful that there is a service that will take care of my needs and
help me with my living needs.
61-058 I think you all are doing what you can right now. I appreciate it.
32-018 I have appreciated every bit that they have given me.
32-023 I was just very glad that I went there.
32-032 I think it is deficient in educating the blind or near blind. People need
more information concerning what is offered to them or what they may need.
32-033 Just for the visually impaired, they need to offer counseling over the
phone. My husband has had a heart attack and I need transportation to get to
help. I also need time to be able to go. If I could talk with someone over the
phone, it would be very helpful and beneficial to me.
32-034 I was disappointed in the machine and what I could get out of it. I
thought it would help me more, but it does what they said it would do. It is not
their fault, I just cannot do any better.
61-025 Everyone that I dealt with was very nice and helpful and I am really glad
that I got to go with the program. I really appreciate it.
32-040 I would like to thank everybody that has helped me and I hope they
continue to help everybody.
32-041 It is a very great program and it is very accessible to me.
32-044 I appreciate their help very much. They ended up sending me to the VA.
32-043 No, I know it is there if I need it in a year or two.
32-047 No, everything was just great.
32-048 They were very helpful. I was well pleased.
12-196 I think on the whole they do their best. I was very impressed. They also
try to help those who are on limited income, by either reducing the price of items
or even giving them to you.
12-198 [Service Provider Removed] is doing an excellent job. I appreciate them
very much.
12-201 I think the program is very good.
12-204 It was good for her.
12-101 On a scale of 1 - 10 with 10 being the best, I would give them a 1 the
way I feel right now with the way I have been done. However, I spoke with
[Name Removed] and I would give her a 10. She was great.
106
12-108 The attitude is bad. I had one appointment and she called me the
morning that she was going to be 15 minutes late. Then she called that she was
going to be later. Then when she finally arrived she had things to do. She didn't
even have the decency to tell me we needed to reschedule the appointment, but
just left me sitting there all day. I am still waiting on my glasses and it has been
a year.
12-114 The [Service Provider Removed] service has really helped me out a lot
and the service is good. The staff are good.
12-121 Just worrying about social security and things like that.
12-122 I need a talking blood pressure monitor and things for my shower, but
they are too expensive.
12-128 I think they have a good service that is needed for a certain population.
12-137 None. I just will never go there again. Everything was too expensive and
the magnifier I bought only shows one word at a time. Then when I move it to
another word, I got on the wrong line. It was a waste of my time.
12-147 I thought it was a very good program, I just don't require it quite yet.
12-157 If they would permit me to come to the center more than once a year I
would appreciate it. They are very helpful.
12-107 It does the job.
12-102 They have helped me so much. I appreciate all that they have done for
me.
12-145 They need to improve their prices. For people who don't have funds,
they need to be able to know how expensive things are before just letting them
shop for nothing.
12-146 I was just dissatisfied because they didn't follow through with the
transportation that I was promised or get me my glasses.
61-028 Just that I think it is a good program, and I would like to see her be able
to get more benefits from it.
61-030 I just appreciate what all you all have done for me.
61-043 I think it is great.
12-099 Not at this time. They have just been very good to me.
12-100 I got the evaluation, but I thought it would be more. I thought I would get
some training or something.
12-176 Everything was good.
12-181 The program is really good. It has helped a lot.
12-187 I am a great supporter and I am contributing to the program as much as I
can.
12-170 It seems to me that a number of these questions that you have called
and asked now, should have been asked within a week after I left the center. I
107
have still been waiting for a call. I just went to the VA Office this past Monday
and they have been very helpful. I will be going to them from now on.
12-186 We have recommended several people to go there. It was a great
experience for us.
12-189 The doctor was wonderful, however, when we moved next door to have
a simulation of everything and to see what would be best for him, their set-up
was not sufficient for people. We expected to have a living room situation with
an up-to-date TV and a chair about 5 feet from it. Instead, we were in a closet,
with other people eating, a 19 inch TV that was not a flat screen. There was no
way to tell if anything would help him when we got it home. We were very
disappointed and will not go back again.
12-188 I wish the machine that I need wasn't so expensive. I wish I could see
and read again.
12-151 It was satisfactory. It showed me things that I could do.
12-159 I need better public transportation here where I live. With my eyesight
getting worse, I don't know what I am going to do.
12-165 We are just so glad there. They do a wonderful job and we are proud to
be able to be a part of it.
32-030 We know a lot of people there and we think it is wonderful.
32-025 Only that they have been very, very good.
32-042 They are doing a magnificent job. Keep up the good work.
61-051 I would just like to thank them for what they are doing. It is a great
program and it helps a lot of people.
61-053 I appreciate the help that I have had. I appreciate all that they have done
for me.
12-104 They have helped me out a lot. I just wish they were closer to me so I
could take advantage of what they could do for me.
12-169 Just that I know my eyes are getting worse, I go the eye doctor every
month and get a shot in them.
12-172 I couldn't believe how nice and helpful those girls were.
12-153 It is a great service. We want to go back and go through the gift shop. I
work during the days and it is kind of hard to get there.
12-209 We think the program is wonderful. We wish more people knew about it
in the beginning where they could really help them with their disabilities.
41-003 Everyone at the center was extremely helpful. Each one was very
experienced in their area. I felt like I was accepted and a part of the group. It
was an easy environment in which to study and learn.
108
62-060 No, I am just thankful that the man from [Name Removed] came and
said machine that helps him to read the newspaper. We bought the machine
from him.
62-080 I appreciate your help and it has helped. The books on tape are
entertaining when I can't read or see the TV.
62-082 I am appreciative for the help I received. I would like to take advantage
of some of the equipment that I was shown, but my income will not allow it for
now.
62-084 I am in favor of the program 100%. It is very good for people who need
it.
62-061 The help they give is good.
62-069 I think the blind meetings need to be more uplifting and encouraging.
Our program is very depressing.
62-078 I know they have helped a lot of people and I am thankful that they are
there.
62-091 No. I just appreciate everything everybody is doing.
62-068 I was doing good in January with the seminars. They really opened my
eyes at what I needed to do.
62-071 They were good, I really liked them.
62-074 It is just a great thing.
62-081 I am just grateful that they have a program like this for people.
62-095 It is a good program for handicapped or vision impaired. They do a good
job and focus on the individual.
62-102 I think it is wonderful for people who need help in this area.
62-104 They did a wonderful job. I am just glad you all did it.
62-107 I just think it is a wonderful program.
62-094 We are very appreciative of the program and what they do to help.
62-111 I think it is wonderful. I think [Name Removed] does a super job, and
they are all professionals. Without them, I don't know where I would be.
62-116 I would just like to see more free stuff given to the blind to help them
function better.
62-122 We enjoyed and liked the program very much. They do need to get
some large magnifiers that will allow people to read a whole page at a time
instead of just a few words.
62-126 I appreciate their help and I think they help people.
63-141 I think they were very helpful and it is a wonderful program. They work
very hard to see that we get everything that we want or need.
63-147 I appreciate it. It is working well.
62-135 I was really impressed with everything.
109
62-138 I am just so thankful for the program. I am so thankful that I could be
helped.
63-159 I just think it was really good.
63-162 It is a good program.
63-163 It is a wonderful program and I regret that I didn't know about it earlier.
63-170 It has been helpful. I am hoping to be able to get more help.
63-171 I think it is a great program. I have told several of my friends about it. It
has been a blessing to me and I appreciate everything they have done.
63-172 I just think it was great.
63-174 They did a great job. They were very thorough.
63-180 I think the program is really great. It has helped a lot. The people that
came to my home and that work there have been really wonderful and
generous. I really appreciate it.
62-062 [Name Removed] was wonderful.
62-109 I was satisfied with everything.
62-118 The program is great. I really appreciate the help. There are a lot of new
things available today that I didn't know about.
62-124 The people were very dear, they came and were very concerned, but I
guess I just expected more.
62-125 The people there in Georgia were super nice.
63-142 We were very pleased with them.
62-132 We appreciate their help.
63-146 I sure do appreciate everything that you all have to offer. In the future, I
am sure that you will help me more.
63-148 I think they are doing a good job.
63-150 I am just proud that they have such a program. I wish they would extend
it. They need more stores with the ability instead of having to go downtown. That
is a real chore.
63-152 We did appreciate their effort, but her vision was so poor by the time we
heard about it. They were wonderful to us.
63-181 We were very pleased with the services that have been provided.
62-114 I think it was very good. It helped me a lot.
63-154 Everyone was nice, but they were not equipped to cover our needs. We
felt like we wasted our time.
63-155 They have always been nice.
23-019 My complaint is that I would like to have another lighted magnifier. I think
that would help me a lot. I need one to go to the stores and grocery shop.
44-009 It was just really a wonderful experience.
44-012 The program helped her until she had her stroke.
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23-018 Only that I am very happy with the program.
44-008 I think the program was wonderful in [City Removed]. I didn't get
anything out of it in [City Removed].
44-010 I am just glad that they are there and then they helped me and other
people. I know that if I need other help where to go.
44-022 I think everyone did everything that they could to help me with my eyes
like they are.
44-028 The program is great and [Name Removed] was wonderful. We were
extremely pleased. We wish we could get her to use the monoscope.
44-034 No, I am just glad I was told to get in touch with them.
44-020 They have helped me a lot. I am glad that I could go to them. My
eyesight is getting worse now. I may call them and see if I can get more help.
44-024 I am just very satisfied with everything they have done for me.
24-013 I have been very happy so far.
24-014 Only that they did a very good job and I would have been lost without
them.
24-015 Yes, I thank them for coming here and showing us what to do.
63-188 They are wonderful people. I enjoy working with them. They are very
caring and that is hard to come by in this day and time.
63-193 I think it is a wonderful program. We are on a reservation and great
people always come and do a great job.
13-248 They are good. I just need somebody to come and give me a bath and
things. I need someone to help me to get around. I can't get around by myself.
13-258 I thought the program was good, but it could be better. I wanted
computer training, but the counselor wouldn't approve it. Also, I did not get much
help or time in finding a job.
13-288 Just keep up the good work.
13-298 Everything was good.
13-308 I am high on the program and I think it is a very good one.
13-348 They would have helped me more, but I changed my coverage at the
same time, and now I go to the VA.
53-004 I just hope they will stay around and be able to help me when I need it.
13-388 I was extremely well prepared for getting my guide dog in terms of
orientation and mobility.
13-408 I support them 100%, I think it is a great thing they are doing. [Name
Removed] really went to work to help me and I really appreciate it.
13-428 We just thought it was good.
111
13-228 They are in the preliminary stages of getting me help. However, so far I
am is satisfied with everything. I just need to get things going as soon as
possible.
44-031 I think it is helpful and I appreciate any help that I can get.
44-007 I think the program is wonderful. I appreciate everything they can do for
me.
44-013 I think the program is a good one. I just don't think I was ready for most
of the items they showed me.
13-443 I think the program is great for those who know about it. There are so
many people that don't know about them. I wish I could participate more, but at
my age I just can't.
13-318 We think it is a wonderful program and we are grateful and appreciative
of everything they have done for him.
13-418 I wish it was easier to get to and from the Center. I need another
evaluation and more things to help me.
44-014 No. I just really liked the doctor. I got over there and he did not tell me
what I had to do. He gave me several options that would work for me, and let
me choose which one I wanted to do. I liked that.
44-019 Everything is fine as far as I know.
41-002 I am just glad they are here to help us.
112
113
Appendix C: Part VIII: Narrative (FFY16, 7-OB)
114
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 Title VII-Chapter 2 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 assist 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.
We maintained 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 Georgia Vision Collaborative Statewide Independent Living Council Georgia Library for Accessible Services Older Driver Task Force
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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
IN FFY 16, we expanded our working relationships with the Division of Aging Services and the Georgia Gerontology Society to help reach the underserved and unserved older blind in Georgia.
Our main initiatives to reach underserved and/or unserved populations in Georgia this year were: 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 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, 3) maintaining and expanding our relationship with the Statewide Independent Living Council and Centers by inviting them to send their blind and low vision consumers to our peer support group meetings, 4) continuing to increase awareness of the dual sensory loss by scheduling a Georgia Confident Living Program for our deaf-blind seniors in FFY16, and 5) renaming our program to “Project Independence: GA Vision Program for Adults Age 55 and Over” to more accurately reflect the population with whom we work. 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) The VISTAS CENTER continues to contact the local Optometrist’s office by leaving brochures of our program and the services provided. We participate in as many community services as possible in order to spread the word about our program. We subscribe and announce in the Special Needs Program brochure information in order to reach a mass number of persons with visual disabilities. We continue to maintain a close relationship with local agencies e.g. the Area Agency on Aging, Council on Aging, faith based organizations, Optometrists, Ophthalmologists and physicians who help to spread the word about our program. Transportation is provided to our seniors for low vision exams and training when needed.
Implementation of our program is provided by our LV Optometrist and our five sub-contractors who provide services in Technology, Orientation & Mobility, Vision Rehabilitation Therapy (including braille instruction) and Low Vision Evaluations. We also have two certified Peer Support Group leaders.
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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. The general service delivery model follows a progression of intake and eligibility, low vision examination, functional assessments in vision rehabilitation therapy, orientation and mobility, assistive technology, service plan development, skills training, plan reviews and closure, and finally follow-up case management. Training is either center or home based, depending on the senior’s individual needs and living situation. The type, duration and location of services delivered are determined and noted in the service plan. Most seniors receive a full range of compensatory skills training, while others receive short term services aimed at immediate need/s. Many times, the latter is appropriate for clients who have immediate safety concerns or require only a few basic skills to maintain or regain their independence and quality of life. SCBLV continues to succeed in its’ family rehabilitation program. This program is provided to seniors’ 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, and it serves as a necessary support for family members. All direct services are provided by SCBLV’s professional staff, as well as Dr. Brown, our contracted Optometrist specializing in Low Vision. SCBLV utilizes staff members dually certified in Orientation & Mobility (OM) and Vision Rehabilitation Therapy (VRT) to implement home-based services, allowing one instructor to provide our scope of services to each (OB) client, thus reducing travel costs and maintaining a level of consistency for each client. SCBLV continues the traditional outreach activities through in-service trainings and office visits with medical professionals, service agencies and senior residential facilities and centers. 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) For 20 years Mons International, Inc was awarded the Older Blind grant and the non-profit arm of Mons International, the Visually Impaired Foundation of GA, Inc., helped fund devices or individuals not covered under the Older Blind grant. This is the fourth year that the Older Blind grant was handled through the Visually Impaired Foundation of GA, Inc. (VIFGA).
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VIFGA is not a “brick and mortar” facility. Since we serve rural South Georgia, we go to the communities to work with the clients instead of the seniors coming to our facility. I work with twelve different doctors over the state along with subcontracting with OM, VRT and Computer Technology Specialists as well as 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 are given to the senior if available and/or applicable. Additional services are also recommended at this time as well.
Products and Services: The recommended products are listed on the exam summary that is given to the senior at the end of the exam. The senior is asked to choose one or two items (totaling no more them $200.00). Project Independence provides those “favorite” items if possible. The products provided through PI include a magnifier or magnifying glasses, a pocket magnifier and/or sunglasses. The items are sent directly to the senior, together with a packing slip for the client to sign and return to VIFGA.
If special services are needed, the appropriate teacher is contacted and he/she contacts the senior. Additional devices may be recommended by the VRT, computer technologist and/or O&M 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 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
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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.
Center for the Visually Impaired (CVI) CVI implements Title VII-Chapter 2 programming both in-house and in the community. CVI’s Maxwell Low Vision Clinic provides two to three clinics per week in-house, and monthly satellite clinics in Macon, Suwannee, Fayetteville and Cumberland. The Maxwell Low Vision Clinic has three part-time sub-contracted optometrists in the Atlanta Low Vision Clinic; one of them is also available to conduct the various satellite clinics and another who is available sporadically to cover vacations and other scheduling conflicts of the other doctors.. Maxwell Low Vision Clinic staff includes a full-time Low Vision Clinic Director who also functions as a practicing Occupational Therapist, a second full-time Occupational Therapist, a Medical Secretary and an Information and Intake Specialist. Program staff also includes a Case Manager, one full-time Vision Rehabilitation therapist (currently vacant), and a full-time Certified Orientation and Mobility Specialist from CVI's Community-Based Program. Outreach efforts to reach unserved/underserved populations during the past year have included presentations spread across metro Atlanta, by several CVI staff members from various agency programs (Community Based Services, Facility Based Services, the Low Vision Clinic, the VisAbility Store, Volunteer Services, and agency Executive Staff). 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. Appropriate participants receive a low vision examination from an Optometrist, with the exception of the Macon location. Following the assessment, the senior receives individualized therapy with either a Low Vision Occupational Therapist or a Vision Rehabilitation Therapist to address all aspects of daily living and to provide further training of the doctor’s recommendations. Often seniors require follow-up services to address all their challenges and to ensure that the senior has been able to successfully use devices and 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 stretch across as many individuals as possible. All participants served by CVI’s Community Based Team receive one on one assessments followed by provision of individualized one on one training. Whenever indicated, some seniors receive training in group classes. Assignment to group classes is case by case and occurs only if appropriate for the particular individual.
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Vision Rehabilitation Services of Georgia (VRS) Implementing the Title VII-Chapter 2 program, Vision Rehabilitation Services of Georgia (VRS) offers comprehensive vision rehabilitation services to any resident of our 33 county, north Georgia service area, who is over 55 and who meets the state requirements regarding functional vision loss. This year 86% (157/182 new clients) of our clients began their program with a comprehensive low vision evaluation (LVE) conducted by one of our three consulting optometrists who specialize in low vision. The majority (141) of these exams were covered under Project Independence funding, but we also performed 16 additional LVE using other grant funding that we had made available for this purpose. We continue to average 2-3 Low Vision Clinic days per month; typically 2 days in our Smyrna office and 1 day in different towns within our rural service delivery area. Most VRS program participants purchase their own prescribed devices; this year this practice saved the grant around $11,000.
Many seniors receive at least one follow-up visit from an instructor to go over the use and care of the device. If they cannot afford a device, VRS will help pay for one tool through Project Independence or other grant funding. The instructor will also provide follow-up instruction to clients in other skills areas based on needs identified from the initial intake, the client’s time with the doctor and the social worker during the LVE process. The Individualized Service Plan is created at the time of the LVE or during an initial visit from a VRS staff member if a client does not have an LVE. Generally, instructors try to provide training weekly to the client, until their instructional goals are met. All follow-up vision rehabilitation services are provided by university trained and Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) certified staff. Staffs provide instruction in activities of daily living, access technology, orientation & mobility and adjustment to blindness counseling. To provide these services we utilize a core of staff teachers ((nine in 2015-16) as well as independent contractors who reside in various regions within our service delivery area. VRS strived to provide services in a timely and efficient manner to maximize the funds we have. To reduce continually increasing mileage reimbursement costs and our instructor’s driving time, we encourage seniors to come to centralized training sites or to our main office, when possible, to receive services. Walton Options for Independent Living (WO) Outreach - Referral Sources Self-referrals come thru AAA home modification referrals as well as individual or family calls into the agency. Other sources are: eye doctors, vision therapists from the University and the Veterans Administration, Home Health, nurses, social
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workers/case workers, the blind peer support group, Area Agencies on Aging, Tools for Life, the Walton Foundation, and Money Follows the Person. Referral Process Once a referral for Blind Services is received, the OBP department will contact the consumer and collect more demographic information and find out the consumer’s needs. The senior is instructed that we will need a copy of their latest eye report with acuities to verify their eligibility for the program. We offer to mail them a Release of Information (ROI) form and stamped envelope for them to mail the signed form back to us. The signed ROI form is faxed to their eye doctor who, in turn, sends us their eye report (by mail or fax). Upon receipt of report, we determine if the consumer is eligible for the OB program. Once eligibility is determined, the eye report is sent to a VRT. The senior’s needs are discussed by email or phone with a VRT and an evaluation is usually scheduled. If the VRT evaluation identifies a need for O&M, the OBP department sends a referral to the O&M instructor with the demographic information and a copy of the eye report, indicating a need for an O&M evaluation. There are three options, once eligibility is determined:
1. Staff will send eye report to VRT/O&M and request assessment(s), or 2. If the consumer is only requesting something specific (talking watch) and
does not need an assessment, OBP staff will schedule an appointment to see the consumer, collect all the info needed, obtain signed documents, order equipment, deliver and train the person on the device. During the home visit, if observation indicates that consumer is having more challenges than referenced in referral e.g. suggesting current tools are no longer effective, OBP staff may request a LVE, or
3. VRT will recommend a LVE after assessment, if needed. Upon receiving summary requesting LVE, OBP staff will refer consumer for a LVE.
Service Delivery
VRT assessments – meets consumer for first time and assesses needs. Completes required paperwork, establishes goal(s) and obtains required signatures. Provides agency a written summary describing assessment and recommends AT and all training needs (VRT, O&M, TAT). Agency approves hours for trainings and orders AT if needed or seeks preapproval for AT.
Staff meets with consumer - completes required paperwork, establishes goal(s) and obtains required signatures. Together with consumer identifies need and based upon need, refers for VRT/O&M
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or orders AT. Once AT comes in, delivers to consumer and trains on proper use.
LVE is scheduled (a) when the staff conducting a home visit identified that the consumer’s vision is changing and the AT used before is not working any longer or (b) the VRT may refer consumer for a LVE if it is determined needed.
WO subcontracts with OM and VRT certified professionals to provide those services.
Data Entry
Summaries from VRT and O&M are copied and pasted into Netcil (agency data collection).
Staff notes are entered into Netcil.
When goals are met and/or cases are closed – all the data notes are printed and included in the consumer’s case file (case file includes referral, intake form, ROI for eye report and eye report, written notes, printed notes from Netcil, summary forms, appointment logs, purchase request, invoices, equipment log, cost worksheets, receipts, equipment responsibility form if over $1000, Kay’s approval email if necessary, eligibility form, goal sheets, voter registration, CAP form, WOIL indemnity form and end of year form).
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, the Georgia Vision Collaborative, 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, the Georgia Gerontology Society and the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults.
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Attendance at the National Program Directors Meeting and the American Foundation for the Blind Conference, both in Arlington, VA brought information on new policy and new methods and approaches from other states so that GA might incorporate these activities in our program i.e. expanding staff qualifications and financial resources. 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 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. Information was distributed and discussions were held with interested parties at these various locations. This collaboration and community awareness resulted in numerous phone calls and referrals for Project Independence.
Even though the Independent Living (IL) Centers have transitioned to a new agency, it is 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. Furthering our coordination with the Statewide Independent Living Council (SILC), one of our peer support group leaders is on the SILC Board having been appointed by the Governor of Georgia in FY13. She is the Project Independence (PI)/SILC liaison. The Project Manager participates in the IL meetings and sends 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 April 2016. Our final meeting for FFY16 was via phone with the contractors in September 2016. 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 outreach, collaboration, WIOA policy, recommendations of the MSU evaluation and overall PI program recommendations. The fall phone meeting brought the providers up to date on the final WIOA rules for OBP, reworked some financial policy concerns regarding aids/devices and policies involving other services.
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In July 2016, we conducted a statewide Peer Support Group Leader conference call to update the peer group leaders on the new OBP polices as well as shared innovative ideas about each peer leaders’ group. In FFY16, PI sponsored two new peer leaders for a three day intensive peer training taught by the Independent Living staff. In Georgia, our peer leaders must have completed this intensive IL training course or have group training in their college or post-secondary curriculum as we want our peer leaders to have a standardized level of competency. Georgia Radio Reading Service (GARRS) continued dissemination of the 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. In FFY16, updated 30 and 60 second PSA’s were recorded in the Program Manager’s voice. 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 http://gvra.georgia.gov/vocationalrehab/project-independence.
2. Distributed a number of 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 our second Georgia Confident Living Program (CLP) training using Georgia providers for December 2015.There were eight participants and five Support Service Providers.
4. 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.
5. Using FFY15 carryover funds we purchased training services, training items and supplies; registration, travel, lodging for contractors’ meeting/training; and peer support group leader training. These funds allowed Project Independence to conduct critical activities for seniors and staff we would not have been able to do that allowed us to incorporate new
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methods and approaches in our program, especially for our seniors who are deaf-blind.
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) We continue to participate in local health fairs and distribute our brochures throughout the community. There is a local SPIL based in our area and, as needed, we refer clients to each other. Because we serve seniors 55 years and over we refer those that are younger to the CIL. We also advise consumers, if they are younger and are interested in services we provide to contact the local Georgia Vocational Rehabilitation Agency Counselor for the Blind. We work with the Lions Club and the local division of the American Council of the Blind. We’ve worked with the ‘I Can Connect’ program this fiscal year. Because of this communications program we have been able to expand our services and serve more clients, especially with the utilization of a DaVinci CCTV and iphone.
Savannah Center for Blind and Low Vision (SCBLV) SCBLV is improving the field of vision loss by hosting the annual Vision Conference for local and surrounding area Ophthalmologists, Optometrists, Ophthalmology Technicians, etc. This conference, aimed at vision specialists, trains professionals to identify vision loss and provide referrals to patients who could benefit from our services. In our second year as host, 42 regional specialists participated and earned professional certification credits. Furthermore, SCBLV continues attempting to resolve the issue of identifying and serving rural Georgians by working with local community centers to identify individuals that may have fallen through the traditional referral route of starting with an Ophthalmologist or Optometrist. The SCBLV management team and Board continue to evaluate the option of opening an outreach office that would provide services more accessible to clients in rural communities away from Savannah. 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. 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. The Visually Impaired Foundation of GA, Inc.
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maintains a website (vifga.org) and a toll free number (1-877-778-4342) to help people find the Georgia resources available to them. We also provide eye exams and glasses twice a year at the Native American Reservation in Whigham, GA.
Grant for Capital Expenditures for Equipment: In FFY16, a grant was awarded to VIFGA. The Center for the Visually Impaired (one of our PI contractors) worked with VIFGA and provided fiscal sponsorship for the grant, which benefited all six Georgia PI contractors. The funds were awarded specifically for Project Independence contractors to purchase new demonstration equipment, up-date old demonstration equipment, or purchase equipment to enhance our competency to deliver services. The grant demanded many hours of hard work which we all invested as a team. Our hard work paid off. We not only were rewarded with funding to improve our work places, but also with a much stronger bond of trust and cooperation between all the PI contractors.
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 Valdosta, one in Macon, and one in Douglas. All did well this year. However, the leader for the Valdosta group moved and left us with no group in Valdosta at this time. There are four other groups to which I 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.
Helen Keller Registry: VIFGA has incorporated into the Low Vision Exam the distribution of the Helen Keller Registry for those with dual sensory loss. I have found that nearly 40% of VIFGA clients have a dual sensory loss.
Assistive Listening Devices: I have found that I use the “Pocket Talker” in 40% of my exams to enable seniors to communicate with me.
Presentations: I enjoy presenting at doctor’s offices, support groups, and civic clubs.
Brochures and Resource Guides: This is an invaluable tool!
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 services began providing instruction to program participants, particularly in the areas of assistive technology. Not surprisingly, the demand for instruction in mobile devices, such as, iPhones, iPads, and similar devices has increased significantly during the past year. With the elimination of Homemaker as a viable vocational goal in the VR program, we have also seen an increase in client referrals for keyboarding and computer training, including the use of the Apple Mac computer. In response to
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this demand, we began providing both individualized and group training to seniors at our facility. In addition, CVI’s Assistive Technology staff has provided ongoing training and support to our Low Vision and Community-Based staff, so that they, too, can begin providing this service to seniors not able to come to the center. Outreach efforts to reach unserved/underserved populations during the past year included targeting ophthalmology practices’ doctors and staff by the Low Vision Clinic Director who spoke directly to doctors and staff regarding the benefits of low vision examinations and therapy. Attendance at an ophthalmology conference and a Foundation Fighting Blindness event in Atlanta provided further networking opportunities. Many attendees were eligible for OBP-related services. As mentioned in our FFY15 report, and in response to a decrease in overall referrals to our services, CVI hired a full-time Program Marketing Manager. He has been busy contacting, collaborating and networking with 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 has also begun reaching out to less traditional referral sources, such as dialysis programs, diabetes clinics and diabetes professionals, falls prevention initiatives, etc. 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, no doubt as a result of these efforts. In order to facilitate access to services by Spanish-speaking adults, CVI maintains an especially 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. Vision Rehabilitation Services of Georgia (VRS) VRS continues to work to maximize collaborations with other organizations to stretch our funding resources to their maximum limit. Our list of collaborating partners continues to grow as all staff work to seek out new partnerships in their daily work around North Georgia. Continued Collaborations:
United Way of Metro Atlanta: We provided Diabetic Education to 28 seniors who live with diabetes and Vision loss.
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University programs: VRS continued to support one Salus University student working on their VRT certification, one OM intern and a Georgia State University intern in the field of Social Work.
Georgia Center of the Deaf and Hard of Hearing/ ICC-GA: VRS continued to work on a limited basis in 2015-16 with ICC/GA to help seniors with a dual-sensory loss access this grant for the provision of tools to meet their communication needs.
HKNC/CLP – VRS works together with our HKNC representative to ensure our seniors with a dual-sensory loss are receiving the most up-to-date services, tools and resources to help with communications and ADL’s. (VRS staff are trained in working with clients with dual-sensory loss).
VRS hired a Development Director this past year to help with Grant Writing and community outreach, resulting in a number of grants awarded to assist with providing services and tools to our seniors. We have been able to connect more consistently with our referring doctors and participate in more community awareness activities. In the area of volunteers, VRS continued to receive volunteer support in the areas of data collection and management, board activities, office and program support and for our fundraising race. This year VRS also added a Dining in the Dark event which served to both raise awareness of our work and needed funds for our program. Volunteers come to us from a wide variety of businesses and community partners, extending our reach and connections beyond our traditional means. VRS volunteers have logged approximately 2,729 hours in the past FY. VRS implemented a more comprehensive screening process of potential Low Vision Evaluation clients. The cases/eye notes are more closely previewed by our intake coordinator, and if she has concerns, by the program director and/or the doctor. Our goal is to ensure that clients who are coming in for an LVE will benefit from the services – ensuring funds are used more wisely. Clients for whom we are not sure an LVE will be appropriate are added to our Home Visit First (HVF) list – where a teacher will visit the client in their home to further explore the nature of their vision loss, their needs and their ability to benefit from an evaluation. If it is determined that an LVE would be of benefit, an appointment is scheduled; if not, services in other skill areas are provided. This year VRS was lucky to have both an Adjustment to Blindness Counselor AND a Social Work Intern providing support to our seniors. We are beginning to experiment with some phone counselling and expanding our support group networks. We have identified the need to start new groups in several other north Georgia areas that we hope to have up and running by June 2017.
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Walton Options for Independent Living (WO) Walton Options included many collaborative activities and community awareness throughout eastern Georgia. These efforts included the Area Agencies on Aging, Resource/Health Fairs, Elder Rights conference, the YMCA, Senior Centers, the National Council on Independent Living, Disaster Preparedness, local ophthalmologists, consumer organizations for the blind, local businesses, a senior rally at the Georgia State Capitol, legislators, transportation meetings, Tools for Life, the Georgia Vocational Rehabilitation Agency, Georgia Center of the Deaf and Hard of Hearing, Nutrition programs, and local businesses. To expand and improve services, Walton Options is:
1. Developing possible demonstration/training days on high ticket aids/devices for the consumer to try before purchasing.
2. Developing a resource funding guide. 3. Assisting consumers, if needed, to complete applications for funding. 4. Encouraging consumers to donate their aids/devices back to the OBP
program if they no longer need them. 5. Creating and implementing a three month follow-up process to verify the
devices (AT) the senior received are still beneficial to them. 6. Creating a Healthy Options resource book that includes healthy recipes, a
healthy diet on a budget and cost saving tips. 7. Teaching various life skills classes in the community, to include but not
limited to, self- advocacy, money management, disaster preparedness, identity theft, self-defense for the visually impaired and falls prevention.
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 2017.
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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, 233 consumers participated in telephone interviews. The majority of participants (60%) were aged 75 and older. Almost two-thirds (65%) were female. About 87% 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 (56%), with the second most reported reason being glaucoma (14%). 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 timeliness in which those services were received (95%), and overall quality of services (91%). Consumer ratings of functioning after receiving different types of independent living service areas follow:
94% reported that they were better able or had maintained their ability to
travel independently
90% reported that they were better able or had maintained their ability to
function more independently having received assistive technology devices
100% reported that they were better able or had maintained their ability to
function more independently having received communication skills training
93% reported that they were better able or had maintained their ability to
function more independently having received daily living skills training
60% reported that they had greater control and confidence in their ability to
maintain their current living situation; 30% indicated no change; and 10% indicated less control and confidence
Program participants were asked what the biggest difference the program had made in their lives. Typical comments include the following quotes:
It has made it easier for me to read. It is great to know that someone cares
and is willing to help.
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The various techniques and the tools that are available were very
enlightening. Things they showed me that will help me along the way.
It lets me know that there is help when I need it. I will know when I need
more help and the type help that I need. The magnifier has helped me a lot.
As the caregiver they have helped me to understand her situation better.
They were able to keep me from being totally immobilized in my house, not
being able to do anything. They were able to take me out of my fear of going blind and to find people that were able to help me and who wanted to help me. I am able to walk and talk and cook. They saved my life.
I am not so scared of losing my sight.
I have more confidence and they made me more aware of things that I did
not know. The teaching is great.
Just them uplifting me and making sure that I understood there was help
there anytime I wanted it or asked for it. Other than that, the cane has helped me the most.
They provided me with the magnifier that I can read again. The important
stuff. Like my medicine bottles.
Helping me understand more about vision loss and how to cope daily.
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 MC has been a client of our center for more than 15 years. When she was first introduced to our services as a senior in her early 70’s, she received training in the areas of OM and VRT to remain independent in her home. At that time, staff realized that her combined Vision Loss to Retinitis Pigmentosa with a significant hearing loss could indicate that she had Usher’s Syndrome. After consulting with doctors, Ms. C was diagnosed with Usher’s Syndrome, Type III. For the past 15+ years MC has reached out to us for additional training and/or support whenever her vision or life circumstances have changed. Staff have helped Ms. C move 4-5 times - orienting her to new communities. We have continued to help enhance her communication skills by aiding in the purchase of assistive listening devices and providing training to those in her life on how to best communicate with her. Ms. C, now in her 80’s, continues to be an active member of her community e.g. living on her own in a senior apartment, going to support group meetings and going out on her own as she is up to it. Center staff continue to support MC formally and informally. MC’s journey with our center is indicative of the types of relationships we strive to build. We hope clients grow to trust our staff and feel
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comfortable to call us when their needs change. Our goal is to always be available to provide support and training – lifelong training – for those who may need it. We are very proud of how MC has been able to maintain her independence over the years and the example she gives to others like her in her community. Senior #2 Since she was 18 years old, Ms. B has endured a vision loss resulting from Stargardt’s Disease. Now 67, she has received varying degrees of blind rehabilitation over the years. Recently, a change in her living situation paired with additional vision loss created new obstacles and additional goals for her changing lifestyle. Nearing 70, she found herself without a support system and living on her own. Energetic and independent, she wanted to make sure she stayed this way. In 2016, Ms. B came to the Center in order to learn Braille and assistive technology to access email and internet on her computer. After a couple of weeks at the Center, she realized that with her decreased vision, she would benefit from additional training in Orientation & Mobility. During her training, the client addressed goals and concerns relating to using the local bus system, traveling on roads without sidewalks, and gaining the skills needed to one day procure a guide dog. At the conclusion of her program, Ms. B had achieved all of her original objectives, as well as the goals she added as she progressed through the program. Since returning to the Center, Ms. B has learned basic Braille, mastered both Windows and MAC operating systems, and even participated in a community Marathon! In September of 2016, she was evaluated and approved for a guide dog by Guide Dogs for the Blind. As a current client, peer support member, and supporter of the Center, Ms. B is truly a role model and inspiration to others. Senior #3 Ms. D was seen at the low vision clinic for her visual difficulties related to Wet Age Related Macular Degeneration; she is 92 years old and currently lives in an Assisted Living Facility (ALF). She has assistance with meals and laundry from the ALF; however, she wanted to be able to engage in activities within her complex, read and remain as independent as possible. She reported having difficulties with all aspects of reading such as reading the activity list and menu at the ALF as well as pleasure reading books and newsprint. She also wanted to participate in bible study within the facility and maintain independence with managing her medication. She was using her over-the-counter magnifier, but reported that it was not really helping her anymore. Following instructions with
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several reading options, she ultimately had best results with using moderate magnification with both hand held and stand magnifiers – and was confidently able to reach her reading goals. She was also educated on how to use the magnifier outside of her apartment by using a lap desk while sitting at Bible study. She can read her own menus and verbalized great pleasure in not relying on the ALF staff. Ms. D. expressed that because of her age, her finances had become very difficult to manage. As a result, with the assistance of the OBP Funds (and a financial contribution from her!), she was able to receive services, two magnifiers and a lap desk. Ms. D. verbalized a great deal of pleasure with her increased independence. She reported that without the assistance from the magnifiers, she would have felt even more frustrated knowing that something could help her, but not being able to financially obtain. She expressed that she felt people of her age were often ignored when verbalizing complaints and felt renewed self-confidence after working with the doctor and therapist at our center. Senior #4 Mr. J’s sister and primary caregiver shared her feedback on the program from her perspective as she provides the primary care and handles her brother’s personal business. (Her feedback was very meaningful and warranted inclusion in this report.) She stated that [provider] had truly been a blessing for him and that [provider] was quick to respond to his needs. When asked, “What was the greatest impact of the services received? “She stated it was the watch. He is now able to tell time; and with the cane, he is able to be more independent. She stated he said he doesn’t feel helpless and doesn’t have to bother others about the time of day. He is now able to get around and walk down the road by himself with his cane. She stated he loves being able to do things alone and without the help of others. She stated she is very thankful because he has a better outlook on life and is more positive. He was often frustrated and angry because he had to wait on others to help him; now he can do stuff on his own, which she said was a blessing. She stated [provider] is helpful by sending an O&M Instructor out to help him on Saturday to learn how to better use his “stick” (cane).
E. Finally, note any problematic areas or concerns related to implementing the Title VII-Chapter 2 program in your state.
Funding In Georgia, the program still struggles with getting the word out in the rural communities as there are not enough resources or money to advertise. While providers continue to look for grants to help with the program, funds for continuous outreach is still very much needed.
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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 low on funds. 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. Project Independence continues to provide services to eligible seniors regardless of income for little or no cost. However, we put a cap of $200 per person on the items – unless special circumstances. Due to the rising costs and demand for visual aids and devices (especially electronic video magnifiers), we continue to ask more consumer involvement to help cover the cost of visual aids and devices. Participants are given information on financial third party resources as well as provided loaner equipment when available. The $200 annual cap per consumer will not meet some consumer’s needs. Consumers may not be able to get devices they need to increase their independence. Others may have to wait an extended period of time to obtain the devices, due to waiting on funding approval from other resources. While the cap allows Project Independence to maximize resources to pay for those direct services where third party funding is generally not available, obtaining the third party funding may increase the consumer’s frustration and they may just give up. We will continue to revisit the aids/device cap and resources throughout FFY17. While certified professionals receive over 95% of the reimbursement, the program does not allow full cost of administrative fees for the providers’ services. Despite using creative methods to ensure that all available funds are appropriately utilized and stretched as far as possible for some providers, we were still unable to make the money stretch to the end of the fiscal year. We need to prepare for additional seniors that may come our way due to the changes implemented by WIOA. Access to resources is needed so that teleconferences and face to face meetings for contractors and peer support group leaders are available. These types of meetings are so important to the success of our Georgia program. Staffing We continue to struggle having certified staff who can deliver Orientation and Mobility and Vision Rehabilitation Therapy services. The challenge remains to
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identify and keep certified individuals for OM and VRT. Finding qualified professionals who are willing to 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.
