VA Response to 60th National Convention Resolutions

RESOLUTION 38-05

RESOLVED, that BVA supports members’ desires that their VIST Coordinators
be authorized to provide instruction in the use of the ScripTalk device.

VA Comment:

VA concurs with the resolution. VIST Coordinators are members of the clinical team whose goal is to ensure patient safety with medications. As case managers handle cases and situations related to legal blindness, VIST Coordinators play a support role to the primary care team. Through assessment of veterans’ visual limitations, personal lifestyles, support systems, and abilities to use assistive devices, VIST Coordinators can help the primary care team select the medication management system that is most appropriate for each veteran.

In order to identify appropriate candidates for ScripTalk-assisted medication management, VIST Coordinators can orient blinded veterans to the operation and maintenance of the ScripTalk device using sample medication bottles supplied by the manufacturer. They can observe the veteran’s performance and report, to the primary care team, his/her level of success. Although VIST Coordinators cannot clinically counsel veterans on specific medications, they are allowed to participate in the training process using the ScripTalk device.

RESOLUTION 39-05

RESOLVED, that BVA urge the Under Secretary for Health (USH) to require BRS to provide statistical data with a focus on a cost/benefit analysis of the BRS model of service delivery in order to determine if resources are being properly allocated to address the needs of America’s current and future blinded veterans.

VA Comment:

VA concurs with the resolution. During the period of October 2003 to April 2004, VA responded to concerns expressed by BVA about the fairness of the Veterans Equitable Resource Allocation (VERA) model and its effect on blind rehabilitation services.

The Office of Finance’s Resource Allocation and Analysis Division, in conjunction with BRS’s program office, gathered VERA-related data on the treatment and classification of patients receiving blind rehabilitation care. This action was conducted to determine the equity of the VERA model in meeting patients’ needs and related resource requirements within each Veterans Integrated Service Network (VISN). Patient classifications and costs were also reviewed.
As a result of this analysis, a new Basic Care class in Price Group 4 was established in FY 2005 for legally blind patients. This action recognized the higher cost of providing blind rehabilitation care to these individuals and the funding imbalance. As a result of this VERA change, resources are now being properly allocated.

Additionally, BRS, in collaboration with the Visual Impairment Advisory Board, has recently completed a thorough analysis of demand projections and costs associated with current and proposed new programs targeting provision of a continuum of care and services for visually impaired veterans.

RESOLVED, that VA be required to ensure an adequate model of service delivery that will effectively address the needs of the Nation’s blinded veterans in the most cost effective manner in future years.

VA Comment:

VA will continue to use veteran population estimate models and cost benefit analyses to ensure that the service delivery model for BRS appropriately addresses the needs of America’s blinded veterans.

RESOLUTION 40-5

RESOLVED, that BVA strongly recommend to the Secretary that, in order to ensure uniformity of care and appropriate follow through, that set-up of computers be provided as a standard of practice and not as an exception.

VA Comment:

VA concurs with the resolution. BRS will work with Prosthetics and Sensory Aids Service to develop guidelines for computer set-up. These guidelines were developed in April 2006, and can be found on the BRS website via the following hyperlink: http://www1.va.gov/blindrehab/. These guidelines will ensure that set-up is provided when appropriate. We agree that set-up should become the standard of practice and the exception should be when an individual veteran desires and is able to perform set-up independently.

Some veterans participating in BRS’s CAT training programs need assistance with computer set-up. This applies to those receiving computers as inpatients or outpatients. While veterans are taught to set up their equipment, some need assistance due to physical limitations. Some veterans also lack access to reliable assistance from family or friends. In addition, there are veterans who require assistance in setting up and configuring Internet service. Assisting these veterans with in-home set-up provides good customer service, contributes to continuity of care, and may avoid injury to veterans. In addition, it prevents damage to equipment.

RESOLVED, that BRS partner with BVA and Prosthetics and Sensory Aids Service (P&SAS) to develop policies and procedures to standardize the set-up of computer equipment and peripherals by putting in place clinical indicators to include but not be limited to: health, age, physical condition, manual dexterity and demonstrated ability or lack thereof in determining if the set-up service is appropriate.

VA Comments:

BRS worked with P&SAS to develop guidelines for computer set-up. These guidelines will ensure that setup assistance is provided when appropriate.

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