a. Rotation of Instructors. Rotation (planned, periodic type) of instructors is believed to be highly detrimental to the success and quality of VA's Driver Rehabilitation Program. A considerable amount of money and training time is invested in preparing the designated instructors for this role within PM&RS. The product of this training (as the qualified driver rehabilitation specialist) must demonstrate unique abilities, attitudes, and capabilities in order to provide the highest quality of service in driver rehabilitation to the Veteran. The skills, psychological adjustment, teaching expertise, and tools utilized by the therapist in driver rehabilitation are different from those attributes needed in other treatment areas, and cannot be readily acquired.
b. Education. In addition to the basic qualifications required for the driver rehabilitation specialist, the following educational experiences are offered:
(1) Instructor Training Facility. The VA Medical Facility Long Beach, CA, has been designated as the primary training facility for newly appointed driver rehabilitation instructors. The National Director, PM&R Program Office, may designate an additional training site, as necessary to meet VA's need for training new instructors. A minimum of one 2-week training program must be provided each year in collaboration with the assigned VA Employee Education Resource Facility (see Appendix. C).
(2) Mandatory. All primary and alternate instructors must receive a minimum of 2 weeks of instruction in a VA Central Office approved Driver Rehabilitation Specialists Trainee (DRST) (one time only) course, provided in collaboration with the assigned VA Employee Education Resource Facility prior to assuming responsibilities for the Driver Rehabilitation Program.
(3) Continuing Education. PM&RS VHA Central Office promotes the provision of workshops, seminars, and/or educational conferences for all active specialists; this includes training in special skill areas as simulation and vehicle modification. NOTE: If VHA Central Office support is not available, or specifically appropriate for continuing education needs, contact the facility ACOS for Education.
(4) Procedures. Primary and alternate instructors, or their supervisors, must be contacted prior to scheduling for VHA Central Office sponsored training. Travel, per diem, and tuition costs are the responsibility of the local facility or VISN.
c. Business Office
(1) Initial staffing, annual operational fund, and equipment were centrally funded in 1976 and became part of each designated driver rehabilitation center's recurring budget base in 1979. Since that time centers have been expected to cover all future medical care requirements of this program.
(2) Local medical care and equipment funds may be used for:
(a) Purchase and/or replacement of driver rehabilitation vehicles (automobiles, vans, etc.) which are approved by the Under Secretary for Health and which meet the current standards (see Para. 13).
(b) Purchase of add-on adaptive equipment for installation in, or on, the vehicles.
(c) Purchase of simulators for training purposes.
(d) Costs of repair and maintenance of vehicles and other driving rehabilitation equipment used in conducting the program.
(e) Purchase of special equipment to be used for demonstrations at VHA Central Office, or medical facilities.
(f) Per diem and travel for new driver rehabilitation instructor candidates to attend a required 2-week VA Instructor's Training Course prior to assuming program responsibilities.
(g) Cost of transporting vehicles from one site to another when it involves contracting with a transport company. NOTE: Facility travel funds must be used if a VA employee is required to drive the vehicle.
(h) Coverage of non-VA consultants for program review, attendance at conferences, etc., must be covered by contract.
d. Supporting Services
(1) Clinical support of the Driver Rehabilitation Program needs to be available from various services in the host Medical Facility. Educational efforts need to be coordinated though the Associate Chief of Staff for Education. Likewise, additional clinical support needs to be solicited from Audiology and Speech Pathology Service, Neurology Service, Nursing Service, Ophthalmology/Optometry Service, Pharmacy Service, Prosthetic and Sensory Aids Service, Psychiatry and Psychology Services, and Spinal Cord Injury Service. Any or all these services can provide valuable input to assist the Driver Training Instructor in obtaining more detailed assessment, and in planning an individualized plan of care for a Veteran enrolled in the program.
(2) Administrative services also play a key role in the success of the program. Services such as Engineering/Facilities Management, Fiscal/Business Office, and Office of Acquisition and Logistics (OAL) are integral in ensuring that the resources are available for the program, and that the equipment is maintained and available for the program. Additional support may be needed in eligibility determination and in transferring of patients from one facility to another if Driver Training Services are not available. (See VHA Handbook 1601B.05.)
e. Professional Organizations. Certain professional and service organizations can provide support, guidance, and assistance in the administration of local Driver Rehabilitation Programs. Identification of these groups is appropriate and each driver rehabilitation specialist needs to make an effort to utilize such resources. These organizations include, but are not limited to:
(1) American Driver and Traffic Safety Education Association (ADTSEA) and the State affiliates.
(2) The Association of Driver Rehabilitation Specialists (ADED), formerly known as the Association of Driver Educators for the Disabled.
(3) American Automobile Association (AAA).
(4) American Congress of Rehabilitation Medicine (ACRM).
(5) American Kinesiotherapy Association (AKTA).
(6) American Occupational Therapy Association (AOTA).
(7) American Optometric Association (AOA).
(8) American Physical Therapy Association (APTA).
(9) Society of Automotive Engineers.
f. Other Federal and Local Organizations. Some Federal agencies and local rehabilitation centers, etc., involved in activities relating to driver rehabilitation of the disabled include the:
(1) National Highway Traffic Safety Administration of the Department of Transportation (NHTSA).
(2) Rehabilitation Services Administration of the Department of Education Resources.
(3) Transportation Research Board, a division of the National Research Council.
(4) National Mobility Equipment Dealers Association.
g. Safety Performance Standards. Safety Performance Standards for the conduct of VA's Driver Rehabilitation Program must be developed and published as part of each driver rehabilitation specialist's annual performance appraisal.
h. Public Information. The Drivers Rehabilitation Specialist and other key leadership staff need to ensure that eligible Veterans are aware of the existence of the program and the referral mechanisms needed for enrollment.
i. Study and Research. Research activities in Driver Rehabilitation Programs for the disabled are encouraged. Driver Rehabilitation Programs are dynamic and are constantly evolving, thus requiring constant updating, evaluation, and supportive data. NOTE: Competent proposals for study and/or research must be reviewed for approval and possible funding by the Coordinator, VA Driver Rehabilitation Program, VHA Central Office and by Rehabilitation Research and Development (122). Research and other forms of independent study are important avenues of improving local programs and providing additional visibility to driver rehabilitation activities, and they need to be supported at all VA driver rehabilitation centers. NOTE: These studies are to be conducted with the approval of the local Research and Development (R&D) Committee and coordinated through the local ACOS for R&D.
j. Statistical Reports
(1) The gathering and accumulation of data in the Driver Rehabilitation Program are important and must be stressed in the program's overall operation.
(a) This information permits local administrators and VHA Central Office to justify staffing, equipment, and other program needs to higher authority.
(b) These statistics help in the development of standards-productivity, staffing, operations, and program utilization.
(2) VA Form 10-4790 the Annual Report on Driver Training (RCS 10-0099), available at http://vaww.va.gov/vaforms, (This is an internal web site not available to the public) must be completed and forwarded electronically to PM&RS VHA Central Office (117), no later than October 31. NOTE: Further clarification and information may be received by contacting the Coordinator of Driver Rehabilitation in VHA Central Office (117).