1.1: Services to Veterans with Disabilities

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.

Other Information:

Purpose and Outcomes: VA is committed to maintaining its leadership role in medical services for conditions uniquely related to veterans’ health. The purpose of this objective is to maximize the functional status of veterans with disabilities within the limits of each veteran’s illness or injury. Providing for the specialized health needs of veterans is an integral component of VA health care. Due to the prevalence of certain chronic and disabling conditions among veterans, VA has developed strong expertise in certain specialized services that are not uniformly available in the private sector. For the purposes of this document, VA has designated the programs in the following eight areas as its special emphasis programs that focus primarily on restoration: • Spinal Cord Injury; • Blindness; • Traumatic Brain Injury; • Amputation; • Post Traumatic Stress Disorder; • Serious Mental Illness; • Homelessness; and • Substance Abuse. VA remains firmly committed to meeting the needs of veterans who have come to rely on us for these special emphasis programs. This includes VA’s coordination of health care and other benefits in a manner that enhances the likelihood of restoration of an individual veteran to wholeness. For example, a veteran suffering a catastrophic injury or illness should expect that VA will focus on his or her immediate needs as well as on the coordination of all benefits, including research and other rehabilitation benefits that have the highest likelihood of optimizing his or her life functioning over time. Strategies and Processes: VA will be the leader in understanding and providing restoration services that are uniquely related to veterans’ health. Although VA has undergone a significant transformation over the past 5 years, with an increased focus on providing outpatient care in ambulatory clinic settings, we remain committed to providing the best possible specialized health care services. VA will establish and use Centers of Excellence for research and treatment of illnesses and disabilities related to special populations. For example, VA recently established two Centers of Excellence to develop new therapies for veterans with spinal cord injuries. The centers will explore the use of pharmaceuticals to treat secondary disabilities of spinal cord injury and will study pain management, recovery of motor and sensory function, and other related issues. VA will maximize the independent functioning of veterans in the least restrictive setting. We will improve and enhance home care services and develop an assisted living strategy. The use of care management to facilitate care in the least restrictive and most efficient setting will be promoted. For example, VA’s specialized homeless treatment program will strive to restore patient function through: aggressive outreach to veterans living on the streets and in shelters; clinical assessment and referral to needed medical treatment for physical and psychiatric disorders; long-term sheltered transitional assistance, case management, and rehabilitation; employment assistance and linkage with available income supports; and supported permanent housing. Access to Blind Rehabilitation Services is currently being evaluated. The Visual Impairment Advisory Board is addressing alternative settings for providing services, including expanding outpatient capacity through a number of programs including providing some services in the home and shifting some computer access training from an inpatient setting to an outpatient setting. These and other initiatives will significantly reduce waiting times for veterans to be admitted to one of the Blind rehabilitation programs. VA will provide coordinated, comprehensive, and integrated care to promote health and improve patient functioning. Variability of health outcomes will be reduced by providing for a more consistent delivery of services. VA will optimize the use of telehealth care information and technology for the benefit of the veteran by accelerating the development of the Health Data Repository, HealtheVet, and telehealth initiatives. VA will continue to implement a comprehensive program of education and outreach in the area of preventive medicine. We will proactively reach out to veterans who participate in VA’s special emphasis programs to ensure that they are informed about the importance of receiving screening for illnesses such as influenza, Pneumococcal pneumonia, and various forms of cancer. We will also provide information and counseling services regarding tobacco consumption and alcohol and substance abuse. In addition, VA will ensure the consistent delivery of health care by implementing standard measures for the provision of preventive care. The prevention measure includes several indicators that allow comparison of VA and private health care outcomes. The Prevention Index II is a secondgeneration composite measure comprised of nine disease or health factors that measure how well VA follows nationally recognized primary prevention and early detection recommendations that determine health outcomes. The indicators within the Index include screening for influenza, Pneumococcal pneumonia, tobacco consumption, alcohol abuse, breast cancer, cervical cancer, colorectal cancer, prostate cancer, and cholesterol levels. This improved prevention measure includes additional diagnoses. Crosscutting Efforts in Health Care VA has a vast number of sharing agreements with the Department of Defense (DoD) that result in both increased access to, and quality of, medical care for recently separated military personnel and veterans. The sharing agreements with DoD provide access to care for key subgroups of current and recently separated military patients for conditions such as spinal cord injury and acute traumatic brain injury. In addition, collaboration and sharing of information assists both agencies in providing care to other special populations such as those with Gulf War illnesses and those in need of prosthetic services. VA and DoD will identify Centers of Excellence where specialized services can be made available to eligible beneficiaries. VA will continue its partnership with HUD and community organizations to enhance home care services and develop an assisted living strategy. Special Emphasis Areas Increase score on the Prevention Index II for emphasis areas 74% 85% Substance Abuse Increase the percent of patients entering substance abuse treatment who maintain continous treatment involvement for at least 90 days 35% 65% External Factors: Improvements in the overall health in special emphasis areas will be affected, in part, by constituencies who influence these programs as well as by other government agencies and private interest groups.

Indicator(s):

Indicator:1

Content