HomeVA ProstheticsVA Handbook 1173.16 - Driver Rehabilitation for Veterans with Disabilities ProgramResponsibilities

16.5. Responsibilities

   a. Under Secretary for Health. The Under Secretary for Health is responsible for ensuring overall VHA compliance with this directive.

   b. Deputy Under Secretary for Health for Operations and Management. The Deputy Under Secretary of Health for Operations and Management, or designee, is responsible for: 

   (1) Communicating the contents of this directive to each of the Veterans Integrated Services Networks (VISN);

   (2) Ensuring that each VISN Director has the sufficient resources to fulfill the terms of this directive in all of the VA health facilities within that VISN; and 

   (3) Providing oversight of VISNs to assure compliance with this directive, relevant standards, and applicable regulations. 

    c. The Physical Medicine and Rehabilitation Services National Program Director. The Physical Medicine and Rehabilitation

Services (PM&RS) National Program Director is responsible for: Ensuring current national policy and procedures related to Driver

Rehabilitation Program based on relevant laws, regulations, and VA’s mission, goals and objectives are current and relevant, and updated accordingly;

   (1) Providing consultation and guidance to VISNs and VA medical facilities that have Driver Rehabilitation programs.

   (2) Reviewing and submitting Driver Rehabilitation National program reports annually or as directed by the PM&R Program Office to identify efficacy and opportunities for continued successful implementation. 

   (3) Ensuring liability insurance contract is in place for the Driver Rehabilitation Program.  

   (4) Appointing a VHA Field Advisor who is responsible for advising VHA Central Office on new techniques and equipment relating to driver rehabilitation; educational needs of the driving rehabilitation specialists; problem areas involved in teaching the disabled individual; and all pertinent information that will assist VHA Central Office’s administrative officials in maintaining adequate background knowledge of this specialty area; and, when directed, act for or represent VHA Central Office program officials at meetings, conferences, and/or work groups.

   (5) Selecting and prioritizing new Driver Rehabilitation candidates for training based on applications from the field. 

   (6) Designating a primary training facility for the Driver Rehabilitation Program and designate additional facilities as needed to meet the need for new instructors in the VA system. NOTE: Currently the Long Beach, California VA Medical Center is the primary
training facility for this program. 

   (7) Promoting the provision of workshops, conferences, seminars webinars and/or other education related to this specialty program.

   (8) Ensuring accurate and reliable program data is captured, analyzed, and monitored to identify trends, including but not limited to assessments of the health equity impact on Veterans and Servicemembers with Disabilities, in accordance with VHA Directive 1125, Driver Rehabilitation Program Report (RCS 10-0099), dated July 9, 2015, or subsequent policy.

   d. VISN Director. Each VISN Director is responsible for ensuring Driver Rehabilitation programs are conducted in compliance with relevant Public Laws, regulations, and VHA policy and procedures. 

   e. VA Medical Facility Director. Each VA medical facility Director, or designee, that has a Driver Rehabilitation Program is responsible for:

   (1) Providing and maintaining program oversight to ensure quality services and compliance with VHA policy and procedures. NOTE: This program must be active on a continuing basis to ensure patients are treated without interruption.

   (2) Ensuring adequate resources are devoted to the program including, full time equivalent (FTE) personnel, sufficient work space, up-to-date equipment, replacement of vehicles as appropriate, vehicle repairs, to meet education needs and travel needs, and providing other resources necessary to maintain the program. Local medical care and equipment funds may be used for:

   (a) Purchase or replacement of driver rehabilitation vehicles (automobiles, vans, etc.) that are approved by the Under Secretary for Health and meet the current standards.

   (b) Purchase of add-on adaptive equipment for installation in, or on, the vehicles.

   (c) Purchase of drivers training 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 VA medical facilities, or at VHA Central Office.

   (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. NOTE: Travel and per diem costs for the 2 week instructors training
course are the responsibility of the local VA medical facility or VISN.

  (g) Cost of transporting vehicles from one site to another when it involves contracting with a transport company. NOTE: VA medical facility travel funds must be used if a VA employee is required to drive the vehicle.

   (h) Contracting for non-VA consultants for program review, if necessary.

   (3) Ensuring parking sites for the driver rehabilitation training vehicles receive priority. Parking sites must be immediately accessible to the classroom or clinical area in which the patient receives appropriate pre-driving instruction. Efforts need to bemade to have adequate room for egress and ingress for the disabled Veteran or Servicemember on both sides of the vehicle, and in case of a van, adequate room must be maintained at the sides and rear for wheelchair lift systems.

   (4) Ensuring accurate and reliable program data is captured and forwarded to appropriate authority, in accordance with VHA Directive 1125.

   f. Chief, Physical Medicine and Rehabilitation Services or Appropriate Care
Line Manager
. The Driver Rehabilitation Program is under the professional direction of the Chief, PM&RS, or other designated care line manager as appropriate. Technical direction and supervision are the responsibility of the Chief, PM&RS, or designee, the
appropriate section supervisor under which the Driver Rehabilitation Program is assigned, and/or the qualified rehabilitation specialist. The Chief PM&R or Designee is responsible for:

   (1) Promoting, advocating, and supporting the Driver Rehabilitation Program to top management in the areas of FTE, space, up-to-date equipment, repairs, education needs, travel needs and other resources necessary to maintain the program.

   (2) Designating a qualified individual as the primary Driver Rehabilitation Specialist (instructor), preferably full time.

   (3) Designating a qualified individual as the alternate Driver Rehabilitation Specialist.  The alternate specialist may be responsible for assuming driver rehabilitation responsibilities in the absence of the primary specialist, or may provide only part-time duty to this program. Alternate Driver Rehabilitation Specialists must have completed the VA Driver Rehabilitation Instructor’s Training Course prior to assuming the Driver Rehabilitation Specialist duties and responsibilities.

   (4) Ensuring clinical support is available as needed from the following specialties/departments including but not limited to: Audiology and Speech Pathology, Education, Neurology, Nursing, Ophthalmology/Optometry, Pharmacy, Prosthetic and Sensory Aids, Mental Health, and Spinal Cord Injury.

   (5) Ensuring administrative support is available as needed from the following areas including but not limited to: Acquisition, Contracting, Engineering/Facilities Management, Fiscal, and Motor Pool.

   g. Driver Rehabilitation Specialist(s). The primary and/or alternate Driver Rehabilitation Specialist is responsible for maintaining a skill set that enables them to perform the driving screening as described in Appendix C, paragraph 5. They are also responsible for Driver Rehabilitation Program tasks, which include but are not limited to:

   (1) Clinical evaluation;

   (2) Behind-the-wheel training;

   (3) Prescription of adaptive equipment required to maximize function and safety for
on road driving;

   (4) Prescribing vehicle modifications;

   (5) Equipment training;

   (6) Administrative program support;

   (7) Assigning workload;

   (8) Assisting in the evaluation and selection of additional Driver Rehabilitation

   (9) Recommending appropriate equipment and supplies;

   (10) Supervising maintenance of the equipment;

   (11) Taking precautions to ensure that the vehicle is secure;

   (12) Submitting any necessary reports requested by VA medical facility management and/or VHA Central Office;

   (13) Gathering necessary information to complete the mandatory annual report required by VHA Directive 1125. This report must be completed by October 31 of the current year. The information must be entered at the following site. http://vaww.vhaco.va.gov/AnnualDriverRehabReport/. NOTE: This is an internal VA Web site that is not available to the public. Further clarification and information may be obtained by contacting the Coordinator of Driver Rehabilitation in VHA Central Office or
by reviewing VHA Directive 1125.  

   (14) Initiating appropriate referrals to other services for more detailed evaluations, as indicated (i.e., cognitive assessment, neuro-sensory evaluation, visual examination, etc.); and

   (15) Prioritizing continuing education needs, which may be met by attendance at workshops, seminars, conferences, webinars, online training, etc., to ensure maintenance and updating of knowledge skills and abilities necessary to meet the requirements of this position.


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