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RESOLUTION 36-04
RESOLVED, that the Blinded Veterans Association, in convention assembled in Reno, Nevada, on this 14th day of August, 2004, request and strongly urge the top VA management to review the current practices to determine if they properly meet the needs of blinded veterans in a timely manner.
RESOLVED, that BVA recommends and strongly urges that a system be established in which aids and devices would be issued based on clinical evaluation and determination as to whether an item is necessary, without interference or subjective oversight by non-clinical Prosthetic staff.
VA Response: The Department of Veterans Affairs does not concur with the Blinded Veterans Association Resolution 36-04. The staff of the Prosthetic and Sensory Aids Service provides assistive aids and case management on equipment needs of disabled veterans, per prescriptions. Prosthetic staff does not make clinical determinations as to the need for particular items. However, Prosthetic staff is trained to know VA legal authority to issue certain devices and can deny items that are not medically indicated. If an item is denied, the veteran is provided an explanation as to his or her rights to appeal.
RESOLUTION 37-04
RESOLVED, that the Blinded Veterans Association, in convention assembled in Reno, Nevada, on this 14th day of August 2004, fully supports the clinical decision making and judgment of eye care professionals in the determination of which equipment is best suited to the needs of a blinded veterans.
RESOLVED, that BVA request top VA management to review the restrictive practices and strongly urge VA to prohibit Prosthetic Service from denying or unduly delaying the provision of off-contract CCTVs and other optical devices, prescribed by an eye doctor, that best meet the blinded veteran's medical needs.
VA Response: The Department of Veterans Affairs does not concur with the Blinded Veterans Association Resolution 37-04. A national contract was awarded for CCTVs to Magnisight in July 2002. A Prosthetic Clinical Management (PCM) work group composed of selected clinicians, blind rehabilitation specialists, and consumer representatives from the Blinded Veterans Association convened to recommend Clinical Practice Recommendations (CPRs) regarding standardization, patient care quality, and cost-effective prescribing of CCTVs and other electronic optical enhancement devices. The Under Secretary for Health approved the CPRs on August 9, 2002, and the CPRs were distributed to field facilities. Prosthetic Services maintains an inventory of these CCTVs, as volume of need arises, for evaluation, training, and issuance to visually impaired veterans in treatment. Prosthetic Services does not maintain an inventory of models/brands other than Magnisight. If a provider feels that the contract item is not meeting the needs of his or her patient, there is a process in place where the requesting provider can submit a waiver request, including medical justification for using a non-contract item, to the Chief of Staff at their respective facility. VA is not aware of any evidence that this process unduly delays or denies the provision of off-contract CCTVs and other optical devices prescribed by an eye doctor.
RESOLUTION 38-04
RESOLVED, that the Blinded Veterans Association, in convention assembled in Reno, Nevada, on this 14th day of August 2004, strongly urge BRS to immediately develop a strategic action plan using clinical indicators to identify veterans that need to go to a BRC and those that would be better served by local services in the community, thus providing needed guidelines to VA field staff.
RESOLVED, that BVA convey to BRS and the Congress that "no blinded veteran be left behind," and that such a notion has top priority within the BVA organization.
VA Response: The Department of Veterans Affairs concurs with the Blinded Veterans Association Resolution 38-04. To maintain capacity and to provide world class care, BRS, together with the Visual Impairment Advisory Board, is currently developing and implementing a continuum of care model that extends from the veteran's home environment to the local VA care site and the regionally based inpatient training program. Development of a continuum of care model will encompass alternative rehabilitative service delivery and build upon existing infrastructure.
Additionally, the 2005 BRS Strategic Plan will enhance the timeliness and quality of care by standardizing procedures in all center-based blind rehabilitation center programs, including Blind Rehabilitation Centers, Visual Impairment Service Outpatient Rehabilitation, Blind Rehabilitation Outpatient Services, and Visual Impairment Services Teams, throughout all other components of BRS. The strategic plan will use clinical indicators to determine outcomes of services and their delivery mechanisms. The Strategic Plan will also foster the development of a clinically-based functional assessment tool for use throughout BRS, for the entire continuum of care for visual impairment. |
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