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The inability to track funds allocated to the networks through
VERA is another frustrating aspect of the funding issue. It is
even more difficult if not impossible to track dollars allocated
to the individual facility within the network. Dollars allocated
to the host facilities are not fenced or earmarked for blind rehabilitation.
Consequently, facility directors and BRC managers cannot determine
how much funding they have received to operate these special programs.
The decentralized resource allocation practice apparently provides
a lump sum to each facility from which they have the discretion
and responsibility to operate all the programs and services assigned
to that facility. Mr. Chairman, there must be a more clearly defined
method for tracking these resources to insure that the specialized
programs for which the network and facilities are receiving the
high reimbursement rate are indeed being utilized for those purposes.
Theoretically, VERA provides networks with sufficient funds
to operate the special disabilities programs. Unfortunately, BRCs
are continually required to share in facility FTEE reductions
or freezes as the result of funding shortfalls. Field managers
strenuously resist demanding this degree of accountability. They
complain that this will infringe upon their flexibility as managers
to establish priorities and carry out their assigned missions.
It is not our intent to suggest that VERA
is flawed in terms of providing sufficient resources to the networks
charged with providing specialized services. We are saying that
there are not adequate tracking mechanisms in place to accurately
assess whether the high reimbursement rate is indeed appropriate
to cover the real costs of these programs. As outlined, there
is a determined effort on the part of facility and network managers
to force BRS to provide services that have been traditionally
provided in the residential setting in an ambulatory or outpatient
environment. This would, in their view, significantly reduce costs
associated with the BRC component of BRS.
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