The Vision Rehab Podcast is a short monthly podcast about topics and issues related to vision rehabilitation therapists and vision rehab. You can also listen on your smart speaker, just ask for, “Vision Rehab Podcast.”
Vision Rehabilitation Therapist Appreciation Week
With Vision Rehabilitation Therapist Appreciation Week just weeks away, the week of April 14th in honor of Anne Sullivan’s birthday, now is the time to reexamine how to reduce the high cost of vision loss and blindness. Age-related vision loss, and the costs associated with it, both personal and financial, are increasing dramatically. The CDC estimates that vision loss and blindness cost the U.S. $134.2 billion annually. As a result, the American Academy of Ophthalmology (AAO) reports, “Provision of, or referral to, vision rehabilitation is now the standard of care for all who experience vision loss.”
In spite of this, the highest quality vision rehabilitation is often very difficult to find, referrals from eye doctors rarely happen. Additionally, insurance companies and Medicare routinely approve vision rehab services from some of the least qualified providers and refuse to cover the most highly qualified vision rehabilitation specialists.
Currently the most highly trained and nationally certified vision rehabilitation specialists are found in social services. Certified Vision Rehabilitation Therapists (CVRT), and Certified Orientation and Mobility Specialists (COMS), acquire Master’s level graduate degrees in blindness and vision loss, followed by a national certification through the Academy for Certification of Vision Rehabilitation Education Professionals (ACVREP). Both CVRT and COMS are found at state and local agencies for the blind and visually impaired, and within the Veterans Administration healthcare system. The profession of Vision Rehabilitation Therapist in the U.S. is over 150 years old, beginning as Home Teachers (most notably Anne Sullivan), and that of Orientation and Mobility is nearly 80 years old, and to date, neither is recognized by Medicare or third-party insurance. As a result, there are fewer than 1000 CVRTs and little more than 3000 COMS in the U.S. —too few to respond to the referrals, if made, for vision rehabilitation services.
Although the Occupational Therapist (OT) is a medical generalist, often with no specialized training or certification in vision rehab, they are nonetheless able to bill Medicare. As a result, the OT with a specialization in Pediatrics or Orthopedics, for example, can bill for vision rehabilitation services. Like other vision rehab professionals, the OT is eligible for certification through the ACVREP. The OT may also get a CVRT or COMS certification. Other certifications include both a Low Vision Therapist (CLVT) or CATIS (Certified Assistive Technology Instructional Specialist).
So, without a requirement for specialized training or certification to bill insurance, there is no incentive for a medical practice or agency to hire an OT with certification or encourage certification. Without requirements for specialized training, the OT generalist may not have the skills for the best vision rehab outcomes. Ironically, it often costs less for clients to work with the more highly skilled CVRT and COMS, because they work through state and local agencies, where services are provided at no out-of-pocket cost or on a sliding scale.
The CDC reports that as the population ages, blindness and vision loss will double in the U.S. by 2050, impacting more than 9 million people. Without immediate changes in how we provide vision rehabilitation services, this will result in a significant increase in the personal and social cost of vision loss. It’s time to ask why the most highly trained vision rehabilitation professionals are unable to access Medicare and insurance reimbursement, and why appropriate national certification is not a requirement for both providing these services, and billing Medicare for them. Both measures will increase the number of skilled vision rehabilitation professionals and reduce the overall personal and social cost of vision loss.