North Dakota
and the
U.S. Department of Veterans Affairs

• General:  The Department of Veterans Affairs (VA) offers a wide variety of programs and services for the nation’s 24.3 million veterans.  In 2006, about 5.3 million people were treated in VA health care facilities, 3.6 million veterans and survivors received VA disability compensation or pensions, nearly 600,000 used GI Bill education benefits and more than 2.4 million owned homes purchased with GI Bill home loan benefits originally valued at $236 billion.  More than 100,000 veterans and family members were buried in VA’s national cemeteries and nearly 360,000 headstones and markers were provided for veterans’ graves worldwide.

VA spent nearly $207 million in North Dakota in 2006 to serve about 53,000 veterans who live in the state.  That same year, 10,105 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in North Dakota.  VA provided 1,811 veterans, reservists or survivors education benefits through the GI Bill; 4,933 owned homes with active VA home loan guarantees originally valued at $148 million.  North Dakota veterans held more than 4,000 VA life insurance policies worth $44 million.

• Health Care:  One of the most visible of all VA benefits is health care.  VA has 153 hospitals, 895 ambulatory care and community-based outpatient clinics, 209 Vet Centers, 135 nursing homes, 47 residential rehabilitation treatment programs and 92 comprehensive home care programs.  To improve patients’ ability to access care, VA has changed from a hospital-based system to a primarily outpatient-focused system over the past decade.  Veterans will make 55 million outpatient visits to VA health care facilities this year.

In North Dakota, VA operates a major medical center in Fargo and outpatient clinics at Williston, Grafton, Bismarck, and Minot.  In fiscal year 2006, VA facilities in North Dakota had 1,905 inpatient admissions and provided 152,946 outpatient visits.  The Fargo medical center serves veterans in North Dakota, northwestern Minnesota and northeastern South Dakota.  Primary and secondary medical, surgical, and psychiatric services are provided in the hospital along with a 50-bed transitional care unit.  Affiliated with the University of North Dakota School of Medicine, the medical center supports residencies in internal medicine, surgery and psychiatry.  The medical center participates in sharing agreements with private vendors and other federal health care providers.

• Post-Conflict Care:  VA has launched special efforts to provide a "seamless transition" for those returning from service in Operations Iraqi Freedom and Enduring Freedom (OIF/OEF).  Each VA medical facility and benefits regional office has a point of contact to coordinate activities locally to help meet the needs of these returning combat service members and veterans.  In addition, VA increased the staffing of benefits counselors at key military hospitals where severely wounded service members from Iraq and Afghanistan are frequently sent.  Once home, recent Iraq and Afghan veterans have ready access to VA health care, which is free of charge for two years following separation for any health problem possibly related to wartime service.  Some 205,000 veterans from the Global War on Terror have sought VA health care since returning stateside, about one-third of the total number of men and women leaving military service.

In North Dakota, more than 1,500 active duty service members and veterans of the Global War on Terror sought VA health care in 2006.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Bismarck, Fargo and Minot.  These community-based Vet Centers serve as an important resource for veterans who, once home, often seek out fellow veterans for advice or help transitioning back to civilian life.

• Geriatric Care:  Long-term care is a critical issue for America’s veterans.  Approximately 39 percent of living veterans are at least 65 years, compared with 12 percent of the general population.  The challenge to care for these 9.5 million men and women is met through a spectrum of home and community-based programs such as home-based primary care, homemaker and home health aide services, home respite and hospice and adult day care health.  VA also provides home and domiciliary care for veterans who can no longer be safely maintained in non-institutional settings.  Additionally, VA conducts nationwide research on the causes and treatment of Alzheimer’s disease and other dementias and funds 21 geriatric research, education and clinical centers, each focusing on a major geriatric problem.

In North Dakota, 17,297 veterans 65 and older received medical care from VA in 2006.  The VA Medical and Regional Office Center at Fargo has a 50-bed restorative care unit for rehabilitation, recuperation, hospice and respite services.  Additionally, VA provides skilled nursing, physical and occupational therapy, homemaker, home health aide and in-home hospice care.  VA North Dakota provides referrals to contract nursing homes, residential care and assisted living, and partners with the community for adult day-health care when available.

• Research:  To provide the highest quality of health care to the nation’s veterans, VA sponsors a world-renowned research and development program that addresses some of the most difficult challenges facing medical science today, such as aging, vision loss, women’s health, Gulf War illnesses, diabetes, bioterrorism and hepatitis. VA researchers led the way in developing the cardiac pacemaker, the CT scan, magnetic source imaging and improving artificial limbs.  More recently, injuries sustained by armed forces engaged in current deployments have further increased the long-standing emphasis on VA research on limb loss; prosthetics and tissue replacement; traumatic brain injury; spinal cord injury; and mental health issues including post-traumatic stress disorder.  The quality of the research and relevance to the veteran population remain the determining factors in deciding what studies to fund.

The Fargo VA has a research coordinator and received nearly $57,000 in VA research funding in 2006.

• Disabilities and Pensions:  Not all military service related issues end when people are discharged from active duty.  About 2.7 million veterans receive monthly VA disability compensation for medical conditions related to their service in uniform.  VA pensions go to about 330,000 wartime veterans with limited means.  Family members of about 527,000 veterans qualify for monthly VA payments as the survivors of disabled veterans or pension recipients.

VA's Fargo VA Medical and Regional Office Center serves veterans and their survivors in North Dakota who are seeking VA financial benefits.  In fiscal year 2006, the Fargo VAMROC processed 3,172 disability compensation claims, including 1,162 veterans applying for the first time and 2,010 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 600 North Dakota veterans participated in VA’s Vocational Rehabilitation and Employment program in 2006.

• Homeless:  Less than one-quarter of all homeless adults are veterans, and many more veterans who live in poverty are at risk of becoming homeless.  VA is the only federal agency that provides substantial hands-on assistance directly to the homeless.  It has the largest network of homeless assistance programs in the country.  Nearly 16,000 residential rehabilitative, transitional and permanent beds are available for homeless veterans throughout the country.  VA aggressively reaches out to veterans on the street, conducts clinical assessments, offers needed medical treatment, and provides long-term shelters and job training.  More than $265 million is dedicated to specialized homeless programs to assist homeless veterans, including grants and per diem payments to more than 400 public and non-profit groups.

Since 1994, VA’s programs for homeless veterans have assisted thousands of veterans in North Dakota.  Initiatives outside of Fargo include outreach, case management and community-based residential care. Fargo works with community organizations to sponsor standdowns, where homeless veterans and their families receive help with housing, health care, employment, legal issues and other barriers that prevent them from joining the social mainstream.  Standdowns give veterans a safe place to begin treatment and the journey out of homelessness.

• Memorial Affairs:  Most men and women who have been in the military are eligible for burial in a national cemetery, as are their dependent children and usually their spouses.  VA manages the country’s network of national cemeteries with more than 2.9 million gravesites at 125 national cemeteries in 39 states and Puerto Rico, as well as in 33 soldier’s lots and monument sites.  In 2007, more than 100,000 veterans and dependents were buried in VA's national cemeteries.  Additionally, VA provided more than 359,000 headstones and markers and 423,000 Presidential Memorial Certificates to the loved ones of deceased veterans.  VA-assisted state veterans cemeteries provided more than 23,000 interments.

North Dakota has no national cemeteries.  A state veterans cemetery at Mandan, near Bismarck, conducted 344 burials in 2006.  VA provided 1,360 headstones and markers for the graves of veterans in North Dakota and provided 861 Presidential Memorial Certificates to North Dakota survivors of veterans.