STATEMENT OF
BRUCE W. DAVIS, MSW
VISUAL IMPAIRMENT SERVICES TEAM COORDINATOR
NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM
VA MEDICAL CENTER, GAINESVILLE FL
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
HOUSE OF REPRESENTATIVES

July 22, 2004

Mr. Chairman and Members of the Committee:

          For the past 21 years I have been the Visual Impairment Services Team (VIST) Coordinator at Malcolm Randall VA Medical Center (VAMC) in Gainesville, Florida.  The North Florida/South Georgia Veterans Health System is committed to providing quality services to our blind and visually impaired veterans.  In 1983, we had identified a total of 275 legally blind veterans.  These veterans were served by two part-time VIST Coordinators.  As of July 12, 2004, we had identified 1,114 legally blind veterans within the North Florida/South Georgia Veterans Health System.  They are currently served by 3 full-time VIST Coordinators, 2 part-time VIST Coordinators, and one full-time Blind Rehabilitation Outpatient Specialist (BROS).  My personal caseload is comprised of 454 legally blind veterans.

          As the VIST Coordinator at the Gainesville VAMC, I am responsible for coordinating the efforts of a multi-disciplinary team to provide comprehensive medical and rehabilitative services for the blind.  We work to identify the legally blind veterans in our primary service area and invite them to participate in the services provided by the Department of Veteran Affairs.  This is accomplished by an active outreach effort to local and state agencies that work with the visually impaired, as well as other consumer advocates groups.  We also work with medical center staff to identify and refer veterans with visual impairment to the VIST program.

          We invite all blind veterans to participate in the annual VIST review, which is comprised of a medical examination, eye examination, hearing screening, and a psychosocial assessment.  During the VIST review, we assess each veteran’s adjustment to vision loss, his or her need for blind rehabilitation, and his or her need for adaptive equipment.  We also review the veteran’s eligibility for VA compensation, pension, and other benefits.  Based on the findings of the VIST review, referrals are made to VA Blind Rehabilitation programs, local blind rehabilitation training with the BROS, low vision services, veterans benefits, prosthetics and sensory aids, medical sub-specialties and other local and state benefits and services as indicated.

          I serve as the point of contact for the blinded veteran within the medical center.  I assist the veteran and their families in the establishment of primary care, coordination of appointments, prosthetic requests, pharmacy concerns, eligibility questions, VA benefits, travel consults and other requests for services.

          I run two support groups for blinded veterans to help them and their families adjust to their vision loss.  These groups meet monthly at the Gainesville VAMC and at the Florida Center for the Blind in Ocala.  We have a variety of speaker’s present information on topics ranging from the causes of vision loss to veteran benefits.  We sponsor activities that allow the veterans in the area to reintegrate themselves into activities, which they may have given up due to their vision loss.  These have included an annual bowling activity, support group luncheons, and a deep-sea fishing trip.

          As the subject matter expert on blindness within the medical center, I conduct ongoing in-service training to eye care professionals, nursing staff, and other medical center personnel.  I also meet regularly with state and local agencies for the blind, as well as fraternal organizations such as the Lions Club to inform them of VA services for the blind.  I also provide ongoing consultation for the part-time VIST Coordinators at the Tallahassee and Daytona Beach Outpatient Clinics.

          In an effort to reach out to the community, we have sponsored an annual Vision Awareness Day Open House.  We invite agencies, veteran service organizations, and private vendors that work with the blind to display their services and adaptive equipment.  We work closely with the State Division of Blind Services, WUFT Radio Reading Service, and the Bureau of Braille and Talking Book Services to invite both the legally blind veterans and other visually impaired individuals from throughout North Florida and South Georgia to attend.  The open house is also available to all VA employees and allows them an opportunity to learn more about visual impairment and the services that are available to assist the blind in leading a more productive and independent life.

          We are working with an aging veteran population.  There is a positive correlation between the incidence of blindness and age.  Sixty-nine percent of our legally blind veterans are over the age of 75.  This shift in demographics has required our VIST program to identify alternative methods of providing blind rehabilitation services for our blind veterans.  We currently have one Blind Rehabilitation Outpatient Specialist who is providing training for those veterans who are unable to participate in one of the VA residential blind rehabilitation programs.  She also works with those veterans who are returning from VA Blind Rehabilitation to help them reintegrate those newly acquired skills into their home setting.

          The North Florida/South Georgia Veterans Health System recently funded a new full time VIST Coordinator position at the Lake City Division to meet the needs of the veterans in northern Florida and southern Georgia.  This has allowed these blind veterans to receive services closer to their home instead of traveling to Gainesville for VIST services.

          The VIST program at the Gainesville VAMC is working to implement enhanced services that will improve patient safety.  We are working with Pharmacy and Prosthetics to implement Script Talk, which will allow a blind veteran to independently identify their medications.  We are also implementing a means to provide computer access training with local agencies for the blind and other vendors in an effort to shorten the lengthy wait list for these services at the regional VA Blind Rehabilitation Centers.

Mr. Chairman and Members of the Committee, I have tried to give a few examples of the spectrum of blind rehabilitation services we provide at the Gainesville VAMC.  I will be happy to answer any of your questions.  Thank you.