THE HONORABLE GORDON H. MANSFIELD
DEPUTY SECRETARY OF VETERANS AFFAIRS
BEFORE THE SUBCOMMITTEE ON MILITARY QUALITY OF LIFE AND
VETERANS AFFAIRS AND RELATED AGENCIES
HOUSE APPROPRIATIONS COMMITTEE
U.S. HOUSE OF REPRESENTATIVES
VA/DOD JOINT INCENTIVE FUND
March 28, 2006
Good Morning Mr. Chairman and members of the Committee. Thank you for your invitation to discuss the Joint Incentive Fund (JIF). This program is one of many important collaborative efforts between the Department of Veterans Affairs (VA) and the Department of Defense (DoD).
Our goals for this program are ambitious and vital to the missions of both Departments. We seek to promote and develop collaborative partnerships that enhance the cost-effective use of Federal healthcare resources and maximize the shared use of resources. Most importantly, our goals are to improve access to care by beneficiaries, improvements in the quality of care received by those beneficiaries, and gain efficiencies in delivering services to those beneficiaries.
The FY 2003 National Defense Authorization Act, Public Law 107-314, Section 721, requires that DoD and VA establish a joint incentives program, through the creation of a DoD-VA Health Care Sharing Incentive Fund. The intent of the program is to identify, fund, and evaluate creative local, regional, and national sharing initiatives.
A DoD-VA Memorandum of Agreement (MOA) signed on July 8, 2004, assigned VA as administrator of the fund under the direction of the VA/DoD Health Executive Council (HEC). VA is responsible for executing funding transfers for projects approved by the HEC.
Each year the Departments issue a joint call for proposals. All submissions must include a description of the proposal, business case analysis, and an official certification by the Service and VISN/Chief Officer that the proposal will be either self-financing, have no recurring costs, or that recurring costs will be funded within existing budgets after JIF funding ends. The Departments have developed templates, which are provided in the call to assure consistent submissions by the applicants. A joint VA/DoD work group reviews the proposals and makes recommendations to the VA/DoD Health Executive Council for approval. Criteria used to evaluate proposals include:
Both VA and DoD are required to contribute $15 million each year from FY 2004 through FY 2007 to the Joint Incentive Fund. The funds remain available to facilitate the incentives program until expended, but the authority for the joint incentives program terminates at the end of FY 2007. Total minimum contributions from each Department will be $60 million, with a combined total of $120 million over the four years (FY 2004-FY 2007). To date, 33 projects have been approved with a total funding of $58 million. All projects funded in FY 2004 and FY 2005 have implemented start-up of joint operations.
Some of the more noteworthy projects are:
Interim Project Reviews (IPRs) are conducted quarterly for all JIF projects throughout the funding life of the project. IPR are jointly prepared by the VA and DoD representatives from each site. Special emphasis is placed on lessons learned and exportability to other sites. Reporting categories include:
Evaluation is based on progress in achieving the goals stated in the original project submission. Measurements such as return on investment are used to measure operating performance and efficiency in utilizing funding provided. Direct benefits such as cost avoidance have a measurable impact on budgets or costs, and indirect benefits such as productivity changes provide returns not directly measurable. It is important to take a measured approach to calculating both types of benefits; however, indirect benefits pose the most difficult challenge. Strategies for measuring the value of an indirect benefit include; employee and patient satisfaction surveys, benchmarking information, and results of a pilot or test case.
Lessons learned are applied to many aspects of the project – including overarching interests, project announcement, solicitation of proposals, communications, and implementation. These will be reviewed, assessed and wherever possible will be implemented for process improvement and exportability.
I believe the JIF program has potential that has not been fully realized due to time constraints in getting fully up to speed. Obligation of JIF project funds has been slower than anticipated. The major reasons for this delay are the following:
VA fully supports the intent and success of the JIF program. We are continuing to refine the submission and review process to align the selection of projects and the start of obligations more closely to the funding years. VA and DoD have strongly encouraged identification and development of joint projects that will benefit the delivery of care to beneficiaries of both Departments.
Mr. Chairman, I conclude by reaffirming VA’s commitment to faithfully serve and support veterans, and to be good stewards of the taxpayers’ money. I believe the Joint Incentive Fund program embodies these principles.
I look forward to responding to your questions about this program.