HV1794 B619 D34 V artment of eterans We dedicate this publication to VA’s half century of distinguished service to blinded veterans and a legacy ofexcellence. From a humble beginning to a program of national prominence, Blind Rehabilitation Service has become one of the Department ofVeter- We ans Affairs’ outstanding success stories. honor the extraordinary talents, commitment and high professional standards of the early pioneers and the current staff. In more than five decades of leadership, the principles and VA programs established within have signifi- cantly contributed to raising the level of quality services for the blind in the United States and abroad. The publication was sponsored through the combinedfunding ofthe BlindAmerican Veterans Foundation and VA. The text was prepared and published by the Hines BlindRehabilitation Center andMedical Media staff. Avon Old Farm campus is where 850 blinded servicemen were trained from 1944-1947. VA Blind Rehabilitation Service July 4,1998, marks the 50th anniversary of VA President Roosevelt’s Commitment Blind Rehabilitation Service with the establish- The roots ofVA Blind Rehabilitation Service can ment of the first VA Blind Rehabilitation Center be traced directly to the pioneering military reha- (BRC) at Edward Hines Jr. Hospital in the bilitation programs for war-blinded servicemen of WW western suburbs of Chicago. From a humble II and events surrounding that armed conflict. WW beginning with a nine-bed facility and a staff of Early in II, the United States government nine, VA Blind Rehabilitation Service has grown was uncertain whether to pass legislation for a significantly during the past half century, marked unified rehabilitation program for both disabled by a continued expansion of comprehensive war-injured and civilians, or to establish separate rehabilitation services to blinded veterans. programs. In 1942, President Franklin Roosevelt There are now nine BRCs strategically lo- delivered a special address to Congress personally cated throughout the country and Puerto Rico, 92 advocating a unified plan serving both civilians full-time Visual Impairment Service Team and veterans. However, pressure from veteran (VIST) Coordinators and 15 Blind Rehabilitation service organizations resulted in legislation sup- Outpatient Specialists (BROS). VA, through its porting separate programs, and the passing of innovative training programs, education and Public Law 78-16 on March 24, 1943, which VA research, is recognized nationally and interna- authorized to provide benefits, including tionally for its leadership role as a premier vocational rehabilitation to veterans. Three months service provider. later, passing of the Barden-LaFollette bill provided rehabilitation for disabled civilians. -1- The first VA Blind Rehabiliation Center (relocated in 1970) was established in 1948 at Edward J. Hines Jr. Hospital near Chicago, III. On Jan. 8, 1944, the United States govern- Farms Convalescent Hospital, Avon, Conn., ment made an extraordinary commitment to the where an 18-week, extensive rehabilitation blinded war-injured with an order under Presi- training and vocational training program was dent Roosevelt’s signature declaring “no blinded conducted. The Navy operated another special servicemen from WWII would be returned to program for sailors and naval officers at Phila- their homes without adequate training to meet delphia Naval Hospital. The final stage of the the problems of necessity imposed upon them by rehabilitation program was the discharge of the VA their blindness.” soldier or sailor, at which time would provide vocational training and placement. Army and Navy Programs The Army programs were heavily modeled To meet this commitment, the Army Medical after the St. Dunstan blind rehabilitation program Corps developed a three-phase program. The in England and, from 1944 through 1947, pro- medical and surgical treatment of the blinded vided 1,400 war-blinded servicemen rehabilita- soldier was to be accomplished at two chief tion training that many considered superior to centers. One was Letterman General Hospital, existing services in the private sector. San Francisco, Calif., later transferred to Dibble General Hospital, Menlo Park, Calif.; and the VA Adopts New Mission WWII other at Valley Forge General Hospital, With the conclusion of and the probability Phoenixville, Pa. of the deactivation of the military blind rehabili- While receiving medical care, the blinded tation program, the question arose as to which servicemen started to receive basic blind reha- agency would provide remedial and ongoing bilitation training. The second phase was at Old treatment of the 1,400 war-blinded veterans. -2- — In the spring of 1947, the Federal Budget Bureau VA raised the question of whether could legally provide any services beyond vocational rehabili- tation. President Harry Truman, on May 28, 1947, settled the issue by signing a Presidential Order whereby responsibility for the social adjustment training of blinded servicemen was transferred from the Army and Navy to VA. In June 1947, the armed services deactivated all wartime rehabilitation programs for blinded Russell C. Williams, Hines BRC Chief, greeting first patient, Naron Ferguson, on Independence Day 1948. servicemen. tation Program, was appointed Chief of the new A center. group of three outside consultants comprised of Kay Gruber, Harry Sparr and Dr. — Richard Hoover were selected to assist Will- iams in selecting, indoctrinating, and training the nine-member staff. After four months of intensive staff training, the nine-bed unit admitted the first patient, Naron Ferguson, on July 4, 1948. Williams, himself a product of both the Valley Forge and Old Farms The first VA Blind Rehabilitation Center staff at Hines blind rehabilitation programs, provided expert (1948). First row (from left): A. Stafford Chiles, Russell C. Williams, Dr. Louis Newman, Edward Mees and leadership in developing a model program. A Joseph Romanko. Back row (from left): Edward Thuis, Loretta Goergen, Alfred Corbett and Stanley Suterko. well-rounded instructional curriculum was con- structed around Williams’ unshakable faith in the Hines Chosen as First Site capabilities of the blinded veterans. On Sept. 15, 1947, VA Administrator Gen. Omar Bradley and VA Chief Medical Director Gen. Orientation and Mobility Paul Hawley appointed C. Warren Bledsoe as VA The rehabilitation was demanding, with both Coordinator of Blinded Veterans Affairs, charged high expectations and standards. The long cane with the development of a blind rehabilitation concept, developed by Richard Hoover at Valley program. Hines Hospital was selected as the site Forge Hospital, was instituted, refined, and of the first VA BRC, due in part to its large and expanded by the staff. During the next two well-functioning Physical Medicine and Reha- decades, a systematic approach to independent bilitation Department. On Feb. 20, 1948, Russell travel utilizing the long cane technique became C. Williams, a WWII blinded veteran and former the foundation of the new training in Orientation counselor at the Valley Forge Military Rehabili- and Mobility. 3- Early interest in the new training program and techniques taught became so widespread that other rehabilitation professionals and agencies requested and were granted rudimentary training at Hines BRC. From 1949 to 1960, the Hines Orientation and Mobility staff also conducted more than one dozen workshops Multiply-handicapped blinded veteran using adaptive devices. for teachers at several universities and unilateral and bilateral leg amputees, neurologi- schools for the blind cally impaired, and brain injured. Many new in the principles of techniques were created, as well as adaptations to A veteran receives long cane ^^e new long cane training and prosthetic devices, which later instruction from early mobility instructor Jim Enzinna. techniques. proved to benefit the general population. In 1953, VA, with the cooperation of the BRC During Korean Conflict Department ofAgriculture, produced a one-hour During the Korean War in 1951, the beds at Hines film entitled The Long Cane, which documented BRC were increased to 27, plus an additional 13 the adjustment process. Utilizing the BRC staff beds in the Ophthalmology Ward. The nature of at Hines and featuring a blinded veteran, Lloyd combat in the Korean Greenwood (later the War resulted in numer- Executive Director of The nature of combat in the Korean ous instances of blind- BVA), the film was War resulted in numerous instances ness and multiple created to promote of blindness and multiple handicaps. handicaps. More than awareness of the new More than 500 servicemen were VA 500 servicemen were program within the blinded, accounting for five percent of blinded, accounting for system. During the all casualties, the highest ratio of any five percent of all ensuing years, the film American conflict up to that time. casualties, the highest was viewed by not only VA ratio of any American personnel but seen conflict up to that time. During this period, the throughout the country and abroad by a variety blind rehabilitation program at Hines treated a of organizations as a model training film on substantial number of unique cases including blindness and mobility. bilateral hand amputees, unilateral arm amputees. 4- outstanding model for the many university training programs to follow. VA Through the continued support of stipends and new university affiliations, VA BRCs have played a major role in preparing teachers in blind rehabilitation. Nationally, 1,154 specialists in Orientation and Mobility, and Rehabilitation Teaching have received their VA BRC. clinical intern training at a In addi- Western Michigan University intern observing veteran tion, through a VA-funded Optometric Resi- being instructed in manual skills. dency Program, 117 optometrists have success- University Training Programs VA fully completed residency training at a VA Beginning in 1960, assisted in playing a BRC, while 849 optometry students have also major role in developing university training received training. programs in blind rehabilitation. In 1961 and VA 1962, approved clinical training affiliations with Western Michigan University (WMU) to train Orientation and Mobility specialists and Rehabilitation teachers at Hines. Support for funding the university program was under the sponsorship of the Department of Health, Education and Welfare. Three staff members BRC from the Hines had previously joined the WMU program to administer it and create the Orientation and Mobility training segment. WMU The program at soon became an Research and evaluation of new technology resulted in programs in closed circuit television, reading machines and computers. 5- Rehab Blind Veterans Integrate! BLIND REHABILITATION CENTERS • VIST PROGRAMS (Full-Time) Washington D.C. Indianapolis, Ind. American Lake/Tacoma, Wash. Birmingham, Ala. Bay Pines, Fla. Des Moines, Iowa Augusta, Ga. Tuskegee, Ala. Ft. Myers, Fla. Wichita, Kan. Birmingham, Ala. Little Rock, Ark. Gainesville, Fla. Lexington, Ky. Hines, III. Phoenix, Ariz. Jacksonville, Fla. Louisville, Ky. Palo Alto, Calif. Tucson, Ariz. Miami, Fla. New Orleans, La. San Juan, P.R. Fresno, Calif. Oakland Park, Fla. Shreveport, La. Tucson, Ariz. Loma Linda, Calif. Orlando, Fla. Togus, Maine Waco, Texas Long Beach, Calif. Tampa, Fla. Baltimore, Md. West Haven, Conn. Los Angelos, Calif. West Palm Beach, Fla. Boston, Mass. Sacramento, Calif. Augusta, Ga. Ann Arbor, Mich. San Diego, Calif. Decatur, Ga. Detroit, Mich. San Francisco, Calif. Boise, Idaho Minneapolis, Minn Denver, Colo. VA Chicago (West Side) III. Biloxi, Miss. West Haven, Conn. Hines, III. Jackson, Miss. -6- Services litation Service Networks Kansas City, Mo. Winston-Salem, N.C. Sioux Falls, S.D. * BLIND REHABILITATION St. Louis, Mo. Cincinnati, Ohio Dallas, Texas OUTPATIENT SPECIALIST Omaha, Neb. Cleveland, Ohio El Paso, Texas PROGRAMS (BROS) Las Vegas, Nev. Columbus, Ohio Houston, Texas Albuquerque, N.M. Manchester, N.H. Muskogee, Okla. Lubbock, Texas Ann Arbor, Mich. East Orange, N.J. Oklahoma City, Okla. San Antonio, Texas Bay Pines/St. Petersburg, Fla Albuquerque, N.M. Portland, Ore. Waco, Texas Baltimore, Md. Albany, N.Y. Lebanon, Pa. Salt Lake City, Utah Boston, Mass. Brooklyn, N.Y. Philadelphia, Pa. Hampton, Va. Cleveland, Ohio Buffalo, N.Y. Pittsburgh, Pa. Richmond, Va. Dallas, Texas New York, N.Y. Wilkes-Barre, Pa. Salem, Va. Gainesville, Fla. Northport, N.Y. San Juan, PR. American Lake, Wash. Los Angeles, Calif. Syracuse, N.Y. Providence, R.l. Seattle, Wash. Phoenix, Ariz. Durham, N.C. Charleston, S.C. Spokane, Wash. Portland, Ore. Fayetteville, N.C. Columbia, S.C. Huntington, W.Va. San Antonio, Texas Milwaukee, Wis. San Juan, PR. Seattle, Wash. West Haven, Conn. -7- New Centers Open After 18 years with only one VA BRC, a combi- nation of events led to a steady expansion. The — Vietnam War coupled with the earlier inclu- sion of non-service connected veterans, more low-vision applicants, and a more expansive — referral system increased the demand for additional blind rehabilitation sites. BRCs were VA strategically created within the system at VAMC Palo Alto (Calif.) (1967), West Haven VAMC (Conn.) (1969), American Lake (Wash.) VAMC Waco VAMC (1971), (Texas) (1974), VAMC Birmingham (Ala.) (1982), San Juan, VAMC, Puerto Rico (1986), Tucson (Ariz.) VAMC VAMC (1994), and Augusta (Ga.) (1996). As the number ofVA BRCs expanded, so did the number of accomplishments and innova- tions. Research was conducted in fostering advances and progress in electronic travel aids, reading machines, low-vision devices, and Veteran being taught by a nurse to independently computers. Involvement in prosthetic equipment administer medications. evaluations directly resulted in new clinical VA programs. Blind Rehabilitation Service led improving adjustment to sight loss. the nation in incorporating a family training Today, VA has 228 beds committed to the program at all its facilities. The development of nine BRCs staffed by more than 300 blind new methodology in the blind rehabilitation of rehabilitation specialists and support personnel the multiply handicapped, the geriatric popula- providing a variety of training programs. Last tion, and in program evaluations continued year, 1,634 blinded veterans attended a BRC; through the 1970s, ’80s, and into the ’90s. and since 1948, 23,41 1 blinded veterans partici- The multi-disciplinary team approach to pated in a residential BRC training program. treatment was expanded to include not only blind rehabilitation specialists, but also a physi- Research Studies cian, nurse, optometrist, dietitian, social worker, The first comprehensive follow-up study of and psychologist. Regardless of discipline, all WWII and Korean blinded veterans was con- team members’ efforts focused on promoting ducted from 1952 to 1954, involving 386 VA health, developing skills of independence, and social workers interviewing 1,949 service- 8-