Kentucky
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 more than $1 billion in Kentucky in 2006 to serve nearly 352,000 veterans who live in the state.  That same year, 59,966 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Kentucky.  VA provided 5,900 veterans, reservists or survivors education benefits through the GI Bill; 30,283 owned homes with active VA home loan guarantees originally valued at $934 million.  Kentucky veterans held more than 15,000 VA life insurance policies worth $172 million.   In 2006, 691 were interred in Kentucky's seven national cemeteries.

• 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 Kentucky, VA operates major medical centers in Lexington and Louisville.  The  facilities offer a wide range of health care including primary, extended, and specialty care, nuclear medicine, blind rehabilitation, cardiovascular surgery, and numerous programs for the aging veteran.  In fiscal year 2006, the Louisville medical center had 5,608 inpatient admissions and the Lexington medical center had 5,735 inpatient admissions.

The Louisville VA Medical Center has been serving veterans for more than 50 years.  The center offers a premier state-of-the-art acute medicine unit that also serves the specialties of hospice and oncology.  The unit has private hospice suites, which provide a more home-like setting.  Each suite is equipped with pullout beds for family members.  The oncology suite is comprised of positive pressure rooms with order entry and electronic charting software.  These rooms provide an enhanced setting where chemotherapy is administered to cancer patients.  The facility has 20 beds, including four private and four semi-private rooms.  All rooms are equipped with the newest hospital beds available, private bathroom facilities and the latest in modern technology and convenience.

The medical center also has a 16-bed, fully computerized intensive and coronary care suite that is equipped with the most advanced technology available today, including point of care computerized medical record and charting capabilities.  Each room is also equipped with a total care bed.  These beds have low air pressure mattresses for maximum comfort and a hydraulics system that helps staff to move patients comfortably and safely.

To improve access to care for veterans, VA operates community-based outpatient clinics in Bellevue, Bowling Green, Dupont, Florence, Fort Campbell, Fort Knox, Hanson, Newburg, Paducah, Prestonsburg, Shively and Somerset.  The Louisville VA Medical Center operates a contract clinic for TRICARE members in partnership with the Kentucky Air National Guard.  These clinics give veterans more options and help the medical centers to create a contiguous corridor of care covering the entire state.

The Lexington Veterans Affairs Medical Center is a fully accredited, two-division, tertiary care medical center.  The Leestown Road Division, established in 1931, offers nursing home care, hospice and respite services, primary care, home based primary care, prosthetics, optometry, mental health and substance abuse treatment, women's health, and post-traumatic stress disorder residential rehabilitation treatment.

The Cooper Drive Division, established in 1973, was built adjacent to the University of Kentucky.  In addition to primary and specialty clinics, acute medical, neurological, surgical and psychiatric inpatient services are provided at this location.  Lexington VA Medical Center has been designated a polytrauma network site, a facility where severely injured soldiers will receive comprehensive care and rehabilitation.

The Lexington and Louisville VA Medical Centers are members of the Kentucky Hospital Association and actively participate on the Subcommittee on State Veterans Affairs and the Joint Executive Council of Veterans Organizations (JECVO).

Both medical centers are affiliated with major universities in Kentucky and other institutions of higher learning.  The Lexington VA Medical Center is affiliated with the University of Kentucky Colleges of Medicine and Dentistry for the training of approximately 500 medical and dental residents in 25 accredited specialty and subspecialty programs.  Affiliations with 15 institutions in Kentucky and elsewhere allow training in 30 health professions involving more than 1,100 students annually.

• 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 Kentucky, more than 3,100 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 Lexington and Louisville.  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 Kentucky, nearly 30,000 veterans aged 65 and older received medical care from VA in 2006.  Both Lexington and Louisville medical centers offer an array of services, including adult day health care, hospice, respite care, home health care, palliative care, rehabilitation and extended care services.  VA's goal is to provide preventive, therapeutic and rehabilitative care for veterans to enable them to return to their homes and communities.

• 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 Lexington VA Medical Center is involved in more than a hundred research projects and VA research funding of $1.3 million.  In Lexington, areas of study include amyotrophic lateral sclerosis (Lou Gehrig’s disease), anaplastic thyroid carcinoma with the drug Pacitaxel, arteriosclerosis, endocrinology, gastroenterology, hematology, oncology, Type 1 and Type 2 diabetes, small cell lung cancer, beta-blocker evaluation, HIV, prostate cancer, alcoholic liver disease, chronic obstructive pulmonary disorder (COPD), stroke, Parkinson's disease, epilepsy, transplantation and immune response, lipoprotein metabolism and infectious diseases.

The Louisville VA Medical Center has a medium-sized funded research and development program, including studies in surgical sepsis, heart disease, liver disease, and cancer treatments.  Other areas of research include neuropsychiatry, endocrinology, vision and infectious diseases.  VA-funded research totals nearly $2.1 million.

• 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 Louisville Regional Office serves veterans and their survivors in Kentucky who are seeking VA financial benefits.  In fiscal year 2006, the Louisville Regional Office processed 10,331 disability compensation claims, including 3,023 veterans applying for the first time and 7,308 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 1,600 Kentucky 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.

Lexington and Louisville medical centers have extensive outreach and treatment programs for homeless veterans in need of mental health, substance abuse treatment and other long-term assistance.  VA benefits counselors at both facilities serve as points of contact for homeless veterans to make sure they receive VA benefits checks even though they have no fixed addresses.  Both medical facilities in Kentucky have homeless assistance programs offering chronically mentally ill services for the homeless through partnerships with local homeless shelters.  Additionally, homeless programs provide crisis intervention, temporary shelter, treatment and referrals, residential treatment and housing assistance.

The Louisville VA Medical Center organized the city’s first stand down for homeless veterans in October 2000.  Since then, Operation Stand Down has evolved into an annual outreach effort giving homeless veterans and other homeless people immediate help and long-term support.

• 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.

VA has seven national cemeteries in Kentucky.  In 2006, the Camp Nelson National Cemetery in Nicholasville had 369 burials; the Mill Springs National Cemetery in Nancy had 65; and the cemetery at Lebanon had 194.  Four other national cemeteries bury only eligible family members.  The Zachary Taylor National Cemetery in Louisville had 59 burials; the Cave Hill National Cemetery in Louisville had only four burials; the cemeteries at Danville and Lexington had no burials.  Kentucky opened a veterans cemetery in 2004 at Hopkinsville with VA assistance, which conducted 138 burials in 2006.  The state also received a VA grant for $8.5 million for a new cemetery in Radcliff. VA provided nearly 7,000 headstones and markers for the graves of veterans in Kentucky and sent 3,969 Presidential Memorial Certificates to Kentucky survivors of veterans.