Program Assessment Rating Tool (PART)

• Develop capability to begin reporting on five new performance measures

• VA developed reporting capability on two of the five measures. Development of a reporting capability for the other three measures is contingent on completion of a program outcome study, which will be scheduled after the Disability Benefits Commission issues its report in October 2007.

• Develop analyses of how results information from new measures is used and how this information impacts program performance.

• VA is analyzing data from two of the five new measures to determine how the results will impact program performance.

• Evaluate recommendations from the Veterans' Disability Benefits Commission

• The Veterans' Disability Benefits Commission is scheduled to conclude its review and issue its report in October 2007.

• Total disability based on individual unemployability.

• VA has reinstated procedures to verify and monitor entitlement based on an individual's potential for employment.
• VA is also reviewing the potential benefits of using a New Hires database maintained by the Department of Health and Human Services to verify employment status.

• Reinstate a cost-effectiveness measure before the 2006 Budget, such as the 'Administrative Cost per Trainee' measure.

• VA has developed a proposed cost-effectiveness measure. The result calculation is as follows: Divide the total number of students by the direct FTE. Multiply the result by the payment accuracy rate, and divide this by the average claims timeliness for each year.
• Prior to implementing this measure, 2 years of validity testing using actual data will be required. Once the testing period is complete, targets will be established.

• Develop analyses of how results information from new measures is used and how this information impacts program performance.

• VA began an analysis of the new measures to determine how they will impact program performance.

• Develop capability to begin reporting on the new long-term performance measures focused on outcomes that meaningfully reflect the purpose of the program

• VA secured funding for the veterans' home loans program to conduct customer satisfaction surveys in fiscal years 2006 and 2007. The surveys will yield data for the new "specially adapted housing" measure and the existing lender satisfaction measures. Results data will be available in spring 2007, analyzed, and used to make program decisions as appropriate.
• The program has begun efforts to secure source data and calculate results pertaining to the new "veteran homeownership" outcome measure. The program anticipates that the homeownership data will be available by year-end 2006 and will be used to make program decisions where appropriate.

• Accelerate the collaborative activities with DoD and other Federal agencies, e.g., interoperable computerized patient health data, improved data on insurance coverage, and enrollment and eligibility information.

Collaboration with the Department of Defense

• VA and DoD initiated the Joint Incentive Fund, now in its third year of implementation. The fund's purpose is to identify, implement, fund, and evaluate creative coordination and sharing initiatives at the facility, intra-regional, and nationwide level. Thus far, the Departments have contributed a total of $90 million to the fund. To date, 47 projects totaling $89 million have been approved and are in various stages of progress.
• VA established the Office of Seamless Transition to improve VA/DoD collaboration in the transition of servicemembers to civilian life.
• VA and DoD currently support the one-way and bidirectional exchange of electronic health data for legacy systems. In June 2006, VA and DoD achieved the successful bidirectional exchange of computable data. VA remains very active with interagency standards development organizations and will soon develop an action plan to work within the new framework set by the American Health Informatics Community.
• DoD has been providing VA with combat pay information for OIF/OEF and other qualifying veterans since January 2006. This information is shared automatically through the Defense Manpower Data Center (DMDC) interface with VA's VA/DoD Identity Repository (VADIR) database. DoD has agreed to provide VA separation/activation and inactivation information for reserve component members via this same interface.

Collaboration with the Indian Health Service

• VA signed a formal agreement with the Indian Health Service (IHS) resulting in more than 150 activities and programs undertaken.
  • VA and IHS have signed an interagency agreement to provide for IHS use of VistA Imaging and for IHS to fund VA services in support of IHS test sites.
  • The VHA Employee Education Service is providing training programs for the IHS staff and tribal community.
  • The Behavioral Health workgroup developed a framework for American Indian/American Native (AI/AN) communities to assist returning OIF/OEF AI/AN servicemembers and veterans to reintegrate with their families and communities.
  • Three VHA-HIS Diabetes Prevention programs have been initiated in San Diego, Greater Los Angeles, and Albuquerque.

• Continue the enrollment policy for non-enrolled priority level 8 veterans (higher income, non-disabled), and implement additional programmatic and cost-sharing policies aimed at focusing resources on core veteran populations.

• VA is continuing the enrollment policy. The 2007 budget submission included proposals for assessing an annual enrollment fee of $250 and changing the veteran's share of the pharmacy co-payments from $8 to $15 for Priority 7 and Priority 8 enrollees. In this way, VA will be able to bring greater resources to bear on behalf of its core veteran population such as the following:

  • OIF/OEF veterans, who have Priority 6 status for a period of 2 years after their discharge from active duty service.
  • Veterans with a service-connected disability, who have priority when seeking medical care for a service-connected disability (VHA Directives 2002-059; 2003-062; 2003-068).

• Develop performance based budgets and clearer resource requests.

• Performance measures are evaluated annually and adjusted as necessary to improve the linkage between budgetary resources and desired results.
• VA has developed a methodology for estimating the marginal costs of changing performance targets. This will be applied to a subset of measures and included in VA's 2008 submission to OMB.

• Define performance measures for the new traumatic injury protection program.

• The Insurance program has established a key measure for the new traumatic injury protection (TSGLI) program. It measures the average number of days to process a TSGLI disbursement. The strategic target is 5 days.

• Develop first steps in aligning budget requests to performance.

• VA has developed a methodology for estimating the marginal costs of changing performance targets. This will be applied to a subset of measures and included in VA's 2008 submission to OMB.

• Collect and use data to implement three new performance measures regarding access, income and dignity.

• Two new performance measures were added to the 2007 budget submission for the purposes of measuring income and dignity, joining the access-related measure, which has been in place for a number of years. In response to GAO Report 05-47 and during the Pension PART process, VA developed a productivity measure as well. Currently, VA is collecting and analyzing data to report the income measure. Dignity is measured by responses to the customer satisfaction survey regarding the processing of a veteran's claim.

• Continue to develop more ambitious strategic targets.

• Ambitious strategic targets are currently being determined as part of the VA Strategic Plan.

• Provide initial steps in linking performance to budget.

• The 2007 Compensation and Pension (C&P) budget submission contains detailed information about workload and the FTE needed to manage the workload and maintain performance.
• VA has developed a methodology for estimating the marginal costs of changing performance targets. This will be applied to a subset of measures and included in VA's 2008 submission to OMB.

• Use information derived from new performance measures to identify and make program improvements.

• When results data become available, VA will use information from the three new measures to identify and make necessary program improvements. However, for two of the measures pertaining to income and dignity, results reporting will not begin until FY 2007.

• Continue to strengthen methods to link performance, budget, and accountability.

• VA established the Organizational Assessment and Improvement (OAI) Program for the national cemeteries.
  • OAI strengthens the link between budget and performance by identifying improvement opportunities for prioritizing resources and providing a scorecard for performance reporting at each of the national cemeteries.
  • OAI strengthens accountability by assessing cemetery performance against operational standards and measures.
• VA has developed a methodology for estimating the marginal costs of changing performance targets. This will be applied to a subset of measures and included in VA's 2008 submission to OMB.

• Collect and analyze data from two new performance measures to assess processing of burial claims.

• VA included data for two new burial claims measures beginning in the 2005 budget. (Data tracked by VBA)

• Use data results from three new performance measures to drive improvements in program operations (National Shrine Commitment).

• During 2004, VA collected baseline data for the three new National Shrine Commitment measures. As a result, the gap between current performance results and strategic goals has been identified.
• Data for these measures are now regularly collected and reported, and are helping to drive performance improvements.

• Continue to refine meaningful and useful performance measures to assist VA in management.

• Program-specific performance measures and assessment tools have been developed for Biomedical and Clinical Research Centers, Research Enhancements Award Programs, and the Research Career Scientist Program. Performance measures and assessment tools need to be developed for the Merit Review Program. This will be facilitated when we transition to an electronic project management system. The timeframe for completion is 2 years.

• Assess the physical condition of VA medical research infrastructure to determine its adequacy to support high-quality veteran-centric research.

• VA developed a business plan; identified staffing needs; performed first pilot survey visit; and scheduled two additional pilot site visits as an initial step towards assessing the physical condition of VA's medical research infrastructure.
• VA needs to develop a survey schedule for the first year and draft an initial report to Congress by first quarter of FY 2007 based on survey results. Seventy-five sites will be surveyed within the next 3 years, which represents all sites with substantial research programs.

• Develop a streamlined process for collecting and analyzing regulatory approval information prior to release of research funds.

• VA tested the beta version of a new collection process at pilot sites and recommended changes. Implementation will take place in the fourth quarter of FY 2006 and full implementation will take place in FY2007.

• Develop performance based budgets and clearer resource requests.

• VA is taking initial steps in linking performance to budget by developing an approach that provides senior leadership with information on the marginal costs of improving performance. This approach is being piloted and will be implemented in future budgets.