VA’s Visual Impairment Services Team Program

Eligibility For The VA’s Visual Impairments Services Team (VIST) Program

The VIST program provides services to veterans who are legally blind or visually impaired. Eligibility is defined in a number of ways. The VIS Coordinator is the local VA facility subject matter expert with regard to blindness and low vision. The Coordinator provides case management of blind and visually impaired Veterans. Visually impaired veterans are provided restorative services and referrals on a consultation basis. Non- legally blind veterans are provided services as needed (PRN). All veterans referred to the program receive an assessment of needs and appropriate interventional strategies. The three main ways to qualify includes:

  1. Legal blindness – Best corrected visual acuity of 20/200 on a Snellen eye chart or fields no greater than 20 degrees with both eyes.
  2. Functional vision impairment – Functional visual impairment is a significant limitation of visual capability resolution from disease, trauma or congenital condition that cannot be fully corrected by standard refractive correction, medication or surgery, and is manifested by one or more of the following; (1)insufficient visual resolution (worse than 20/60 in the better eye); (2) inadequate field of vision (worse than 20 degrees along the widest meridian in the eye with the more intact central field) or homonymous hemianopia; (3) reduced peak contrast sensitivity; and (4) insufficient visual resolution or peak contrast sensitivity (see 1 and 3) at high or low lighting within a range typically encountered in every day life.
  3. Excess disabilities – An excess disability is characterized by problems and task performance difficulties related to vision loss that have a substantial impact on the person’s functional independence or personal safety, and that are out of proportion to the degree of visual impairment as measured by visual acuities or visual fields.  Veterans whose vision is better than legal blindness may have excess disability due to; (1) sudden and/or traumatic visual disorder (especially related to military service); (2) disabling co-morbidities (e.g., hearing impairment, mobility impairment, etc.); (3) systemic diseases that cause fluctuating visual impairment; (4) combined losses of other vision functions (e.g. contrast sensitivity, stereopsis, etc.); (5) sudden changes in caregiver status; or (6) other reasons.

If you have or know a Veteran that meets any of these criteria, contact your nearest Veterans Affairs Medical Center and ask for their Visual Impairment Services Team coordinator. If you wish to talk with a blinded Veteran before taking this first step, contact the Heartland Regional Group of the Blinded Veterans Association at )816) 718-2792 or (785) 409-1838. The VA offers Veterans a variety of services from low vision clinics to extensive blind rehabilitation training for qualified Veterans. Additionally, legally blind Veterans receive the priority designation of Catastrophically disabled level 4 (or Cat4), opening numerous benefits and services.

Visual Impairment Services Team Coordinators for Kansas and Missouri

The Visual Impairment Services Team coordinators are our gatekeepers for the VA’s low vision and blind rehabilitation programs. Listed below are the VIST coordinators serving Veterans throughout Kansas, Missouri, and parts of Illinois, Arkansas, Iowa, and Nebraska.

Kansas City VA Medical Center

  • Paul Clary
  • Phone: (816) 861-4700, Ext: 56294

Columbia VA Medical Center

  • Lauren Swift
  • Phone: (573) 814-6458

St. Louis Cochran VA Medical Center

  • Kevin Jacques
  • Phone: (314) 652-4100, Ext: 54121

VA Medical Center of the Ozarks

  • Paula Ellington
  • Phone: (479) 443-4301, Ext: 65364

Eastern Kansas VA Medical Center

  • Dawn Clouse
  • Phone: )913) 682-2000, Ext: 53825

Wichita VA Medical Center

  • Bob Hamilton
  • Phone: (316) 685-2221, Ext: 53682

Celebrating National Blinded Veterans Day on March 28th

March 28 commemorates the 72nd anniversary when approximately 100 World War II blinded Veterans banded together and declared their independence. These heroes came together at Avon Old Farms Army Convalescent Hospital, where war blinded received therapy to cope with sight loss. The assembly established the Blinded Veterans Association and commenced advocacy efforts for the establishment of what we now call the Department of Veterans Affairs Blind Rehab Services.

President Obama and the 111th Congress recognized the importance remembering March 28th as National Blinded Veterans Day by signing Public Law 111-156. Governor Sam Brownback validated the service of blinded Veterans by issuing the Heartland Regional Group with its own proclamation. “Today and every subsequent March 28th, I know the American people will remember the sacrifices of the thousands of Veterans who live with a visual impairment, thanks to our day,” remarks Timothy Hornik, the Vice President of the heartland Regional Group of the Blinded Veterans Association. The Heartland Regional Group offers blinded Veterans various services from peer support to recreational programs.

General Omar Bradley, VA Administrator in the late 1940s, appointed BVA to be the first official representative for blinded veterans for the filing of claims and appeals to VA, making it only the eighth Veterans Service Organization to receive such authorization. In 1958, BVA received its congressional charter as a Veterans Service Organization.

Blinded Veterans continuously encourages their peers, families, and friends to do more than live with blindness but thrive. National Blinded Veterans Day represents more than a time to remember our Veterans services and sacrifices, but a day when we proudly announce our presence throughout the country. These actions aid in accomplishing our goals to regain independence, confidence, and self-esteem. It matters not if a Veteran’s blindness stems from military service to natural causes, since we all are Veterans living with a visual impairment.

How Blindness Impacts Different Generations of Veterans

Imagine you are in a combat zone and you find yourself disorientated and blind after being injured. Imagine you are in the middle of your career and an eye exam concludes with a diagnosis of retinitis pigmentosa, which results in blindness. Imagine you approach retirement but age related macular degeneration or your exposure to Agent Orange in Vietnam caused diabetes retinopathy altering your plans. These are just some of the ways Veterans find themselves developing a visual impairment, but rest assured there is hope. We, the Heartland Regional Group of the Blinded Veterans Association, our here to assist our fellow Veterans.

The Department of Veterans Affairs projections estimates 147,887 severely visually impaired Veterans in FY2015, which declines to 140,436 by FY2020. This reduction largely stems from the passing of our greatest generations of Veterans from WWII through the Korean war, and advances in medical procedures staving off legal blindness. While declining numbers might depict positive change, the VA’s Blind Rehabilitation Services (BRS) serves only 47,310 of these Veterans, due to lack of awareness of these benefits and entitlements. This article will describe how visual impairments impacts each generation of our nation’s Veterans, so you may assist in informing others about blindness related services for Veterans.

World War II and Korean War Veterans

Our WWII and Korean War Veterans face a combination of service and age related visual impairments. Conditions like macular degeneration, glaucoma, diabetes retinopathy, stroke related visual impairments, and retinal detachments are the prevailing conditions diminishing independence. Only 14,474 members of the Greatest Generation attended VA VRS services.

Vietnam Era Veterans

The VA recognizes numerous conditions associated with Agent Orange and other herbicides ranging from cancers to type II Diabetes. This allows Veterans to receive a VA service connected disability rating for conditions which arose later in life. Most notably are those secondary impacts from Diabetes. Alternatively, many of our Vietnam Era Veterans continue to reach the age when various age related conditions arise like glaucoma. VA statistics ranks Vietnam Veterans as the largest wartime era facing blindness with 39,869 cases.

Persian Gulf War Era Veterans

The swiftness of combat operations in Iraq leaves many to forget we sustained casualties, and overshadows the numerous other smaller deployments conducted throughout Central and South America, Kosovo, Bosnia, and Africa between the end of the Cold War and start of the Post 9/11 Era. Each of these left their marks through direct enemy engagements to exposure to toxins from burn pits to oil fields. VA BRS records identified 15,258 of these Veterans possess a severe visual impairments, with 3,586 residing outside the VA’s continuum of care. Visual impairments results from retinitis pigmentosa, service related injuries, and environmental exposures.

Operations Enduring Freedom,Iraqi Freedom, and New Dawn

From the recent conflicts in Iraq and Afghanistan, the National Alliance on Eye and Vision Research reports that over 197,555 combat injuries impacted the optical system. Amongst those with a Traumatic Brain Injury, over 36,000 have presented in poly-trauma clinics with short to long term functional visual impairments. All of these differing conditions are directly related to penetrating or concussive/blast injuries from Improvised Explosive Devices (IED), shrapnel, gunshot wounds, and environmental incidents. There are still many more unreported cases of these recent Veterans with functional sight impairments that range from issues with glare, headaches, blind spots, reading difficulties, and numerous other conditions.

Department of Veterans Affairs Services

One should not give up hope, as the VA offers an array of Blind Rehabilitation Services that can occur anywhere from home based interventions to extended training within the Blind Rehab Centers. TO learn more about these programs ask your primary care team or eye doctors who your VAMC’s Visual Impairment Services Team coordinator is.

Heartland Regional Group

We form an integral part in assisting blinded Veterans through peer support services, raising awareness about BRS programs, and aiding individuals file disability claims for blindness. Our monthly teleconferences, participation at VA support groups, and presence throughout Kansas and Missouri ensures Veterans will have a chance to talk with others who shared their experiences. We understand the struggles adapting to blindness, so we encourage Veterans to attend day to extended inpatient VA blind rehab programs to regain their independence. Finally, many causes of blindness may be linked to military service, so we inform Veterans about their rights and how to pursue service connected disability ratings.

Reflecting Upon Dr. David Shulkin's Selection as Secretary of Veterans Affairs

The testimony of Dr. David Shulkin should relax Veterans. His hearings and unanimous approval by the Senate transpired with little positive or negative excitement from anyone. In the short history of the new administration and 115th Congress, this is a sigh of relief. However, the lack of responsiveness may leave many not knowing much about our new Secretary of Veterans Affairs.

 

Dr. David Shulkin comes to the Secretary position after spending the last 18 months as the Under Secretary of Health for the VA. This experience enables him to start off with inside knowledge about the VA and its current beneficial programs and controversies. His years as a medical doctor, leadership roles in other healthcare settings, growing up in a military family, and practice experiences at VA medical centers outweigh the fact he never personally served in the military. The combination of these items affords him the knowledge to continue Secretary Robert McDonald’s initiatives, while establishing his own priorities. The VA’s scandals allured Dr. Shulkin into the Undersecretary position. He stated in his Congressional testimony, “I view my service at V.A. as a duty to give back to the men and women who secured the uniquely American freedoms and opportunities we all enjoy,” due to the barriers to timely service Veterans face. This sense of both urgency and duty stems from his Grandfathers service in WWI, father’s service as a Psychiatrist and Captain, and his own residency experiences in a VA medical center.

 

Dr. Shulkin’s 18 months as President’s Obama’s appointee to the Undersecretary fostered the belief “it was years of ineffective systems and deficiencies in workplace culture,” that lead to many VA problems. Numerous VA employees from healthcare providers and counsellors to departmental chief echo similar comments. Additionally, break down in communications between the various VA layers restrict the flow of information and knowledge throughout the entire system. Dr. Shulkin informed Congress it will require years to resolve the numerous concerns and barriers impacting VA’s service to Veterans, so his first act increased urgent care clinics and same day appointments for those in crisis. Just like anyone us, us Veterans sometimes just need these types of crisis based services to resolve many of our healthcare needs.

 

By attending many of the Veteran Service Organization’s annual conventions and conducting town hall forums throughout the country, Dr. Shulkin obtained direct input from individuals to major stakeholders in the VA. He realized Veterans receive the VA as “one V.A., and not as three separate administrations.” After all the VA consists of the Veterans Healthcare Administration (BHA), Veterans Benefits Administration (VBA), and the National Cemetery Administration. Supporting the thousands of VA employees, Dr. Shulkin informed Congress, “that V.A. has many dedicated employees across the country, and our veterans tell us just that every day.” I completely agree with this statement. Many of the frontline VA employees care deeply about Veterans services and will figure out workarounds when barriers exist.

 

For example, Blind Rehab Services acknowledge the barriers Veterans with visual impairments face, and often become our advocates when requesting prosthetics. Many Social Workers in case management roles will synchronize appointments to reduce travel barriers and fight for us to receive appointments in specialty clinics. Primary care managers will take advantage of the Choice Program upon request and justification.

 

Dr. Shulkin’s most impressive statement pertained to VA reform. “It is unfortunate that a few employees who have deviated from the values we hold so dear, have been able to tarnish the reputation of so many who have dedicated their lives to serving those who have served, but there should be no doubt that if confirmed as secretary, I will seek major reform and transformation of V.A. There will be far greater accountability, dramatically improved access, responsiveness and expanded care options, but the department of veteran affairs will not be privatized under my watch.” This answers many of the questions about Dr. Shulkin’s positions addressing VA issues. First, this statement coincides with legislative efforts over the last several years to eliminate loopholes used by VA employees facing putative actions. Secondly, he will continue efforts impacting Veterans’ abilities accessing everything from healthcare services to backlogs I benefits processes. Finally, Dr. Shulkin will not standby as legislators attempt to destroy the Department of Veterans Affairs by privatizing it. These stances mirrors the resolutions adopted by Veteran Service Organizations, like the Military Officers Association of America, Disabled American Veterans, American Legion, and Veterans of Foreign Wars.

 

Veterans groups and Dr. Shulkin do not oppose the Choice plan, but we do oppose privatization. Dr. Shulkin seeks to “strengthen system within V.A that are essential for veteran well-being, and use services in the community that can serve veterans with better outcomes and value to the taxpayerk.” Dr. Shulkin cited about 5,000 Veterans solely rely on the Choice plan for all of their care, but the majority of the 31% of Veterans who use the Choice plan prefers a combination of both VA and private care. The VA remains the best provider for many specialty care services and therapeutic interventions predominately found in Veterans populations, like Post Traumatic Stress, Agent Orange and other environmental exposures, and many other conditions.

 

When addressing Veteran suicides, Dr. Shulkin stated, “we have made significant progress in suicide prevention, including hiring more mental health professionals, implementing a predictive tool to identify those at greatest risk and fixing the crisis line to better serve our veterans.” By impacting access to urgent care and mental health services, Dr. Shulkin suggestions mirrors findings from a national Veterans suicide study from 2016. The study reported failure to access VA services on a regular basis, along with age are key lethality factors. The predictive tool and increase in mental health providers aims to resolve these concerns.

 

Based on Dr. David Shulkin’s Congressional testimony and supportive actions, I feel he will continue to positively impact the Department of Veterans Affairs. However, I say this with some apprehension. Dr. Shulkin is one individual, and many systems impact the daily to longitudinal operations of the VA. We still will have employees enhancing and diminishing VA services. We will still have legislative priorities assisting and hindering VA progress. We still have a Veteran population steadily dwindling, removing the percentage of the public who directly and intimately knows a Veteran. Therefore it is our job as Veterans to make sure decision makers and stakeholders know our thoughts about the Department of Veterans Affairs. We need to speak up at civic events, writing editorials to news outlets, and contact the offices of our elected officials.

 

All quotes used in this post come from Dr. Shulkin’s Congressional testimony.

Blinded Veterans of the Heartland Mid Year Meeting Announcement

We cordially invite all visually impaired Veterans in Kansas and Missouri interested in furthering the mission of the Heartland Regional Group of the Blinded Veterans Association to join us and Envision for the Heartland mid year meeting. Continuing our efforts to bring the Blinded Veterans Association to you, Envision in Wichita assembled a wonderful itinerary to demonstrate how blinded Veterans assist each other. The meeting will occur on the Envision campus, and lunch will be provided to all. The agenda includes:

Friday, October 14

  • 10:00 to 10:15 – opening ceremonies
  • 10:15 to 11:15 – Low Vision Services, by Dr. Donald C. Fletcher MD of the EVRC Clinic
  • 11:15 to 12:00 – Wichita VAMC Visual Impairment Services Team Update, by Bob Hamilton of the Robert J. Dole VAMC
  • 12:15 to 1:30 – Box Lunch, provided by Envision for those who RSVP
  • 1:30 to 2:30 – Talking Books of Kansas Presentation, by Dana Carter of the NLS Talking Books Program for Kansas
  • 2:30 to 3:00 – open discussion
  • 3:00 to 4:00 – Heartland Regional Group business meeting and closing ceremonies

The mid year will occur on the Envision campus in Wichita, Kansas. The address is:

  • Envision

  • 610 N. Main Street

    Wichita KS 67203

  • www.EnvisionUS.com

RSVP Instructions

We request you RSVP by October 10 if you wish to attend. To RSVP, contact the Heartland Regional Group’s Secretary, Paul, at (816) 266-1773 or

The Heartland Regional Group extends our heartfelt salute to Envision and Sandy Alexander for pulling this meeting together and underwriting all expenses for the event. Only through these types of partnerships are we able to ensure all visually impaired and blinded Veterans in Kansas and Missouri possess the necessary information, resources, and services to obtain the highest quality of life.

The 71st Blinded Veterans Association's National Convention Recap

The 71st Blinded Veterans Association National Convention occurred from August 22 to 26 at the Hilton City Center Hotel in Milwaukee. The convention kicked off with the Visually Impaired Patriots Experiencing the Road (VIPER) Ride. John Carter, the Wisconsin Regional Group President organized the VIPER Ride with the goal of engaging convention participants, community supporters, and public awareness for blindness’ possibilities. This consisted of blinded veterans enjoying a 50-mile motorcycle ride, lunch, and, of course, the 50-mile return ride. All reviews consist of high praise and excitement for empowering them to experience the road, and plans will investigate continuing this program for future conventions.

Tuesday featured the exhibition hall’s opening and training seminars for attendees. This year’s exhibit hall consisted of the most vendors in recent history. Prominent among the offerings were several companies with headgear that contained hardware and software to perform tasks like OCR, GPS, money Identification, and recognition of faces and objects.
There were several education sessions that day. Included was a presentation on Medical Marijuana and its benefits. There was training for becoming a National Volunteer Service Officer (NVSO). Training sessions were held to assist Regional Group Presidents and Vice Presidents, and a separate session trained Secretaries and Treasurers in performing their duties within the regional group. There was also a legislative update and tips on how to impact legislation at local and national levels. Tuesday was capped off with the President’s reception.

The opening ceremonies on Wednesday morning invigorated all those in attendance. Starting off the ceremony the Wisconsin National Guard posted our National colors. The Mayor of Milwaukee then welcomed the BVA to the city. Governor Scot Walker enthusiastically spoke to the membership and presented his Governor’s Proclamation announcing the day as BVA’s day. Department of Veterans Affairs Secretary Robert McDonald completed the opening ceremony with a keynote address, highlighting the changes in the VA and his goals for the future.

Immediately following the opening ceremony, the opening business meetings set the tone for the rest of the week. This meeting included the financial report, presentation of the budget, and nominations for national office. No new nominees for any of the executive board positions were offered, so only the incumbents ran for their current seats.

Later in the day the Resolutions and Bylaws committee met to form recommendations to the membership. Additional meetings discussed the possibility of investigating new and operations of current special interest groups. Some of the groups proposed include Blind Golfing, a new Women Veterans Concerns Working group, and Veteran Guide and Service Dog Handlers. The evening consisted of the Council of Veteran Guide and Service Dog Handlers annual meeting, which transpired both in-person and through a call teleconferencing platform, uniting those present with members who could not physically attend. Other evening events includes a Brewers baseball game and trip to the casinos.

Thursday’s events started with a presentation by the Honorable Dr. David J. Shulkin, Under Secretary for Health for the U.S. Department of Veterans Affairs. Additional morning presentations consisted of vision research, consumer protection and the Sprint Vision Accessibility program. The Father Carroll Luncheon, officer candidate speeches, and district caucus meetings. rounded out the rest of Thursday’s schedule.

The closing business meeting occurred on Friday. The by-law amendment proposing a pathway to a balance budget failed by an overwhelming majority, 79% to 21%. The second Bylaw amendment passed, which transfers the selection of the National Convention location from the assembled delegation at the National Convention to the BVA’s Convention Coordinator and Board of Directors. The belief is the change would allow more efficient and cost conducive planning process for the National Convention. The two next Bylaws were technical corrections to our existing Bylaws, and also passed with no opposition. The fifth Bylaw amendment passed without objections, changing the lifetime membership cost to a flat $20 for all applicants. However, the flat membership rate will only be in effect from September 1st, 2016 until August 1st, 2017. As no one was nominated for any Executive Board position, all incumbents were reappointed, and consist of:

Robert Stamper, President
Joe Parker, Vice President
Paul Mimms, Secretary
Joe McNeil, Treasurer

The convention came to a festive close with the final banquet. The prestigious Major General Melvin J. Maas award was bestowed upon Wally Guerra of San Antonio. The selection for the next convention is unknown as of the drafting of this summary.