US. Department
it}, 5; . of Veterans Affairs

Modernizing the

Veterans Crisis Line (VCL)
VHA Member Services

1 6 December 201 6

OBJECTIVE

Prevent Veteran Suicides and Improve Quality of Life

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MASTER
ECD NLT 31 Dec 2016
INTRO TITLE
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to edit
Master
Title
100%
Access
toIntro
VCLSub
Responders

(Eliminate Routine Rollovers to Contract Backup Call Centers)
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U.S. Department of Veterans Affairs
By
Click to edit Author

2

 OIG/GAO - STATUS

OIG Recommendations

Due to OIG

VCL Rec.
to MRS

MRS Rec.
to OIG

Pending New OIG Investigation

1.VCL Responsiveness & Lifecycle of Call-L2H

01 May 16

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EDIT
Clinical
Oversight
MASTER• Training
• Quality
INTRO TITLE

Days to
OIG
185

2. Orientation & Training of all VCL Staff

30 Sep 16

59

3. Silent Monitoring Compliance

01 Jun 16

59

4. Establish Quality Assurance Program

30 Sep 16

59

5. Develop VHA Directive for VCL

01 July 16

185

6. Contractual Improvement Efforts-L2H

01 May 16

185

01 July 16
Click to edit Master Intro
Sub Title

7. Develop Algorithms & Situational Protocol

GAO Recommendations
Click to edit Submitted to

Meeting Pending VCL Rec.
Due to GAO

1. Regularly Test “VCL’sU.S.
TextDepartment
Message System”
of Veterans Affairs

01 Jul 16

2. Development Key Performance
Indicators
By

01 Oct 16

Click to edit Author

3. Call Routing Assessment (VCL vs. Lifeline)

31 Oct 16

4. National IVR Menu Monitoring

01 Jan 17

to MRS

OIG
Closed

59
MRS Rec.
to GAO

Days to
GAO

GAO
Closed

VCL Acting Director collaborating with SAMHSA to complete Recommendation 4 prior to 31 Dec 2016
CL Acting Director collaborating with SAMHSA to complete Recommendation 4 prior to 31 Dec 2016
3

 MAJOR MILESTONES AND ACCOMPLISHMENTS

May 2016
Established
Clinical Advisory
Board (CAB)

Mar 2016
Realigned
organization
from OMHO
to Member
Services

Dec 2016
Feb 2017
Dec 2016
100%
ICMI Survey
Pilot Same Access
Jun 2017
Day Mental
Complete
Same
Jan 2017
Health
Day
Mental
Design /
Health Care
Oct 2016
Implement
1st Atlanta Calls
Employee
Resiliency
Mar 2017
Program
Oct 2016
Call Control
Complete
VAMC
Press 7

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MASTER
INTRO TITLE
Sep 2016
Begin New
Avaya Work
Force
Optimization

8
FY1

Sep 2016
1st Training
Class Atlanta

Apr 2016
Start VAMC
Press 7

Dec 2017
CBOC Rollout
Complete

Click to edit Master
Intro Sub Title
Y17

May 2017
CARF Survey

F

Nov 2016

6
FY1

Dec 2017
Canandaigua Facility
Redesign

Jan 2017
Salisbury
CBOC

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U.S. Department of Veterans
PressAffairs
7
Dec 2016
By
Jul 2016
Initiated
VCL Atlanta
Click
to edit
Author

Implemented MHANYC
Contract
Extension

Expansion

Apr 2016
Implemented Quality
Management Program

Oct 2016
NY Call
Recording

Dec 2016
Atlanta Call
Recording

Mar 2017
CBOC Rollout
Start

Jul 2017
MHANYC
Permanent
Contract

Jul 2017
AAS Survey

Feb 2017
Begin Same
Day Mental
Health

4

 FORTHCOMING ACCREDITATION (GOLD STANDARD)
Commission on Accreditation of Rehabilitation Facilities (Carf)
•

Commitment to quality improvement

•

Focus on the unique needs of each person

•

Monitor the results of services

•

Clearly defined and internationally accepted standards

•

Validate service delivery programs that are performing according to nationally recognized standards

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MASTER
American Association of Suicidology (AAS)
INTRO TITLE

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International Customer Management Institute (ICMI)
•

Increase strategic
Clickvalue
to edit Submitted to

•

Optimize operations

•

Improve service
levels
Click
to edit Author

U.S. Department of Veterans Affairs
By

5

 NO VETERANS CRISIS LINE CALL SHOULD GO UNANSWERED
– PUBLIC LAW 114-247

Revise
Quality Assurance
Document
(ECD 23 Dec)

Develop Plan
(ECD 23 Dec)

Internal
Concurrences

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MASTER
INTRO TITLE

Estimated
Completion Date:
January 2017

Quality Assurance Document

• Clearly defined measurable performance indicators and objectives
• Improve responsiveness and performance of VCL, including back-up centers
• Quantifiable timeframes to meet designated objectives
• Track performance of VCL and back-up centers (indicators and objectives)
Click
toguidance
edit Master Intro Sub Title
• Be consistent
with OMB

Plan
• Ensure each call, chat and text received at VCL and back-up centers is answered by a person in a timely manner,
consistent with AAS
guidance
Click
to edit Submitted to
• Periodic testing ofU.S.
VCL,
including back-up
centers,
during each Fiscal Year - identify/correct problems
Department
of Veterans
Affairs
By Report (QA Document and Plan) by Secretary of VA
Submission of Final
Click to edit Author

• NLT 180 days (26 May 2017) to Committee on Veterans’ Affairs of the House of Representatives and the Senate

6

 RE-START PRESS 7 ROLL-OUT
Phoenix
• 01 Sep

VISN 6, VISN 8
• 13 Oct

(COMPLETION OF VISNS)

Big Springs, Salem
Erie, Long Beach
• 20 Oct

CLICK TO
EDIT
VISN 10, VISN 2
Roll-Out Complete
Rolled-out• 06
159
of
161
facilities
• 20 Oct
Oct
MASTER
- Auto-transfer capability issue
TITLE
•INTRO
Birmingham - CPN
travel issues

Buffalo, Coatesville,
Manchester
• 02 Sep
• Salem
Butler
• 08 Sep

VISN 9, VISN
1 Sub Title
solved
Click to edit Master
Intro
Alexandria R• eVISN 16, Wilmington /
Already Implemented:

• 29 Sep

Click to edit Submitted to
U.S. Department of Veterans Affairs

Wilkes Barre, VISN 7
By
• 15 Sep
Click to edit Author

VISN 17, VISN 5
• 22 Sep

Lebanon (23 May)
• Pittsburgh, Amarillo,
Clarksburg (13 June)
• VISNs 20, 21, 22 (20 June)
• VISNs 23, 18, 19 (27 June)
• VISNs 11, 12, 15 (05 July)

7

 CBOC PRESS 7 ROLLOUT
Objective
• Implement Press 7 functionality within all CBOCs to ensure VCL maintains 100%
access to callers

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• Caller Provider Number (CPN) must travel
MASTER
• Revert Option
functional
• #7 must be utilized
INTRO
TITLE
Completed Tasks
Requirements

Click to edit Master Intro Sub Title

• OI&T Submitted Action Item (AI) into the Veteran Focused Integration Process
Request (VIPR) platform
Pending Tasks Click to edit Submitted to
•
•
•
•

U.S. Department of Veterans Affairs

30 Jan: CBOCs
data suspense date to OI&T
By
Click to edit
Author
25 Jan: Salisbury
rollout
9 - 12 Feb: VISN 23 rollout
Remaining CBOCs rollout (schedule dependent on data submission to OI&T)
8

 PRESS 7 INTERNAL CONTROL TESTING

Member
Services

Compliance
and Internal
Controls
Program
Office

Objectiv
e

Timeline

Scope

CLICK TO EDIT
MASTER
INTRO TITLE

Ensure
VAMC
Sustainment
of Press 7
Click to
Functionality

Testing for Accuracy

08 Dec
Execute
Toll-Free
Test Plan
and local
12 Dec
number
IVR
during duty
Language
Complete
and
nonedit
Master Intro Sub Title
Test Plan
duty hours
Test
Quarterly

Revert
Option

Caller
Provider
Number
(CPN)
Travel

Click to edit Submitted to
U.S. Department of Veterans Affairs

Findings
By
Click to edit AuthorResults available week of 19 Dec 2016

9

 RESPONDER QUALITY AND EXPERIENCE
LEVEL
Component

Classroom Training

Preceptorship

Supervisor Verification

Prior Quality / Experience Level

Current Quality / Experience Level

Training conducted via a SharePoint self-study, atwill module

Must successfully complete a comprehensive
training program:
 A minimum of 81.5 hours of classroom training
 One final knowledge check administered at the
end of classroom training

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MASTER
INTRO TITLE
 Listened to and took calls with a preceptor
 No minimum expectation for hours of
preceptorship
 Progress of employees was not tracked

 A minimum of 24 hours listening to calls with
a preceptor (~30 calls)
 A minimum of 56 hours answering calls
monitored / coached by a preceptor (~70 calls)

 Supervisor listened to/monitored live calls
 No standard process for failure of monitored
calls
 No standardized continuous training - at
discretion of trainee’s supervisor.

 Supervisor listens to/monitors live calls
 Must pass one call successfully based on
specific, standardized criteria to work
independently
 If unsuccessful, trainee continues
preceptorship until passing 3 core monitors

 No
formalized
process
Click
to edit
Submitted
to to monitor quality and
appropriateness
U.S. Department of Veterans Affairs

 New responders are monitored 10 times
during first 90 days of working independently
 Seasoned / legacy responders are monitored
~6 times every 90 days

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 Supervisors monitored approximately 50
(Ongoing Silent Monitoring) By calls/month
Click
to edit
Author
 No
minimum
expectation for number of monitors
for trainees
Quality Assurance

10

 P144 MILESTONES (25 JULY 2016)
Hire 209

• Aug

Start Press 7 (01 Sep)

Responde •
19 Sep
r Class
(n = 46, 3 Resign)
1, 2

39/43
39/43
Cleared
Cleared

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MASTER
INTRO TITLE
Responde
r Class
3, 4, 5

38/56
38/56
Cleared
Cleared

15/42
15/42
Cleared
Cleared

• 03 Oct
(n = 58, 2 Resign)

First Atlanta Calls (10 Oct)

Responde •
17 Oct
r Class
(n = 42)
6, 7

Responde
r Class
8

Complete Press 7 (20 Oct)

Oct
Click to edit Master Intro• 31
Sub
(n
= 17, 1Title
Resign)

Click to edit Submitted to
U.S. Department of Veterans Affairs

Responde
r Class
9

Click to edit Author

Canandaigua: 115
Total: 324

(CAO 15 Dec 2016)

Nov)
• 14 Nov
(n = 23, 1 Resign)
Responde
• 28 Nov
r
Class
(n = 23)
10

# Responders HiredBy(Member Services)
Atlanta: 209

myVA311 (11

Next Class
09 Jan 17

100%
Access

• NLT 31 Dec 16

11

 VCL ATLANTA CALLS

ge
Avera y
Da
Calls/ /14)
0-12
(10/1

Daily

Week

CLICK TO EDIT
319 MASTER
INTRO TITLE

Month

Quarter

12/14

12/11 - 12/14

12/1 - 12/14

10/1 - 12/14

Calls Handled

604

2,525

8,453

18,899

Avg. Handle Time

27:24

26:10

26:48

25:40

• Member Services AVAYA Data

Click to edit Master Intro Sub Title

Progressive Click to edit Submitted to
17 Oct – 12 Nov:
10 Oct – 14ofOct:
Veterans Affairs
7:00am – 12:30am
Atlanta Hours U.S. Department
8:00am – 11:00am
(No Weekends)
of Operations
By
Click to edit Author

13 Nov – 27 Nov:
7:00am –
12:30am
(Includes Weekends)

27 Nov:
24/7 Operations

12

 PROJECTED VS ACTUAL
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2,000
0

16 /23 /30
7/
7
7

CLICK TO EDIT
MASTER
INTRO TITLE
6
3
0
7
8/ 8/1 8/2 8/2

3
0
7
4
1
8
2
5
2
3
4
5
9
9
6
0
7
1
9/ 9/1 9/1 9/2 10/ 10/ 0/1 0/2 0/2 11/ 1/1 1/1 1/2 12/ 2/1 2/1 2/2 2/3
1
1
1
1
1
1
1
1
1
1

Click to edit Master Intro Sub Title
Projected Volume/Week

•

NLT
31 Dec

Projected Calls Answered

L2H being used
until
Avaya
re-queuing
data corrected
Click
to edit
Submitted
to
U.S. Department of Veterans Affairs

Date

Jan
2016

Feb
2016
By

Mar
2016

Rollovers

13,901

15,692

12,895

%

31.9%

36.6%

29.3%

Apr
2016

May
2016

June
2016

July
2016

Aug
2016

Sep
2016

Oct
2016

Nov
2016

Dec
2016

14,296

13,864

13,382

11,112

10,496

14,053

18,231

14,777

3,904

32.9%

29.1%

27.6%

24.0%

21.6%

28.8%

35.9%

30.1%

15.4%

Click to edit Author

13

 ACCESS IMPROVEMENTS (2015 VS 2016) AVERAGES

November 2015

November 2016

December 2016
(To-Date)

Daily Emergency
Dispatches

30 (3.14%)

45 (3.97%)

774

Daily Referrals to SPC

210 (22.17%)

274 (24%)

332 (23%)

Daily Calls Answered

945

1,143 (+20.95% Increase)

1,430 (+51.32%)

Daily Calls Offered

1,385

1,702 (+22.89% Increase)

1,775

 DAILY ACTIVITY REPORT
Sat
12/03

Sun
12/04

Mon
12/05

Tue
12/06

Wed
12/07

Thu
12/08

Fri
12/09

Sat
12/10

Sun
12/11

Mon
12/12

Inbound

1,470

1,418

1,937

1,797

1,718

1,806

2,018

1,686

1,540

2,075

Offered

1,417

1,365

1,846

1,684

1,624

1,708

1,930

1,619

1,493

1,966

Answered

1,054

971

1,570

1,525

1,551

1,487

1,652

1,366

1,262

1,607

Rollover

363

394

276

159

73

221

278

253

231

359

9.44%

4.50%

9.05

9.39

Rollover %
Average Speed
of Answer (Secs)
VCL
Average Speed
of Answer (Secs)
Backup Centers
Responders
Cleared
Request for
Emergency
Dispatch of
Services

25.62% 28.86% 14.95%
9.18

9.16

8.91

(11/28/16 - 12/4/16):

2-1-1 Lifeline:
12

12.94% 14.40% 15.63% 15.47% 18.26%
9.35

9.13

Line for Life:
59

9.37

9.37

8.98

Switchboard of Miami:
137

0

2

6

3

3

6

1

1

0

1

57

51

69

56

63

50

53

60

51

51

Report included in daily briefing to Dr. Stone

 COORDINATE IMMEDIATE MENTAL HEALTH ACCESS FOR
CALLERS

CLICK TO EDIT
MASTER
INTRO TITLE
Click to edit Master Intro Sub Title

02 Dec 16:
Pilot CTX
VAMC

15 edit
Jan Submitted
17:
Click to
to
Nationwide
U.S. Department of Veterans Affairs
Rollout (est)

By
Click to edit Author

01 Jan 17:
Results /
Lessons
Learned

31 May 17:
Complete
Rollout (est)
16

 WEEKLY CLINICAL ADVISORY BOARD
CAB Outcomes
CAB 30 Nov:

•

SAMHSA is working on obtaining signatures to complete
Interagency Agreement with VA
Group consensus among CAB members on the call that
VCL provides a clinical service
Reviewed CAB charter/attendance

•
CLICK
TO EDIT
•
MASTER
• Preliminary
planning for a CAB retreat in ATL or CAN for
INTRO
TITLE
1/31/16. Potential agenda topics include innovations in
CAB 07 Dec:

monitoring,
of CAB
in supporting Military Crisis
Click to edit quality
Master
Introrole
Sub
Title
Line, and Responder Resilience/Wellness.

Click to edit Submitted to
U.S. Department of Veterans Affairs
By
Click to edit Author

Planning for face-to face CAB Suicide Prevention Strategy Session – 31 Jan 2017

17

 VCL RIBBON CUTTING – MEMBER SERVICES ATLANTA
CAMPUS
Schedule of Events
8:50am Meet & Greet
9:00am VCL Leadership Briefing
10:00am Meet with VCL Training Class Participants
11:30am VCL/MS Leadership Briefing
12:30am Stakeholder Meeting

Dr. Rajeev Ramchand
Johnny Isakson
James Wright

1:15pm Ribbon-Cutting Ceremony / Media Event
2:30pm Depart

General Mark Graham

CLICK TO EDIT
MASTER
INTRO TITLE

10:45am VCL Facility Tour

1:00pm Media Prep

Sloan Gibson
Dr. Richard Stone

Attendees
Deputy Secretary
Principal Deputy Undersecretary for Health
Senior Director, Rutgers UBHC National Call
Center & Director, Vets4Warriors
Senior Behavioral and Social Scientist, RAND
Corporation
U.S Senator (R-Ga); Chair – Senate Ethics
Committee and Senate Veterans’ Affairs
Committee
Public Health Advisor, Substance Abuse and
Mental Health Services Administration
Congressman
Congresswoman
Congressman
Congressman
Congressman
Congressman
American Legion*
Military Order of the Purple Heart*
Disabled American Veterans*
American Veterans (AMVETS)*
Veterans of Foreign Wars of the US*

Sanford Bishop*
Lynn Westmoreland*
Henry Johnson*
John Lewis*
Tom Price*
David Scott*

Click to edit Master Intro Sub Title

VSOs
Click to edit Submitted to
U.S. Department of Veterans Affairs

20 Dec
2016

By
Click to edit Author

*Tentative Attendance
18