Search

The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans’ health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA’s) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans’ demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth.

The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans’ health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade.

The purpose of this study was twofold: (1) to determine the efficacy of the Leveled Literacy Intervention program (LLI) in increasing reading achievement for K-2 students and (2) to examine LLI program implementation fidelity. This study evaluated LLI in two U.S. school districts and used a mixed-method design to address the following key research questions: "what progress in literacy do students who receive LLI make compared to students who receive only regular classroom literacy instruction?" and "was LLI implemented with fidelity to the developers' program model?" Five elementary schools in the Tift County School District (TCS) in Tifton, Georgia, and four elementary schools in the Enlarged City School District of Middletown (ECSDM) in Middletown, New York, volunteered to participate in the study. A total of 28 LLI teachers and 125 classroom teachers across both districts participated in this study. The findings of this evaluation indicate that LLI combined with regular classroom instruction can positively impact student literacy achievement to a greater degree than classroom instruction alone for K-2 students who are struggling with reading and writing. ELL and special education students can also benefit from the LLI program, some with strong, educationally significant effects. Robust effects were found on the LLI Benchmarks across all grade levels for students who received LLI. Students in LLI achieved between 1 1/2 benchmark levels up to almost 5 1/2 benchmark levels while students who did not receive LLI achieved between less than 1 benchmark level up to about 3 benchmark levels. Students in LLI also finished on par with grade-level goals. Further, because the majority of students in the study were economically disadvantaged, the findings indicate that the LLI program is effective with this high-risk population. However, the current study is limited in generalizability to rural and suburban populations, as well as those economically disadvantaged. The efficacy of the LLI program has important implications for schools and districts with limited resources and time available for early reading interventions. LLI's short-term, small-group format allows a greater number of struggling students to achieve grade-level competency within a shorter period of time. LLI's success with early learners also demonstrates its potential for reducing the development of chronic, long-term reading deficiencies and academic problems. Given the positive potential of the LLI program, future research is warranted in this area. Specifically, additional studies should be conducted in urban areas, and longitudinal tracking should be utilized to determine the long-term impact of LLI on students' literacy development. (Contains 13 tables.).

Accompanied by a CD-ROM.

Get solid career advice from successful businesswoman and former Trump Organization executive and costar of The Apprentice in this New York Times bestseller that shows how to take your career to the next level. Known for her cool demeanor and her no-holds-barred assessments of the candidates in the boardroom on The Apprentice, Carolyn Kepcher co-starred with Donald Trump on the hit reality television show for five seasons. Here, in Carolyn 101, she reveals the secrets of her own success and provides readers with guidance for their professional lives. By looking at the types of people most often encountered in the workplace, she illustrates her advice with examples from her career—largely within The Trump Organization—showing readers how to: • ace an interview • ask for a raise or promotion • maintain a healthy balance between work and home life • deal with a difficult boss • spot and seize potential business opportunities • dress for success • be a strong team member or team leader Inspirational to both recent college graduates entering the workforce for the first time as well as seasoned employees looking to distinguish themselves, Carolyn 101 shows ambitious professionals what they need to do to get ahead and take their careers even further than they had imagined.