Provide data in each of the categories below related to the number of individuals for whom one or more services were provided during the reported fiscal year.
A. Individuals Served
1. Number of individuals who began receiving services in the previous FY and continued to receive services in the reported FY
0
2. Number of individuals who began receiving services in the reported FY
0
3. Total individuals served during the reported fiscal year (A1 + A2)
0
B. Age
1. 55-59
19
2. 60-64
24
3. 65-69
18
4. 70-74
22
5. 75-79
37
6. 80-84
66
7. 85-89
77
8. 90-94
41
9. 95-99
9
10. 100 & over
0
11. Total (must agree with A3)
313
C. Gender
C1. Female
213
C2. Male
100
C3. Total (must agree with A3)
313
D. Race/Ethnicity
1. American Indian or Alaska Native
0
2. Asian
0
3. Black or African American
1
4. Native Hawaiian or Other Pacific Islander
0
5. White
293
6. Hispanic/Latino of any race or Hispanic/ Latino only
0
7. Two or more races
0
8. Race and ethnicity unknown (only if consumer refuses to identify)
19
9. Total (must agree with A3)
313
E. Degree of Visual Impairment
1. Totally Blind (LP only or NLP)
10
2. Legally Blind (excluding totally blind)
106
3. Severe Visual Impairment
174
4. Total (must agree with A3)
313
F. Major Cause of Visual Impairment
1. Macular Degeneration
168
2. Diabetic Retinopathy
40
3. Glaucoma
16
4. Cataracts
3
5. Other
65
6. Total (must agree with A3)
292
G. Other Age-Related Impairments
1. Hearing Impairment
27
2. Diabetes
68
3. Cardiovascular Disease and Strokes
60
4. Cancer
5
5. Bone, Muscle, Skin, Joint, and Movement Disorders
24
6. Alzheimer's Disease/Cognitive Impairment
0
7. Depression/Mood Disorder
0
8. Other Major Geriatric Concerns
218
H. Type of Living Arrangement
1. Lives alone
143
2. Lives with others (family, spouse, caretaker, etc.)
140
3. Total (must agree with A3)
313
I. Type of Residence
1. Private residence (house or apartment)
231
2. Senior Living/Retirement Community
22
3. Assisted Living Facility
20
4. Nursing Home/Long-term Care facility
8
5. Total (must agree with A3)
313
J. Source of Referral
1. Eye care provider (ophthalmologist, optometrist)
81
2. Physician/medical provider
13
3. State VR agency
4
4. Government or Social Service Agency
17
5. Senior Center
6
6. Faith-based organization
5
7. Independent Living center
0
8. Family member or friend
38
9. Self-referral
99
10. Other
50
11. Total (must agree with A3)
313