Research - Rehabilitation - Re-Employment

Sgt. Shaft 12/31/2009

Dear Sgt Shaft,
We met briefly at one of the conferences for the wounded in Washington, D.C., a couple of years back, and I appreciate your calling-card nail file, but I am not writing as a thank-you but in regard to your article about the special adaptation entitlements by the Department of Veterans Affairs.

I am on terminal leave, retiring with more than 24 years of service as a medical provider and Navy SEAL. Over those years, I have encountered many of our service members with severe wounds and have since made it my personal goal to do whatever it would take to increase the VA special-adaptation entitlements for both automobiles and housing.

I think the VA has the programs in place to care for our veterans and address these issues, but they are in need of updating and adaptation to the present day. Case in point is the single one-time maximum payment of $11,000 for automobile adaptation.

I am sure in the past this would have been sufficient to cover the cost of a vehicle for the severely wounded, but today, the cost to purchase or modify a vehicle is much more than that amount. Likewise, the average age of the severely wounded is less than 30 years, and if one considers that an average American travels 12,000 to 15,000 miles per year, these members would require a new vehicle every five to six years.

The Specially Adapted Housing Program, which provides a one-time payment up to $60,000, assumes that an individual would not relocate in his or her remaining years, which is unrealistic for a young man who has lost his legs in his early 20s because of an improvised explosive device.

I was wanting to address this issue on the first of the year and contacted the Iraq and Afghanistan Veterans of America in early November to gain some support. However, after your article, I thought I would write to you for your thoughts and guidance on how to work this issue. Thank you for your service and consideration on this issue, and I look forward to hearing from you.

Mark D.
Service and veteran advocate
Albuquerque, N.M.

Dear Mark,
I have shared your missive with the chairmen of the House and Senate Veterans' Affairs committees. I suggest that you also contact them about these issues because it is Congress that legislates and funds these vital programs.

Shaft Notes
The VA notes that Iraq War veteran Joseph "Jay" Briseno Jr. can receive a comprehensive examination at his bedside in Northern Virginia from his team of clinical specialists. His new telehealth unit uses a broadband camera and video-conferencing technology, enabling his VA care team to keep tabs on everything from the condition of his skin to the settings on his ventilator. Telehealth, remote health care technology, is an important lifeline for Jay and his family, providing a real-time link to his health care team about 30 miles away at the Washington DC VA Medical Center.

In 2003, while serving in Iraq, Jay was shot in the back of the neck at point-blank range. The fateful shot changed his life forever, causing paralysis and ultimately blindness and brain injury. Jay resides in his VA-modified family home and gets his health care from the VA medical center.

More than 400 veterans participate in DCVAMC's Care Coordination Services home telehealth program, giving them direct connections to their health providers through the use of telehealth devices installed in their homes. Many units are used by veterans to enter information such as blood pressure, weight and results of their home glucose tests, which enables their physicians to monitor their health. These devices electronically transmit vital data to the care team. Some patients use a video phone to communicate with their care providers. These systems are especially useful to people with mobility issues that restrict travel and those with chronic conditions that require regular monitoring.

In Jay's case, the two-way video telehealth unit brings his team of specialists into his home to remotely monitor his condition. Because he must travel by ambulance each time he visits the medical center, this telehealth unit assists in gauging the necessity of putting him and his family through the ordeal of preparing him for the trip. His parents, Eva Marie and Joseph Sr., are thankful to VA staff members who shepherded the project. They also support wider use of this technology.

"I believe practicing telemedicine and remote monitoring is an incredible backstop for homebound veterans," Joseph Briseno Sr. said. "It prevents costly hospitalization and disruption of the veterans life." Similar technology is used in VA Community Based Outpatient Clinics nationwide, bringing specialty care closer to home for many Veterans.

The VA Office of Telehealth Services, directed by Dr. Adam Darkins, worked with Tandberg Corp. and VA's own technical team to create a telehealth unit specifically for Jay's special needs. "This is an exciting innovation which gets to the heart of what VA is about - providing the right care, in the right place at the right time," Dr. Darkins said.

For more information about telehealth technology visit the VA Web site atwww.carecoordination.va.gov/telehealth.

Rep. Steve Buyer of Indiana, ranking Republican on the House Veterans' Affairs Committee, said he will request an independent review of the allocation process to help ensure that each VA medical center is able to provide timely treatment for veterans.

Mr. Buyer pointed to the need for the study during a full House Committee on Veterans' Affairs hearing on the resource distribution process that occurs between VA's Veterans Integrated Service Networks and its 153 medical centers.

Send letters to Sgt. Shaft, c/o John Fales, P.O. Box 65900, Washington, D.C. 20035-5900; fax to 301-622-3330; call 202-257-5446 or email sgtshaft@bavf.org.

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