by Tom Zampieri
VCE Progress Report
Our recent focus has narrowed even further
than ever before on the funding, staffing, and other critical tasks
involved in institutionalizing the joint Department of Defense
(DoD)/Department of Veterans Affairs (VA) Vision Center of Excellence
(VCE). Because of past roadblocks that have hindered these efforts, we
are pleased that $9.5 million in appropriations was provided for VCE
once the final Continuing Resolution was passed by Congress in late
The additional funding was a first
of sorts for VCE and its component Defense Veterans Eye Injury Vision
Registry (DVEIVR), the latter of which was created so that DoD and VA
would more effectively share medical records of the eye injured and
provide for the "seamless transition" of those who have experienced
Traumatic Brain Injury visual dysfunction.
VCE now has its own program funding for the first time since its
establishment in Fiscal Year (FY) 2008. Until now, it has struggled
with limited discretionary funds. We hope that this latest breakthrough
is a sign of better things to come for service members and veterans who
are listed in and tracked by DVEIVR.
VCE has now increased DoD staffing
to four full-time staff and nine contractor staff. VA has funding for
five full-time positions, still another sign of progress and evidence
that our patience and perseverance have been worthwhile.
The new administrative headquarters
for VCE will be at the National Naval Medical Center in Bethesda,
Maryland. An area of the medical center is now under renovation to
accommodate VCE. We understand that the work is actually ahead of
schedule and that VCE staff will move into the new offices in August
near the dates of our convention.
VCE Director Colonel Donald Gagliano
will be attending some of our convention events this year in Las Vegas.
At the same time, he will be conducting the first ever DoD-VA eye care
conference at the same Golden Nugget Hotel and Casino. Some 80 military
and VA optometrists and ophthalmologists will meet to discuss vision
technology and research.
We are pleased that the eye care
conference will be occurring simultaneously with our convention since
the annual VA Blind Rehabilitation Service (BRS) meetings have become
biennial events and will not be held in Las Vegas this year. Having the
medical professionals near us in the same hotel will add a new dimension
to this year's BVA convention.
VCE and Other Joint
Centers of Excellence
We continue to request status reports on
the implementation of Section 1623 of the FY 2008 National Defense
Authorization Act (P.L. 110-181) and Sections 706, 721, and 723 of the
FY 2009 National Defense Authorization Act (P.L. 110-417). These
legislative actions authorized VCE and two other centers, the Hearing
Center of Excellence (HCE) and the Extremity Amputation Center of
Excellence (EACE), both of which we have mentioned in previous Updates
and emailed Legislative Alerts.
HCE was established to improve the
care of American military personnel and veterans affected by combat
hearing trauma while EACE seeks to do the same for those with limb
extremity trauma. Our interest in the other two Centers of Excellence
has come about because those with vision trauma have often experienced
additional injuries related to loss of limbs and/or hearing.
In addition, all three agencies have
experienced many of the same funding and staffing challenges in moving
forward with the registries, which should contain up-to-date information
on the diagnosis, treatment, and monitoring of the injuries to our
nation's military personnel. For example, HCE currently has just two Air
Force physicians assigned to it.
We have included in our recent
annual testimony and in other correspondence the need for Congressional
oversight of HCE and adequate staffing from both DoD and VA.
Funding for Research
We continue to collaborate with the
National Alliance for Eye and Vision Research, the American Optometric
Association, and the American Academy of Ophthalmology in efforts to
secure increased Congressional funding for programmatic research in the
area of combat-related eye trauma.
This line item has been funded at
just $4 million the past four years. We are aware of 56 requests for
vision-related research grants in 2010 and only nine that were actually
funded. Because our goal for FY 2012 is a much higher $10 million, we
have met with House and Senate Committee members on Armed Services,
Appropriations, and VA.
The demand for new research grows as
statistics continue to reveal just how many service members are
affected by vision loss. Some 16 percent of all of the evacuated wounded
from Iraq and Afghanistan have experienced some type of eye injury.
Approximately 5,000 have severe blast eye injuries. We know that 150
have now attended a residential Blind Rehabilitation Center (BRC)
Budgets and Funding
For VA Health Care
Since March, hearings of the House
Committee on Veterans Affairs of this, the 112th Congress under the
chairmanship of Representative Jeff Miller (R-FL-1), have been dedicated
almost exclusively to oversight-related matters. Congress is looking at
many VA programs and attempting to come up with cost savings within
As a result, far fewer new bills
relating to veterans have been introduced this year. Although we are not
expecting this to change in the near future, we will continue to work
with new Members on such issues as Seamless Transition, Special Adaptive
Housing, and Beneficiary Travel.
We will also continue to monitor the
FY 2012 and 2013 VA budgets. The White House proposed budget increases
for those two years are close to the figure that the Veterans Service
Organizations (VSOs) have recommended. The proposed increase for FY 2012
over FY 2011 appropriations is 6 percent.
VSOs are concerned about a floating
suggestion that both Category 7 and 8 veterans be eliminated from the
system. Although there is no major or official movement in this
direction, we are aware from experience that anything is possible during
the upcoming budget battles in July and August. Because BVA has worked
so hard over the years to improve VA funding for a "Continuum of Care"
for blinded veterans, we must do everything possible to ensure that such
We also worry about trends toward
privatization of care that are exemplified by programs such as HERO
(Health Care Effectiveness through Resource Optimization), a pilot
project in which veterans within four VA networks are outsourced to
Humana providers. Such programs will most definitely decrease future
And Status of Pending Bills
For a time, it appeared that combat
blinded veterans would continue to be billed indefinitely for
co-payments even after the legislation had passed. The problem was a
technical one that required a software patch. We feel confident that the
issue has been addressed and that veterans will avoid these co-payments
as long as they make certain that their Visual Impairment Service Team
(VIST) Coordinators enter them into the billing system as
The Twenty-first Century
Communications and Video Accessibility Act of 2010 went into effect last
summer. The legislation established new safeguards for disability
access to ensure that people with disabilities are not left behind as
technology changes and the United States migrates to the next generation
of Internet-based and digital communication technologies. It requires
that electronic communication devices be fully accessible for blind
individuals and that emergency alert television systems include both
audio and visual warnings for natural disasters and emergencies.
As anticipated, enforcement of the
legislation has many built-in complexities. Progress is being monitored
by citizens and technical experts from the disabled community who have
been appointed by the Federal Communications Commission. We will
continue to provide periodic updates and Internet links to relevant
information in the Bulletin and through our Legislative Alerts.
We have also referred several times
in recent issues to our efforts to help deserving blinded veterans
receive the housing benefits they have earned. Eligibility for the
$13,860 Special Adaptive Housing grant currently requires that veterans
meet the 5/200 criteria for blindness rather than the more commonly
accepted visual acuity standard of 20/200 or 20 degrees of field loss.
We mentioned in our last issue that Ranking Member Bob Filner (D-CA-51)
had introduced H.R. 117 in January to correct this injustice. We are
happy to report now that Senator Bernie Sanders (I-VT) sponsored a
companion bill in the Senate in early May. We sincerely hope to report
progress on this legislation in the future.
In May 2010, President Barack Obama
signed into law the historic Caregivers and Veterans Omnibus Health
Services Act. The landmark bill established a new program for VA which
offers training, living stipends, and respite care for veterans' family
members tasked with caring for their wounded loved ones. Included in the
new law was the aforementioned elimination of co-payments charged to
veterans with a catastrophic disability.
The implementation of the provisions
of this legislation was slow until VSOs, working with key members of
the Senate, raised the issue earlier this year in hearings with VA
Secretary Eric K. Shinseki. On May 9, VA finally started accepting
caregiver applications and during the first week more than 850 veterans
applied. VA estimates that the program will eventually provide benefits
for 3,000 severely injured war veterans.
Only the caregivers of the current
generation of Operation Iraqi Freedom (OIF) and Operation Enduring
Freedom, Afghanistan (OEF) service-connected veterans were originally
included in the group that would benefit from this statute. Once VA
establishes a clearer regulatory policy concerning the program by the
end of 2013, the caregivers from previous generations of severely war
injured veterans will also receive support.
Applications can be processed by
telephone through the Caregiver Support Line at 855-260-3274, in person
at a VA Medical Center with a Caregiver Support Coordinator, by mail, or
online at www.caregiver.va.gov
with the new Caregiver Application (VA Form 1010-CG). The website
application also features a chat option that provides the family
caregiver with a live representative to assist in completing the form.
One of the issues raised during the
hearings and subsequent meetings was that the support line was not open
24 hours a day seven days a week. Concerns were expressed that
caregivers in distress might call during off-hours and receive an
answering service. Although the normal hours of operation are still
Monday through Friday from 8 a.m. to 11 p.m. Eastern Time and on
Saturday from 10:30 a.m. until 6 p.m., the line is now being answered by
staff from VA's Crisis Line when the support line is closed.
As of June 1, the clinical social workers who staff the line had responded to more than 6,000 calls since its inception.
The growing backlog of VA benefits claims
is an additional problem for all veterans and especially those caught in
long delays between the DoD medical boards and VA ratings.
The medical board process for a
military disability rating now averages 267 days. The long process to
become service connected for VA benefits now averages 168 days.
Frustration is growing in Congress
over the 800,000 unresolved claims. BVA frequently attends hearings on
this issue and remains similarly frustrated.
Now on Horizon
Two new BRCs will open by November 2011.
Their locations are Biloxi, Mississippi, and Long Beach, California. By
act of Congress (H.R. 4360) that was signed into law on May 7, 2010, the
latter BRC will be named in honor of Major Charles R. Soltes, Jr., the
first Army optometrist killed in action in Iraq in 2004. We strongly
supported this legislation at the time, having become acquainted with
Major Soltes' widow, Dr. Sally Dang.
Professional staff members at both
new BRCs are now being hired. We are pleased to report that Sally has
been appointed by VA as the low-vision optometrist at the Long Beach
facility. As we reported in previous Updates, Sally volunteered to make a
presentation and otherwise assist the Operation Peer Support program at
the last two conventions. We hope she will be joining us again in Las
We also anticipate that blinded
veterans who receive training at the Long Beach BRC will come to
appreciate the unusual connection between the name of the Center and the
low-vision optometrist working at the facility.
Operation Peer Support
Looks Ahead to Convention
Through the Association's Operation Peer Support initiative, Tom Miller and Tom Zampieri met blinded veteran A.J. Tong, right, at the 64th National Convention in 2009 in Portland, Oregon. A.J., a resident of Snoqualmie, Washington, paid a visit to BVA National Headquarters less than a year later.
We continue to visit OIF and OEF service
members and their family members at Walter Reed Army Medical Center and
the National Naval Medical Center. Although such visits are desirable in
and of themselves, we consider them to be an integral part of our
Operation Peer Support initiative begun back in early 2006.
Locating the eye injured and
inviting them to attend the August conventions has been the mainstay of
the program since its beginning. We are now seeing many of our past
attendees come to the conventions at their own expense and as BVA
members. While still small, Operation Peer Support alumni are a growing
sector of the BVA membership. At press time, the number of Operation
Peer Support alumni having joined BVA was 44.