Florida
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.

VA spent more than $5.3 billion in Florida in 2006 to care for nearly 1.8 million veterans who live in the state.  That same year, 280,617 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Florida.  VA provided 32,815 veterans, reservists or survivors education benefits through the GI Bill; 184,168 owned homes with active VA home loan guarantees originally valued at $5.9 billion.  Florida veterans held more than 140,000 VA life insurance policies valued at nearly $1.6 billion.  More than 9,000 were interred in Florida’s five national cemeteries.

• Health Care:  One of the most visible of all VA benefits is health care.  VA has 153 hospitals, 882 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.

Florida VA operates medical centers at Bay Pines, Miami, Tampa, and West Palm Beach, and two medical divisions at Gainesville and Lake City, which comprise the North Florida and South Georgia Veterans Health System.  Additionally, VA has narrowed to two the possible site locations for the newest VA medical center to be built in Orlando.  Nine multi-specialty VA outpatient clinics are located in Pensacola, Panama City Beach, Tallahassee, Jacksonville, Daytona Beach,  Viera (Brevard County), Port Richey, Ft. Myers and Oakland Park.  Pensacola is consolidating services from three locations into one Joint Ambulatory Care Clinic at the Pensacola Naval Air Station, with an estimated opening date in 2007.  Primary care also is provided at 32 community-based outpatient clinics located throughout the state.

Between 1996 and 2006, outpatient visits increased from 2,081,192 to 5,470,616.  Hospital inpatients treated increased from 45,762 in 1996 to 53,562 in 2006.  Hospitalized patients are estimated to decrease in future years as workload continues to shift from inpatient to outpatient settings.  Women veterans represent 8 percent of the total number of veteran patients in Florida, with that percentage expected to increase.

Among the initiatives to improve health care access in Florida are the establishment of a Community Care Coordination Service that uses current technology such as tele-health throughout the state.  A spinal cord injury tele-home care program at Tampa, by which veterans with spinal cord injuries receive care in their own homes, is being exported to other sites in the state.  In addition, mobile telemedicine systems at outpatient clinics provide faster access to specialty care.

VA medical centers are affiliated with all four medical schools in Florida, providing more than 560 medical resident positions in the 2006 academic year.  Additionally, VA has affiliations with medical schools in nursing, dentistry, dietetics, audiology and speech pathology, medical technology, radiation technology, pharmacy, podiatry, psychology, rehabilitation, optometry, physical and occupational therapy and social work.

• 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 Florida, more than 13,000 former active duty service members (now veterans) of the Global War on Terrorism have sought VA health care.  The James A. Haley Veterans Hospital in Tampa is home to one of four national polytrauma rehabilitation centers providing specialized, complex medical care and therapy to veterans suffering from traumatic blast injuries and other severe medical conditions.  Some veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Ft. Lauderdale, Ft. Myers, Jacksonville, Key Largo, Palm Beach, Miami, Orlando, Pensacola, Sarasota, St. Petersburg, Tallahassee, and Tampa.  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.

The number of veterans in Florida who are 65 or older is projected to increase through 2012.  Fifty-four percent of the veterans seen in 2006 were 65 or older.  The Bay Pines medical center has one of the largest community nursing home programs in the VA system, with specialized care in visual impairment, alcohol dependency and post-traumatic stress disorder.  Miami and Tampa have more than 170 nursing home beds each.  The Orlando medical center has 120 nursing home beds.  The West Palm Beach medical center provides 98 beds in its extended care facility.  The North Florida and South Georgia Veterans Health System has a 230-bed nursing home care unit at its Lake City division, with 75 of those beds dedicated to specialized care for dementia patients.  The nursing home unit in Gainesville has been designated a Geriatric Research, Education and Clinical Center.  In conjunction with hospital care, Florida VA supports the “aging in place” concept, advocating aggressive use of services designed to promote alternatives to institutional care.  VA set up programs to ensure that long-term care patients are discharged to appropriate community settings.  This is accomplished through a variety of programs including adult day care, expanded home care services such as tele-health and telemedicine, homemaker and home aide programs, use of intermediate-care beds and assisted-living facilities and other community-based programs.

• 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.

Funding for research in Florida continues to increase rapidly.  The expanded research covers such areas as stroke rehabilitation and patient safety.  The North Florida and South Georgia Health Care System operates two centers of excellence: the Center for Brain Rehabilitation Research, to develop a rehabilitation research program that improves quality of life for brain impaired veterans, and the Rehabilitation Outcomes Research Center that focuses on stroke outcomes and outcomes related to newly emerging rehabilitation therapies.  Tampa operates the Patient Safety Center of Inquiry and two research enhancement award programs in patient safety.  These patient safety initiatives focus on the prevention of adverse events in elderly and disabled people including falls, hospital bed entrapment, pressure ulcers and adverse events associated with patient handling and movement.  Miami operates the Center for Functional Recovery in Chronic Spinal Cord Injury, which focuses on spasticity, pain management, recovery of motor and sensory function, and other areas of critical importance to veterans with spinal cord injury.  Extensive geriatric research is conducted at Gainesville and Miami, focusing on biomedical, clinical and health services, geriatric evaluation and management programs and dementia.

• 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 St. Petersburg Regional Office serves veterans and their survivors in Florida who are seeking VA financial benefits.  In fiscal year 2006, the St. Petersburg Regional Office processed 43,148 disability compensation claims, including 12,654 veterans applying for the first time and 30,494 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 4,600 Florida 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.

Florida has one of the highest numbers of homeless veterans in the country.  Many of these veterans are also some of the oldest and most at risk due to illness.  In 2005, VA homeless programs in Florida registered nearly 3,000 new homeless veterans for VA services.  To try to alleviate the pressing housing needs of these veterans, the medical centers' homeless programs have collaborated with local homeless provider community agencies that apply for VA Grant and Per Diem monies.  This national VA program offers federal grants to community agencies for the building or acquisition of transitional housing projects and veteran service centers.  The agencies are eligible to receive from the VA per diem or services-rendered payments for veterans enrolled in their programs. During 2006, VA medical centers in Florida received $2,831,206 (an increase of $473,296.00 from fiscal year 2005) from the VA Grant and Per Diem program for disbursement to community providers to pay for the beds and services associated with these projects.

• 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 125 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.

VA has five national cemeteries in Florida.  In 2006, the Florida National Cemetery in Bushnell had 6,938 burials.  The Bay Pines National Cemetery, which buries eligible family members and cremation remains, had 1,160 burials.  Barrancas National Cemetery in Pensacola had 1,141 burials and the cemetery at St. Augustine, which buries only family members, had one burial.  VA opened its newest national cemetery – South Florida, in Palm Beach County – to serve veterans of south Florida.  VA continues to examine possible sites for two more cemeteries, in the Jacksonville and Sarasota areas.  In 2006, VA provided 13,099 headstones and markers for the graves of veterans in Florida and sent 14,113 Presidential Memorial Certificates to Florida survivors of veterans.

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