Iowa
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 $673 million in Iowa in 2006 to serve more than 254,000 veterans who live in the state.  That same year, 29,761 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Iowa.  VA provided 4,647 veterans, reservists or survivors education benefits through the GI Bill; 11,817 owned homes with active VA home loan guarantees originally valued at $349 million.  Iowa veterans held nearly 18,000 VA life insurance policies worth more than $213 million.  In 2006, 91 were interred at Keokuk National Cemetery.

• 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.

In fiscal year 2006, VA facilities in Iowa had 5,897 inpatient admissions and provided 573,296 outpatient visits.  Iowa VA operates a major health-care facility in Iowa City; the Central Iowa Health Care System, with campuses in Des Moines and Knoxville; and seven community-based outpatient clinics in Bettendorf, Waterloo, Dubuque, Mason City, Fort Dodge, Spirit Lake, and Sioux City.

The Iowa City VA Medical Center is a comprehensive tertiary health care center, teaching hospital and research facility.  It has a strong affiliation with the University of Iowa's Roy J. and Lucille A. Carver College of Medicine.  The Central Iowa Health Care System is a fully integrated, two-division health care system with locations in Des Moines and Knoxville.  A shuttle transports patients and employees between the two divisions.  The Central Iowa Health Care System has medical affiliations with numerous area colleges and universities, including the University of Iowa in Iowa City and the Osteopathic School of Medicine in Des Moines.  Throughout the state, veterans are transported to VA facilities in vans donated by the Disabled American Veterans or leased through partnerships with veterans service organizations, county veterans service offices and VA facilities.  VA's volunteer transportation system has 24 vans serving eastern Iowa and western Illinois and 12 vans serving central Iowa.

VA's vocational rehabilitation program in Iowa serves about 740 disabled veterans each year.  Through the veterans outreach program of the Iowa Department of Workforce Development, several thousand veterans found new employment or were referred to services to assist them in their job search.  The cooperative case management program assists disabled veterans receiving vocational rehab.

• 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 Iowa, 4,481 active duty service members and veterans of the Global War on Terror have enrolled for VA health care.  At the Iowa City VA Medical Center, doctors have treated 3,127 returning veterans; in the Central Iowa Health Care System, 1,354.  Some veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Cedar Rapids, Des Moines, and Sioux City.  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 Iowa, more than 40,684 veterans aged 65 or older received health care in 2006.  Iowa VA health care facilities, like other VA facilities in the Midwest, have established an extended care and rehabilitation care program to improve the quality of patient care by promoting best practices, uniform standards of care, communication and patient satisfaction while decreasing costs and duplication of efforts.  The extended care and rehabilitation program includes nursing home and hospice programs, as well as non-institutional care in group facilities or the veteran's home.  Also included are home-based primary care and geriatric day care to help elderly disabled veterans at home, the medical center or other community-based sites.

• 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.

In 2002, the Iowa City VA Medical Center became a national referral center for renal transplants; it performed 26 kidney transplants in 2006.  The Iowa City VA facility is one of three national VA referral centers where patients travel from across the nation for surgery, which is performed in a state-of-the art intensive care unit.  The local research program at Iowa City is one of the top five funded VA medical research programs in the country.  VA Central Iowa Health Care System has six active research studies.  Three of the studies are multi-site studies covering a variety of topics; two are retrospective data collection studies.

• 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 Des Moines Regional Office serves veterans and their survivors in Iowa who are seeking VA financial benefits.  In fiscal year 2006, the Des Moines Regional Office processed 4,703 disability compensation claims, including 1,721 veterans applying for the first time and 2,982 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 600 Iowa 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.

Iowa VA medical facilities seek to break the cycle of homelessness by forming a homeless coordinating group to identify the needs of homeless veterans and to develop programs to meet those needs.  This team of professionals has identified four basic needs of the homeless: housing, transportation, dental care and eye care.  The team is focused on meeting these basic needs and increasing housing to improve the quality of life.  Regional coverage for homeless outreach is based in Des Moines, Iowa City and the Quad Cities area.  Domiciliary care is available in Des Moines; compensated work therapy is available for homeless veterans in Des Moines and Knoxville.

• 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 one national cemetery in Iowa.  The Keokuk National Cemetery had 91 burials in 2006.  Iowa also has a state veterans home cemetery in Marshalltown.  VA provided 3,755 headstones and markers for the graves of veterans in Iowa and 3,685 Presidential Memorial Certificates to Iowa survivors of veterans.

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