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Submission For The Record of Mr. Thomas Zampieri, Blinded Veterans Association, Director of Government Relations

INTRODUCTION

Madame Chairwoman and members of the House Veterans Affairs Subcommittee on Economic Opportunity, on behalf of the Blinded Veterans Association (BVA), thank you for this opportunity to submit for the record our strong legislative support for the “Vision Impairment Specialists Training Act” (VISTA), H.R. 1240. BVA is the only congressionally chartered Veterans Service Organization exclusively dedicated to serving the needs of our Nation’s blinded veterans and their families. BVA has worked with VA Blind Service in improving the VA ability to provide the necessary blind outpatient mobility and orientation training for blinded veterans for years and this legislation will help ensure that this will continue to occur. With the growing numbers of wounded in both Operation Iraq Freedom (OIF) and Operation Enduring Freedom (OEF) who are entering the VA health care and benefits system today, with direct eye trauma history and over 30% of Traumatic Brain Injury (TBI), having Post Trauma Vision Syndrome (PTVS), more of these highly skilled professionals are necessary and critical for VA.  

As of May 22 of this year there were 25,549 traumatic combat injuries, of which 7,267 required air medical evacuation from Iraq and another 6.991 military  personnel have been injured in non-hostile action have also been evacuated from OIF and OEF operations. Such numbers reflect the probability that an ever increasing number of future veterans will depend on VA Blind and Low Vision Services in order to live independently in their own homes. More than 1,886 of the total TBI-injured have sustained moderate enough injuries that they are experiencing neurosensory complications. Epidemiological TBI studies find that about 30 percent have associated neurological visual disorders of diplopia, convergence disorder, photophobia, ocular-motor dysfunction, and an inability to interpret print. Some TBIs result in visual field loss or even legal blindness and other manifestations. Like other generations of disabled veterans who have desired to continue living independently, the current generation of OIF and OEF veterans deserves the same opportunity.  

BVA would like to stress again to this Committee that data compiled between March 2003 and April 2005 found that 16 percent of all causalities evacuated from Iraq were due directly to eye injuries. Walter Reed Army Medical Center has surgically treated approximately 700 soldiers with moderate to severe visual injuries while the National Naval Medical Center has had 450 individuals with eye injuries requiring surgery. VA reports that 46 such service members have attended one of the ten VA Blind Rehabilitation Centers (BRCs), 89 are enrolled in local VA Blind Visual Impairment Service Teams (VISTs), and others are in the process of being referred. It should be very obvious to members of this Committee that a new generation of blinded or impaired low vision veterans will require lifetime specialized programs to meet their needs. Such rehabilitation programs must be very individualized for such veterans and their family members, as has been the case for an older generation of veterans who have recently suffered from age-related degenerative blindness.

The Vision Impairment Specialist Training Act (VISTA), H.R. 1240, will help our nation's blind and low-vision veterans by establishing a scholarship program for students seeking training in blind rehabilitation. There are 167,000 legally blind veterans in the United States, and 47,450 are currently enrolled in Veterans Health Administration services.  In addition, it is estimated that there are over 1 million low-vision veterans in the United States, and incidences of blindness among the total veteran population of 24 million are expected to increase over the next two decades.  This is because the most prevalent causes of legal blindness and low vision are age-related diseases like glaucoma, macular degeneration, diabetic retinopathy, cataracts, and the veteran population is increasing in age, the current average age is about 80 years old.

Members of the armed forces are important to our nation and we show them our appreciation by taking care of them after they no longer serve.  But the fact is that there are not enough blind rehabilitation specialists to serve all legally blind and low-vision veterans in the VA currently there are only 33 of these critical Blind Rehabilitative Outpatient Specialists (BROS).  Two of the VA Poly Trauma Centers had difficulty for over a year in finding certified blind instructors at those centers. Blind rehabilitation training helps give these veterans awareness of and mobility functioning in their surroundings and enables them to retain their independence and dignity.  Veterans without these services may find it difficult to be self-sufficient, relying on others to perform certain skills or even simple tasks on their behalf. Research on blind and low vision Americans show they are at high risk of falls, or making medication mistakes, resulting in costly hospital admissions every year, and of losing their independence to live at home. Falls are the sixth leading cause of death in senior citizens and a contributing factor to 40% of all nursing home admissions with annual federal costs over $45,000 for each nursing home bed. According to Framingham Eye Study, 18% of all hip fractures among senior citizens- about 63,000 hip fractures a year- are attributable to vision impairment. The cost of medical-surgical treatment for every hip fracture is over $39,000, if outpatient rehabilitation services prevented even 20% of these hip fractures, the annual federal savings in health care costs would be over $441 million. Essential outpatient, cost effective services that would allow blind veterans to safely live independently at home should be supported by this congress and the administration from a health care policy stand point. Research has found that 25% of all falls resulting in hip fractures result in nursing home admissions with chronic disability; it is seven times more expensive to care for a disabled nursing home resident, than a healthy independent American over age 65.

Public Law 104-262, The Eligibility Reform Act 1996, requires the Department of Veterans Affairs to maintain its capacity to provide specialized rehabilitative services to disabled veterans, but it cannot do so when there are not enough specialists to address these needs.  Last December, the Veterans Programs Extension Act was passed, which included a provision by Congressman Michael Michaud to increase the number of Blind Rehabilitation Outpatient Specialists by thirty- five new positions over the next thirty months serving our nation's veterans.  However, there are currently not enough counselors certified in blind rehabilitation to provide for the growing number of blind or low-vision veterans, let alone the rest of our nation's elderly population. According to National Council of Private Agencies for the Blind and Visually Impaired today there are only approximately 3,000 certified in the field in the entire country. Because of this shortage, some of the ten VA Blind Centers have had longer waiting times for admissions.

The Vision Impairment Specialists Training Act H.R. 1240 helps remedy this situation by directing the Secretary of Veterans Affairs to establish a scholarship program for students seeking a degree or certificate in blind rehabilitation (Vision Impairment and/or Orientation and Mobility).  This will provide an incentive to students considering entry into the field to consider a VA career in return for this scholarship funding.  In addition, in exchange for the scholarship award, students are required to work for three years in a healthcare facility of the Department of Veterans Affairs, to ensure that our veterans are well cared for.

RECOMMENDATIONS

BVA supports including this occupational specialty in the current VA educational program and provide for the aging population of visually impaired and blinded veterans the rehabilitative specialized staffing needed. BVA requests the committee pass this VISTA act. Chairwoman Herseth-Sandlin and ranking member Boozman, BVA expresses thanks to both of you for this opportunity to present our statement for the record. The current lack of access in many networks of VA will continue unless changes are made by enacting this legislation. The future strength of our Nation depends on the willingness of young men and women to serve in our military. This willingness depends, in turn and at least in part, on the willingness of our government to meet its full obligation to them as veterans.