Fiscal Year 2006 Performance and Accountability Report
Published November 15, 2006

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Strategic Goal Four: Contributing to the Nation's Well-Being

STRATEGIC OBJECTIVE 4.1: Emergency Preparedness

Making a Difference for the Veteran

The Secretary's Valor Award

Dedication, selflessness, and heroism took center stage at VA Central Office as Secretary of Veterans Affairs R. James Nicholson recognized the efforts of 73 VA police officers and security staff during hurricanes Katrina and Rita. "Our employees are true heroes," Secretary Nicholson said, as he presented them with the Department's Valor Award. "Their professionalism and bravery during an unprecedented catastrophe allowed us to focus on the well-being of our veterans. Even as they endured personal tragedy, they showed a commitment to their patients that never wavered."

The Secretary's Valor Award recognizes employees and citizens for heroic efforts displayed during a major catastrophe. The Valor Award is the highest level of recognition and is given to VA employees who exhibit courage and who put their lives in jeopardy to save others. These employees were nominated because they exhibited great courage by voluntarily risking their personal safety to prevent the loss of human life or government property. As a result of their efforts, VA maintained continuity of care for several hundred acutely ill veterans under difficult conditions.

In addition to exhibiting heroism in catastrophic situations, hundreds of VA police officers across the country are working day to day in VA hospitals to ensure that they are a safe place for our patients, their families, and VA employees.

Significant Trends, Impacts, and VA's Use of FY 2006 Results

Related Performance Information

Major Management Challenges

The following major management challenges have been identified for this strategic objective:

GAO

• Prepare for Biological and Chemical Acts of Terrorism
• Establishing Appropriate and Effective Information-Sharing Mechanisms to Improve Homeland Security: A Governmentwide High-Risk Area

Program Evaluations

No independent program evaluations have been conducted recently that specifically address this objective.

Program Assessment Rating Tool (PART) Evaluation

No PART evaluations have been completed that specifically address this objective.

New Policies and Procedures

As a result of lessons learned from Hurricane Katrina across the federal government, the National Response Plan has been revised to improve command and coordination. Under the new Natural Disaster Incident Management Unified Command and Coordination Structure that is employed during a national-level disaster, VA is represented at every level including the White House Homeland Security Council, the Department of Homeland Security National Operations Center, and the Joint Field Office involved in providing federal assistance at the site of the disaster or incident. The Department is positioned to ensure that minimum essential services to our veterans are maintained under all circumstances. VA will assist our Nation's veterans by providing support, along with all other federal partners involved with the National Response Plan, in those areas where our veterans and their families live and work.

Data Quality

VA's data quality improvement efforts including its work on data verification and validation are described in the Assessment of Data Quality.

STRATEGIC OBJECTIVE 4.2: Medical Research and Development

Making a Difference for the Veteran

Senior VA Research Scientist Receives "Distinguished Scientist Award" from Hepatitis B Foundation

Raymond Schinazi, Ph.D., one of the Atlanta VA Medical Center's prestigious Senior Career Research Scientists, received the "Distinguished Scientist Award" from the Hepatitis B Foundation during a ceremony on March 25, 2006, in New Hope, Pennsylvania.

Dr. Schinazi was honored with the foundation's highest scientific award in recognition of his extraordinary contributions to the science and discovery of new drugs for the treatment of chronic hepatitis B and his strong commitment to finding a cure for this chronic liver disease.

"The Hepatitis B Foundation is proud to recognize the accomplishments and commitment of Dr. Raymond Schinazi whose work is bringing hope to the 400 million people living with chronic hepatitis B worldwide - a liver disease that infects silently and can progress to fatal cirrhosis and/or liver cancer," said Timothy M. Block, Ph.D., President of the Hepatitis B Foundation.

"It is estimated that as many as 70% of all people treated for HIV and HBV have been treated by a drug discovered all or in part by Dr. Schinazi, a record not equaled by any other university scientist," Dr. Block said.

Dr. Schinazi, who is also a Professor of Pediatrics and Director of the Laboratory of Biochemical Pharmacology at Emory University School of Medicine, was one of three celebrated Emory researchers who helped discover a widely-used drug to treat HIV and hepatitis C. In July 2005 their discovery resulted in the single largest payout exceeding $525 million for intellectual property ever awarded to an American university.

Significant Trends, Impacts, and VA's Use of FY 2006 Results

Related Performance Information

Major Management Challenges

Neither VA's Office of Inspector General nor the Government Accountability Office identified any major management challenges related to this objective.

Program Evaluations

An independent evaluation of the VA Research program was conducted in July 2006 by the National Research Advisory Council (NRAC), a federal advisory committee. The NRAC was instructed to consider the appropriateness of the research conducted to the VA health care mission. It was also to consider the balance of this research between the burden of disease and the special responsibilities of VA in the areas of mental health, central nervous system injury, and deployment health. The VA Research program was rated "Fully successful." The NRAC recommended that VA research should include an emphasis on genomics research and research in areas of concern for OIF/OEF veterans.

Program Assessment Rating Tool (PART) Evaluation

In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Medical Research and Development program during 2005, which resulted in a rating of "Moderately Effective." Please see OMB PART reviews for more information.

New Policies and Procedures

• VA has established Master Clinical Trial Cooperative Research and Development Agreements to provide a template and set the essential terms for negotiating study-specific agreements with major pharmaceutical companies. These agreements will streamline negotiations with companies that support VA clinical research.
• The Department has developed a streamlined process for collecting and analyzing regulatory approval information prior to the release of research funds.
• VA is publicizing clinical trials that veterans can participate in via a Web site: www.csp.research.med.va.gov

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.

STRATEGIC OBJECTIVE 4.3: Academic Partnerships

Making a Difference for the Veteran

Interprofessional Fellowship Program in Patient Safety

The Patient Safety Center of Inquiry, located at the James A. Haley VA Medical Center in Tampa, Florida, has been approved by the Office of Academic Affiliations as a site for the Interprofessional Fellowship Program in Patient Safety. Two fellows will be funded.

The purpose of this program is to provide post-residency trained physicians and post-doctoral or post-master's degree trained associated health professionals in-depth education in patient safety practice and leadership.

This program takes advantage of the resources of the internationally renowned VHA National Center for Patient Safety both to provide outstanding training opportunities and to contribute to the improvement of patient safety within the VA system, the body of knowledge of research in patient safety, patient safety education to clinicians in training and practice, and the recruitment and retention of patient safety practitioners, officers, managers, researchers, and administrators.

Significant Trends, Impacts, and VA's Use of FY 2006 Results

Related Performance Information

Major Management Challenges

The following major management challenges have been identified for this strategic objective:

OIG

• VA Disbursement Agreements with Affiliated Medical Schools

Program Evaluations

The Secretary of Veterans Affairs established a Federally Chartered Advisory Committee on Resident Education. The Advisory Committee was charged with examining the philosophy and deployment of VA's residency training positions and undertook a broad assessment of graduate medical education in relationship to veterans' future health-care needs. The Advisory Committee affirmed the critical role that VA plays in providing high-quality graduate medical education from the general perspective of the preparation of the Nation's future physicians and, more specifically, from the perspective of meeting VA health-care delivery needs. The Advisory Committee recommended, "VA should restore and maintain its historic support for 11 percent of total U.S. physician resident positions." The Under Secretary for Health tasked the Chief Academic Affiliations Officer to develop an implementation plan to increase the number of physician resident positions and the proportionate share of total U.S. positions funded by VA.

Program Assessment Rating Tool (PART) Evaluation

The Administration conducted a PART evaluation of VA's Medical Care program during 2003. However, the evaluation did not specifically cover any aspects of the medical education program.

Data Quality

VA's data quality improvement efforts including its work on data verification and validation are described in the Assessment of Data Quality.

STRATEGIC OBJECTIVE 4.4: Socioeconomic Well-Being of Veterans

Making a Difference for the Veteran

VA Leads Federal Government in Contracting with Disabled Veterans

Edging closer to its target for contracting with service-disabled, veteran-owned businesses, the Department of Veterans Affairs has bested other federal agencies, according to a report on last year's federal contracting program.

Of 18 federal agencies that procured at least $1 billion through contracts, VA led in its percentage - 2.15 percent - of total procurement dollars awarded to small businesses run by veterans disabled during military service. VA awarded more than $200 million to these veteran-owned businesses in fiscal year 2005 - the most recent year for which complete data are available. Through July 2006, VA had awarded 3.68% of its total procurement dollars to service-disabled veteran-owned small businesses.

"VA is committed to helping veterans, not just with health care and other benefits, but in experiencing the opportunities of entrepreneurship," said the Honorable R. James Nicholson, Secretary of Veterans Affairs.

VA's leadership role in supporting service-disabled, veteran-owned businesses was cited in the Small Business Goaling Report issued by the Small Business Administration in June 2006. According to the report, VA's $9.8 billion in total acquisitions last year made it the fourth largest purchaser of goods and services within the federal government, behind the Department of Defense, the Department of Energy, and the National Aeronautics and Space Administration.

Across the federal government, the report said contracts with service-disabled veterans increased to $1.9 billion last year, up by 58 percent since 2004.

Significant Trends, Impacts, and VA's Use of FY 2006 Results

Related Performance Information

Major Management Challenges

Neither VA's Office of Inspector General nor the Government Accountability Office identified any major management challenges related to this objective.

Program Evaluations

No independent program evaluations have been conducted recently that specifically address this objective.

Program Assessment Rating Tool (PART) Evaluation

No PART evaluations have been completed that specifically address this objective.

Data Quality

VA's data quality improvement efforts including its work on data verification and validation are described in the Assessment of Data Quality.

STRATEGIC OBJECTIVE 4.5: Maintaining National Cemeteries as Shrines

Making a Difference for the Veteran

VA Adds Maps to Online Nationwide Gravesite Locator

The grave locations of more than 3 million veterans and dependents buried in national cemeteries can be found more easily now because the Department of Veterans Affairs has added maps of burial sections online that can be printed from home computers and at national cemetery kiosks.

The latest improvement builds upon a service begun 2 years ago, in which a VA online feature permits family members to find the cemetery in which their loved one is buried.

"This new map feature makes it easier for families, friends, and researchers to find the exact location of a veteran's grave in all national cemeteries and some state veterans cemeteries," said the Honorable R. James Nicholson, Secretary of Veterans Affairs. "It enhances VA's service at national cemeteries, already highly regarded, and our commitment to them as national shrines and historic treasures."

The Nationwide Gravesite Locator (http://gravelocator.cem.va.gov), online since April 2004, makes it easier for anyone with Internet access to search for the gravesite locations of deceased family members and friends, and to conduct genealogical research. Making it easier to identify burial locations may bring more visitors to the honored resting places that VA considers national shrines and historic treasures.

Significant Trends, Impacts, and VA's Use of FY 2006 Results

Related Performance Information

Major Management Challenges

Neither VA's Office of Inspector General nor the Government Accountability Office identified any major management challenges related to this objective.

Program Evaluations

The Veterans Millennium Health Care and Benefits Act, Public Law 106-117, directed VA to contract for an independent study to look at various issues related to the National Shrine Commitment and its focus on cemetery appearance. Volume 3: Cemetery Standards of Appearance was published in March 2002. This report served as a planning tool and reference guide in the task of reviewing and refining VA's operational standards and measures.

In August 2002, Volume 2: National Shrine Commitment was completed. This report identified the one-time repairs needed to ensure a dignified and respectful setting appropriate for each national cemetery. VA is using the information in this report to address repair and maintenance needs at national cemeteries. Through 2006 NCA has addressed approximately 25 percent of the total repairs identified in this report.

Program Assessment Rating Tool (PART) Evaluation

In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Burial program during 2002, which resulted in a rating of "Moderately Effective." Please see OMB PART reviews for more information.

New Policies and Procedures

In order to ensure a high-performing, well-trained workforce, VA established the National Cemetery Administration Training Center in 2004. Initially focused on training cemetery directors and assistant directors, the new facility has expanded its classes to train supervisors, foremen, gardeners, cemetery representatives, and contracting officer technical representatives. As the facility continues to expand its classes, training for other employees, such as equipment operators, will be added to the curriculum. As eight more new national cemeteries become operational by the end of this decade, the center's efforts will help ensure consistency in operations throughout the national cemetery system as well as a high-performing workforce and well-trained staff for key positions.

NCA is partnering with the National Center for Preservation Technology and Training (NCPTT), an office of the National Park Service (NPS), to conduct a materials conservation and treatment analysis of government-issued marble veteran headstones issued from the 1870s through 1973. Second to VA, NPS has the largest number of national cemeteries, including Gettysburg National Cemetery, under its jurisdiction. Through a 2-year interagency agreement, NCPTT will identify alternatives for cleaning historic headstones based upon criteria such as cost effectiveness and environmentally and historic-resource friendly chemicals.

In 2006 VA improved its Web-based (Internet) Nationwide Gravesite Locator (NGL) system to include a mapping feature that shows the burial sections of each VA national cemetery and some state veterans cemeteries. This feature enables families, friends, and researchers to more easily find an exact grave location in these cemeteries. The NGL, originally launched in 2004, contains more than 3 million records of veterans and dependents buried in VA's 123 cemeteries since the Civil War. It also has records of some burials in state veterans cemeteries and burials in Arlington National Cemetery from 1999 to the present.

Other Important Results

The willingness to recommend the national cemetery to veteran families during their time of need is an expression of loyalty toward that national cemetery. In 2006, 98 percent of survey respondents (family members and funeral directors who have recently received services from a national cemetery) indicated they would recommend the national cemetery to veteran families in their time of need.

VA has established standards and measures by which NCA can determine the effectiveness and efficiency of its operations. These standards and measures identify performance expectations in key operational processes including interments, grounds maintenance, and headstones and markers.

To ensure the appearance of national cemeteries meets the standards our Nation expects of its national shrines, VA performed a wide variety of grounds management functions including raising, realigning, and cleaning headstones to ensure uniform height and spacing and to improve appearance. The rows of pristine, white headstones that are set at the proper height and correct alignment provide the vista that is the hallmark of many VA national cemeteries. In 2006 VA collected data that showed that 67 percent of headstones and/or markers in national cemeteries are at the proper height and alignment; 77 percent of headstones, markers, and niche covers are clean and free of debris or objectionable accumulations; and 86 percent of gravesites in national cemeteries had grades that were level and blended with adjacent grade levels. In 2006 VA initiated National Shrine Commitment projects at 11 national cemeteries. These projects will raise, realign, and clean more than 145,000 headstones and markers and renovate gravesites in nearly 65 acres. While attending to these highly visible aspects of our national shrines, VA also maintained roads, drives, parking lots, and walks; painted buildings, fences, and gates; and repaired roofs, walls, and irrigation and electrical systems.

In 2006 more than 97 percent of survey respondents (family members and funeral directors combined) agreed that the overall appearance of national cemeteries was excellent. The response rate solely among family members was slightly higher at nearly 98 percent. Performance on this key initiative is statistically unchanged from the previous year, and the results demonstrate VA's continued commitment to maintaining national cemeteries as shrines dedicated to preserving our Nation's history, nurturing patriotism, and honoring the service and sacrifice veterans have made.

NCA has also established an Organizational Assessment and Improvement Program to identify and prioritize improvement opportunities and to enhance program accountability by providing managers and staff at all levels with one NCA "scorecard." As part of the program, assessment teams conduct site visits to all national cemeteries on a rotating basis to validate performance reporting. NCA schedules 12 visits each year to a representative group of national cemeteries from each Memorial Service Network that illustrates the diversity of our system in terms of age, size, workload, and climate. To date, NCA has completed 25 site visits assessing 43 national cemeteries. Ten visits assessing 16 national cemeteries were conducted in 2006.

VA continued its partnerships with various civic organizations that provide volunteers and other participants to assist in maintaining the appearance of national cemeteries. For example, an interagency agreement with the Bureau of Prisons provides for the use of selected prisoners to perform work at national cemeteries. Under a joint venture with VHA, national cemeteries provide therapeutic work opportunities to veterans receiving treatment in the Compensated Work Therapy/Veterans Industries program. The national cemeteries are provided a supplemental workforce while giving veterans the opportunity to work for pay, regain lost work habits, and learn new work skills.

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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