VA Expands Spinal Cord Injury Care

WASHINGTON, D.C. — Veterans with spinal-cord injuries (SCI) can expect expanded services in the near future, announced Acting Secretary of Veterans Affairs Hershel Gober, who has made SCI one of his top priorities.

In his first week on the job, Gober authorized a new SCI directive from Acting Under Secretary for Health Thomas L. Garthwaite that requires VA health care managers to fully staff designated SCI beds.

“Designating the number of beds is the easy part,” said Gober.  “Finding and keeping qualified nurses, doctors, social workers, therapists and SCI psychologists is a much more complicated matter, but Dr. Garthwaite and I are committed to seeing this carried out.  The new directive designates a minimum of 71 full-time nurses for every 50 patients, one physician for every 10 patients, and one social worker for every 20 patients.  We know this will be a challenge for a number of facilities.  We are ready to do whatever is necessary to help facilities meet these goals and keep SCI a strong and vibrant program.”

The new directive designates 1,209 beds for SCI patients located at VA’s 23 spinal-cord injury centers and in extended-care beds in nursing home units.  “This is the minimal acceptable level of beds to be established and maintained,” according to the directive.

It is estimated that there are about 250,000 Americans living with spinal cord injury; approximately 40,000 are veterans.  VA has the largest single network of SCI care in the nation.

Last spring, Booz-Allen & Hamilton, Inc. released an independent study that compared VA’s SCI services to SCI services funded by Medicare, Medicaid, Aetna, Kaiser, Alliance, Blue Cross/Blue Shield and the Swedish medical system.  The findings showed that VA provided more comprehensive coverage for SCI than any other American health program and that the department’s benefits and services met or exceeded those provided by each of the plans reviewed.  The report added that VA’s services were uniquely organized and that no other health care provider was as involved in the full continuum of care for SCI patients.

In addition to medical and therapeutic care provided veterans with spinal-cord injuries, VA is a leader in defining new methods of rehabilitation through scientific research and engineering.  In Fiscal Year 1999, VA spent $8.3 million to fund 69 research projects dealing with spinal cord injury.  Additionally, VA investigators had 113 SCI projects supported by $4.7 million in grants from non-VA sources.

Researchers are involved in such study as: tissue engineering; combining living cells with synthetic materials; new biomaterials and techniques to regenerate the central nervous system; a walking system that allows a patient with paraplegia to exercise and walk in a limited area around his wheelchair; and a new hand-grasp system that offers finer control and function to the elbow and forearm.

VA also has four Centers of Excellence for SCI at VA Puget Sound Health Care System, Seattle, Wash.; James A. Haley Veterans Hospital, Tampa, Fla.; VA Medical Center, Milwaukee, Wis.; and VA Medical Center, Augusta, Ga.  These programs were recognized as providing the best in health care, as judged by national standards, and serve as models for the measurement of outcomes, as well as education, training and research.

“We have a world-class SCI program,” said Gober.  “Throughout VA we have had a tremendous growth in the number of patients treated and in the shift to outpatient care.  Many programs are in place that weren’t in place three or four years ago. However, is it a perfect system?  No, not yet.  But I promise you, we’re working on it.”