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Until the explosion in computer technology
and the more recent advancements in adaptive access technology,
blind people were at a distinct disadvantage in obtaining essential
information previously available only in print. As our society
began to enter the technological age, people with severe visual
impairments or blindness were effectively left by the wayside.
Adaptive access technology is now beginning to catch up with information
technology, enabling people who are blind to access the same information
to which sighted people have had access from the onset of the
electronic revolution.
Even more important is the increasingly popular
opportunity to participate in e-commerce. Access to the internet
enables blind people to conduct much of the business of daily
living such as banking, shopping and paying bills online. Possessing
this capability obviates the need for transportation, a chronic
problem for people who are blind. For a number of years, BVA advocated
that VA provide computer evaluation and training for blinded veterans
to enable them to have access to information similar to that of
their sighted counterparts. As you know, employment today almost
demands the ability to utilize computers for most entry-level
positions and certainly is required for upward mobility. When
BVA began advocating this important evaluation and training, qualified
instructors equipped to teach adaptive access technology were
not available in the local community. Consequently, from our perspective
it was imperative that VA BRS provide such services. The benefits
to blinded veterans would be greater opportunities to obtain meaningful
employment and to access essential information.
As a result of the FY1995 appropriation with
the special funds earmarked for VA BRS, monies were made available
to establish Computer Access Training (CAT) programs at the five
major blind rehab centers. The demand for admission to these programs
has dramatically increased to the point that an eligible blinded
veteran may have to wait a year or more for admission. Ironically,
as the waiting time for admission to the basic adjustment to blindness
programs has declined, the waiting time for computer training
has increased. During the intervening years, the private sector
has begun to catch up in terms of having qualified providers who
can teach adaptive access technology to the blind. BVA has been
working with VA BRS, encouraging the referral of eligible blinded
veterans, when appropriate, to local resources for this vital
training. We believe this approach will dramatically reduce the
length of wait for veterans and substantially reduce the cost
for VA. Having to admit a blinded veteran into a VA BRC for this
specialized training, including housing him or her in a hospital
bed, is quite expensive, and local training would eliminate this
expense. At the same time, it would be more responsive to meeting
the veteran's needs. Unfortunately, this is an excellent example
of VERA providing a disincentive for local managers. If VERA provides
local training and recommended equipment, it is responsible for
paying for those services. Referral to a VA BRC enables it to
avoid those expenditures, which saves VERA facilities those costs
but significantly and unnecessarily adds to the overall system
expenses. Regrettably, VA BRS response to the increasing demand
for CAT is the expansion of the number of BRC beds dedicated to
CAT. It should be noted that this expansion of CAT beds is at
the expense of basic adjustment to blindness beds.
As outlined previously, quality must be
assured if VA is to pursue contracting for this specialized training.
To satisfy this objective, VA BRS can and should develop training
protocols, incorporating VA standards and necessary outcome measures
that must be achieved to meet the obligations of the contract.
We expect some resistance to this service delivery approach from
the VA BRC programs because of turf issues and potential loss
of sufficient workload to support the existence of the CAT programs.
We believe there will continue to be sufficient workload for the
CAT programs at the VA BRC because not all blinded veterans will
have this specialized training available in their local communities.
Therefore, they will continue to depend on the VA for these services.
Let me be clear, Mr. Chairman. We certainly are not recommending
wholesale contracting authority, but we do feel this is one instance
within the array of blind rehab services that could potentially
realize cost savings without seriously compromising access to
quality service.
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