1. FHCC Lovell: Joint Venture Review 2010 VA/DoD Joint Venture Conference We have Liftoff! The Captain James A. Lovell Federal Health Care Center The 1 st of its kind DOD/VA Medical Facility Demonstration Project CAPT David Beardsley, MC, USN, Deputy Director Marianne Semrad, Associate Director, Facility Support Ver. 3

2. FHCC Lovell: Joint Venture Review 2 New Initiatives – Projects Closed IDENTIFY ALL NEW INITIATIVES OVER THE PAST YEAR: 1. ACTIVATION OF THE CAPTAIN JAMES A. LOVELL FEDERAL HEALTH CARE CENTER 2. Transfer of Function (approx 500 civilians) 3. IM/IT – Single Patient Registration, Medial Single Sign On (MSSO), Orders Portability (Pharmacy, Lab, Rad, Consults) 4. New state-of –the-art 37-bed inpatient ward 5. TRICARE Co-payment waiver IDENTIFY ANY PROJECTS OR EFFORTS THAT WERE CLOSED OR FAILED IN THE LAST YEAR: 1. Finalized the local VA/DoD Joint Incentive Fund Programs (Closed) 2. Executive Agreement (EA) signed by the Secretaries of Defense and Veterans Affairs on April 26, 2010 (Closed) 3. Resource Sharing Agreement (while under CRA in FY11) (Closed) 4. Stood up the FHCC Advisory Board & Stakeholder Councils (Closed)

3. FHCC Lovell: Joint Venture Review 3 Joint Venture Performance Measures PMs USED TO TRACK JV SUCCESS: 1. Patient satisfaction measures meet VA and DoD benchmarks 2. Maintenance of Medical Individual Accounts for Recruits at less than five percent; maintain Training Center Support Students Not Under Instruction (NUI) for medical reasons at less than two percent; Individual Medical Readiness –indeterminate status for active duty less than five percent 3. Stakeholders Advisory Council determination that the FHCC meets both DoD and VA missions 4. Successful annual Comptroller General review. 5. Validation of fiscal reconciliation report by annual independent audit. DATA SOURCES USED FOR THE PMs: 1. VA Component -SHEP questionnaires / BUMED Patient Satisfaction survey 2. CeTARS report 3. Percentage of patient issues addressed and closed to the satisfaction of the Advisory Council. 4. Comptroller General would make clearly defined data requests of various facility operations, including, but not limited to, fiscal, human resources, performance improvement, and business operations. 5. This benchmark is only a placeholder for a mutually accepted measurement. OUTCOMES FOR EACH PM LISTED: 1. Inpatient satisfaction: 64% / Outpatient satisfaction: 56% 2. Students not under instruction (NUI) for medical reasons 0 - 1% 3. The target will be to have no more than 15 patient care issues per quarter. 4. Fully acceptable implementation progress with no negative effect on provision of care and/or facility operation 5. The independent audit will be based on pass or fail

4. FHCC Lovell: Joint Venture Review 4 Joint Venture Performance Measures PMs USED TO TRACK JV SUCCESS: 6. VA clinical and administrative performance measures exceed mean for all VA Medical Centers. 7. Meet all access to care standards in a three-year period. 8. Evidenced Based Health metrics meet/exceed VA/DoD Benchmarks 9. Officer promotion/retention and enlisted advancement/retention meet or exceed Navy means. 10. IM/IT implementation timeline met and no negative impact on Patient safety. DATA SOURCES USED FOR THE PMs: 6. Clinical data, Clinical access data & Administrative data 7. VA Primary Care component / DoD Primary Care component 8. VA component / DoD component 9. Officer & Enlisted 10. IM/IT issues will be considered as a potential etiology during the evaluation of all documented patient safety concerns. OUTCOMES FOR EACH PM LISTED: 6. FHCC mean score of passing measures to exceed National mean. 7. Percent of Unique Patients on the Access List Waiting more than 30 days from Desired Date / Number of eligible members in the population appointed to DOD Primary Care meeting ATC standards 8. Percent of VHA measures passing target / Percentage of MTF enrollees, age 5–56, with persistent asthma who are prescribed medications considered acceptable as a primary therapy for the long-term control of asthma. 9. Advancement & Retention goals met or exceeded 10. As the ultimate goal is delivery of safe patient care utilizing a series of new computer solutions, any impact on patient safety in unacceptable.

5. FHCC Lovell: Joint Venture Review 5 Joint Venture Performance Measures PMs USED TO TRACK JV SUCCESS: 11. Staff satisfaction measures meet VA and DoD benchmarks 12. RVU/RWP/DWV production meets Business Plan targets. 13. Maintain pre FHCC academic and clinical research missions 14. Satisfactory clinical and facility inspection outcomes from external oversight/accreditation groups 15. Trainee Satisfaction as measured by the Learner Perception Survey. DATA SOURCES USED FOR THE PMs: 11. VA component / DoD component (VHA all-employee survey / Defense Equal Opportunity Management Institute (DEOMI) Organizational Climate Survey (DEOCS) 12. Inpatient and outpatient workload will be input into either CHCS or VISTA at the time the medical care is documented. 13. Research / Academic Affairs – Medical Resident Supervision & Associated Health Supervision 14. Each accrediting body has their own specific indicators as listed in their manuals 15. A validated questionnaire, mailed by VACO to trainees registered at VA facilities nation-wide. OUTCOMES FOR ACH PM LISTED: 11. While 100% staff participation is encouraged, the target minimal participation rate is 40%. 12. The FHCC RVU, RWP, and DWV production will be measured against the targets set in the annual FHCC Business Plan 13. The quality of health care, veteran safety, and the success of the educational experience are inexorably linked and mutually enhancing. 14. Number of Non-Compliance cases found compared to the number of Non-Compliance cases reported. 15. National Performance Measure: Learners are asked to rate their current training experience on a scale of 0 – 100 where 70 is passing. The target is 85 or better.

6. FHCC Lovell: Joint Venture Review 6 Access to Military Installation Procedures REQUIRED ACCESS PROCESS and POLICIES FOR FHCC BENEFICIARIES and/or EMPLOYEES TYPE OF VISITOR ID BADGE* PRIOR COORDINATION VA APPOINTMENT DOCUMENTATION / VERIFICATION VISITOR CENTER FHCC LOVELL EMPLOYEE FHCC IDYes Memo to Base Security 1X FHCC LOVELL PATIENT Yes No FHCC LOVELL PATIENT ESCORT ADSMNo FHCC LOVELL PATIENT VISITOR N/A * Enter Type of ID Required: ( DoD, DVA, GOVT, State, Post or Base)

7. FHCC Lovell: Joint Venture Review 7 Access to Care and Referral Management ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT: ACCESS ANTICIPATED TO REMAIN STATUS QUO. THE FHCC MAY SERVE ALL ELIGIBLE BENEFICIARIES. Medical emergencies will be given treatment preference. IN THE CASE OF RESOURCE RESTRAINTS, Patient Priority is as follows: 1. Members of the Armed Forces on Active Duty (as authorized by the NDAA 2010, § 1705(b)(1)), 2. All enrolled Veterans and non-Veteran VA beneficiaries and TRICARE Prime enrolled Active Duty dependents 3. TRICARE Prime enrolled retirees, their dependents and survivors, 4. TRICARE Standard Active Duty dependents, 5. TRICARE Standard retirees, their dependents, and survivors (including TRICARE for Life beneficiaries ANCACI/NACI and issues regarding foreign national residents RESOLUTIONS TO ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT:

8. FHCC Lovell: Joint Venture Review 8 Future Initiatives and/or Proposals NEAR TERM (1-2 YEARS) INITIATIVES: 1. Activation of new Inpatient Med/Surg Ward (November 2010) 2. Implement an information system that safely integrates VA and DoD legacy systems in an integrated VA/DoD facility with multiple care locations 3. Resident Green Houses (State-of-the-art, self –contained houses for Veterans) 4. GAO and other Congressional over site 5. Pharmacy & Consults Orders Portability LONG TERM (>2 YEARS) GOALS / INITIATIVES / STRATEGIES: 1. Cardiac Cath Lab Suite 2. GI Suite 3. Authorization to a permanent status VS 5-year demonstration project 4. GAO and other Congressional over site

9. FHCC Lovell: Joint Venture Review 9 Dedication Ceremony Oct 1, 2010

10. FHCC Lovell: Joint Venture Review 10 Dedication Ceremony Oct 1, 2010

11. FHCC Lovell: Joint Venture Review QUESTIONS? Readying Warriors and Caring for Heroes