In fiscal year 2003, VA estimated that about 157,000 veterans were legally  blind, with more than 60 percent age 75 or older. About 44,000 legally  blind veterans were enrolled in VA health care. 1.) Blind Rehabilitation Outpatient Services Are Available in Few VA Locations

VA offers three types of blind rehabilitation outpatient services to legally  blind veterans, but these services are available in few VA locations. The  three types of services include Visual Impairment Services Outpatient  Rehabilitation (VISOR), Visual Impairment Center to Optimize Remaining  Sight (VICTORS), and Blind Rehabilitation Outpatient Specialists (BROS). The services range from short-term outpatient programs provided in VA  facilities to home-based services. Outpatient Services Provide Opportunities to Benefit Veterans

VA officials who provide services to legally blind veterans told us that  some veterans could benefit from increased access to outpatient blind  rehabilitation services. We obtained this information by asking VA to  review all of the veterans who, as of March 31, 2004, were on the waiting  lists for admission to the five BRCs we visited and to determine whether  outpatient services could meet their needs. VA officials reported that 315  out of 1,501 of these veterans, or 21 percent, could potentially be better  served through access to outpatient blind rehabilitation services, if such  services were available. In 1999, VA convened a Blind  Rehabilitation Gold Ribbon Panel to study concerns about the growing  number of legally blind veterans. Factors that Affect Expansion of Blind Rehabilitation Outpatient Services

There are two factors that affect VA’s expansion of outpatient services  systemwide. One factor is the agency’s long-standing belief that  rehabilitation training for legally blind veterans can be best provided in a  comprehensive inpatient setting. The second reported factor is VA’s  method of allocating funds for blind rehabilitation outpatient services,  which provides local medical center management discretion to provide  funds for them. Currently, the VIAB is working with VA’s Office of Finance  and Allocation Resource Center to develop an allocation amount that  would better reflect the cost of providing blind rehabilitation services on  an outpatient basis, which could in turn, provide an incentive for networks  and medical centers to expand outpatient rehabilitation services for legally  blind veterans.
Why GAO Did This Study

In fiscal year 2003, the Department of Veterans Affairs (VA) estimated that about 157,000 veterans were legally blind, and about 44,000 of these veterans were enrolled in VA health care. The Chairman of the Subcommittee on Health, House Veterans' Affairs Committee, and the Ranking Minority Member, Senate Veterans' Affairs Committee expressed concerns about VA's rehabilitation services for blind veterans. GAO reviewed (1) the availability of VA outpatient blind rehabilitation services, (2) whether legally blind veterans benefit from VA and non-VA outpatient services, and (3) what factors affect VA's ability to increase veterans' access to blind rehabilitation outpatient services. GAO reviewed VA's blind rehabilitation policies; interviewed officials from VA, the Blinded Veterans Association, state and private nonprofit agencies, and visited five Blind Rehabilitation Centers (BRC).

What GAO Found

VA provides three types of blind rehabilitation outpatient training services. These services, which are available at a small number of VA locations, range from short-term programs provided in VA facilities to services provided in the veteran's own home. They are Visual Impairment Services Outpatient Rehabilitation, Visual Impairment Center to Optimize Remaining Sight, and Blind Rehabilitation Outpatient Specialists. VA reported to GAO that some legally blind veterans could benefit from increased access to outpatient blind rehabilitation services. When VA reviewed all of the veterans who, as of March 31, 2004, were on the waiting list for admission to the five BRCs GAO visited, VA officials reported that 315 out of 1,501 of them, or 21 percent, could potentially be better served through access to outpatient blind rehabilitation services, if such services were available. GAO also identified two factors that may affect the expansion of VA's outpatient blind rehabilitation services. The first involves VA's longstanding position that training for legally blind veterans is best provided in a comprehensive inpatient setting. The second reported factor is VA's method of allocating funds for medical care. VA is currently working to develop an allocation amount that would better reflect the cost of providing blind rehabilitation services on an outpatient basis.