Saturday, November 21, 2009

The Rainbow Tour ends with a whimper



Face the facts, the rainbow's starting to fade
I don't think she'll make it to England now
It wasn't on the schedule anyhow



"According to the Defense Manpower Data Center, at the Department of Defense, approximately 35,000 service members have been wounded in Iraq and Afghanistan," explained US House Rep Stephanie Herseth Sandlin yesterday afternoon. She was opening the House Veterans Affairs' Subcommittee on Economic Development's hearing entitled Adaptive Housing Grants. What are Adaptive Housing Grants? The VA explains: "Veterans or servicemembers who have specific service-connected disabilities may be entitled to a grant from the Department of Veterans Affairs (VA) for the purpose of constructing an adapted home or modifying an existing home to meet their adaptive needs. The goals of the Specially Adapted Housing (SAH) Grant Program is to provide a barrier-free living environment that affords the veterans or servicemembers a level of independent living he or she may not normally enjoy."

The first panel was composed of Disabled American Veterans' John L. Wilson, Paralyzed Veterans of America's Richard Daley, Blinded Veterans Association's Thomas Zampieri and Homes For Our Troops' John S. Gonsalves. From Daley's opening statement, we'll note this section:

The $63,700 currently available using the Specially Adapted Housing grant is a significant help for a veteran to make the needed modifications to their existing home or newly purchased previously owned home. Since it is difficult to find an existing home that can be made totally accessible, some veterans choose to design a new house incorporating accessibility into the plans. Often financial considerations or a convenient living location near family members may preclude designing a new home. In those situations the often monumental task of making the existing structure accessible must be considered. Guidance and information to make modifications for accessibility can be found in the VA's newly issued VA pamphlet 26-13, Handbook for Design: Specially Adapted Housing for Wheelchair Users, which was also reviewed by PVA's Architecture Department before its publication.
Many existing homes can be modified to improve access for a wheelchair user and enhance the function of the home. Some basic alterations would include creating an accessible entrance to the home including an accessible route to the entrance door, a level platform that is large enough for maneuvering during door operation, and enlarging entrance doorways. One bathroom would need complete renovation including plumbing arrangements if an accessible roll-in shower is required. The movement of an existing wall may be necessary for a person in a wheelchair to use each fixture of the bathroom, allow room for door operation and general circulation in the bathroom. Similar construction alterations would be required for the kitchen to be accessible and usable, and perhaps alterations to the master bedroom. The current grant amount of $63,700 in many situations would not pay for the entire project of making a home accessible for a wheelchair user. Since the house must be made accessible for the veteran, they would have no other option than to pay for remaining construction costs from personal savings, arrange a loan from a bank, or borrow needed funds from family members. We have been told that more often, than not, this is the situation the veteran faces.

That provides a general overview of some needs shared by many disabled veterans. We'll now zero in on an example of one person's needs in particular.

Thomas Zampieri: I had an OIF blinded service member that sent me an e-mail about the special housing grant program which I included in my [prepared] testimony because it sort of explains some of the frustration. While he was happy that he got the $10,000 grant in 2007, I actually had to spend $27,000 to do the adapted housing changes that he needed to provide room and space for his computer, the monitors, the scanners, the printers and the magnifiers in order for him to complete his college degree. All of this was great VA adaptive technology that was provided to him as a blind veteran but you have to have a place in order to store it and a way for that equipment to be connected. A lot of the blind veterans have unique, uh, requirements in regards to lighting and electrical work and the current amounts don't cover that.

Today Kerry Feltner (The New Hampshire) reports on Nathan Webster's campus lecture "Can't Give This War Away: Three Iraqi Summers of Change and Conflict." Webster is a photo journalist. Feltner spoke with people who attended the lecture. Gretchen Forbes declared, "It's really unusual to get a first-hand report of the war. You'd think by now it would be our duty to have major news organizations over there to write about the war . . . that really surprises me. I feel like it's the media's responsibility." Betty Nordgren declared, "I'm always interested in hearing about the war and the images were great to see, but I think that the news organizations are in trouble if they don't start covering this war more thoroughly." Both women are correct and it's also true that the least covered in any war are the ones with visible wounds. It's apparently too tempting to look away. That's true of the challenged and disabled population in general but especially true of those members of that population whose wounds derive from a war or military conflict. We'll note the following exchange from the hearing.

Chair Stephanie Herseth Sandlin: One of the concerns, I know that, Dr. Zampieri, you have in terms of the updated version -- Well, maybe not a concern. But maybe you could elaborate for us. With the updated version of the handbook, is that helpful for visually impaired veterans. What further provisions would your organizations like to see in-in the handbook?

Thomas Zampieri: Yeah, the handbook is helpful. A lot of the modifications in regards to lighting and additional electrical outlets and all those things. And then the --

Chair Stephanie Herseth Sandlin: You had mentioned that in your oral statement. That you would like to see those types of adaptions added.

Thomas Zampieri: Right.

Chair Stephanie Herseth Sandlin: So maybe a comprehensive list of what would be available --

Thomas Zampieri: Okay.

Chair Stephanie Herseth Sandlin: Is that?

Thomas Zampieri: Right. And the voice activated types of devices are also, you know, he [John Gonsalves] had mentioned. Especially for blind veterans who now days live alone. All those things add to safety and other things.

Chair Stephanie Herseth Sandlin: And then, Mr. Gonsalves, you had expressed concerns that I think that in terms of some requirements in the grants -- that there are injuries that require some sort of adaptions or its sort of mandatory but to have some additional flexibility in the grants would be helpful.

John Gonsalves: Right.

Chair Stephanie Herseth Sandlin: Is that correct?

John Gonsalves: Yes, and I think some of that may have been taken I hadn't seen the new VA pamphlet. I-I hadn't seen it before the testimony but one of the things that Homes For Our Troops does now -- and you can kind of tell from one of the pictures that we have here -- we have a soldier who actually, before his house is being built -- this is under the Fully Functioning Kitchens For Mobility. We qualify what kind of adaptations are going to happen in a house based on injury. And I guess it would sort of work the way VA rates disability percentage. We -- At the time a service member gets qualified for SAH, we have enough information at that time. And what Homes For Our Troops has done is we have an adaptation check list. We only have five sets of home plans that we build. And the home, the footprint is always the same. The windows are always the same. The floor plan is always the same. But there's an adaptation check list based on what the soldier needs and that's why I provided some photos in here. It really gives you an idea. Obviously a quadriplegic would need a lifting care system where somebody that has the mobility of their upper arms probably doesn't need it. And I think at the time of being qualified for SAH, basically all of the technology is there. We've built for, I think, every type of injury out there from amputees who are blind to different levels of spinal cord injuries. So we know what's available to put in a home and it would be really great to be out in the front once they qualify. A whole checklist be put together.

Chair Stephanie Herseth Sandlin: I think that that's very helpful and you have some ideas and recommendations that would be helpful and would like you to share those with us, with the VA. I think that with addition to what they've done to update their pamphlet, to have someone who's undertaken the mission that you've undertaken doing this work on the ground would be beneficial in creating those types of checklists. I would also think that it would be somewhat beneficial based on the work that you've done in having these checklists for the different types of injuries that the veteran may have suffered from and how to construct a home suitable to his or her needs as it relates to the overall cost of that. And I know that you agree in addition to TRA that the specially adapted housing grant be increased and again that's sort of the historical analysis that you're providing specific in Exhibit One for that grant. What do you -- do you have a ballpark figure? I mean, knowing again that if we adjust ed it to inflation, it would be up to $170,000. But based on the work you've done and the relative cost of doing that, do you have a ballpark figure?

John Gonsalves: Yes. On average, uhm, we've averaged $343,00 for the cost of building a new home.

Chair Stephanie Herseth Sandlin: Okay. So that's even greater than the average new home price.

John Gonsalves: Right. But these are 100% fully adapted homes --

Chair Stephanie Herseth Sandlin: Yes.
John Gonsalves: -- which they do cost a little more to build. You need a little extra square footage compared to what the average home that the census bureau uses.

[. . .]

Chair Stephanie Herseth Sandlin: One last question. Mr -- Dr. Zampiri. Can you explain the difference in changing the Specially Adaptive Housing Grant from 5 - 200 to 20 - 200 with regard to visual impairment?

Thoomas Zampieri: Yes. In fact, thank you very much. I was afraid someone didn't notice that. And also I appreciate that Congressman [John] Boozman [Ranking Member] just coincidentally showed up at the right time [laughter from Zampieri and Boozman]. I'm legally blind. I can't drive. A lot of jobs I can't do. My vision is worse than 20/200. And I don't qualify for anything under this program because the requirement is 5/200 which is really just you can't tell if there's a light on. There's no light/dark perception for lack of a better way to describe it. If somebody has 5/200 and they waive their hand in front of your face and you don't see it, you're quote-quote, 'meet this requirement, "totally blind." Our concern is -- and this is growing thing -- a lot of the Traumatic Brain Injured service members who have significant functional impairments, who need extra lighting and all these other things get zip. When I was in Houston and I was first service-connected for my blindness, for example, because of the 20/200 vision, they said no. So I went and I ended up spending not a whole lot but almost $7,000 to do the modifications to my house in Houston because, you know. And so the total number of service members coming back that would be 5/200 is fairly low. In fact, the Navy says there's less than 20 in the last 8 years out at Bethesda. But there are 140 that are enrolled in the VA with this 20/200 and are told "nope" and -- So it's a frustrating thing. And I realize of course that the magic problem is that if you change this section and you open it up to 20/200 as the definition of blindness then of course, you know, the automatic reaction is "Uh-oh. You're going to expand the costs of the program." And-and, I'm always suspicious of that. It's sort of like a few years ago, a couple of years ago when you did the TRA legislation. I'm sure people initially reacted by saying this is going to cost millions and millions and you're going to have all sorts of veterans applying for this. And the experience that I have is it usually isn't that way. People don't apply automatically. But I think Mr. Boozman may have some thoughts about this problem of the vision complications.

Ranking Member John Boozman: I appreciate you bringing that up and you make such an important comment -- that probably the VA's the only entity in the world that uses that standard versus the 20/200 standard. As an optometrist, I helped start -- in fact I started the School For The Blind's low vision program in Little Rock. And I would say probably about 90% of the kids in there did not -- would not meet the -- did you say 5/200 was the standard? Yeah, I mean, that's the standard I'm familiar with because nobody uses it. But I would say that if you looked at all the kids in blind schools or schools for the impaired, the vast majority, the vast-vast majority, there's no way that they would meet a 5/200. Most people, and lay people don't understand this but, most people that-that are blind have a lot of usable vision that can be worked with. And it truly does, you know, going in and setting up a kitchen or setting up a house so that a person can easily pour a cup of coffee -- you know, do things, that we just take for granted. Somebody might really struggle with that that did not meet this definition of vision which is so stringent in the VA so I think you make a great point.

Thursday's snapshot noted the House Foreign Affairs Subcommittee on the Middle East and South Asia which Kat covered Thursday night. Wednesday's snapshot covered the Senate Veterans Affairs Committee hearing and Kat covered that Wednesday night.

Remember the two women in New Hampshire noting the lack of Iraq coverage in the media? On NPR today, The Diane Rehm Show didn't have time for Iraq but it did have time for Nadia Bilbassy to laugh condescendingly at an e-mailer (Tom from Jacksonville, Florida) caller and presumably all Americans before she went on to declare what American tax payer money should be spent on. Nadia scored a double: She managed to (a) be insulting and (b) also pimp opinion passed off as fact. It was not attractive. And it was cute the way she worked every answer back to her own community and issues -- a fact not revealed on the broadcast. I wonder if the Basques in Spain will next be brought on to lobby for an hour without NPR revealing who they are? Her remarks did not approach journalism. But, hey, she got to be rude and insulting and isn't that what NPR is all about? Strangely, Diane's show last week (with a guest host) told people the vote was on track in Iraq. That's now up in the air so you'd think they would have felt the need to do an update. But possibly when one guest keeps talking about 'her people' (but forgetting to inform the listeners of that) there's very little time for anything else.

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