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Fiscal Year 2006 Performance and Accountability Report
Published November 15, 2006
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Strategic Goal One: Restoration and Improved Quality of Life for Disabled Veterans
Maximize the physical, mental, and social functioning of veterans with disabilities and be a leader in providing specialized health care services.
Making a Difference for the Veteran
New Amputee Rehabilitation Center Opens at Miami VA Medical Center
A new million-dollar amputee rehabilitation center at the Miami VA Medical Center aims to bring to older veterans the aggressive, high-tech rehabilitation given to many of the troops coming back from the Middle East. The center, which opened in March 2006, has physical therapy beds alongside treadmills and weight machines. In a nearby room, computerized machines test patients' ability to stand, balance, and walk.
Physical therapist Bob Gailey helped design the center to meet the needs of all veteran amputees, young and old. According to Gailey, in the past 5 years, more than 400 U.S. troops have returned as amputees from Iraq and Afghanistan. During that time, he said, more than 40,000 veterans have lost feet or limbs because of diabetes, other vascular diseases, and injuries. "Everybody wants to take care of amputees who are coming back from Afghanistan and Iraq," Gailey said, "but there's also this large population of veteran amputees who want the same level of care."
Gailey has worked with athletes training for the Paralympics and other events for disabled athletes. In recent years he spent time at Walter Reed Army Medical Center in Washington, DC, helping to create training regimens for amputees returning from the Operation Enduring Freedom and Operation Iraqi Freedom.
Significant Trends, Impacts, and VA's Use of FY 2006 Results
| Performance Trend |
2006 Impact on Veterans |
How VA Uses The Data |
Supporting Measure: Prevention Index II (Special Populations)
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|
| 2003 |
80% |
| 2004 |
86% |
| 2005 |
87% |
| 2006 Result* |
86% |
| 2006 Plan |
86% |
| Strategic Target |
86% |
* Actual data through May 2006. Final data are not yet available.
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Meeting the 2006 target means that VA efforts to promote healthy lifestyle changes and health promotion activities such as immunizations, smoking cessation, and early screening for chronically disabling diseases for our most vulnerable populations (traumatic brain injured, amputees, spinal cord injured, etc.) are having the desired impact. This index is an average of nationally recognized primary prevention and early detection interventions for nine diseases or health factors that significantly determine health outcomes. For this measure, the index is applied to those patients who meet the definition of a special population as a sub-group. |
This measure serves as a tool for early identification and intervention for risky behaviors and for disease prevention; the measure also enables VA to target education and immunization programs and enhance clinic access to prevent and or limit potential disabilities and diseases. |
Related Performance Information
Major Management Challenges
The following major management challenges have been identified for this strategic objective:
OIG
GAO
Program Evaluations
No independent program evaluations have been conducted recently that specifically address this objective.
Program Assessment Rating Tool (PART) Evaluation
In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Medical Care program during 2003, which resulted in a rating of "Adequate." Please see OMB PART reviews for more information.
New Policies and Procedures
Each Polytrauma Rehabilitation Center must provide social work case management services for the OIF/OEF polytrauma patients, with a ratio of one social worker case manager to no more than six polytrauma inpatients.
VA is collaborating with DoD and its medical treatment facilities (MTFs) to seamlessly transition the health care of injured or ill returning combat active duty servicemembers and veterans from the MTF to a VA facility. VA has assigned part-time and full-time social workers to major MTFs to serve as liaisons. Each VA facility has selected a point of contact who works closely with these liaisons and with VBA representatives to ensure a seamless transition and transfer of care. While this initiative pertains primarily to military personnel returning from Iraq and Afghanistan, it also includes active duty military personnel returning from other combat theater assignments. It does not include active duty military personnel who are serving in non-combat theaters of operation.
VA supports the DoD Post Deployment Health Reassessment program for returning deployed servicemembers. The program is a force health protection program designed to enhance and extend the post-deployment continuum of care. It offers education, screening, and a global health assessment to identify and facilitate access to care for deployment-related physical health, mental health, and re-adjustment concerns for all servicemembers, including the Reserve Component personnel deployed for over 30 days in a contingency operation. At this time, VA's involvement is focused on managing referrals from the Reserve Component servicemembers and separated veterans.
Data Quality
VA's data quality improvement efforts, including its work on data verification and validation, are described in the Assessment of Data Quality.
Provide timely and accurate decisions on disability compensation claims to improve the economic status and quality of life of service-disabled veterans.
Making a Difference for the Veteran
Regional Office's Support Services Division Receives Customer Service Team Award for Hurricane Katrina Response
The Muskogee, Oklahoma, VA Regional Office (VARO) Support Services Division is this year's recipient of the Veterans Benefits Administration Leo C. Wurschmidt, Jr., Customer Service Team Award. The award recognizes the team effort of employees who are "Making a Difference in VBA" through their commitment to provide the highest level of customer service.
The Muskogee team, responsible for the day-to-day financial operations of the Muskogee VARO, was cited for its quick response to the needs of veterans and VA employees affected by Hurricane Katrina. Immediately after Katrina struck and the levees surrounding New Orleans broke, the New Orleans Regional Office was closed and its active case workload transferred to Muskogee.
The Muskogee VARO was also one of four offices chosen to field customer service calls for the New Orleans office, and the team handled numerous requests for special payments from displaced veterans unable to receive benefit payments. This generated a 1,500 percent workload increase for the finance team in September 2005.
In addition to the 532 employees this team normally serves, it processed payroll for 190 New Orleans VARO employees for 7 consecutive pay periods, while beginning the transfer to the new Enhanced Time and Attendance system. "This unbelievable demand for support was met with an even more unbelievable response," said Lynda Armstrong, the team's coach. "This group never once complained about the additional workload. We all felt it was extremely gratifying to be able to help the folks in New Orleans. This team would not hesitate to do the same amount of work again."
Significant Trends, Impacts, and VA's Use of FY 2006 Results
Related Information
Major Management Challenges
The following major management challenges have been identified for this strategic objective:
OIG
GAO
Program Evaluations
The Veterans' Disability Benefits Commission, established under Public Law 108-136, is conducting a comprehensive evaluation and assessment of benefits provided under current federal laws to compensate veterans and their survivors for disability or death attributable to military service. The Commission will make recommendations concerning the appropriateness of such benefits under existing laws, the appropriateness of the level of such benefits, and the appropriate standards for determining whether a veteran's disability or death should be compensated. The Commission began the study in May 2005 and will conclude its work in October 2007.
Program Assessment Rating Tool (PART) Evaluation
In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Compensation program during 2002, which resulted in a rating of "Results Not Demonstrated." Please see OMB PART reviews for more information.
New Policies and Procedures
Three VA forms have been reinstated to verify and monitor entitlement to individual unemployability. Additionally, VA now sends a motivational letter to all new individual unemployability recipients to advise them of possible eligibility for Vocational Rehabilitation and Employment benefits.
In March 2006 VA completed the final consolidation of all Benefits Delivery at Discharge rating activity sites for processing claims from separating servicemembers.
Other Important Results
The Board of Veterans' Appeals (BVA) introduced a number of employee incentives and training programs to increase productivity while maintaining high decisional quality. BVA trains Veterans Law Judges and staff counsel to write clear, correct, coherent, and concise decisions and employs a quality review process that translates "lessons learned" into directed training through quarterly "Grand Rounds" training sessions. BVA has a full-time training coordinator who oversees training sessions on specific legal issues, writing skills, and other matters. Grand Rounds and other training keep the legal staff current with continuing changes in the law. The ultimate benefit to our Nation's veterans is improved decisional quality, reduced remands, and quicker resolution of appeals.
Data Verification and Measure Validation
Verification and validation information for the three key measures that support this objective is provided in the Key Measures Data Table.
Provide eligible service-connected disabled veterans with the opportunity to become employable and obtain and maintain employment, while delivering special support to veterans with serious employment handicaps.
Making a Difference for the Veteran
Maximizing a Veteran's Potential Through the 5 Tracks to Employment Program
A critical component of the Vocational Rehabilitation and Employment (VR&E) program's new focus on employment is the "5 Tracks to Employment" initiative. A key element of this effort has been the establishment of Job Resource Labs in each VBA regional office jurisdiction to provide veterans and their counselors with the tools and resources required to enable a timely return to work.
In addition to the Labs, a newly developed VetSuccess.gov Web site provides access to numerous on-line employment tools including expert advice on writing cover letters and resumes and preparing for job interviews, links to labor market information and small business information, and detailed information about the VR&E program.
Significant Trends, Impacts, and VA's Use of FY 2006 Results
| Performance Trend |
2006 Impact on Veterans |
How VA Uses The Data |
Key Measure: Vocational Rehabilitation and Employment (VR&E) Rehabilitation Rate
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| 2002 |
62% |
| 2003 |
59% |
| 2004 |
62% |
| 2005 |
63% |
| 2006 Result |
73% |
| 2006 Plan |
69% |
| Strategic Target |
70% |
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A "rehabilitated" veteran is one who enters the rehabilitation program and successfully completes the program plan with the objective to obtain employment or gain independence in daily living. This rate is a critical indicator of success for VA's VR&E program. |
The effectiveness of the VR&E program and how well the program is meeting the needs of the veteran is measured by this rate. The measure is also used to assess individual performance for all vocational rehabilitation counselors, counseling psychologists, VR&E officers, and regional office directors. |
Related Performance Information
Major Management Challenges
The following major management challenge has been identified for this strategic objective:
OIG
Program Evaluations
The Secretary's Task Force Report of 2004 on the Vocational Rehabilitation and Employment program made over 100 recommendations. Over 72 recommendations have been completed/implemented. One of the major recommendations was to implement the Five-Track Employment Model, which was completed during 2006.
Program Assessment Rating Tool (PART) Evaluation
In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Vocational Rehabilitation and Employment program during 2006. The rating has not yet been issued.
New Policies and Procedures
The formula to calculate the rehabilitation rate was modified beginning with the 2006 fiscal year. The rehabilitation rate previously included all discontinued cases; now any discontinued case that falls under one of the three Maximum Rehabilitation Gain categories as follows is excluded from the formula:
- The veteran accepted a position incompatible with disability limitations.
- The veteran is employable but has informed VA that he/she is not interested in seeking employment.
- The veteran is not employed and not employable for medical or psychological reasons.
VBA produced an orientation video, "Veterans & VR&E Working Together: VR&E's 5-Track Employment Program," which was disseminated to all VA regional offices. In addition to using the video in Disabled Transition Assistance Program presentations, all VR&E offices are using this standardized information about the VR&E program as part of the veterans' orientation process.
Evaluation and planning (E/P) guidelines were developed to address concerns pertaining to the consistency of the entitlement determinations made during the E/P phase of the Vocational Rehabilitation and Employment program. The standard of practice outlines the steps counselors and case managers must follow. Each section has mandatory and/or optional job aids. The job aids provide both structure and assistance to counselors and case managers as they complete required actions.
Other Important Results
VBA conducted an Employment Coordinators Training Conference and Five Tracks to Employment Model training sessions. These focused on the success of the recently completed Five Tracks to Employment pilot, which was the first step in the national deployment of the Five Tracks to Employment process. The conferences focused on topics including:
- The role and function of the employment coordinator.
- Job Resource Lab functionality.
- Vetsuccess.gov Web site functionality.
- Partnership with the Department of Labor's Veterans Employment and Training Service.
Data Verification and Measure Validation
Verification and validation information for the key measure that supports this objective is provided in the Key Measures Data Table.
Improve the standard of living and income status of eligible survivors of service-disabled veterans through compensation, education, and insurance benefits.
Making a Difference for the Veteran
"The Little Things"
Tom Visser, Casualty Assistance Officer, Pittsburgh VA regional office, shares his visit with the surviving spouse of an Iraqi Freedom casualty and her young daughter in the spring of 2006.
"I knew it was the right house as I saw two large flags on the front porch. One flag was a U.S. Army flag and the other a flag of the United States of America. While waiting, the little girl asked if I wanted to hear a song. I said sure. She held a small flag up in front of her and began singing God Bless the USA. She was so careful to hit every note and sing the words just right. Here is a little child who has lost her father to war and yet she's so proud of him that she sings this song. The mother came down to the living room and she must have noticed my red eyes. She said, 'Oh, did she sing God Bless the USA to you too?'
"We finished the paperwork for Dependency and Indemnity Compensation and discussed other benefits. Almost a week had gone by when I received a telephone call from the surviving spouse. She just wanted to say thank you. She mentioned that she was so impressed by VA making the time to provide the briefing and for the quick service provided by the insurance center. She also thanked me for listening to her daughter sing. The spouse explained that it must have left an impression on her daughter because she told the neighbors that she had gotten the chance to sing 'to the government guy.'"
It is the little things that make the biggest differences, and it is the little things that people remember.
Significant Trends, Impacts, and VA's Use of FY 2006 Results
| Performance Trend |
2006 Impact on Veterans |
How VA Uses The Data |
Key Measure: Average Days to Process Dependency and Indemnity Compensation (DIC) Actions
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|
| 2002 |
172 |
| 2003 |
153 |
| 2004 |
125 |
| 2005 |
124 |
| 2006 Result |
136 |
| 2006 Plan |
120 |
| Strategic Target |
90 |
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VA missed the 2006 target by 16 days. The timeliness increased from 124 days in 2005 to 136 days in 2006. Thus, compared with 2005, survivors and dependents waited on average an additional 12 days to receive their benefits. |
VA uses the results data to manage the compensation and pension programs and to implement performance improvement strategies. For example, as performance is monitored during the year, if performance declines are manifested in certain field offices, management takes corrective actions such as providing additional training and realigning workload or staffing levels. |
Related Information
Major Management Challenges
The following major management challenges have been identified for this strategic objective:
OIG
GAO
Program Evaluations
The Veterans' Disability Benefits Commission, established under Public Law 108-136, is conducting a comprehensive evaluation and assessment of benefits provided under current federal laws to compensate veterans and their survivors for disability or death attributable to military service. The Commission will make recommendations concerning the appropriateness of such benefits under existing laws, the appropriateness of the level of such benefits, and the appropriate standards for determining whether a veteran's disability or death should be compensated. The Commission began the study in May 2005 and will conclude its work in October 2007.
Program Assessment Rating Tool (PART) Evaluation
In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Compensation program during 2002, which resulted in a rating of "Results Not Demonstrated." Please see OMB PART reviews for more information.
Data Verification and Measure Validation
Verification and validation information for the key measure that supports this objective is provided in the Key Measures Data Table.
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