| |
Despite all the potential benefits to be realized
from participating in blind rehabilitation, many veterans are
not highly motivated to leave home after losing their vision,
particularly the elderly. There are several reasons for this reluctance.
One, veterans are anxious about leaving their home and families
for a period of six to eight weeks because they remain unconvinced
that the proposed rehabilitation will be beneficial. Most of us
had little or no experience with blindness or blind people before
loss of our own vision. Therefore, we were influenced by the negative
stereotypes of blindness. Further, we had little confidence that
rehabilitation would have any positive benefit. Depression, characterized
by feelings of being overwhelmed and without hope, does not generate
a high degree of motivation to reach out for help. Motivating
such veterans to receive the rehabilitation that will prove beneficial
to overcoming that depression is the primary task of the VIST
Coordinator.
The physical and emotional limitations inherent
in sight loss are formidable deterrents for veterans seeking blind
rehabilitation. Those limitations are severely exacerbated by
the veteran's inability to travel to the appropriate BRC. Some
blinded veterans are not eligible for Beneficiary Travel and therefore
are expected to pay for their own travel to the BRC. In most of
these cases, air travel is required because of the long distances
involved and the price of airline tickets are cost prohibitive
for these veterans. When motivation is marginal to begin with,
the additional financial burden of transportation often proves
to be the proverbial straw causing the veteran to decline rehabilitation.
When the Beneficiary Travel Law was changed
in part to reduce the VA cost for this program, we believe the
law and subsequent regulations were intended to address Beneficiary
Travel applicable to veterans traveling to their local VA facilities
for care. The special disability programs only available at a
few facilities around the system require longer and more expensive
travel. We strongly believe that if a veteran enrolled in VA health
care must be referred to another VA facility other than the primary
station to receive the care they need, VA should then be required
to pay for those travel expenses. Although these veterans are
normally outpatients when referred for blind rehabilitation, we
believe for Beneficiary Travel purposes they should be treated
as inter-facility transfers. This form of transfer is not bound
by the General Beneficiary Travel Regulations and relieves the
veteran of the burden of paying for his or her own travel.
We understand VHA has completed a review of the
Beneficiary program to determine whether the amounts paid for
travel should be increased, which they should be. However, VHA
believed increases would negatively affect the medical care account
and, given constrained funds, it was determined not to provide
such increases. BVA hoped, because of this program review, that
VHA would offer a legislative initiative to amend Title 38 to
provide a waiver of beneficiary travel for those veterans accepted
for care in special disabilities programs. Mr. Chairman, we encourage
these Committees to consider favorably an amendment to Title 38
governing Beneficiary Travel, and an exception for Beneficiary
Travel associated with participation in one of the special disabilities
programs. The exceptions should only be granted to veterans who
have been accepted for care at the receiving facility. In the
case of blind rehabilitation, there is a very formal and detailed
application procedure for admission to a BRC. An application must
be completed at the veteran's home facility and then forwarded
to the appropriate BRC. Clearly, therefore, these are veterans
who are patients enrolled at one facility that is unable to provide
the necessary care and who have been accepted by a distant VA
facility capable of providing the needed services. The cost to
expand the travel eligibility to these veterans would certainly
be minimal for VA. If the responsibility continues to fall on
the veteran, it will surely serve as a deterrent to blind rehabilitation
or any other specialized program that requires veterans to travel
great distances at their own expense.
Further complicating this entire issue is
the fact that these same veterans, determined not to be eligible
for Beneficiary Travel, are also required to pay the Social Security
co-pay for their episode of care. The vast majorities of blinded
veterans who fall into this category have income that barely exceeds
the NSC Pension threshold and certainly are not in a position
to pay the co-pay, let alone the expenses associated with travel.
BVA respectfully requests these Committees to consider further
amending Title 38 in addition to the Beneficiary Travel Law, exempting
from Means Testing veterans in need of the services provided by
special disabilities programs. Mr. Chairman, there are not many
wealthy blind people, particularly veterans. Furthermore, necessary
services are not readily available in the local community. The
specialized nature of these services and the VA's international
reputation for being the premier provider should not be denied
to blinded veterans. BVA applauds these committees for their efforts
last year to pass the Millennium Health care and Benefits Act.
Included in that important legislation is a provision that waives
the co-pay responsibility for military retirees eligible for Tricare.
While this is very helpful, very few blinded veterans meet these
qualifications.
|
|
