About the Program

Loss of sight affects each person differently and is capable of hindering overall functioning, including employment, recreation, social and family life, and communications. The VA's many years of experience have shown that a program of comprehensive rehabilitation is usually the best course to follow. Here an experienced professional staff guides the individual through a process that eventually leads to maximum adjustment to the disability, reorganization of the person's life, and return to a contributing place in the family and community. To achieve comprehensive rehabilitation, the Blind Rehabilitation Centers offer a variety of skill courses to the veteran designed to help achieve a realistic level of independence. The veteran is also assisted in developing a healthy attitude toward themselves, blindness, and the future.

Services

• Orientation and Mobility
• Living Skills
• Communication Skills
• Activities of Daily Living
• Independent Living Program
• Manual Skills
• Visual Skills
• Computer Access Training Section (CATS)
• Physical Conditioning
• Recreation
• Adjustment to Blindness
• Group Meetings
  

Continuum of Care:

The Blind Rehabilitation program is designed to improve the quality of life for blinded and severe visually impaired veterans through the development of skills and capabilities needed for personal independence, emotional stability, and successful integration into the community and family environment.  It is comprised of 10 Inpatient Blind Rehabilitation Centers (BRC), 92 full-time Visual Impairment Services Team (VIST) Coordinators, 20 Blind Rehabilitation Outpatient Specialists (BROS), 5 National Program Consultants, and Inpatient Computer Access Training programs at medical centers throughout the country and Puerto Rico.  Services are provided using a multi-disciplinary team approach.  In addition, there is one Visual Impairment Services Outpatient Rehabilitation Program (VISOR) and three Visual Impairment Centers to Optimize Remaining Sight (VICTORS) programs.

To maintain capacity and to provide World Class Care, the Blind Rehabilitation Gold Ribbon panel Commissioned by the Under Secretary for Health, identified the need to "develop and implement a continuum of care model that extends from the veteran's home environment to the local VA care site and the regionally based inpatient training program (Panel Report, February, 1999).  The Visual Impairment Advisory Board (VIAB), a VA group established to implement the Gold Ribbon Panel recommendations, identified treatment of severe visual impairment as a critical need for the veteran population .   Development of a continuum of care model encompassing alternative rehabilitative service delivery is provided and supported by the following program components:

The patients are identified by the Visual Impairment Service Team Coordinator (VIST).   VISTs coordinate the administrative and professional services provided to blinded/visually-impaired veterans at the Medical Centers. They also serve as case managers for blinded veterans and liaison with blind rehabilitation centers, clinics and other facilities that provided services to blinded veterans.  VIST coordinators ensure that all eligible blinded veterans are informed of VIST services including general medical, surgical, ophthalmologic, mental health, and other needed health care services.

Patients are referred by the VIST to the following programs based on their visual needs: 

• Minimum Low Vision Care Clinic - Clinic for veterans with beginning acuity/field/contrast loss, problems limited to reading small print, illumination control).  Veterans with minimum low vision can be managed within eye clinics with current staff. No additional space required.  Many medical centers have these clinics as part of their Eye Care Services.

• Maximum Low Vision Care and Alternative Sensory Enhancement Clinic - For veterans whose vision loss is severe, but they maintain useful vision that can be enhanced for every day tasks

• Enhanced Low Vision Care   Clinic :   - For  veterans with acuity/field/contrast loss so severe that it has affected more areas of daily activities, i.e., grooming, writing, recognizing faces, cooking, health care).  Examples of this type of service is the VICTORS  Program.  The VICTORS   program is an outpatient low vision rehabilitation program emphasizing a team approach through definitive medical diagnosis, functional vision evaluation, prescribing and training in the use of low vision aids, and counseling and follow up.  VICTOR's programs are located in Chicago, Kansas City and Northport. 

• The Visual Impairment Services Outpatient Rehabilitation Program (VISOR):   The VISOR program is an outpatient intermediate (two week) rehabilitation program offering skills training, orientation and mobility, and low vision therapy located in Lebanon, PA.  Veterans must be legally blind and capable of self-care, due to the program being a HOPTEL with no medical or nursing personnel on unit.  Veterans who have low vision but who are not legally blind, or those who are legally blind who do not wish to or cannot participate in the VISOR HOPTEL Program are seen in the VISOR outpatient clinics according to their individual needs.  If clinically appropriate referrals are made to the West Haven, CT VA Blind Center.    Referrals come from a variety of sources, including Optometry, Primary Care, Special Pops surveys, state and private agencies, self-referrals and VIST Coordinators.

• Blind Rehabilitation Outpatient Specialist (BROS):   BROS are multi-skilled professionals who perform a wide array of blind rehabilitation services including assessments, low vision training, living skills and orientation & mobility.  These services are provided to veterans in the most appropriate setting, i.e. home, VA, CBOC, college, nursing home or assisted living environments and in rare instances at the work site.  They also provide training to family members.

• Blind Rehabilitation Centers (BRC):   There are 10 centers that provide rehabilitation to legally blind and profoundly visually impaired veterans.  Comprehensive individualized blind rehabilitation services are provided in an inpatient medical center environment by a multidisciplinary team of providers.  The average length of stay is six weeks.  A specialized Computer Access Training Program (CAT) is offered as part of the intensive training or as a specialized inpatient rehabilitation option in FY 01, 1885 veterans were discharged from this program.

The VACO Blind Rehabilitation Program Office staff and the Chief Consultant, Rehabilitation Strategic Health Care Group are available to assist with planning.  Please contact Wanda Washington at 202-273-8482 or e-mail at Wanda.Washington@hq.med.va.gov  for further information.

Visual Impairment Services Team (VIST)

VIST Coordinator
The VIST Coordinator is a case manager who has major responsibility for the coordination of all services for legally blind veterans and their families. Duties include providing and/or arranging for the provision of appropriate treatment modalities (e.g., referrals to BRC's and/or BROS) in order to enhance a blinded veteran's functioning level. Other duties include identifying new cases of blindness, providing professional counseling, resolving problems, arranging annual healthcare reviews and conducting education programs relating to blindness.