Slide 1 - Washington State Department of Veterans Affairs

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					Washington State Department of Veterans Affairs
            “Serving Those Who Served”




                  Returnees   Homeless


                Mental              Long-
                Health              Ter m
                          Field     Care
                         Services
                         Network




                                              WDVA GMAP
                                            December 5, 2005
                                                               1
Strategic and Operational Priorities (05-07)
 Strategic Priorities                          Operational Priorities
 Homeless                                      Benefits – Claims Quality Assurance
 Homeless Action Plan for the Governor
 Transitinal/Rehab Program                    DSHS Veterans Enhancement Project
                                               Business Scorecard
 Baldrige
                                               HR Scorecard
 Enterprise Initiatives                        IT Scorecard
 HRMS
 Information Technology                       Mental Health/PTSD
 Electronic Health Records
 Military.com – E-veterans                    MOU/Outreach to Returnees
 Sustainability
                                               Retsil 80 Bed Unit
 EW Cemetery                                   Veterans Homes – Quality Indicators
                                               (GRID)
 Community Based Long-term Care
 Partnerships                                 Other Presentations this Quarter
 New venues and delivery
 Master Plan                                  VEMP Electronic Banking
 DSHS
                                               Veterans Conservation Corps – Intro.

                                          Next Step: Firm up performance measures and update
                                          Performance Management System for tracking success.
                                                                                                2
DSHS Partnership – Jim Rising
Region 6 Pilot

 DSHS Contract with WDVA – $216,000 year
 Current contract is for Region 6 – serving Klickitat,
  Skamania, Wahkiakum, Clark, Pacific, Cowlitz, Lewis,
  Mason, Grays Harbor, Thurston, Jefferson and Clallam
  Counties
 Began serving Region 5 in November 05 – Pierce County
 Next Steps – Region 4 – King County
 Results (7-1-04 through 6-30-05):    Number of Clients Served 2,014
                                       Claims Filed 624
                                       $730,000 in healthcare costs avoided
                                       Healthcare Enrollments 625
                                       $1.2 million Federal VA compensation
                                        and pension into the state of WA.



                                                                               3
VEMP Electronic Banking - Gary Condra
Problem Statement
VEMP generates approximately five thousand checks to pay client bills every
month. For many years a manual process drove numerous staff hours to
generate checks, stuff envelopes, and mail payments – plus incurring significant
supply & mailing costs.



Solution
 Phase I - Manual On-Line Bill Pay and Consolidated Mail
 Phase II - Auto Clearing House Banking
 Phase II Implementation Progress Report
            - Complete - Required data elements defined by staff and bank
            - In Process - Computrust writes the necessary code
            - 12/31/05 – Initial programming complete - Software testing begins
            - 1/31/06 – Testing complete - Software functionality in place
            - 2/06/06 – Vendor notification letters mailed – Input Vendor profiles
            - 2/15/06 – Go live with Auto Clearing House Banking


                                                                                     4
Eastern WA Cemetery – Jerry Towne
Timeline
    5/05 – 9/05             6/05                 7/05            8/05 – 11/05             11/05               12/05

   Community &       RFP and Interviews     Eastern              Obtained List of     Interim Report      Final Report to
   Stakeholder       (Edaw Inc. chosen)    Washington             Public Lands        to the Director      the Director
    Meetings                               VBS Hired                                                      Sites Listed in
                                                                    Site Visits
                                                                                                              Priority


   12/05             1/06          1/06 – 5/06            5/06              9/06          10/06              12/06

Submit Design     Submit Design Acquisition of           RFP and         Design         Develop             Submit
  Funding            Funding       Land                 Contractor      Completed       Eligibility       Construction
 Request to         Request to                           Chosen                        Guidelines       Funding Request
                                                                        Submit VA
   OFM             Legislature                                                          (Who we             to OFM
                                                                          Grant
                                                                                         serve)
                                                                        Application

    1/07             5/07               8/07               9/08             11/08

     Submit          RFP and           Begin            Construction        Grand
  Construction      Contractor       Construction        Completed         Opening
Funding Request      Chosen
 to Legislature




                                                                                                                            5
Criteria
 Roads - easy accessibility
 Population - 30% over age 50
 Services - availability
  (especially burial services)
 Public land- cost of land not reimbursed
 Site must have at least 30 useable acres.
Constraints
 Slope
 Water table
 Geology
 Historical sites
 Critical species habitant
 "Offensive" neighboring land-
  (not close to industry)
All 7 sites have been visited.

Recommendation of top four to
Director by December 15, 2005




                                              6
Homeless Veterans – Jerry Towne
National Homeless Veteran Profile
 33% of adult homeless are veterans
 Single, Male, Age 56
 Unemployed
 Honorably Discharged (discharged under conditions other than
  Dishonorable)
 High School Graduate
 10% Still Married                      Approximately 6,000
                                         homeless veterans
 40% never married
                                           in the state of
 No Family Support                         Washington
 No Transportation
 Need Medical and Dental Care


                                                                 7
          Homeless Plan Elements
        BREAKING THE VETERANS HOMELESSNESS CYCLE
  PREVENTION
Sustained Housing       H                           PARTNERS
                                 STRATEGIES
Employment              O                           WDVA
                            •Outreach
Health Care             M   •Communication          CTED
                            •Reliable Statewide     DOC
Substance Abuse         E    Tracking System
Treatment               L   •Education              DSHS
Mental Health           E   •Coordinated Services   LEGAL
Services                    •Partnerships
                        S                           ESD
Legal Assistance                                    USDOL
                        S
Federal Benefits                                    DOH
Active Duty             V                           USVA
Transition              E
Assistance                         Funding
                                                    VSO's
Financial
                        T                           COUNTIES
                                  Federal
Management              E                           FB0’s
Services                          State
                        R                           BUSINESS
Fiduciary Services                County
                        A
Support                 N         City
Enforcement
Adjustments             S         Private




                                                               8
Priorities

Priority One - Temporary
Those who stay in the system for brief periods and do not return. This group consists of about 80% of the
homeless and based on national research they consume about 32% of the resources devoted to support
the homeless. Returning veterans from recent military deployments are often in this category.


Priority Two - Chronic
An unaccompanied individual with a disabling condition who has been homeless for a year or more, or
those who have experienced at least four episodes of homelessness within three years. This group
represents about 10% of the homeless and consumes about 50% of the resources supporting the
homeless. A significant number (one third) are veterans.


Priority Three - Episodic
Those who move in and out of the system on a fairly regular basis over time and consist of about 10% of
the homeless. They consume about 18% of the resources devoted to support the homeless.




                                                                                                            9
Action Plan
                     Objective                          Owner            Due Date   Status      Comments
1.   Develop a coalition of key agency staff
     for information collection on existing homeless    Alfie Alvarado   Nov 05     Completed
     strategies and initiatives
2.   Pursue the establishment of the State’s
     Interagency Council on Homeless and secure         Alfie Alvarado   Jan 06
     a relevant role for WDVA
3.   Align WDVA with the Statewide 10 year Plan         Alfie Alvarado   Mar 06     Completed
4.   Establish an operational lead to coordinate
                                                                                                Jerry Towne
     WDVA’s role with statewide homeless service        Alfie Alvarado   Jan 06     Completed
                                                                                                Designated Lead
     providers
5.   Establish an intra-agency work group to
     develop a veteran specific resource network and    Jerry Towne      Jan 06
     a homeless veterans services scorecard
6.   Establish Homeless Veterans baseline data
                                                        Jerry Towne      Mar 06
     based on the statewide homeless count
7.   Identify the needs of homeless veterans with
     a focus on federal benefits, housing, employment
     and mental health in partnership with state and
                                                        Jerry Towne      July 06
     local governments, appropriate federal agencies
     and community organizations that serve the
     homeless population
8.   Open a Community Reintegration program at
                                                        Jerry Towne      Jan 07
     the Veterans Home at Retsil
9.   Utilize WDVA’s Veterans Benefits Services
     Network to connect and track eligible homeless
                                                        Jim Rising       Jan 06
     veterans and family members to the benefits for
     which they are eligible
Transition/Rehab. Program
Program Timeline                                                       Stakeholder Meetings

  7/05 – 10/06             10/05              12/05            5/06                            12/06            1/07

      Develop        Gather Transitional   Hire Program       Present                     First Staff Hired     Begin
   Partnerships        Employment            Manager        Transitional                                      Admission
                                                                                           Purchase Van
(available services)   Program Data                       Resident Plan to                                     Process
                                                          Deputy Director



Building 9 Renovation Timeline
     6/05               7/05                 8/05                  10/05                           Funding
                                                                                          Federal VA          $317,211
   Submit VA       VA Conditional     2nd Submission of Received Acceptance
 Grant Per Diem      Approval         VA Grant Per Diem Notification from VA
                                                                                          State               $189,773
   Application                            Application                                           Total:        $506,984

    12/05               1/06               4/06             6/06               7/06                9/06            12/06

 Submit Funding Submit Funding             RFPs            Choose            Renovation           Program        Renovation
 Request to OFM   Request to                              Contractor           Begins              Design        Completed
                  Legislature                                                                    Completed




                                                                                                                           11
HR Scorecard Introduction – Lisa Benavidez
DOP is finalizing the statewide HR Scorecard. WDVA HR will provide
measures and targets for the elements below by December 31, 2005

 Overtime
 Sick Leave
 Diversity
 Grievances
 WMS Reduction
 L&I Claims
 Performance Plans
 Employee Survey




                                                                     12
MOU Outreach (Returnees) – Tom Riggs
WA National Guard (WNG)


“WNG Family Activity Day” Results - CY2005
  23 events for 32 units
    • Average 18 volunteers and staff per event
  2,055 Service Members processed out of 4,391 (47%)
  360 VA Claims Filed                            (17.5%)
  856 Readjustment Referrals Made                (41.65%)
  449 Received Employment Assistance             (22%)
  1,061 Enrolled in VA Health Care




                                                             13
         A Coordinated Program of Outreach, Early Intervention and
                           Collaborative Care
                                                            FAD (11)                                                 12 Soldiers Have been
                                        Marriage            Marriage                                                     Enrolled in the
                                                                            FAD (6)
                                        Retreats            Retreats                                                  Homeless Veterans
                  Marriage                                                  Marriage
                                         (2)                  (2)                                                    Reintegration Program
      Reunion and Retreats                                                  Retreats
                   (1)                                                        (1)              620 PAX
      Retention
                                                                                               Reverse SRP
      For                                      Marriage           Marriage
                             Marriage                                                          Hurricane Katrina
      Families                                 Retreats           Retreat for           FAD
                             Retreats                                                          47 Referred to                 FAD
       (18)                                      (2)              792nd Chem            (4)
                               (1)                                                             Readjustment                   (3)
                                                          FAD
            FAD                                                                                Counseling
                                                          (2)
            (1)




February March     April     May        June       July         August     September        October                November




         Demob 3300 PAX                                                                                  MOB 75 PAX        Demob 94 PAX
         81st BCT                                                                          MOB 18 PAX    341st MI          541st PSD
                                                                                           E/168 AVN     For OEF           941st PSB
                                                                                                         75 PAX            319th EOD
                                                Mob 157 PAX
                                                792nd Chemical BN                 MOB 620 PAX
                                                                                  To Support Hurricane
                                                                                  Katrina Survivors



FAD (Family Activity Days)
                                                                                                                                             14
Next Steps: FY 06
Training:
   Conduct Leadership Refresher Training to identify signs of stress and refer
    service members to state or federal resources / support services
   Professional Reading: e.g., “Down Range to Iraq and Back”
   Develop “On Call” State and Federal resources to respond to mental health
    issues when and where needed


Customer Service: Phase I
   Assist Commanders in identifying members who missed FY05 FAD & schedule
    regional FADs (to include all Reserve components)
   Survey units to pin-point requirements (e.g., employment assistance, physical
    and mental health care, etc.); then customize service delivery for individual units




                                                                                          15
         Partnership includes all Reserve Components
                            FY 06




Customer Service: Phase II

Collaborate with Coalition Partners & non-profit organizations to conduct regional
FADs for OIF/OEF service veterans / members of all branches who have returned to
citizen status

    ANG ARM RES C.G. RES AIR GUARD AIR RES MAR RES NAV RES TOTAL
MIL 4,391 2,319   319        1,207   1,363   635      740  11,046
FAM 5,347 3,475   661        2,107   2,405   646    1,036  15,677

                                               Source: Defense Manpower Data Center (DMDC)


                                                                                             16
Quality of Care – David De Vore
(WA Soldiers Home, Orting)

  Clinical Indicators (7/1/05 – 10/31/05)
       Falls ……………………...
       Pressure Ulcers .……......
       Weight Loss ....…….……
       Restorative Program .......


  Federal/State Survey Results



        On Target            Pay Attention   Off Target
                                                          17
                                         Clinical Indicators
                      WSH Falls                                           WSH Restorative
                               Industry Benchmark 15%
                                                                                           No Industry Benchmark
14%                                                       80%
12%
                       DVA Goal 10%
                                                          75%
10%                                                       70%
                                        DVA Goal < 10%
8%
                                                          65%
6%                                                                                                 DVA Goal = or > 60%
                                                          60%
4%
                                                          55%
2%

0%                                                        50%
      July   August    Sept       Oct     Nov      Dec          July   August   Sept         Oct      Nov       Dec


                WSH Weight Loss                                          WSH Pressure Ulcers
                               Industry Benchmark 10.3%                                    Industry Benchmark 12%
                                                          15%
10%

 8%
                                                          10%
 6%
                                        DVA Goal < 6%
 4%                                                       5%
                                                                                       DVA Goal in-house acquired < 5%
 2%
                                                          0%
 0%
                                                                July   August   Sept         Oct      Nov       Dec
      July   August     Sept      Oct      Nov     Dec




                                                                                                                         18
Federal/State Survey Results
 Regulatory Agency   Survey Date                  Results


      U.S.
   Department                                2005 2 Deficiencies
       of             October 04 & 05
    Veterans                                 2004 5 Deficiencies
     Affairs




     State                                   2005 3 Deficiencies
     DSHS                                         (2 B and 1 D)
                     September 04 & 05
    Medicaid                                 2004 3 Deficiencies
                                                  (1 B, 1 D and 1 E)




                                         Target - 0 Deficiencies
                                                                       19
Quality of Life – Kathy Magonigle
(Spokane Veterans Home)
Resident Satisfaction Survey 12/04-6/05
 Administrative Services………….                     Overall Environment………
                                                    •     Call Lights
 Dining Services……………………
     • The food taste good                         Nursing Assistant
     • The food is served at the
       appropriate temperature                      Services……………………..
     • The food is presented attractively
     • The menu offers variety and                 Staff Courtesy………………
       choices
     • I have the opportunity to make
       suggestion about dining choices             Social/Therapeutic RT…….
                                                    •     Spiritual Care
 Medical Care……………………….                            •     Beauty & Barber Shop
     • Physician Services
                                                   Overall Rating………………
 Nursing Services………………….

       On Target                  Pay Attention         78-             Off Target
     On Target 85% or >                     84%                            <78%
                                                                                     20
                          On Target
     On Target 85% or >
                                                                0
                                                                    0.1
                                                                          0.2
                                                                                0.3
                                                                                      0.4
                                                                                            0.5
                                                                                                  0.6
                                                                                                        0.7
                                                                                                              0.8
                                                                                                                          0.9
                                                                                                                                1




                                               Administrative
                                                 Services


                                              Dining Services
                                                                                                                    Benchmark




                                             Medical Services



                                          Overall Environment



                                            Nursing Services




     84%
                                            Nursing Assistant




                          Pay Attention
                                                Services


                                               Staff Courtesy




                          78-
                                          Social/Therapeutic
                                          Recreation Services


                                               Overall Rating
                                                                                                                                    Overall Survey Results




                                                Best Practice
     <78%
                          Off Target
21
                     Kitchen Resurvey – September 2005

100           Benchmark
 90
 80
 70
 60
 50
         September




                               September




                                                   September




                                                                        September




                                                                                                September




                                                                                                                  September
 40
 30
 20
 10
-
     The food            The food is        The food is                I get               The menu           I have the
   tastes good.         served at the        presented           assistance                 offers           opportunity
                         appopriate         attractively.       w ith my meal             variety and           to make
                        temperature.                             lif I need it.            choices.         suggestions
                                                                                                            about dining
                                                                                                               choices.


                                     **Participants of September Survey include
                                       only those individuals who ranked food
                                       service poorly – those numbers do not
                                     include those who were happy with food in
                                                the prior 6 mo. period




  On Target                                     Pay Attention                       78-                     Off Target
On Target 85% or >                                             84%                                                 <78%
                                                                                                                              22
                        Strategies Needing Improvement

                              Action Plan
  Dining Services
                      •New kitchen – continue to audit
                      and monitor food service options
                      – LT goal to provide more                Anticipated
                      restaurant style services                  Results
Physician Services
                      •Increased physician visibility
                      with 30 minute office visits
                      quarterly & annually               Increased Quality of Life
Beautician Services
                      •Hire Beautician for female hair    Increased Quality Care
                      services & revamp area where                Choice
                      services are provided to be less        More Homelike
                      cramped.
Spiritual Services
                      •Spiritual Survey completed by
                      chaplain. Requests by residents
                      being evaluated and implemented
                      by December 05.
    Call Lights
                      •Audits/monitor call lights with
                      increased staff education




                                                                                      23
Quality of Operations – Jon Clontz
(Washington Veterans Home)



      Budget.…………………....
      Staff Satisfaction Survey..




        On Target      Pay Attention   Off Target




                                                    24
Budget: July – October 2005 BTD
                                          Budget      Actual
Revenue                                  $5,039,250 $5,850,762
Expenses                                 $5,282,614 $5,607,001
                           Profit/(Loss) ($243,364) $243,761

                  General Fund State               $243,346               $63,765
                               NET                     ($18)             $307,526
Notes:
  1 GF-S expenditure level is netted at the alloted level in order to calculate profit or loss.

  2 Program 35-30 profit results in an under expenditure of GF-State.


                FTE Variance            265.63              275.40                     (9.77)

                FTE allocation correction underway
                                                            *   Source: Profit and Loss Reports, DVA Accounting

                                                       Target – balancing operational
                                                       needs, stay within allotments.
                                                                                                              25
                    Expenses
$2,000,000

                                    Budget   Actual




$1,500,000




                                                                                   Revenues
$1,000,000
             JULY     AUGUST   SEPTEMBER     OCTOBER   $2,000,000
                                                                                                                Budget   Actual




                                                       $1,500,000




                                                       $1,000,000
                                                                            JULY        AUGUST      SEPTEMBER       OCTOBER




                                                                    1   Source: Monthly Profit and Loss Reports, DVA Accounting


                                                                                                                                  26
Budget Action Plan
   Continue to monitor expenses and revenues - Monthly
   Continue to conduct A/R reviews – Bi-monthly
   Work with Consonus to promptly identify Part B opportunities and provide
    revenue based care - meeting scheduled for December 20, 2005 to begin
    discussions.
   Audit and monitor MDS process to limit default, enhance RUG and correct
    error before problem occurs - Monthly audit calendar
   Consolidate Commissary and Central Supply location/logistics and draw
    inventory down to 31 days (currently 60) – March 15, 2005
   Continue to develop census through internal/external marketing plans
   Request funding for utilities rate increases – October 2005
   Manage vacation schedules, leave and overtime, creating even shift coverage
    through the year. Managers conduct a weekly labor review and become
    aware timely. Adjustments are made before month end.
   Continue to absorb non funded costs through above actions.

                                                                                  27
Staff Satisfaction Survey
    – Based on Malcolm Baldrige Quality criteria

       10/26                        12/9
     Extended                 All Facility Staff
    Leadership                     Survey
   Team Survey

 Key Opportunities                  Plan            Anticipated
                                                      Results
     Leadership              Results compiled by   Quality
                              12/15                 Improvements
 Strategic Planning
                             Compare to            Baldrige Focus
   Measurement,
                              Leadership Team
Analysis & Knowledge
                              Survey Results
  Teams Formed               Action plans to be
Creating Action Plans         Determined Based
                              on Results



                                                                      28
Veterans Conservation Corps (VCC) - Mark
Introduction to new program
Legislation: SB 5539
   Enacting, Senator Jacobson
   Allows flexibility for WDVA to create the program

The Program
   Serving veterans who are being treated for PTSD. They are isolated in their
    communities and are severely disabled.
   Partnering with PTSD contractors and WDVA staff to find veterans.
   Partnering with Regional Fisheries Enhancement Groups and other habitat
    restoration programs.
   Consulting with Salmon Recovery Funding Board, Department of Fish and
    Wildlife, Department of Natural Recourses, Parks and other state agencies.

Funding ($70,000 per year)
   Administrative Costs
   Looking at possible land trust grant



                                                                                  29
Goals and Results
Goal: 15 veterans enter program per year (05-06).
Results: Currently have 17 veterans in the program (4 months)


Goal: Develop partnerships to support the program
Results: 14 Regional Fisheries Enhancement Groups.
         8 Stream Team Coordinators
         6 Conservation Districts

Goal: Established five geographical areas of focus
Results: Olympia/Tacoma, Aberdeen, Everett, Mt. Vernon/Bellingham, Tri-Cites/Walla Walla


Goal: Assess veteran satisfaction - benefit of the program (informal survey)
Results: All 17 participants were surveyed via telephone and conveyed positive feedback.

Next Steps
   Create a standardized veteran survey by March 06
   Develop performance measures to show success of the program by January 1, 06
   Increase veteran participation to 30 by June 30, 2006
   Explore options for program self-sufficiency.


                                                              Legislative Tour Scheduled for December 9, 2005


                                                                                                                30
2006 WDVA GMAP Schedule
March 6, 2006 – Washington Veterans Home, Retsil

June 5, 2006 – Washington Soldiers Home, Orting

September 5, 2005 – Spokane Veterans Home

December 4, 2006 – Central Office - Olympia




                                                   31

				
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