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Fiscal Year 2005 Performance and Accountability Report
Published November 15, 2005

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Strategic Goal One: Restoration and Improved Quality of Life for Disabled Veterans

Strategic Objective 1.1: Specialized Health Care Services

Maximize the physical, mental, and social functioning of veterans with disabilities and be recognized as a leader in the provision of specialized health care services.

Performance Trends and Impact of FY 2005 Results

Performance Trend FY 2005 Impact
Supporting Measure: Prevention Index II (Special Populations)
* Actual data through June 2005. Final data are not yet available.
2003 80%
2004 86%
2005 Result 86%*
2005 Plan 86%
2006 Plan 86%
Strategic Target 86%
Meeting the 2005 performance target has resulted in improved health of America's veterans with special needs, including those with disabilities. 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.
Supporting Measure: Percent of veterans discharged from a Homeless Veterans Program, or Community-based Contract Residential Care Program to an independent or a secured institutional living arrangement
* Actual data through June 2005. Final data are not yet available.
2002 65%
2003 72%
2004 79%
2005 Result 82%*
2005 Plan 79%
2006 Plan 80%
Strategic Target 80%
The 2005 performance result of 82 percent exceeded the target of 79 percent to place veterans in the least restrictive setting that improves their mental and social well-being and restores their ability to begin functioning independently. The extent to which VA maintains a high placement rate of veterans to such settings enhances their quality of life.

Related Information

Major Management Challenges

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

OIG
GAO

Program Evaluations

A contract has been awarded to begin a program evaluation of the services for severely mentally ill patients. Four patient populations have been defined for study: schizophrenia, bipolar, post-traumatic stress disorder, and major depressive disorder. These patients represent high-volume, high-cost patients. Patient-centered outcomes have been developed for each of the patient populations along a continuum of care from diagnosis and assessment, treatment, and chronic disease management through rehabilitation. In addition to the evaluation of outcomes for each diagnosis group, research questions will address other aspects of mental health treatment. These will include such areas as variations in availability of services, receipt of care for non-mental health diagnoses, barriers to access for care, and comparison of services and outcomes for non-VA patients. The study will take approximately 2 years to complete.

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 Summary Table 3 for more information.

New Policies and Procedures

A new directive was issued for Physical Medicine and Rehabilitation Outcomes for Stroke, Traumatic Brain Injury, and Lower-Extremity Amputation Patients that does the following:

  • Provides a mechanism for the recording and tracking of medical rehabilitation outcomes for stroke patients and the special patient populations of traumatic brain injury (TBI) and lower-extremity amputations.
  • Utilizes Functional Status Outcomes Database to measure and track rehabilitative outcomes in all new stroke, lower-extremity amputations, and TBI.
  • Ensures that a functional assessment is administered to determine rehabilitation needs following the onset of the impairment.
  • Creates a database for the development of a new Supportive Indicator entitled: Percent of Applicable Inpatients with a Comprehensive Integrated Inpatient Rehabilitation Program (CIIRP) Admission.

A new directive was issued for Polytrauma Rehabilitation Centers that does the following:

  • Establishes the policy for the four regionally established Polytrauma Rehabilitation Centers (PRC).
  • Defines the role of the PRC in providing a full range of care to patients with a sustained and varied pattern of severe and disabling injuries including TBI, amputation, visual and hearing impairment, spinal cord injury, musculoskeletal injuries, wounds, and psychological trauma.
  • Defines a seamless transition and facilitates communication among military treatment facilities, PRC, servicemembers, and family members.
  • Defines the linkage to the larger VHA system of care.
  • Defines a dedicated interdisciplinary core rehabilitation team and dedicated consultative services.
  • Defines the responsibilities necessary to provide comprehensive rehabilitation services for individuals with complex cognitive, physical, and mental health conditions of severe and disabling trauma and to provide support to their families.

Other Important Results

Although data are not yet available, VHA has developed two new performance measures to enable VA to monitor the degree to which veterans returning from a combat zone with or without an injury or illness have access to a primary or specialty care appointment within 30 days of the desired date.