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2.10. Prothetic Treatment Centers
The facilities designated as Prosthetic Treatment Centers (PTCs) in Appendix B have established amputee clinic teams, experienced Prosthetic Staff and Physical Medicine and Rehabilitation Service personnel capable of providing assistance necessary to resolve difficult prosthetic problems. They may also have a substantial number of special medical programs, e.g., Spinal Cord Injury Service (SCIS), Spinal Cord Injury Outpatient Support Clinic (SCI/OSC), Visual Impairment Services Team (VIST), Hospital-based Primary Care (HBPC), Prosthetic- Orthotic Laboratory (POL), Restoration Clinic (RC), Blind Rehabilitation Clinic (BRC), Driver rehabilitation (DR), Geriatric Research, Education, and Clinical Care (GRECC), etc., and the personnel experienced in treating specific disabilities which require prosthetic appliances and/or equipment.
(1) The PTC will ensure that appropriate prescriptions are developed and that protocol checkout procedures are followed on all appliances required for all authorized patients referred by other VA field facilities.
(2) The PTC provides or arranges for adequate pre-prosthetic therapy and post-prosthetic training in the use of prosthetic devices.
(3) A paramount responsibility is to fabricate artificial limbs, braces, orthopedic shoes, artificial eyes, cosmetic restorations, and similar devices. When required devices are commercially procured, the PTC will monitor the adherence to prescription on the same basis as in-house fabrication.
(4) The PTC initiates and, after approval by VHA Headquarters, conducts limited research studies in the field of prosthetics or orthotics dealing with the development of new materials, devices, or fabrication techniques for applicants or with the problems and reactions of patients wearing or using devices.
(5) The PTC provides the professional and technical guidance in the training of all employees who have an interest in prosthetics.
(6) The Prosthetic representative will be responsible for coordinating all aspects of required care, and arranging for necessary patient travel.
(7) The clinical staff normally involved in the treatment of the patient's disability, e.g., spinal cord injury, blindness, amputation, etc., will be responsible for the care of the patients referred to a facility designated as a PTC.
(1) Patients to be considered for referral to a facility designated as a PTC include those with conditions deemed to be complicated or unusual enough to require specialized evaluations, prescription, fabrication and training to resolve the patient's problem.
(2) Referrals will be arranged by the following process:
(a) Communication between the referral and receiving facility regarding the need for clinical records, pertinent findings with regard to other known medical conditions is a prerequisite.
(b) The appropriate administrative records such as VA Form 10-10EZ, VA Form 10-2529-3, and supportive medical documentation will be provided to the PTC when a patient referral is accepted.
(c) If a referral results in a prescription for a custom appliance, the PTC will provide the required equipment and/or appliance. If the referral results in a standardized prosthetic appliance, the equipment and/or appliance will be provided by the facility which initiated the referral.
(d) The PTC must provide copies of documented treatment to the referring Prosthetic representative within 15 working days of any episode of care.