Thomas Zampieri, Ph.D.
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 present BVA's legislative concerns on the topic of Department of Veterans Affairs (VA) Specially Adaptive Housing programs. 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 concerns over the lack of improvement, in recent years, of the Veteran Benefits Administration’s ability to provide the adaptive housing programs necessary to meet the needs of disabled veterans seeking such resources. 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, and with the issue of Traumatic Brain Injury (TBI) also of paramount concern to our members, BVA appreciates this hearing as a significant step as we work together to improve the system.
As of May 22 of this year, just two weeks ago, there were 25,549 traumatic combat injuries, of which 7,267 required air medical evacuation from Iraq. What has not been as widely reported is that another 6,991 personnel 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 adaptive housing grants in order to live independently in their own homes. More than 1,880 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 visual disorders of diplopia, convergence disorder, photophobia, ocular-motor dysfunction, and an inability to interpret print. Some TBIs result in legal blindness and other manifestations known as Post-Trauma Vision Syndrome (PTVS). Like other generations of disabled veterans who have desired to continue living in their own homes, the current generation of OIF and OEF veterans deserves the same opportunity. It is therefore important that economic adjustments be made to the current system to keep pace with inflationary costs of construction labor and materials. If disabled veterans are not able to make adaptive changes to their homes, they run the risk of falls and injuries that result in expensive emergency room visits and costly hospital admissions.
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 a list of 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 visually 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.
CURRENT SPECIALLY ADAPTED HOUSING SERVICES
Home Improvements and Structural Alterations (HISA). VA currently has Specially Adapted Housing Grant programs to assist disabled veterans in the construction of an adapted home or the modification of an existing home. The program goal is for veterans to live independently in a safe environment. For those with service-connected blindness, the current grant amount is $4,100. For the nonservice-connected blinded veterans, the amount is $1,200. These amounts have not changed in more than a decade. Such grants can be used for any home improvement that is necessary for the continuation of treatment or rehabilitation. It can also be utilized for disability access to the home and essential lavatory/sanitary facilities. A HISA grant is available to veterans who have received a VA medical determination that improvements and structural alternations are necessary or appropriate for successful, cost-effective treatment of their disability. For example, legally blinded veterans frequently require additional lighting for maximum utilization of their remaining vision
Specially Adapted Housing (SAH). The SAH grant, currently limited to $50,000 annually, is used to assist veterans with mobility throughout their homes. It can be used for minor construction projects. Eligible are service-connected veterans with a permanent and total disability due to one of the following:
- The total loss, or loss of use, of both lower extremities as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair.
- Blindness in both eyes (having only light perception), plus a loss or loss of use of one lower extremity.
- The total loss, or loss of use, of one lower extremity together with (1) residuals of organic disease or injury, or (2) the loss, or loss of use, of one upper extremity which so affects the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair.
- The loss, or loss of use, of both upper extremities such as to preclude use of arms at or above the elbow.
Special Home Adaptation Grant (SHA). BVA’s experience has been that very few blinded veterans meet the above criteria to obtain the SAH grant. The Special Home Adaptation (SHA) grant, on the other hand, helps service-connected veterans with specific mobility problems within the home. The SHA grant is for $10,000. The disability must be permanent and total due to:
- Blindness in both eyes with a 5/200 visual acuity or less, or
- Anatomical loss or loss of both hands and extremities below the elbow.
RECOMMENDATIONS AND CONCLUSIONS
BVA supports the Independent Budget recommendations that Congress increase specially adapted housing grants and provide for future automatic annual adjustments indexed to the rise in the cost of living. BVA supports H.R. 675, the “Disabled Veterans Adaptive Housing Improvement Act.” The bill would increase an SAH grant from the current $50,000 to $60,000 and would change the SHA grant from $10,000 to $12,000. BVA requests that a HISA grant for service-connected veterans be increased from $4,100 to $5,400 and that the same grant for non-service connected be raised from $1,200 to $2,400.
Chairwoman Herseth-Sandlin and ranking member Boozman, BVA expresses thanks to both of you for this opportunity to present our testimony for the record. We are concerned that injured veterans and their family members from OIF and OEF operations, as well as those from previous conflict eras, are not currently able to access the updated adaptive housing services necessary to live in their own homes once they have successfully completed the appropriate rehabilitation programs. This lack of access will continue unless changes are soon made. 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. Waiting will only increase the problems and expenses associated with this growing policy problem.