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| > ![](media    | **DEPARTMENT OF VETERANS AFFAIRS**                  |
| /image1.png){w |                                                     |
| idth="1.125in" | **Veterans Health Administration**                  |
| > hei          |                                                     |
| ght="1.125in"} | **Washington DC 20420**                             |
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**IL 11-2005-002**

In Reply Refer To: 113

**July 22, 2005**

**OFFICE OF PATIENT CARE SERVICES' INFORMATION LETTER**

**USE OF GLOBAL POSITIONING SYSTEM (GPS) DEVICES**

1\. This Information Letter provides information on the use of Global
Positioning System (GPS) devices for traumatic brain injury patients.

2\. Pursuant to Public Law 107-135 Section 210, dated January 23, 2002,
the Secretary of Veterans Affairs was directed to carry out an
evaluation and study of the feasibility and desirability of providing a
personal emergency response system, a GPS device, to veterans who have
service connected disabilities. A report was issued in March 2002 by a
multidisciplinary workgroup composed of Department of Veterans Affairs
(VA) clinicians and administrative staff. VA concluded that the current
existing technology and associated personal GPS-Emergency Response
System infrastructure was not in place or proven on a national basis.
Therefore, VA did not find it feasible or desirable to furnish such
systems with the exception of vehicle-mounted units authorized by
special legislation under the Automobile Adaptive Equipment Program
(Title 38, United States Code, Chapter 39 and implementing regulations
in Title 38 Code of Federal Regulations 17.155-17.159).

3\. Public Law 108-447 requires VA to establish a new Prosthetics and
Integrative Health Care Initiative to ensure that returning war veterans
with loss of limbs and other very severe and lasting injuries have
access to the best of both modern medicine and integrative holistic
therapies for rehabilitation. The Secretary of Veterans Affairs
designated four VA Medical Centers as Polytrauma Rehabilitation Centers.
The Centers are located at Richmond, VA; Tampa, FL; Minneapolis, MN, and
Palo Alto, CA. These comprehensive medical centers provide a full
spectrum of specialty and subspecialty services to service members and
veterans sustaining multiple traumas, such as: amputation, brain injury,
visual and auditory impairment, spinal cord injury, post-traumatic
stress disorder, and other mental health conditions.

4\. The Prosthetics and Integrative Health Care Initiative provides an
excellent opportunity for the Veterans Health Administration (VHA) to
focus on innovative approaches and extend the scope of rehabilitation
services into areas that are consistent with a younger and more active
group of veterans. Even with severe impairments, these individuals are
motivated to pursue their lifelong ambitions and participate in society
at the highest level possible. It is VHA's responsibility to provide the
highest levels of care, including new holistic therapies, alternative
models of care, therapies that focus on a return to an active lifestyle
in the community, provision of new technologies, and management of
long-term sequelae such as pain.

5\. Since GPS devices appear to be a new emerging technology with a
variety of uses, such as insuring safe, independent travel for traumatic
brain injury patients, disabled veterans may benefit from it. GPS
devices serve not only serve as a travel and location guide, but can
insure a certain degree of safety. For these reasons, the Prosthetic and
Sensory Aids Service Strategic Healthcare Group (PSAS SHG), VA Central
Office, will provide, through VA Form 10-2641, Authorization for
Issuance of Special and/or Experimental Appliances, GPS devices to
traumatic brain injured veterans including soldiers who are still on
active duty but are being treated in VA Polytrauma Rehabilitation
Centers for severe injury. VA Form 10-2641, prepared by the Prosthetic
Representative and submitted through the VISN Prosthetic Representative,
needs to include at a minimum:

a\. Diagnosis,

b\. Prognosis,

c\. Level of functionality,

d\. Alternative technologies considered,

e\. Assurance that the veteran has the capacity to operate a GPS device,
and

f\. The prescription or VA Form 10-2641 signed by a physician
specializing in Physical Medicine and Rehabilitation, Spinal Cord Injury
and Disorders, or Neurology.

6\. PSAS SHG processes the VA Form 10-2641 and obtains the concurrence
of the respective specialty physician in VA Central Office before giving
approval to the facility to procure the GPS device.

7\. References

a\. Automobile Adaptive Equipment Program (Title 38, United States Code,
Chapter 39 and implementing regulations in Title 38 Code of Federal
Regulations 17.155-17.159).

b\. Public Law 108-447, Prosthetics and Integrative Health Care
Initiative.

c\. Personal Emergency Response Feasibility Report (Report to the
Committee on Veterans' Affairs of the Senate and House of
Representatives), 2002.

5\. Questions may be directed to Frederick Downs, Jr., Chief Consultant,
Prosthetic and

Sensory Aids Service Strategic Healthcare Group, at (202) 254-0440.

Madhu Agarwal, M.D., M.P.H.

Chief Patient Care Services Officer

DISTRIBUTION: CO: E-mailed 7/22/2005

FLD: VISN, MA, DO, OC OCRO, and 200 -- E-mailed 7/22/2005