California
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.  About 97,000 veterans and family members were buried in VA’s national cemeteries and 335,000 headstones and markers were provided for veterans’ graves worldwide.

California has the largest number of veterans of any state.  In 2006, VA spent more than $6.1 billion in California, where some 2.2 million veterans live.  That same year, 291,824 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in California.  VA provided 46,434 veterans, reservists or survivors education benefits through the GI Bill; 160,491 owned homes with active VA home loan guarantees originally valued at $5.4 billion.  California veterans held more than 151,000 VA life insurance policies valued at nearly $1.8 billion.  In 2006, 14,090 interments were conducted in California's seven national cemeteries.

• Health Care:  One of the most visible of all VA benefits is health care.  VA has 153 hospitals, 881 ambulatory care and community-based outpatient clinics, 207 Vet Centers, 136 nursing homes, 45 residential rehabilitation treatment programs and 92 comprehensive home care programs.  Due to technology and national and VA health care trends, 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 California, VA operates major medical centers in Loma Linda, Long Beach, Los Angeles, San Diego, which comprise the Desert Pacific Healthcare Network, and in San Francisco, Palo Alto, Sacramento and Fresno, which comprise the Sierra Pacific Network.

In fiscal year 2006, VA facilities in the Sierra Pacific Network had more than 1.9 million outpatient visits and 21,000 inpatient admissions.  Facilities in the Desert Pacific Healthcare Network had nearly 2.9 million outpatient visits and more than 32,300 inpatient admissions.

VA California provides a full range of medical services, including acute medical, surgical, psychiatric and nursing home care.  Specialty units at most medical centers offer veterans cardiac catheterization, lithotripsy, clinical pharmacology, MRI, PET scanning, radiation therapy, women’s health programs, and treatment for spinal cord and traumatic brain injuries, post-traumatic stress disorders and blind rehabilitation.  The medical centers are augmented by 50 community outpatient clinics located throughout the state.  These clinics offer a full array of primary care services for veterans in the communities where they live and work.

Each medical facility is affiliated with at least one major medical school (University of California, San Francisco, Davis, Irvine, San Diego and Los Angeles; Stanford University; University of Southern California and Loma Linda University) and provides training for more than 4,000 students annually in nursing, dentistry, dietetics, audiology and speech pathology, medical technology, radiation technology, pharmacology, podiatry, psychology, physical and occupational therapy and social work.  The San Francisco VA Medical Center (VAMC) is the site of the VA pacemaker and defibrillator monitoring program of the western United States.  The hospital also has an intensive care unit.

The Center of Quality Management in Public Health, located at the Palo Alto medical center, is a national program responsible for developing and maintaining VA’s national disease case registries and develops quality management tools to improve public health activities throughout VA.  Additionally, the Palo Alto VA Health Care System was designated one of VA's four polytrauma centers caring for active duty service members injured in Iraq and Afghanistan.

The Greater Los Angeles and San Francisco medical centers are national VA Parkinson’s Disease Research, Education and Clinical Centers.  San Francisco was the first VA facility to conduct deep brain stimulation procedures to control the devastating effects of Parkinson’s movement disorders.

The Palo Alto, San Diego, Greater Los Angeles and San Francisco medical centers excel in the quality of health care delivered to veterans and have been awarded VA national centers of excellence in a wide variety of specialty programs: cardiac surgery, human immunodeficiency virus, post-traumatic stress disorder, epilepsy, renal dialysis, spinal cord injury, autopsy, comprehensive medical rehabilitation and domiciliary care for homeless veterans.  The Palo Alto medical center is home to the National Center for Post Traumatic Stress Disorder (PTSD) and is one of only two in the nation that offers an inpatient women’s PTSD program.  San Diego was also designated a center of excellence in PTSD.  Long Beach is the site for the largest spinal cord injury (SCI) unit in the VA, providing specialized acute and rehabilitative care to veterans throughout the western United States.  SCI centers are also located in San Diego and Palo Alto. The San Francisco VAMC has increased use of telemedicine providing specialty services to outlying community based outpatient clinics.

• 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 California, more than 13,000 active duty service members and veterans of the Global War on Terrorism have sought VA health care.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers at 21 locations throughout the state.  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.  VA Long Beach and Greater Los Angeles facilities have opened “seamless transition centers” within their hospitals to help returning veterans navigate VA’s benefits and health care systems and connect them with the resources they need.

• 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 California, more than 270,000 veterans aged 65 and older received health care from VA in 2006.  Three national Geriatric Research, Education and Clinical Centers (GRECCs) are located at VA facilities in the Los Angeles area and Palo Alto.  These centers serve as the focal point for geriatric research and education.  GRECCs, working in collaboration with other federal, state, county and city programs for the elderly, are responsible for sharing best practices in the treatment of disorders and conditions related to aging.

In California, a wide range of geriatric health-care services are offered, including home-based primary care, geriatric clinics, adult day care and home-based hospice programs.  Nursing home programs are located at San Francisco, San Diego, Palo Alto (two), Los Angeles (two), Livermore, Fresno, Loma Linda, Long Beach and Martinez.  Services offered in these programs include hospice, sub-acute, dementia, gero-psychiatric, respite neurocognitive, and rehabilitation care.

The California Department of Veterans Affairs operates three state veterans homes supported by VA funds, which are located in Barstow (180-bed skilled nursing care, 56-bed intermediate nursing care and 164-bed domiciliary care); Chula Vista (120-bed skilled nursing care, 60-bed intermediate care, 55-bed assisted living and 165-bed domiciliary care); and Yountville (26-bed acute care, 230-bed skilled nursing care, 177-bed intermediate care, 730-bed domiciliary care and 130-bed residential care).  Yountville is the largest state veterans home facility in the country. 

The California Department of Veterans Affairs is scheduled to start construction on the Greater Los Angeles Ventura County State Veterans Home (GLAVC) in July 2007.  This state home will have one main site in West Los Angeles, and two satellite facilities, in Lancaster and Ventura.  It will offer three levels of care including an 84-bed residential care facility, a 252-bed skilled nursing facility, and a 60-bed dementia care facility.  The main state home in West Los Angeles is expected in December 2009.

• 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.

More than $279 million in VA and non-VA funding supports more than 5,350 research projects in California.  The San Francisco VAMC has the highest total research budget in the VA system (more than $78 million) and operates research centers for AIDS, diabetes, cancer and alcohol and substance abuse.  VA San Diego has the second largest research program ($66 million), followed by Palo Alto ($52 million).   Investigators throughout California’s research facilities received numerous research and science awards and collaborated on joint VA-DoD research initiatives.  One of two National Hepatitis C Centers of Excellence is located at the San Francisco medical center, as well as the VA AIDS headquarters.  The AIDS center disseminates comprehensive scientific, medical and psychosocial information about HIV disease to some 2,000 providers throughout the VA medical system and internationally.

The San Francisco medical center operates research centers for Alzheimer’s disease, Parkinson’s disease, epilepsy, substance abuse, prostate cancer, pulmonary disease and advanced imaging.  The facility successfully promotes research through its partnership with VA’s largest non-profit research foundation, the Northern California Institute for Research and Education.  The San Francisco facility is also the site of a newly designated Center for Imaging of Neurodegenerative Diseases, which will conduct research on neurodegenerative disorders. 

The Palo Alto, Greater Los Angeles, San Diego, Long Beach and San Francisco medical centers are collectively home to a Mental Illness Research & Education Center, providing extensive research programs on clinical response to treatment for veterans with a variety of mental health problems.  The Palo Alto medical center is also home for the National Center for HIV Research, and a general clinical research center is located at the Sacramento VA.

• 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 regional offices in Los Angeles, Oakland, and San Diego serve veterans and their survivors in California who are seeking VA financial benefits.  In fiscal year 2006, these offices processed 46,086 disability compensation claims, including 18,427 veterans applying for the first time and 27,659 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 6,100 California veterans participated in VA’s Vocational Rehabilitation and Employment program in 2006.

• Homeless:  Nearly 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.  More than 15,000 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.

VA homeless programs in northern and southern California are nationally recognized.  VA has partnered with relief organizations such as the Red Cross and US Vets to establish homeless shelters and residential housing programs for homeless veterans with substance abuse disorders.  The residential housing program, originally known as Westside Residential (in conjunction with the VA Greater Los Angeles Healthcare System), was expanded to Long Beach, and now has sites at Cabrillo and Compton.  Working with the Loma Linda medical center, an additional site was designated for residential programs at the former Norton Air Force Base in San Bernardino.

VA Palo Alto has one of the largest Compensated Work Therapy Programs in VA.  A 100-bed domiciliary and extensive inpatient and outpatient rehabilitation programs work together to provide homeless veterans with the tools they need to succeed and work through various substance abuse issues, PTSD, job training and other social issues, when needed.

A VA Comprehensive Homeless Center was established in northern California, providing a large drop-in and treatment center.  Services there include outreach, assessment, stabilization and placement at transitional housing sites in Oakland, Alameda, Treasure Island, San Jose, Fresno, Monterey, Sacramento, San Francisco, Novato and Eureka.  Long-term housing, employment and re-integration into the workforce are available through veterans industries, supported by the VA. The San Francisco medical center is one of 10 national sites focusing on homeless women veterans and their children.  This program was the first domiciliary to be awarded status as a national program of clinical excellence for treating homeless veterans.  These programs continue a strong outreach effort that informs homeless veterans of benefits and services available to them.

VA Long Beach and Greater Los Angeles provide outreach to veterans confined in correctional facilities. The Incarcerated Veterans Program provides veterans with information and VA resources that are available to them upon their release. These veterans also are offered case-management assistance to support their transition back into the community.

• 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 2.7 million gravesites at 124 national cemeteries in 39 states and Puerto Rico, as well as in 33 soldier’s lots and monument sites.  In 2006, nearly 97,000 veterans were buried in VA's national cemeteries.  Additionally, VA provided more than 335,000 headstones and markers and 405,000 Presidential Memorial Certificates to the loved ones of deceased veterans.  VA-assisted state veterans cemeteries provided more than 22,000 interments.

California has seven national cemeteries, including the nation’s newest -- near Sacramento, which began burials in October 2006.  In 2006, Riverside National Cemetery had 8,526 burials - the largest number of any national cemetery -- and the San Joaquin Valley National Cemetery, in Gustine, had 2,094.  The Fort Rosecrans National Cemetery, San Diego, which buries only eligible family members and cremation remains, had 2,648 burials.  The Los Angeles National Cemetery, which also buries only eligible family members and cremated remains, had 123 burials in 2006.  The Golden Gate National Cemetery, San Bruno, and the cemetery at San Francisco bury only family members.  Golden Gate had 602 burials and San Francisco had 97.  California has a state veterans home cemetery in Yountsville and received a $300,000 grant increase for the state veterans cemetery in Redding.  VA provided 22,348 headstones and markers for the graves of veterans in California and sent 12,138 Presidential Memorial Certificates to California survivors of veterans.

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