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Strategic Objective

Improve Veteran Wellness and Economic Security

Strategic Objective

Themes:

Education, Training, Employment, and Social Services Health Veterans Benefits and Services Income Security

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Overview
Progress Update

Overview

Summary:

Numerous programs provide a broad spectrum of benefits and support services that assist Veterans and eligible beneficiaries. To enable Veterans and eligible beneficiaries to choose the best benefits and services for their needs, VA will improve coordination between our programs, leverage supportive interactions between programs, and reduce overlap across programs. Success will be measured by the differences made in the lives of the Veterans we serve, including decreasing Veteran unemployment, decreasing home foreclosures, decreasing homelessness, reducing

Progress Update

Final Assessment: VA, in consultation with the Office of Management and Budget, determined that performance toward this objective is making noteworthy progress.

Achievements: In FY 2015, VA placed an estimate of 64,902 Veterans in permanent housing, including moves into the HUD-VASH^{^[1]} Program, rapid rehousing placements through SSVF^{^[2]} program, and moves from VA residential treatment programs into permanent housing. VA also moved 87 percent of unsheltered Veterans out of unsheltered status within 30 days of engagement.

VA continues to expand research through various initiatives. Over 518,000 Veterans have agreed to participate in the Million Veteran Program^{^[3]} since May 5, 2011, (goal is to study how genes affect health) and over 425,000 Veterans have completed the enrollment process as
of November 2015. Genotype information on about 400,000 will be completed by December 2015. Initial phenotyping alpha and beta-tests are underway. Also, discussions with DoD have resulted in VA-funded researchers working on-site at the Millennium Cohort Study^{^[4]} at the Naval Health Research Center in San Diego. These researchers are studying issues that are of interest to VA, and may in the future provide critical information towards enhancing the long-term health of Veterans and future generations of military members.

VA improved Veteran economic security through the VetSuccess On Campus (VSOC)^{^[5]} program, which helps Veterans and dependents succeed with on-campus assistance and counseling. There are currently 74 VSOC counselors at 147 campuses, with the potential to support a population of nearly 137,758 Veterans, Servicemembers, and eligible dependents. VSOC counselors provide support in transition to campus life, and work with Veterans to enable their education and employment success. Also, the GI Bill Comparison Tool^{^[6]} was launched and enhanced in FY 2014, in response to Executive Order 13607. As of November 10, 2015, there were 1,304,606 unique page views of the Comparison Tool with over one million schools searched. Employers are reporting over 348,000 positions filled toward their Veteran hiring commitments. Since inception in April 2014, the Veterans Employment Center (VEC)^{^[7]}received more than 18 million page-views and features 2.2 million jobs. It contains over 15,000 publicly posted job seeker profiles and over 1,100 committed employers. Implementation of Veterans Economic Communities Initiative^{^[8]}, a phased initiative to provide enhanced economic opportunities for Veterans and their families. On May 18, 2015, Phase 1 of the initiative rolled out to 25 U.S. communities evaluating success across 5 strategic focus areas: Employment, Education, Partnerships, Local Policy Academies, and Integration with Government.

Also, VA is implementing the Veteran’s Choice Program through the use of Third Party Administrators to provide care to Veterans.^{^[9]}^. In order to increase the number of Veterans who can use Choice, VA issued the “Hierarchy of Care” Memo to the field which makes Choice the top option for the VA Community, implemented the Choice First Program which offers Choice when a local facility does not offer service, and expanded “undue burden” to allow more flexibility where medical or distance challenges exist. VA also utilized strategic communications to help Veterans, providers, and staff understand the Veterans Choice Program. VA instituted a user-friendly site, set up a Veterans Choice Google Hangout, sent Home Mailers to Veterans and created a mandatory training program for staff on VA’s Talent Management System. Patient Aligned Care Teams (PACT) continue to transform “Veterans' care by providing patient-driven, proactive, personalized, team-based care oriented toward wellness and disease prevention resulting in improvements in Veteran satisfaction, improved healthcare outcomes and costs.”^{^[10]} The Prevention Index V scores, which indicate how well VA promotes healthy lifestyle, have been positively trending from FY 2010. In FY 2015, the “maintain or exceed Prevention Index V” score is 92 percent.

Furthermore, VA continues to conduct internal and external outreach events that directly connect Service-Disabled Veteran-Owned Small Business (SDVOSB) and Veteran-Owned Small Business (VOSB) owners with Procurement Decision Makers from VA and other Federal and state agencies and corporations with Small Business needs to ensure procurement ready Small Businesses, particularly VOSBs, have access to relevant contracting opportunities. Over 3,900 VOSBs participated in an outreach event during FY 2015.

Challenges: There are some challenges in achieving Objective 1.1. Community help is needed to provide affordable housing options for Veterans, opportunities for meaningful and sustainable employment, and improved access to mainstream programs and services (Homelessness APG).

Also, major shifts in VA’s contracting mix, mostly involving new dollars for non-VA health care, as well as dollars transferred within VA for completion of the Denver replacement hospital, will make VA’s current small business goal percentages unachievable, even as the number of actual dollars awarded increases for SDVOSBs and VOSBs. The percentage changes will give the appearance of a reduction in effort on small business goals, even though at its current pace VA is on-track to award more than $4 billion to VOSBs for the first time ever.

Changes to VA contract policy around liquidated-damages clauses will require an additional $20M in FY 2016 for the VALERI initiative, which enables Loan Guaranty Program’s success in assisting defaulted borrowers avoid foreclosure. VBA leadership will work to identify funding as needed in FY 2016.

Although the prevention index continues to reflect VHA PACT focus on population management, health promotion and disease management, the metric should be recognized as one of sustainment of VHA’s excellence in care delivery. It is unlikely that this metric will demonstrate significant improvement over time, mainly due to the Veterans preference to refuse screenings or vaccinations. The data demonstrate a flat trend over time.

Additionally, Intramural Research Sharing Opportunities between VA, DoD, the Department of Health and Human Services, and the National Institutes of Health are limited and do not allow intramural investigators to work seamlessly across agencies.

VA is experiencing issues communicating to all staff on the Veterans Choice Program and the mitigation plan is to institute mandatory training. Another challenge is Veteran awareness, knowledge, education, and utilization of the Veterans Choice Program.

[1] http://www.va.gov/homeless/hud-vash.asp

[2] http://www.va.gov/homeless/ssvf.asp

[3] http://www.research.va.gov/mvp/

[4] http://www.research.va.gov/mvp/

[5] https://www.ebenefits.va.gov/ebenefits/vsoc-fact-sheet

[6] http ://department-of-veterans-affairs.github.io/gi -bill-comparison-tool/

[7] https://www.ebenefits.va.gov/ebenefits/jobs

[8] http://www.blogs.va.gov/VAntage/20015/va-launches-campaign-increase-veterans-economic-potential/

[9] http://www.va.gov/opa/choiceact/

[10] http://www.va.gov/health/services/primarycare/pact/’

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Strategic Goals

Strategic Goal:

Empower Veterans to Improve Their Well-being

Statement:

Empower Veterans to Improve Their Well-being

Strategic Objectives

Improve Veteran Wellness and Economic Security

Statement:

Improve Veteran Wellness and Economic Security

Description:

Summary:

Strategies:

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FY 14-15 Priority Goal: End Veteran Homelessness

Statement:

In partnership, the Department of Housing and Urban Development (HUD) and VA aim to reduce the number of Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).

Indicators:

Reduction in homeless Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).
The “Number of Homeless Veterans” on a single night is determined by the PIT Count, which is conducted annually the last week of January each year “The PIT Count reflects the results of the work performed and the fiscal obligation/budget made in the prior fiscal year.”
Reduction in total homeless Veterans temporarily living in shelters or transitional housing to 12,500 (as measured by the FY 2016 PIT Count).

Description:

VA has taken decisive action toward its goal of ending homelessness among Veterans. The End Veteran Homelessness initiative is intended to prevent Veterans and their families from entering homelessness and to assist those who are homeless in exiting as safely and quickly as possible. VA’s “no wrong door” philosophy will ensure that homeless and at risk for homeless Veterans have timely access to appropriate housing and services. Any door a Veteran comes to - at a medical center, a regional office, or a community organization - will lead to the tools to offer Veteran assistance. Ending homelessness among Veterans will advance the mission of VA by ensuring that all Veterans and their families achieve housing stability.
On a single night in January 2014 during the Point in Time (PIT) Count ^[1], there were 49,933 homeless Veterans in the US. Effectively ending homelessness among Veterans requires rapid access to permanent housing, health care, employment, benefits, and other supportive services. VA works closely with community partners to meet current and new demands for any Veteran who is experiencing or is at imminent risk of homelessness. Housing First and Rapid Re-housing are two of the many evidence-based approaches VA uses to end homelessness. The Housing First model follows the philosophy of providing permanent housing as quickly as possible to Veterans/individuals experiencing homelessness and then wrapping health care and other supportive services as needed around the Veteran to sustain housing and improve their quality of life. Rapid Re-housing is a set of strategies to help families quickly move out of homelessness and into permanent housing. It typically involves: housing search and landlord mediation assistance, short-term or flexible rental assistance, and transitional case management services. Rapid Re-housing provides crisis intervention services to quickly place an individual or family who is currently homeless into a permanent, sustainable housing situation.

[1] The annual PIT estimates are a snapshot of homelessness. They are submitted to HUD each year by communities and account for homeless Veterans in emergency shelters or transitional housing on the night of the PIT count (i.e., sheltered) as well as homeless Veterans who are in places not meant for human habitation such as the streets, abandoned buildings, cars, or encampments (i.e., unsheltered). Communities typically conduct their PIT count during the last week in January when a large share of the homeless population is expected to seek shelter rather than stay outside. Because counting people in shelters is more precise than conducting street counts, the timing of the PIT count is intended to improve the accuracy of the estimates. (Source: Veteran Homelessness: A Supplemental Report to the FY 2010 Annual Homeless Assessment Report to Congress).

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Increase Customer Satisfaction through Improvements in Benefits and Services Delivery Policies, Procedures, and Interfaces

Statement:

Increase Customer Satisfaction through Improvements in Benefits and Services Delivery Policies, Procedures, and Interfaces

Description:

Summary:

VA is a customer service organization. Complicated application processes, long processing timelines or difficulties getting information and appointments all impact the client’s experience and satisfaction. Veterans and eligible beneficiaries deserve a support system that is responsive to their needs. VA must keep pace with Veterans’ expectations and transform its customer services – soliciting regular customer feedback, streamlining processes, and delivering consistent service across customer-preferred channels.

We live in a connected world. The rapid pace of technological advancement is reshaping Veterans’ expectations regarding how services, benefits, and support should be delivered. Today’s client expects instant access to information and self-service options via the Internet, and increasingly through mobile devices like tablets and smartphones (and the next generation “smart” devices that are yet to be deployed).

To provide a personalized experience, we must listen, learn, and understand the needs and expectations of those we serve. We must have the knowledge, information and insight to understand why some choose not to fully engage with VA.

Strategies:

VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog. We will then implement a robust plan, and revisit procedures to ensure claims are addressed in no more than 125 days with at least 98 percent accuracy. The plan includes redesigning policies and procedures, continuing to enhance training for claims processors, and utilizing the most advanced IT. We will also increase the use of video teleconference hearings to address claims appeals.

VA will continue to expand implementation of PACT to improve partnerships with Veterans and eligible beneficiaries, increase team-based care coordination and management, and expand access to care. VA will improve patient-facing and clinician-facing e-health systems by expanding the development and use of health-related virtual modalities. These modalities include telehealth[1], E-Consult[2], secure messaging, MyHealtheVet, and mobile applications.

VA will enhance client satisfaction by capturing client data once, sharing it enterprise-wide, and using this client data for a lifetime, which will promote more efficient use of data across business lines. We will identify sources of consistent, reliable, and authoritative Veteran data. We will establish architecture, business rules, roles and responsibilities, and governance to enable VA lines of business to use the authoritative common client data to improve delivery of benefits and services to Veterans. VA will gain access to additional external data, knowledge, and experiences so we can broaden our understanding of our client’s needs and expectations. We will enable secure, privacy-protected electronic exchange of personal, health, and economic data on Veterans from induction oath through the final survivor benefit.

VA will rethink its operations as a Department, defining the fundamental crosscutting capabilities and interdependencies required to perform them. We will identify and address any internal organizational, policy, procedural, perceptual, and cultural boundaries that constrain our ability to coordinate, integrate, and deliver benefits and services.

VA will streamline its virtual presence (Web sites, portals and call centers), reducing duplication and enhancing personalization to enable clients to get the information they need, on their schedule.

VA will increase access to burial benefits in national cemeteries through its plans to construct five new national cemeteries and by recognizing and addressing the unique needs of Veterans and eligible beneficiaries who reside in densely populated urban areas as well as sparsely populated rural locations. We will ensure that the service and appearance of our national cemeteries meets the highest standards commensurate with these national shrines.

[1] Telehealth uses information and telecommunication technologies to provide health care services in situations in which the patient and practitioner are separated by geographical distance. Telehealth in VA increases access to high quality health care services using Clinical Video Telehealth (CVT), Home Telehealth (HT) and Store and Forward Telehealth (SFT).

[2] E-Consult is an approach to provide clinical support from provider to provider. Through a formal consult request, processed and documented in the Computerized Patient Record System, a provider requests a specialist to address a clinical problem or to answer a clinical question for a specific patient. Utilizing information provided in the consult request and/or review of the patient’s electronic medical record, the consultant provides a documented response that addresses the request without a face-to-face visit.

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FY 16-17 Priority Goal: Improve Veterans Experience with VA

Statement:

Improve Veterans Experience with VA:

Fulfilling our country’s commitment to Veterans, VA will deliver effective and easy customer experiences in which Veterans feel valued.

By September 30, 2017, reach 90% agreement with the statement “I trust VA to fulfill our country’s commitment to Veterans.”

Because this is a new measure, VA will establish the baseline in FY16 and add the measure to surveys covering all of VA’s primary services and product lines.

Description:

VA offers a remarkable array of services and benefits to Veterans and eligible dependents. But the experience is disjointed and inconsistent. There are hundreds of phone numbers and thousands of websites, each operating independently under different standards. Similarly, there are a wide array of VA and non-VA resources at the Federal, state, local, corporate, non-profit and tribal level that are not coherently organized or coordinated into a single source or reference point for the Veteran. Veterans deserve better and so do VA staff, who care deeply about delivering the best possible outcome for Veterans.

The Veterans Experience team is leading a powerful new effort to improve customer experiences across VA, nationwide. Our goal: Fostering the delivery of effective and easy customer experiences in which Veterans feel valued. We are achieving this goal the same way the world’s most successful companies do: by listening to our customers – Veterans, their families and supporters – when they describe how they want things to work. Equally important, we are listening to our employees about obstacles to excellence on-the-job. Employee empowerment is an essential part of the equation. This is user-centered design. It puts Veterans and the employees who serve them front and center.

VA and the Veterans Experience team face a number of challenges and barriers:

Siloed products and services without a common view of customers and their needs and wants.
Customer touchpoints and experiences owned by individual product and service teams, not integrated within a complementary suite of offerings.
Insular approach that does not account for the community resources used by customers.

The APG will track our ability to overcome these barriers by implementing the strategies described in the next section.

To build trust among our customers, VA must consistently deliver customer experiences marked by effectiveness, ease, and engagement.[1] To ensure comparability across VA’s disparate service and product lines, the same measures of Trust and Customer Experience will be applied.

Trust

VA earns trust among Veterans by knowing them and showing that we care; by understanding and anticipating their needs; by providing fair benefits and timely services; by being there when they need us; and by keeping our promises. With every interaction, VA has the opportunity to deepen a trusting relationship with Veterans, or to diminish that trust.

Our Agency Priority Goal states: By September 30, 2017, VA will reach 90% agreement with the statement “I trust VA to fulfill our country’s commitment to Veterans.”

Timeline:

Q1 FY16: Trust and Experience measures incorporated into existing customer experience surveys

Q2 FY16: Baseline data collection begins

Q3 FY16: Baseline measurement established; quarterly targets specified

Q4 FY 2016: Publish quarterly update

Q1 FY 2017: 70 percent of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement Customer Experience

Q2 FY 2017: 75 percent of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement Customer Experience

Q3 FY 2017: 80 percent of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement Customer Experience

Q4 FY17: 90% of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement

Customer Experience

Trust in VA is built one interaction at a time. The experience must be effective; it must be easy; and, ideally, it must be engaging and reflective of a valued, personal relationship with our customer. Trust is broken when VA does not consistently meet expectations in these three categories. VA will use customers’ ratings of their individual experiences as indicators of performance toward the overall Veterans Experience APG.

The measures will include level of agreement with questions such as:

Effectiveness: “I got the service I needed.”
Ease: “It was easy to get the service I needed.”
Engagement: “I felt like a valued customer.”

These measures are also new, and will be implemented along the timeline for the Trust measure indicated above. They will be added to new and existing VA customer experience surveys where responses will be correlated with operational data to highlight performance improvement opportunities that will improve Veterans experiences.

[1] Adopted from the Forrester Research customer experience framework.

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FY 14-15 Priority Goal: Improve Veteran Virtual Access to VA Benefits and Services

Statement:

Improve client and stakeholder awareness of, and access to, Veterans benefits and health care services. By September 30, 2015, VA will increase the use of virtual service options by increasing the percent of claims received electronically, by increasing the number of accredited Veterans service officers registered on the Stakeholder Enterprise Portal, by increasing the number of registered eBenefits users, and by increasing the percent of patients who access VA health care using a virtual format such as video telehealth or online services.

Indicators:

Increase the annual percent of disability compensation claims received virtually/electronically from a baseline of 2 percent in FY 2013, to 12 percent in FY 2014 and 20 percent in FY 2015.
Increase the number of accredited Veterans advocates who are registered users on the Stakeholder Enterprise Portal (SEP) from a baseline of 1,000 in FY 2013, to 2,000 in FY 2014 and 3,500 in FY 2015.
Increase the number of registered eBenefits users to 3.8 million in FY 2014 and 5 million in FY 2015.
Increase the percent of patients who access VA health care using a virtual format (e.g., video, smart phone, or online services) from 23 percent baseline utilization in FY 2013, to 30 percent in FY 2014 and 35 percent in FY 2015.

Description:

VA’s focus in Fiscal Year (FY) 2015 is to deliver seamless and integrated services while increasing the efficiency and effectiveness of virtual access. To achieve the best possible outcomes for Veterans, Servicemembers, and eligible beneficiaries, VA will improve access to, and encourage the use of, its virtual benefits and services. VA and Department of Defense (DoD) have established a jointly supported portal known as eBenefits, which allows Veterans, Servicemembers, and other eligible beneficiaries to access and submit information when, where, and how they want.

The development and proliferation of virtual access to care supports an organizational approach that is personalized, proactive, and patient-driven. VA virtual health services use technology and health informatics to provide Veterans with better access and more effective care management. Advances in virtual care expand where health care services can be accessed, reduce the need for travel to medical facilities, and transform VA’s delivery of health care and its effect on patients’ health outcomes.

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FY 14-15 Priority Goal: Eliminate the Disability Claims Backlog

Statement:

Improve accuracy and reduce the time it takes to complete disability compensation benefit claims. Eliminate the disability claims backlog and process all claims in 125 days in FY 2015.

Indicators:

Reduce the percentage of disability claims pending for more than 125 days to 50 percent in FY 2014 and 0 percent in FY 2015.
Improve national “issue-based” rating accuracy for disability claims to 97 percent in FY 2014 and 98 percent in FY 2015.*
Improve national “claim-based” rating accuracy for disability claims to 94 percent in FY 2014 and 98 percent in FY 2015.*

* VA is in the midst of reviewing its claims processing accuracy metrics and goals to ensure VA continues to drive decisions of the highest quality. VA plans to engage its VSO partners and other stakeholders as more information becomes available.

Description:

VA will provide timely, accurate decisions on Veterans’ disability compensation and eliminate the claims backlog in Fiscal Year (FY) 2015. Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner. In FY 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency. However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this Agency Priority Goal. To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy. As of the end of June 2015, over 94 percent of VBA’s inventory is in an electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS). All claims are either received electronically or are converted to electronic format for processing.

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Agency Priority Goals

FY 14-15: Improve Veteran Virtual Access to VA Benefits and Services

Statement:

Indicators:

Increase the annual percent of disability compensation claims received virtually/electronically from a baseline of 2 percent in FY 2013, to 12 percent in FY 2014 and 20 percent in FY 2015.
Increase the number of accredited Veterans advocates who are registered users on the Stakeholder Enterprise Portal (SEP) from a baseline of 1,000 in FY 2013, to 2,000 in FY 2014 and 3,500 in FY 2015.
Increase the number of registered eBenefits users to 3.8 million in FY 2014 and 5 million in FY 2015.
Increase the percent of patients who access VA health care using a virtual format (e.g., video, smart phone, or online services) from 23 percent baseline utilization in FY 2013, to 30 percent in FY 2014 and 35 percent in FY 2015.

Description:

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FY 14-15: Eliminate the Disability Claims Backlog

Statement:

Improve accuracy and reduce the time it takes to complete disability compensation benefit claims. Eliminate the disability claims backlog and process all claims in 125 days in FY 2015.

Indicators:

Reduce the percentage of disability claims pending for more than 125 days to 50 percent in FY 2014 and 0 percent in FY 2015.
Improve national “issue-based” rating accuracy for disability claims to 97 percent in FY 2014 and 98 percent in FY 2015.*
Improve national “claim-based” rating accuracy for disability claims to 94 percent in FY 2014 and 98 percent in FY 2015.*

Description:

Learn More

FY 14-15: End Veteran Homelessness

Statement:

Indicators:

Reduction in homeless Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).
The “Number of Homeless Veterans” on a single night is determined by the PIT Count, which is conducted annually the last week of January each year “The PIT Count reflects the results of the work performed and the fiscal obligation/budget made in the prior fiscal year.”
Reduction in total homeless Veterans temporarily living in shelters or transitional housing to 12,500 (as measured by the FY 2016 PIT Count).

Description:

Learn More

Agency Priority Goals

FY 14-15 Agency Priority Goal:

End Veteran Homelessness

Statement:

Indicators:

Reduction in homeless Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).
The “Number of Homeless Veterans” on a single night is determined by the PIT Count, which is conducted annually the last week of January each year “The PIT Count reflects the results of the work performed and the fiscal obligation/budget made in the prior fiscal year.”
Reduction in total homeless Veterans temporarily living in shelters or transitional housing to 12,500 (as measured by the FY 2016 PIT Count).

Description:

Learn More

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