In the Driver's Seat

With the Veterans Mobility Safety Act Signed Into Law, What’s Next for the Automotive Adaptive Industry

H.R. 3471

ROAD SIGN IMAGE/ISTOCKPHOTO.COM/PPRAT

The Veterans Mobility Safety Act (VMSA), also known as H.R. 3471, was signed into law in December.

It was a triumphant moment for the National Mobility Equipment Dealers Association (NMEDA), which had made the VMSA concept, and then gaining support for the formal bill, a major focal point for years.

“From our first meeting with Veterans Affairs (VA) in 2010 to the time the bill passed and was officially signed into law on Dec. 15 was about six and a half years,” says Amy Schoppman, government affairs director for NMEDA. “This bill is a win for NMEDA members, it’s a win for the mobility equipment industry, it’s a win for veterans, and it’s a win for the American tax payer.”

So with the passage of the bill now in the association’s rear-view mirror, what’s next on NMEDA’s agenda?

Making VMSA a Reality

Well, for starters…the VMSA.

To understand the work that still needs to happen on that front, and why, it’s best to start with exactly what the VMSA mandates.

“The meat of the legislation is now that the Veterans Mobility Safety Act is law, the VA is required to establish quality and safety standards for automobile adaptive equipment and installations within their AAE [Automobile Adaptive Equipment] program,” Schoppman says.

“There currently are no such enforceable standards, and [members of VA] are operating with a handbook that was last updated in the year 2000. So you can imagine the advances in technology that have been made: Now you can modify all sorts of vehicles, whereas in 2000, it was pretty much limited to the minivan, and it was sort of the old, clunky, raised-roof kind of deal. That’s not the situation we are presented with today. There are a lot of options for individuals who would like to pursue the independence of driving despite some sort of mobility limitation that they might have.”

The lack of an up-to-date policy handbook in itself is a practical concern, Schoppman adds. “The idea of the VA just updating that handbook to come into concert with the technical and consumer reality of today, I think is a good thing. But in addition to that, part of the [VMSA] requirement is that the handbook include standards for equipment and standards for installation. The absence of those standards has really diminished the quality of VA healthcare generally, and it has also raised some pretty serious safety concerns for veterans and their families, as well as the general driving public: lifts falling off of vehicles, malfunctioning hand controls, vehicle fires resulting from poor electrical wiring because the technician hadn’t completed any sort of basic electrical training.

“That’s not good for anyone. And I think the American public would agree that not only do our veterans deserve a higher standard of care, but our tax dollars should be spent on quality equipment and safe workmanship. The Veterans Mobility Safety Act is what we think will get us to that point. The regulations that are developed will lead to increased safety and quality of VA healthcare within the auto adaptive equipment program, as well as common-sense stewardship of tax payer funds.”

Schoppman says pursuing legislation was not NMEDA’s first choice, and that in meetings, VA representatives did acknowledge that the agency’s handbook needed updating and that quality standards made sense. Unfortunately, those actions were not among the agency’s priorities, and therefore the industry saw no movement forward for years.

Thus, H.R. 3471.

“We actually tried for five years to come to a non-legislative solution, working with VA prosthetics directly, and NMEDA and its representatives would meet with them annually,” Schoppman said. “You learn over time that some things need to be legislated, and this was one of them.”

Developing Those Quality Standards

VA will need to develop quality standards, according to VMSA mandate, and one of the questions Schoppman was asked by members of Congress and their staffers was whether the bill was really just an effort by NMEDA to force VA to purchase adapted vehicles from NMEDA dealers.

“I think we cleared that up pretty quickly by letting them know that the answer was no,” Schoppman said. “If that were what we were trying to do, we would have required that VA adopt NMEDA QAP [Quality Assurance Program], which we never suggested that they do. Quite frankly, the QAP standard, which is really the gold standard for the industry, would likely be too high for a government agency to apply nationally.”

Schoppman said a major factor for NMEDA was making sure veterans in more remote areas would retain access to adapted vehicles after the VMSA passed.

“We’ve always kept in our minds the concern for veterans living in rural areas,” she says. “If the only provider within 50 miles of a veteran in Louisiana is not a NMEDA provider, we don’t want the veteran to go without. So the VA-developed standards will almost certainly be lower than the NMEDA QAP standard. [The VA version] is going to be a minimum standard in place of the previous regime, which was no standard. It was sort of a wild west: Send them to the cheapest bidder with no regard for training, facilities, experience, expertise, abilities.

“Now there will be certain requirements in place, but it’s not going to be to the level of NMEDA QAP. A benefit for our members is if you are NMEDA QAP, you will meet or exceed whatever standard is eventually developed by VA. The only providers who will run into any sort of trouble adhering to the yet-to-be-developed standards are ones who don’t have appropriate facilities or choose not to train their employees in basic electric [work], or don’t use what is largely considered to be appropriate equipment, things of that nature.”

While NMEDA won’t be supplying verbatim the quality standards that VA uses, Schoppman says the association definitely wants to be among those supporting the development process.

“We’re a little uncertain of what the timeline is going to be, but sometime in 2017, VA will release a proposed rule as mandated by the VMSA,” she says. “And that will include the quality standards for the equipment, the safety standards for the installations. There were also included standards for employees at VA who are helping to run and administer the program. There’s a requirement for an annual report. So there are a lot of details that still need to be worked out.”

NMEDA anticipates that VA will call a “stakeholders’ meeting” that could include “vehicle modification experts, veterans groups, adaptive technology professionals, rehab representatives, perhaps disability or aging groups, and of course ADED [Association for Driver Rehabilitation Specialists] on behalf of the CDRS [Certified Driver Rehabilitation Specialist] community.”

After that, VA is expected to develop and release a proposed rule, to be followed by one or more comment periods and possible revisions before the final rule is released.

Schoppman described this portion of the process as “more detailed, less political work.” But even while working directly with Congress — Schoppman and her NMEDA colleagues visited the Capitol Hill offices of all 535 members of Congress in 2016 — she noted that the idea of automobile adaptive standards for VA earned bipartisan support.

“I think our co-sponsors were pretty much split down the middle, 50/50,” she says. “But I think also generally, no matter how hard someone or some organization might try to make it, this is not a partisan issue. Accessibility and access to safe, quality vehicle modifications doesn’t appeal to Democrats more than Republicans or vice versa. I think most reasonable people agree that these sorts of services should be available to people, you should use quality equipment, the installation should be safe, and if the federal government is using tax payer funds to operate a program specifically for automotive adaptive equipment, there should be standards for that.”

2017 Federal & State Agendas

Another major issue for NMEDA and its membership also concerns VA — namely, getting paid in a timely manner for automotive work done for Veterans Affairs, which is an ongoing challenge.

“Our [past] president Sam Cook testified in June 2015 before the House Veterans Affairs Committee on how it negatively impacted mobility equipment dealers,” Schoppman says. “Many of our members are small businesses, and when they have half a million dollars in invoices that are past due, they need to keep their lights on, they need to be able to pay their employees. It’s extremely important that VA pay on time, and when they don’t, folks inevitably begin to shy away from doing work for them. If it weren’t for the end user, the veteran, who really is benefiting, I think some of our members would have stopped doing work for VA altogether, based on their inability to pay. That is not the case, but it’s a chief frustration.”

Currently, NMEDA is working with VA prosthetics staff on behalf of dealer members who hold outstanding VA invoices.

“I have to say VA has been doing a great job,” Schoppman says. “We put together our spreadsheet, separate it by vehicle, we organize it by VA, eliminate duplicates, submit only those 90 days past due, and that’s every three months. And once the next quarter rolls around, the ones that were submitted before have almost 100 percent been taken care of.”

On the state level, Schoppman expects to continue educating vocational rehab offices that don’t currently recommend or prefer NMEDA QAP dealers, because, she explains, vocational rehab offices that elect to work with less qualified adaptive automotive dealers can experience poorer outcomes that later need to be fixed.

“A lift is not something that you can just pick one out that you like, spot weld it onto a car and you’re on your way,” Schoppman notes. “There is a somewhat complex calculation that goes into determining what is the appropriate equipment for the individual’s needs and for the vehicle that they have and for what it will be carrying. Power chairs can be several hundred pounds, lifts themselves can be several hundred pounds, and to trust a safe, appropriate application of that to a vehicle that can handle it without negatively impacting the driveability, etc., is something that [unqualified individuals] should not be doing.”

Spreading the Word

Although H.R. 3471 is now law, the need to educate at both the federal and state levels continues. Fortunately, Schoppman says that after H.R. 3471, members of Congress and their staffs are much more aware of the automobile adaptive industry and the critical work it does on behalf of people with disabilities.

When she and her colleagues visited Capitol Hill, Schoppman says, “I can’t tell you how many times staff in Congressional offices were left almost speechless because they had no idea that this sort of work was taking place. And why would you, unless you have used it or a family member or close friend or loved one uses a modified vehicle? You almost wouldn’t think that it’s out there.

“What we wanted to do in educating was not say, ‘Help us pass this bill.’ It was ‘This is the industry, this is what we do, what are your questions?’ And they almost always had about a dozen.

“I think the profile and understanding of this sort of work has certainly increased on Capitol Hill as part of that.”

This article originally appeared in the February 2017 issue of Mobility Management.

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