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House Veterans Affairs Oversight and Investigations Subcommittee Holds Hearing on the Status of Implementation of the Vision Center of Excellence

Legislative Update
March 18, 2009

Left to right:  Cong. Harold Rogers (R-KY), with witnesses Specialist Travis Fugate, USA (ret.), Sergeant  David Kinney III, USA (ret.), Sherry Magallanes and husband Sergeant Gil Magallanes, USA (ret.) and the Blinded Veterans Association’s (BVA) Tom Zampieri, Ph.D.
Left to right: Cong. Harold Rogers (R-KY), with witnesses Specialist Travis Fugate, USA (ret.), Sergeant David Kinney III, USA (ret.), Sherry Magallanes and husband Sergeant Gil Magallanes, USA (ret.) and the Blinded Veterans Association’s (BVA) Tom Zampieri, Ph.D., who also testified.
On March 17, the Subcommittee on Oversight and Investigations of the House Committee on Veterans’ Affairs held a hearing to discuss the status of implementation of the Vision Center of Excellence (VCE) and Military Eye Trauma Registry, which were authorized in the Fiscal Year (FY) 2008 National Defense Authorization Act (NDAA), enacted in January 2008 (PL 110-181). The VCE/Injury Registry, a Department of Defense (DOD) program that will coordinate with the Department of Veterans Affairs (VA), is a provision of the Military Eye Trauma Treatment Act sponsored by Cong. John Boozman (R-AR) that was included in the NDAA. Although the VCE/Injury Registry provision was authorized, it was essentially unfunded.

The Subcommittee previously held a hearing on April 2, 2008, to discuss visual dysfunction associated with Traumatic Brain Injury (TBI) and to learn how the VCE/Injury Registry would improve the spectrum of care for vision-impaired soldiers. A major issue at the Subcommittee’s current hearing, which included both DOD and VA witnesses, was the status of funding of the VCE/Injury Registry. Subcommittee Chair Harry Mitchell (D-AZ) noted that, although a Congressional effort to include $5 million for the VCE in FY2009 Defense appropriations failed, he recently received a letter from the DOD, dated March 12, 2009, that stated that the VCE would have $3 million in funding, per the FY2009 Defense Health Program Operation and Maintenance Budget. Although the FY2009 Military Construction/Veterans Affairs appropriations passed on September 30, 2008, did include $6.9 million in funding for the VCE, with $2 million for the Injury Registry, witnesses did not describe how those funds would be used in this DOD-driven program. VCE Director Colonel Donald Gagliano did note that, prior to the VA funding for the Injury Registry, initial planning work had already begun, modeled on a complementary civilian eye injury registry.

To emphasize its point about the potential importance of the work of the VCE/Injury Registry, especially its focus on coordinating DOD/VA vision care, the Subcommittee featured dramatic testimony by two vision-impaired veterans—Specialist Travis Fugate, USA (ret.), and Sergeant David Kinney III, USA (ret.)—and by Sherry Magallanes, wife of Master Sergeant Gil Magallanes, USA (ret.), who detailed their injuries, experience with DOD and VA care, and the ongoing impact on their families. Although two of the soldiers noted that their initial injuries occurred several years ago and that there were new programs in the VA to address their unique needs, all expressed frustration with the lack of coordination of their care.

Cong. Harold Rogers (R-KY), a member of the House Defense Appropriations Subcommittee, introduced Mr. Fugate, who is a constituent, and urged the DOD and VA to work together to fully implement the VCE to help young soldiers experiencing vision loss so that they can "not only survive, but thrive." Cong. Rogers related a theme heard in Mr. Fugate’s and the other soldiers’ statements—that there was not a seamless transition between DOD and VA care, especially as it related to medical records. Dr. Gagliano specifically addressed that concern, stating that the VCE could serve as a trailblazer in coordinating a seamless transition, especially with respect to medical records, since the Registry would track records longitudinally and bi-directionally. He added that, due to the Registry’s mission to coordinate care from the initiation of a military injury through diagnosis, treatment, and rehabilitation, it will also drive appropriate research, especially that funded by the DOD’s Peer Reviewed Medical Research Program-Vision. He cited one such example, the physiological impact of eye blast injuries, which is not yet widely understood.

The Subcommittee focused the remainder of its time on the VCE’s strategic plan and how its efforts will ultimately mitigate challenges experienced by vision-impaired soldiers/veterans. The Subcommittee Members all agreed that they want this program fully implemented and that they will provide the assistance, as well as the oversight, as necessary.

NAEVR, in conjunction with Blinded Veterans Association (BVA), has requested $6.8 million for VCE/Injury Registry funding in FY2010 Defense appropriations, in addition to $10 million for the dedicated Peer Reviewed Medical Research-Vision line item.

Cong. John Boozman (R-AR), center, speaks with Vision Center of Excellence Director Colonel Donald Gagliano, M.D.  and Jack Smith, M.D., Deputy Assistant Secretary of Defense for Clinical Policy and Programs
Cong. John Boozman (R-AR), center, speaks with Vision Center of Excellence Director Colonel Donald Gagliano, M.D., right, and Jack Smith, M.D., Deputy Assistant Secretary of Defense for Clinical Policy and Programs
Left to right: NAEVR Executive Director James Jorkasky, VCE Deputy Director Claude Cowan, Jr., M.D., and the American Academy of Ophthalmology’s Rebecca Hyder
Left to right: NAEVR Executive Director James Jorkasky, VCE Deputy Director Claude Cowan, Jr., M.D., and the American Academy of Ophthalmology’s Rebecca Hyder