Defense

Defense

(cont’d)

Defense

(cont’d)

Defense

(cont’d)

• In conjunction with DoD, VA develops and implements clinical practice guidelines with a long-range view toward assuring continuity of care and a seamless transition for a patient moving from one system to the other.
• VA is collaborating with DoD on developing an MOU to have access to each other’s Central Cancer Registry. The Central Cancer Registry of DoD (ACTUR) will provide information to VA and VA’s registry will provide similar information to DoD, thereby improving the quality of care. In addition, VA has arranged for veterans to receive medical care from both VA and DoD, depending upon a facility’s proximity to their residence.
• VA assists DoD on enhancing VA’s Parametric Automated Cost Engineering System (VA PACES); partnering on real property assets; and acquisition and collocation of VA facilities with excess property available through the closure of military bases.
• VA works with DoD on the Government Computerized Patient Record common clinical record architecture.
• VA’s Office of Environmental Hazards works with DoD to address war-related medical issues. The two agencies participate jointly in the following standing committees: Gulf War Program; Veterans Health Coordinating Board on Gulf War Illnesses; and the Canadian and UK Gulf War Veterans Advisory Committee.
• With DoD, VA distributes excess property (sleeping bags, clothing, and furniture) for Homeless Veterans Initiative; comprehensive work therapy program employs veterans to unload, inventory, and ship these goods across the country from New Jersey location.
• An MOU is under development between VA and DoD regarding the provision of VA prosthetic services for active duty, Tricare, and CHAMPUS eligibles and their beneficiaries while in military treatment facilities and the transfer of patients to VA medical centers for the provision of prosthetic services.
• An MOU is under development between VA and DoD to provide acute rehabilitation to military personnel with new spinal cord injury.
• Four traumatic brain injury (TBI) lead centers have been jointly established and cooperatively funded by VA and DoD to receive and screen all TBI patients and maintain a national registry of TBI patients.

• In cooperation with DoD, VA’s Chaplain Service acts jointly in operation of the Clinical Pastoral Education Center to provide clinical training for military, VA, and civilian chaplains.

• VA will work with DoD officials to formulate proposals supporting claims development and the physical examination process prior to separation, with a disability rating to be completed prior to, or closely proximate to, separation from active duty. VA encourages national, state, and county VSOs to be an integral part of the planning and execution in this effort.

• VA will work with DoD and National Personnel Records Center (NPRC) to develop the electronic control and exchange of military records and service verification. Options for exporting the application beyond NPRC in St. Louis, MO, will be identified to allow for electronic information requests to all military records centers (i.e., Defense Finance and Accounting Service, Cleveland, OH, Naval Reserve Personnel Records Center, New Orleans, LA, etc.).

• VA is working to expand its relationship with the Defense Manpower Data Center (DMDC) to interface and use more of their data. This will provide the opportunity for potentially reducing overpayments caused by dual benefit payments using on-line matches against DMDC databases.

• VA works with DoD to provide educational assistance to veterans and servicemembers. These benefits are an important DoD recruiting tool.
• VA coordinates with entities and organizations currently performing or planning to perform outreach activities. In addition to working with each other, every group must work through DoD to identify the service personnel targeted for outreach. State approving agencies and other stakeholders will provide a presence in remote locations. It is intended that VA will establish a network for effective education outreach by supporting various activities in place and creating other activities to improve beneficiary access to benefits and services.

• DoD informs active duty members of their VA home loan benefits.

• VA works closely with components of DoD and veterans service organizations to provide military honors at national cemeteries. While VA does not provide military honors, national cemeteries facilitate the provision of military honors and provide logistical support to military honors teams.

• VA provides headstones and markers for national cemeteries administered by the Department of the Army, Department of the Interior, and the American Battle Monuments Commission. VA also contracts for all niche inscriptions at Arlington National Cemetery, which is administered by the Department of the Army. In addition, Arlington National Cemetery has started placing their orders for headstones and markers directly into NCA’s AMAS-R monument ordering system.

• The National Disaster Medical System is a Federal partnership established by an MOU between VA, DoD, Public Health Service, and FEMA. The mission is to maintain these partnerships to address the varied needs of veterans, active duty military personnel, and victims of catastrophic disasters.

• VA and GSA share in a Government-wide Real Property Information Sharing program on utilization of Government-owned and Government-controlled real property in the Northeastern area of the United States, and in the acquisition of leasehold interests in real property for clinical and administrative purposes within various regions across the United States.
• VA collaborates with GSA for the purpose of building product pre-approval programs (BPPAP).

HHS

HHS

• VA pursues Medicare subvention with HCFA in order to establish a program that would allow Medicare eligible veterans to choose VA for their healthcare. These veterans are defined as those who have income or assets above the VA Means Test and are either compensated zero percent service-connected veterans or non-service connected veterans.
• VA and HCFA share a variety of health care data. For example, VA works with HHS to develop non-VA benchmarks for bed days of care, which are obtained from a HCFA database. VA obtains data on ambulatory procedures from the National Center for Health Statistics.
• VA participates with the National Cancer Institute, DoD, and the American Diabetes Association on the Joslin Diabetes telemedicine project.
• In cooperation with the Center for Mental Health Services (CMHS), VA participates on an Interagency Task Force to develop discharge planning model for hospitalized homeless mentally ill persons, including veterans.
• VA expects to reach an agreement with HHS regarding such issues as respective responsibilities relating to ionizing radiation exposure and co-funding a project to revise radioepidemiological tables.

• There is a partnership with Kaiser Permanente and the National Institutes of Health (NIH) for benchmarking products, processes, and services. Another partnering arrangement involves the American Institute of Architects and NIH in an effort to establish a research laboratory design guide.
• Improving mammography and cervical cancer screening rates includes collaboration with the National Center for Health Promotion and liaisons with other private and public health care agencies involved in women’s health.

• VA works with the American Diabetes Association, the Centers for Disease Control and Prevention, and other organizations in the education of providers and persons with diabetes in the prevention of foot problems through the "Feet Can Last a Lifetime Project."

• Collaborations with the pharmaceutical companies research initiatives with NIH, and liaison activities with other agencies.

• VA disseminates results from the National Institute on Aging (NIA) Collaborative Studies of Dementia Special Care Units and from VA-sponsored research on dementia care. VA also explores areas of research collaboration on Alzheimer’s and related dementia, including medical, rehabilitation, and health services research.

• VA sponsors programs at 35 VA medical centers to provide ongoing case management and other needed assistance to homeless veterans who have received dedicated Section 8 housing vouchers from HUD. Health Care for Homeless Veterans (HCHV) Programs staff and homeless domiciliary staff coordinate outreach and benefits certification at four sites to increase the number of veterans receiving SSI benefits and to otherwise assist in their rehabilitation.

• VA and HUD participate in the Partners for Homeownership, seeking to increase the homeownership rate to 67.5 percent by the year 2000.

Justice

• An Interagency Agreement with the Bureau of Prisons provides for the use of selected prisoners to perform work at national cemeteries. This agreement provides a supplemental source of labor to assist in maintaining the national cemeteries.

• With Commerce and Agriculture, Labor helps VA by conducting approval and oversight activities for job training programs.

• VA partners with DOL to conduct training on employment assistance and techniques with the aid of a new transferable skills inventory.

• VA’s Office of Public Health and Environmental Hazards supports the NRC’s medical education on Gulf War veterans.

• VA’s Office of Public Health and Environmental Hazards works with NRC and the Institute of Medicine on research concerning herbicides, Agent Orange exposure, and the health status of Vietnam era veterans.

• VA and SSA are exploring the possibility of direct access to each others’ electronic databases. This would give VA the potential to rate pension claims using SSA disability codes.

• Under the Debt Collection Improvement Act, Treasury is requesting that a social security number (SSN) be provided with each disbursement. Therefore, VA works with SSA to obtain as many SSNs as possible where our records do not contain one and to verify those SSNs currently on file.

State/Local

State/Local

(cont’d)

• VA provides laundry services to State Veterans Homes and Job Corps programs.
• VA’s Homeless Grant and Per Diem Program provides grants to community-based organizations, state or local governments, or Native American tribes to assist with the construction or renovation of new transitional beds and other supportive services programs. Following completion of construction, grant recipients may receive per diem payments to help offset operational expenses for their programs for homeless veterans.
• VA maintains community-based Vet Centers through continued outreach contacts with all aspects of the veterans’ community and local service providers.

• In conjunction with the medical school at East Tennessee State University, VA participates in an Enhanced-Use lease of 31 acres at its VA Medical Center in Johnson City.

• VA partners with county, state, and national service organization representatives in the national implementation of the Training, Responsibilities, Involvement, and Preparation (TRIP) project.

• VA has established a partnership with the states to provide veterans and their eligible family members with burial options in a national or state veterans cemetery. VA administers the State Cemetery Grants Program which provides grants to states of up to 100 percent of the cost of establishing, expanding, or improving state veterans cemeteries.
• VA is encouraging state veterans cemeteries to place their orders for headstones and markers directly into NCA’s AMAS-R monument ordering system.

• VA has extended its second inscription program to state veterans cemeteries. In this program, the second inscription is added in situ (i.e., at the gravesite) to the currently existing headstone following the death and interment of a subsequent family member. In order to participate, state cemeteries must use upright headstones and have the capability to submit requests electronically.

• Along with eight other federal agencies (Agriculture, Commerce, Defense, Federal Communications Commission, HHS, NASA, OMB, and Appalachian Regional Commission), VA participates in the Joint Working Group on Telemedicine—part of the Vice President’s national information infrastructure initiative.

• VA has close liaison with the Office of National Drug Control Policy whose national drug strategy significantly informs VA’s addictive disorders treatment goals.

• VA’s National Center for Clinical Ethics collaborates with its partners at the White House, DoD, DoE, and NIH to jointly address bioethical issues. VA also contributes funds to the President’s National Advisory Bioethics Committee.

• VA administers the White House program for providing Presidential Memorial Certificates to the families of deceased veterans, conveying the Nation’s gratitude for the veteran’s service.

Private

Private

(cont’d)

Private

(cont’d)

• The non-VA benchmark for customer service satisfaction is based upon data from the non-profit Picker Institute for Patient Centered Care.

• Collaboration with Sarah Lawrence College is underway to complete the initial development of Patient Advocacy programs.
• VA collaborates with the American Hospital Association’s National Conference for Consumer Healthcare Advocacy for Patient Advocate professional development.
• VA participates with a private sector panel to identify enhanced-use lease initiatives at various VA Medical Centers for the purpose of obtaining lower cost utilities and energy services, thus making more existing resources available for direct patient care.
• VA works with the National Academy of Sciences’ Institute of Medicine to provide strategic direction for the clinical, research, education, and outreach programs for veterans who have health problems, possibly as a result of exposure to Agent Orange and other herbicides used in Vietnam.
• VA works together with non-profit organizations, including VSOs, to enhance assistance to homeless veterans. VA collaborates with L.A. Vets, Inc., and Corporation for National Service to expand AmeriCorps member services to homeless veterans at VA medical centers, regional offices, and in community programs. VA participates in Federal Interagency Council on Food Donation/Recovery Initiative with focus on Homeless Veterans programs.
• VA’s Chaplain Service partners with religious organizations to help re-establish community support systems for homeless veterans.
• VA has collaborative efforts with Kaiser Permanente to establish data standards for facilities management.
• VA has a liaison agreement with the Paralyzed Veterans of America to partner in developing the functional design of spinal cord injury (SCI) facilities to ensure SCI service centers best meet customer needs.

• VA researchers participate in a wide range of technical panels and interdepartmental sharing committees. Included among them are the National Science and Technology Council’s Construction and Buildings Subcommittee on research and development to lessen cost of facilities and improved performance; and the Brain Injury Association and the Defense and Veteran Head Injury Program in research projects designed to improve the understanding and treatment of traumatic brain injury.
• VA has established an MOU with the American Legion to share workload data to facilitate American Legion reviews of VA medical centers. Similar sharing with other service organizations is under study.

• VA executes the housing program through the private home building and mortgage lending industries. Most home loans are based on the automatic approval process that does not require VA underwriting approval before loan closure.
• VA uses private sector management and sales brokers to manage and sell homes VA acquires after foreclosure.
• VA sells loans to private investors through mortgage trusts.

• VA will continue its partnerships with various civic associations that provide volunteers and other participants to assist in maintaining the appearance of national cemeteries.
• VA will continue to work with funeral homes and veterans service organizations to find new ways to increase awareness of burial benefits and services.