Federal Register / Vol. 87, No. 126 / Friday, July 1, 2022 / Notices 39595 

or educational background, to obtain 

information relevant to VA’s hiring, 

transfer, or retention of an employee, 

issuance of a security clearance, letting 

of a contract, or issuance of a license, 

grant, or other benefit. The disclosure of 

the names and addresses of veterans and 

their dependents from VA records under 

this routine use must also comply with 

the provisions of 38 U.S.C. 5701. 

16. Federal Agencies, for 

Employment: To a Federal agency, 

except the United States Postal Service, 

or to the District of Columbia 

government, in response to its request, 

in connection with that agency’s 

decision on the hiring, transfer, or 

retention of an employee, the issuance 

of a security clearance, the letting of a 

contract, or the issuance of a license, 

grant, or other benefit by that agency. 

17. State or Local Agencies, for 

Employment: To a state, local, or other 

governmental agency, upon its official 

request, as relevant and necessary to 

that agency’s decision on the hiring, 

transfer, or retention of an employee, 

the issuance of a security clearance, the 

letting of a contract, or the issuance of 

a license, grant, or other benefit by that 

agency. The disclosure of the names and 

addresses of veterans and their 

dependents from VA records under this 

routine use must also comply with the 

provisions of 38 U.S.C. 5701. 

POLICIES AND PRACTICES FOR STORAGE OF

RECORDS: 

Records in this system are stored 

electronically. 

POLICIES AND PRACTICES FOR RETRIEVAL OF

RECORDS: 

Records may be retrieved by name, 

social security number, date of birth, 

place of birth, Defense 

Counterintelligence and Security 

Agency [Investigative Service Provider] 

investigation number, adjudicative case 

identification number or some 

combination thereof. 

POLICIES AND PRACTICES FOR RETENTION AND

DISPOSAL OF RECORDS: 

Records in this system are retained 

and disposed of in accordance with the 

schedule approved by the Archivist of 

the United States. Records on 

government employees and contractor 

personnel are retained for 5 years after 

the employee or contractor relationship 

ends, but longer retention is authorized 

if required for business use in 

accordance with General Records 

Schedule 5.6, item 181. The records on 

applicants not selected and separated 

employees are destroyed or sent to the 

Federal Records Center in accordance 

with General Records Schedule 5.6, 

item 180. Investigative reports are 

maintained in OPM Central-9 (81 FR 

70191). 

ADMINISTRATIVE, TECHNICAL, AND PHYSICAL

SAFEGUARDS: 

Electronic records are maintained in a 

secure, SSOi protected electronic 

system that utilizes security hardware 

and software to include: Encryption, 

multiple firewalls, active intruder 

detection, and role-based access 

controls. 

Safeguarding VA Subjects’ 

adjudicative and background 

investigation information is of the 

utmost importance. Information 

collected or used in the adjudicative 

process will be used and disseminated 

under very strict controls. Permission 

shall be obtained from DCSA to release 

any DCSA or other agency investigative 

material. Reports, records, and files 

pertaining to adjudicative matters must 

be maintained in confidence and 

disseminated only to authorized 

officials in the VA having a clear, 

official need to review the material. 

RECORD ACCESS PROCEDURES: 

Individuals seeking information on 

the existence and content of records in 

this system pertaining to them should 

contact the system manager in writing 

as indicated above. A request for access 

to records must contain the requester’s 

full name, address, telephone number, 

be signed by the requester, and describe 

the records sought in sufficient detail to 

enable VA personnel to locate them 

with a reasonable amount of effort. 

CONTESTING RECORD PROCEDURES: 

Individuals seeking to contest or 

amend records in this system pertaining 

to them should contact the system 

manager in writing as indicated above. 

A request to contest or amend records 

must state clearly and concisely what 

record is being contested, the reasons 

for contesting it, and the proposed 

amendment to the record. 

NOTIFICATION PROCEDURES: 

Generalized notice is provided by the 

publication of this notice. For specific 

notice, see Record Access Procedure, 

above. 

EXEMPTIONS PROMULGATED FOR THE SYSTEM: 

Upon publication of a final rule in the 

Federal Register, this system of records 

will be exempt in accordance with 5 

U.S.C. 552a(k)(5). Information will be 

withheld to the extent it identifies 

witnesses promised confidentiality as a 

condition of providing information 

during the course of the background 

investigation. 

HISTORY: 

73 FR 15852 (March 25, 2008). 

[FR Doc. 2022–14118 Filed 6–30–22; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

Notice of Request for Information on 

the Department of Veterans Affairs 

Blind Rehabilitation Specialist and 

Visual Impairment Services Team 

Coordinator Standard of Practice 

AGENCY: Department of Veterans Affairs. 

ACTION: Request for information. 

SUMMARY: The Department of Veterans 

Affairs (VA) is requesting information to 

assist in developing a national standard 

of practice for VA Blind Rehabilitation 

Specialists (BRS) and Visual 

Impairment Services Team (VIST) 

Coordinators. VA seeks comments on 

various topics to help inform VA’s 

development of this national standard of 

practice. 

DATES: Comments must be received on 

or before August 30, 2022. 

ADDRESSES: Comments may be 

submitted through www.regulations.gov. 

Comments received will be available at 

www.regulations.gov for public viewing, 

inspection or copies. 

FOR FURTHER INFORMATION CONTACT: 

Ethan Kalett, Office of Regulations, 

Appeals and Policy (10BRAP), Veterans 

Health Administration, Department of 

Veterans Affairs, 810 Vermont Avenue 

NW, Washington, DC 20420, at 202– 

461–0500. This is not a toll-free number. 

SUPPLEMENTARY INFORMATION: 

Authority 

Chapters 73 and 74 of the title 38 of 

the U.S.C. and 38 U.S.C. 303 authorize 

the Secretary to regulate the 

professional activities of VA health care 

professions to make certain that VA’s 

health care system provides safe and 

effective health care by qualified health 

care professionals to ensure the wellbeing of those Veterans who have borne 

the battle. 

On November 12, 2020, VA published 

an interim final rule confirming that VA 

health care professionals may practice 

their health care profession consistent 

with the scope and requirements of their 

VA employment, notwithstanding any 

State license, registration, certification, 

or other requirements that unduly 

interfere with their practice. 38 CFR 

17.419; 85 FR 71838. Specifically, this 

rulemaking confirmed VA’s current 

practice of allowing VA health care 

professionals to deliver health care 


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services in a State other than the health 

care professional’s State of licensure, 

registration, certification, or other State 

requirement, thereby enhancing 

beneficiaries’ access to critical VA 

health care services. The rulemaking 

also confirmed VA’s authority to 

establish national standards of practice 

for its health care professionals which 

would standardize a health care 

professional’s practice in all VA medical 

facilities. 

The rulemaking explained that a 

national standard of practice describes 

the tasks and duties that a VA health 

care professional practicing in the 

health care profession may perform and 

may be permitted to undertake. Having 

a national standard of practice means 

that individuals from the same VA 

health care profession may provide the 

same type of tasks and duties regardless 

of the VA medical facility where they 

are located or the State license, 

registration, certification, or other State 

requirement they hold. We emphasized 

in the rulemaking and reiterate that VA 

will determine, on an individual basis, 

that a health care professional has the 

necessary education, training and skills 

to perform the tasks and duties detailed 

in the national standard of practice and 

will only be able to perform such tasks 

and duties after they have been 

incorporated into the individual’s 

privileges, scope of practice, or 

functional statement. The rulemaking 

explicitly did not create any such 

national standards and directed that all 

national standards of practice would be 

subsequently created via policy. 

Need for National Standards of Practice 

As the Nation’s largest integrated 

health care system, it is critical that VA 

develop national standards of practice 

to ensure beneficiaries receive the same 

high-quality care regardless of where 

they enter the system and to ensure that 

VA health care professionals can 

efficiently meet the needs of 

beneficiaries when practicing within the 

scope of their VA employment. National 

standards are designed to increase 

beneficiaries’ access to safe and effective 

health care, thereby improving health 

outcomes. The importance of this 

initiative has been underscored by the 

COVID–19 pandemic. With an increased 

need for mobility in our workforce, 

including through VA’s Disaster 

Emergency Medical Personnel System, 

creating a uniform standard of practice 

better supports VA health care 

professionals who already frequently 

practice across State lines. In addition, 

the development of national standards 

of practice aligns with VA’s long-term 

deployment of a new electronic health 

record (EHR). National standards of 

practice are critical for optimal EHR 

implementation to enable the specific 

roles for each health care profession in 

EHR to be consistent across the Veterans 

Health Administration (VHA) and to 

support increased interoperability 

between VA and the Department of 

Defense (DoD). DoD has historically 

standardized practice for certain health 

care professionals, and VHA closely 

partnered with DoD to learn from their 

experience. 

Process To Develop National Standards 

of Practice 

Consistent with 38 CFR 17.419, VA is 

developing national standards of 

practice via policy. There will be one 

overarching national standard of 

practice directive that will generally 

describe VHA’s policy and have each 

individual national standard of practice 

as an appendix to the directive. The 

directive and all appendices will be 

accessible on VHA Publications website 

at: https://vaww.va.gov/vha

publications/ (internal) and https://

www.va.gov/vhapublications/ (external) 

once published. 

To develop these national standards, 

VA is using a robust, interactive process 

that is consistent with the guidance 

outlined in Executive Order (E.O.) 

13132 to preempt State law. The process 

includes consultation with internal and 

external stakeholders, including State 

licensing boards, VA employees, 

professional associations, Veterans 

Service Organizations, labor partners 

and others. For each identified VA 

occupation, a workgroup comprised of 

health care professionals conducts State 

variance research to identify internal 

best practices that may not be 

authorized under every State license, 

certification, or registration, but would 

enhance the practice and efficiency of 

the profession throughout the agency. 

The workgroup may consult with 

internal stakeholders at any point 

throughout the process. If a best practice 

is identified that is not currently 

authorized by every State, the 

workgroup determines what education, 

training and skills are required to 

perform such task or duty. The 

workgroup then drafts a proposed VA 

national standard of practice using the 

data gathered during the State variance 

research and incorporates internal 

stakeholder feedback to date. 

The proposed national standard of 

practice is internally reviewed, to 

include by an interdisciplinary 

workgroup consisting of representatives 

from Quality Management; Field Chief 

of Staff; Academic Affiliates; Associate 

Director Patient Care Services; Ethics; 

Workforce Management and Consulting; 

Surgery; Credentialing and Privileging; 

Field Chief Medical Office; and 

Electronic Health Record 

Modernization. 

Externally, the proposed national 

standard of practice is provided to our 

partners in DoD. In addition, VA labor 

partners are engaged informally as part 

of a pre-decisional collaboration. 

Consistent with E.O. 13132, a letter is 

sent to each State board and certifying 

organization that includes the proposed 

national standard and an opportunity to 

further discuss the national standard 

with VA. After the States have received 

notification, the proposed national 

standard of practice is published to the 

Federal Register for 60 days to obtain 

feedback from the public, including 

professional associations and unions. At 

the same time, the proposed national 

standard is published on an internal VA 

site to obtain feedback from VA 

employees. Feedback from State boards, 

professional associations, unions, VA 

employees and any other person or 

organization who informally provides 

comments via the Federal Register will 

be reviewed. VA will make appropriate 

revisions, in light of the comments, 

including those that present evidencebased practice and alternatives that help 

VA meet our mission and goals, and that 

are better for Veterans or VA health care 

professionals. We will publish a 

collective response to all comments at 

https://www.va.gov/standards

ofpractice. 

After the national standard of practice 

is finalized, approved and published in 

VHA policy, VA will implement the 

tasks and duties authorized by that 

national standard of practice. Any tasks 

or duties included in the national 

standard will be incorporated into an 

individual health care professional’s 

privileges, scope of practice, or 

functional statement following any 

training and education necessary for the 

health care professional to perform 

those functions. Implementation of the 

national standard of practice may be 

phased in across all medical facilities, 

with limited exemptions for health care 

professionals as needed. 

National Standard for BRS and VIST 

Coordinators 

The proposed format for national 

standards of practice when there is a 

national certifying body is as follows. 

The first paragraph provides general 

information about the profession and 

what the health care professionals can 

do. The second paragraph references the 

education, certification, license, 

registration, or other requirement 

needed to practice this profession at VA 


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Federal Register / Vol. 87, No. 126 / Friday, July 1, 2022 / Notices 39597 

and confirms that this profession 

follows the standard of practice set by 

the national certifying body. A final 

statement confirms that as of the date of 

the workgroup’s research into 

requirements, all individuals in this 

profession follow the same standard of 

practice. 

We note that proposed standards of 

practice do not contain an exhaustive 

list of every task and duty that each VA 

health care professional can perform. 

Rather, it is designed to highlight 

whether there are any areas of variance 

in how this profession can practice 

across States and how this profession 

will be able to practice within VA 

notwithstanding their State license, 

certification, registration and other 

requirements. 

VA qualification standards require 

BRSs to have at least one active, current, 

full, and unrestricted certification 

granted by the Academy for 

Certification of Vision Rehabilitation 

and Education Professionals (ACVREP). 

The following four national 

certifications from the ACVREP 

correspond with four distinct specialties 

within the occupation: 

1. Certified Low Vision Therapist 

(CLVT); 

2. Certified Orientation and Mobility 

Specialist (COMS); 

3. Certified Assistive Technology 

Instructional Specialist for People with 

Visual Impairments (CATIS); and 

4. Certified Vision Rehabilitation 

Therapist (CVRT). 

BRSs can practice under any of these 

four ACVREP certifications. BRSs who 

provide orientation and mobility 

training, communication and daily 

living therapy, low vision therapy, or 

assistive technology must possess the 

corresponding ACVREP certification for 

the type of service they provide. For 

example, a BRS who provides low 

vision therapy must be certified as a 

CLVT. VA reviewed whether there are 

any alternative certifications or 

requirements from any State that could 

be required for a BRS and found that 

there were none. Therefore, VA 

proposes to adopt a standard of practice 

consistent with these four national 

certifications; therefore, VA BRSs in 

each of these four specialties will 

continue to follow the same standard as 

set by their national certifications. 

Standards of practice for each of the 

four certifications can be found at the 

following websites: 

• CLVT: https://www.acvrep.org/ 

certifications/clvt-scope; 

• COMS: https://www.acvrep.org/ 

certifications/coms-scope; 

• CATIS: https://www.acvrep.org/ 

certifications/catis-scope; and 

• CVRT: https://www.acvrep.org/ 

certifications/cvrt-scope. 

This national standard of practice for 

BRSs includes VIST Coordinator 

because all VIST Coordinator positions 

are appointed as BRSs. BRS VIST 

Coordinators may be drawn from 

traditional blind/vision rehabilitation 

backgrounds or from counseling 

backgrounds. There is no national or 

State license or certification for VIST 

Coordinators; therefore, there is no 

variance with a State in the standard of 

practice for VIST Coordinators. VA 

VIST Coordinators must be licensed, 

certified, or registered as BRSs, Social 

Workers, Certified Rehabilitation 

Counselors, or other health care 

professionals. VIST Coordinators who 

are licensed, certified, or registered as 

BRSs, Social Workers, Certified 

Rehabilitation Counselors, or in other 

health care occupations must adhere to 

the VA national standard of practice for 

that specific occupation. 

Because the practice of Blind 

Rehabilitation Specialists and VIST 

Coordinators is not changing, there will 

be no impact on the practice of this 

occupation when this national standard 

of practice is implemented. However, 

national standards of practice for other 

occupations may impact practice of 

those occupations at VA once they are 

implemented. 

Proposed National Standard of Practice 

for BRSs 

BRSs use assessments, therapies and 

technologies to improve the 

independent function, quality of life 

and adjustment for Veterans who are 

blind or visually impaired. BRSs 

evaluate Veterans through interviews, 

tests and measurements and use such 

findings either solely or as a part of an 

interdisciplinary team to develop and 

implement blind and vision 

rehabilitation programs for individual 

Veterans. Instructional activities are 

directed toward achieving therapeutic 

objectives for Veterans who are blind or 

visually impaired. These activities 

include effective communication and 

visual skills; instruction on optical low 

vision devices; orientation to and 

management of the environment; safe 

ambulation and travel; access to 

information through the use of assistive 

technologies; manual skills; proficiency 

and understanding in activities of daily 

living; pursuit of avocational and 

vocational skills; and education and 

adjustment to visual impairment. 

BRSs in VA possess the required 

education and certification from 

ACVREP in accordance with VA 

qualification standards, as more 

specifically described in VA Handbook 

5005, Staffing, Part II, Appendix G41. 

This national standard of practice 

confirms BRSs practice in accordance 

with the ACVREP standards based on 

the certification they hold, including 

CLVT, COMS, CATIS and CVRT, 

available at: www.acvrep.org. As of 

August 2021, BRSs in all States follow 

these national certifications. 

Proposed National Standard of Practice 

for VIST Coordinators 

VIST Coordinators provide 

adjustment counseling, coordination of 

services, assure adequate compensation 

and benefits and conduct complex 

negotiations with the medical and 

benefit systems as well as non-VA 

service delivery systems for Veterans 

who are blind or visually impaired. 

There is no national or State license 

or certification for VIST Coordinators; 

therefore, there is no variance with a 

State in the standard of practice for 

VIST Coordinators. VA VIST 

Coordinators must be licensed, certified, 

or registered as BRSs, Social Workers, 

Certified Rehabilitation Counselors, or 

other health care professionals as 

outlined in VA Handbook 5005, 

Staffing, Part II, Appendix G41. More 

specifically, VIST Coordinators must be 

credentialed or certified through the 

following: 

a. Any certification via ACVREP, 

including CLVT, COMS, CATIS and 

CVRT; 

b. License or certification by a State 

to independently practice social work at 

the master’s degree level; 

c. Certification via the Commission on 

Rehabilitation Counselor Certification, 

Certified Rehabilitation Counselor; or 

d. License or certification by a State 

to independently practice in other 

health care occupations. 

VIST Coordinators licensed, certified, 

or registered as BRSs, Social Workers 

and Certified Rehabilitation Counselors, 

or in other health care occupations, 

must adhere to the VA national standard 

of practice for that specific occupation. 

Request for Information 

1. Are there any required trainings for 

the aforementioned practices that we 

should consider? 

2. Are there any factors that would 

inhibit or delay the implementation of 

the aforementioned practices for VA 

health care professionals in any States? 

3. Is there any variance in practice 

that we have not listed? 

4. What should we consider when 

preempting conflicting State laws, 

regulations, or requirements regarding 

supervision of individuals working 

toward obtaining their license or 

unlicensed personnel? 


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5. Is there anything else you would 

like to share with us about these 

national standards of practice? 

Signing Authority 

Denis McDonough, Secretary of 

Veterans Affairs, approved this 

document on June 14, 2022, and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 

electronically as an official document of 

the Department of Veterans Affairs. 

Jeffrey M. Martin, 

Assistant Director, Office of Regulation Policy 

& Management, Office of General Counsel, 

Department of Veterans Affairs. 

[FR Doc. 2022–14033 Filed 6–30–22; 8:45 am] 

BILLING CODE 8320–01–P 


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