New or replacement vehicles used for this program must be processed in accordance with VA Directive 7002, Logistics Management, dated July 10, 2009, and VA Handbook 7002-1, dated April 14, 2011. These vehicles can be either medium sized or full-sized automobiles, or mini- or full-size vans to accommodate the Veteran trainee with more severe disabilities. Selection of the type and size of vehicle is determined locally, based on need and previous history of training and disability types. Each VA medical facility Director has the discretion to replace the current automobile or van. Reusable portions of add-on adaptive equipment may be retained for installation in, or on, the new vehicle. If funding is available and justification of the need to replace the present vehicle(s) can be provided, documentation must be submitted to the local Office of Acquisition and Logistics (OAL) Officer utilizing the appropriate Integrated Funds Distribution, Control Point Activity, Accounting and Procurement Package (IFCAP) equipment replacement procedures, or as prescribed by existing VHA Directive 2009-017, Acquisition of High-Cost, High-Technical Medical Equipment, dated March 20, 2009, or subsequent policy. Specific details regarding vehicle selection, factory equipment and additional add-on modifications are listed at the following Web site: http://vaww.rehab.va.gov/PMR/Driver_Rehabilitation.asp. NOTE: This is an internal VA Web site that is not available to the public.
a. Vehicles. The following considerations and accommodations must be made regarding these vehicles:
(1) Maintenance and Repair. All maintenance and repair work on the driver rehabilitation automobile is the responsibility of the VA medical facility and will be conducted per the vehicle manufacturers recommendations. Arrangements may be made with the VA medical facility’s Engineering Service to maintain the vehicle at its peak performance. The local Fleet Manager will keep maintenance records on the vehicle. NOTE: As result of recent surveys for accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF) and the Joint Commission, the PM&RS Program Office recommends a written weekly maintenance schedule be maintained with the vehicle.
(2) Parking Space. Parking sites for the driver rehabilitation vehicles must receive priority rating at all VA medical facilities having Driving Rehabilitation Programs. Parking sites must be immediately accessible to the classroom or clinical area in which the patient receives appropriate pre-driving instruction. Efforts need to be made to have adequate room for egress and ingress for the disabled trainee 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.
(a) When not in use, the Driver Training Vehicle must be kept in a secure location and adequate precautionary measures need to be in place such as security checks provided by VA medical facility police officers.
(b) Any damage or loss must be reported to OAL Service (90), in accordance with VA Directive 7002. If there is damage or loss and it is a result of a VA employee, Veteran, or Servicemember, a police report may also need to be filed.
(4) Insurance. An annual commercial automotive liability insurance contract has been established to automatically ensure liability coverage for all Veterans who drive designated driver rehabilitation vehicles, including leased vehicles at any VA medical facility. Coverage under the contract is for third party bodily injury, and property damage either to non-governmental vehicle(s) and/or non-governmental property. The policy does not cover bodily injury of the Veteran or the instructor, or the VA vehicle or other VA property. All changes in driver rehabilitation vehicle inventory must be immediately reported via e-mail to the PM&R Program Office to ensure the applicable vehicles are added, or removed, from the national insurance contract. NOTE: If the Veteran or Servicemember is injured, medical treatment would be provided by VA. If the instructor is injured, VHA Directive 1609, Worker’s Compensation Program Management, dated November 6, 2016, or subsequent policy, must be followed. Information on specific insurance claims may be received by contacting PM&RS VHA Central Office staff or VHA Fleet Management Office.
(5) Safety. All rules for the safe operation and maintenance of the driver rehabilitation vehicle are to be based on Federal and State laws and regulations governing the area in which the vehicle is operating. The Driver Rehabilitation Specialist is responsible for locally written policies regarding emergency procedures and protocols must be available in the driver rehabilitation vehicle at all times.
(6) Transfer of Vehicle. Transfers of driver rehabilitation vehicles from one driver rehabilitation center to another is authorized, initiated, and coordinated by the sending facility with notification to PM&RS VHA Central Office staff (10P4R). Transfers of vehicles must be coordinated through the Chief, OAL, at both the losing and gaining facilities.
(7) Loaned Vehicle. Using driver rehabilitation vehicles on a loan basis from an automobile dealership is discouraged, however, such practice is permissible under certain conditions. Most importantly, the dealer needs to provide adequate and documented proof that the vehicle is insured by the dealer. VA cannot accept responsibility of providing comprehensive insurance on a loaned vehicle. If acceptable, the loaned vehicle needs to be used as a supplemental training vehicle for the VAissued or purchased vehicle, and not as a replacement. The loaned vehicle must meet the specifications and standards maintained by VA for use as a driver rehabilitation
vehicle and needs to be used for driver rehabilitation purposes only. NOTE: Loaned vehicles and/or equipment must be reported to the Chief, OAL.
(8) Donated Vehicles. Donated vehicles may be accepted to the program. The decision to accept the vehicle for the Driver Rehabilitation Program rests with the Chief of Physical Medicine and Rehabilitation Services or the Appropriate Care Line Manager
with consultation with the Driver rehabilitation staff, and as authorized by their local VA leadership. Appropriate policy for donation of equipment to the VA must be followed.
(9) Restriction in Use of Driver Rehabilitation Vehicle. Use of vehicles purchased and leased for the VA Driver Rehabilitation Program for purposes other than driver rehabilitation is forbidden. VA Driver Rehabilitation Program vehicles shall be used only for official purposes and use of the vehicle for driver rehabilitation must take precedence over any other need. Family members of persons being trained in the driver rehabilitation vehicle may not drive or ride in the training vehicle. It is permissible for VA employees to ride in the vehicle for evaluation, orientation, or teaching. Students, residents, or interns with VA appointments in clinical training programs may ride in the vehicle, as long as such involvement is undertaken within a phase of their active training. For safety precautions, the adaptive equipment must not be utilized by unauthorized personnel or untrained VA employees; the inappropriate use of such equipment may pose a safety hazard to non-disabled operators and is prohibited.
(10) First Aid Kits, Fracture Splints, and Road Emergency Kits. Automobiles used in driver rehabilitation must be equipped with first-aid kits, universal precaution packages, fracture splints, and road emergency kits (safety triangles, booster cable, etc.). NOTE: This is a requirement of accreditation bodies. The Driver Rehabilitation Specialist must periodically review expiration dates on this material to ensure compliance with accreditation standards and document the review. This may be requested by accreditation reviewers during a site visit.
(11) Telephone. In accordance with Commission on Accreditation of Rehabilitation Facilities (CARF) standards, communication devices must be available in vehicles, therefore, VA issued cellular telephones are mandated. A global-positioning system (GPS) may also be purchased and is highly recommended. Specific approval and licensing must be processed through the local telecommunication office.
b. Adaptive Equipment and Safety.
(1) Maintenance and Safety. Routine maintenance and weekly safety checks of all adaptive equipment must be scheduled and documented by the Driver Rehabilitation Specialists. They need to be able to identify the operational defects of the adaptive equipment. Other specialists such as VA medical facility engineers, vendors, and the manufacturing representatives of the equipment, may be consulted, as necessary. A copy of the safety policies and procedures must be maintained in the vehicle at all
(2) Prosthetic’s Directive on Adaptive Equipment. VHA Directive 1173.4, Automobile Adaptive Equipment Program, dated October 30, 2000, is available online at VHA Publications Web site (http://www.va.gov/vhapublications/) for the use of all VA
medical facilities having an official designated Driver Rehabilitation Program. Adaptive Equipment recommended for Driver Rehabilitation Vehicles is listed in Appendix C.
c. Clinical Evaluation for Types of Adaptive Equipment Required. To determine appropriate adaptive equipment that may be prescribed to a Veteran or Servicemember, the Driver Rehabilitation Instructor must clinically evaluate the following areas:
(1) Vision. Portable vision devices provide an evaluation of certain vision factors necessary to perform a safe driving task. Equipment must be available to measure the following: visual acuity, color perception, field of vision, depth perception, glare
recovery, and night vision.
(2) Reaction Time. A device is used to measure reaction time from acceleration to braking.
(3) Cognitive and Perceptional Screening. Any potential problems identified from screening of basic cognitive and perceptional motor abilities must be referred to the appropriate professional for a more in-depth evaluation and verification by the Driver
Rehabilitation Specialist or the treating physician.
(4) Neuro-motor Assessment. This is a physical assessment of range of motion, strength, sensation, coordination, and endurance.
d. Simulation Equipment.
(1) Utilization. Driver training simulators create a classroom driving situation, which duplicates the visual, aural, and bio mechanical environment of driving without motion. The simulator increases the number of patients who can be trained by providing driving
experience in a classroom setting. It is an important tool in evaluating and determining the physical and mental capabilities of all types of disabled patients.
(2) Training. At the time of purchase of a simulator, a minimum of 1-full day of training must be incorporated into the purchase order. Driver Rehabilitation Specialists must be familiar with operation and maintenance of the simulator, as well as how the
equipment can be incorporated into the training program for disabled drivers. NOTE: Before purchasing a simulator, the Office of the Director, PM&RS, VA Central Office, must be consulted.
(3) Space. It is recommended that a single room, measuring approximately 18 feet by 16 feet, should be provided for projection-type simulator training at a driver rehabilitation center.