Massachusetts
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 $1.3 billion in Massachusetts in 2006 to serve about 462,000 veterans who live in the state.  That same year, 65,988 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Massachusetts.  VA provided 5,246 veterans, reservists or survivors education benefits through the GI Bill; 14,309 owned homes with active VA home loan guarantees originally valued at $490 million.  Massachusetts veterans held more than 44,000 VA life insurance policies worth nearly $455 million.  In 2006, 2,319 veterans were interred in the Massachusetts National Cemetery.

• 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 fiscal year 2006, VA facilities in Massachusetts had 13,018 inpatient admissions and provided 920,478 outpatient visits.  In Massachusetts, VA operates major medical centers in Bedford, Boston, Brockton, Northampton and West Roxbury.  Additionally, VA has 17 outpatient community clinics in Boston, Dorchester, Fitchburg, Framingham, Gloucester, Greenfield, Haverhill, Hyannis, Lowell, Lynn, Martha’s Vineyard, Nantucket, New Bedford, Pittsfield, Quincy, Springfield and Worcester.

The VA Boston Healthcare System was created in March 2000 and is made up of nine campuses within a 40-mile radius of the greater Boston area, linked by a transportation shuttle system.  The system includes the Jamaica Plain campus, located in the heart of Boston’s Longwood medical community; the West Roxbury campus, located on the Dedham line; the Brockton campus, located 20 miles south of Boston; and six outpatient clinics located in Boston, Dorchester, Framingham, Lowell, Quincy and Worcester.

The Jamaica Plain campus offers state-of-the-art ambulatory care and primary care services.  The ambulatory care center specializes in audiology, ambulatory day surgery, CAT scans, MRI, aphasia treatment and ophthalmology.  Medical services at this campus also include substance abuse, nuclear medicine, oncology, hematology and high voltage radiation therapy and linear accelerator.  The campus also hosts two divisions of the National Center for Post-Traumatic Stress Disorder (PTSD) (Behavioral Science and Women's Health Science), a comprehensive Women’s Health Center, mammography and Gulf War and Agent Orange illnesses programs.

The West Roxbury campus provides inpatient medical care for the Boston area.  This is one of VA's top facilities for cardiac surgery and offers cardiac catheterization and a renowned open-heart surgery program.  West Roxbury also has a nationally recognized acute spinal cord injury program, with an accredited acute rehabilitation program, supported by a hospital swimming pool.  In addition, West Roxbury is the referral center for intensive inpatient surgery and provides unique and high-risk surgeries such as vascular surgery, specialized general and cancer-related surgery, orthopedics, hand and joint replacement, neurosurgery, plastic surgery and urology.  West Roxbury maintains a 24-hour emergency department.

The Brockton campus offers veterans a wide range of health care, including long-term care, spinal cord injury treatment, mental health services and comprehensive primary care.  Brockton also has an inpatient psychiatric unit for women -- one of only four units in VA.  This unit, in conjunction with a recently opened outpatient women’s health center, offers women veterans a complete spectrum of health care services.

VA Boston Healthcare System maintains strong affiliations with Boston University Medical School and Harvard Medical School.  In addition, nursing and other allied health students from different institutions receive training in laboratory and radiological technology, radiation therapy, occupational and physical therapy, optometry, audiology, speech pathology, social work, psychology, pharmacy and physician assistants.  Through this close affiliation, veterans receive the most up-to-date medical treatment available.

The Edith Nourse Rogers Memorial Veterans Hospital in Bedford specializes in geriatric and psychiatric care.  Special programs include the mental health intensive case management program, which serves veterans with serious mental illnesses, who are among the most frequent long-term users of VA inpatient mental health resources.  The program fosters self-sufficiency and independent living in the community to lessen relapses and dependence on inpatient programs.  The Bedford medical center has academic affiliations with Boston University schools of medicine and public health, Tufts University and Boston College School of Nursing.  The Bedford medical center also supports four community-based outpatient clinics in Fitchburg, Gloucester, Haverhill and Lynn.  The medical center provides services in mental health, homelessness, compensated work therapy, ambulatory care and geriatrics.  The mental health program includes a variety of treatments for psychiatric, substance abuse and personality disorders.

The Northampton VA Medical Center in Leeds has served the veterans of western Massachusetts since 1924.  The 167-bed medical center provides primary care, long-term care and psychiatric care to the veteran population of western Massachusetts.  The medical center has 85 psychiatric care beds and 16 psychiatric rehabilitation residential treatment program beds.  Extended care services include a 66-bed nursing home care unit.

Comprehensive outpatient care services, providing an array of diagnostic, support and counseling services are available through satellite outpatient clinics and Veterans Community Care Centers in Northampton, Springfield, Greenfield and Pittsfield.  Ancillary services include dental, radiology, ultrasound, CT, rehabilitative medicine, laboratory, respiratory therapy, pulmonary lab, pharmacy, podiatry, nutrition, speech pathology, orthopedic and ophthalmology clinics.  Mental health services provide inpatient and outpatient psychiatric care including treatment for post-traumatic stress disorder, substance abuse and chronic mental illness.

Affiliations consist of academic affiliations with various schools of dentistry, nursing, clinical nutrition, psychology, physician assistants, optometry, occupational therapy, therapeutic recreation, social work, pharmacy, as well as other health professional and technical fields.  The Greenfield Community College Licensed Practical Nursing Program is located on the campus as well as the Western Massachusetts Shelter for Homeless Veterans, a 155-bed shelter operated by United Veterans of America, Inc.

• 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 Massachusetts, more than 4,300 active duty service members and veterans of the Global War on Terror sought VA health care in 2006.  At the VA Boston Healthcare System, doctors saw 3,096 returning veterans; at Bedford, 629; and in Northampton, 648.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Boston, Brockton, Lowell, New Bedford, Springfield and Worcester.  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 Massachusetts, nearly 49,000 veterans aged 65 or older received medical care in VA facilities in 2006.  Through its VA-operated nursing home care units and the network of state veterans' homes and contract nursing homes, VA has made significant strides in addressing the needs of elderly Massachusetts veterans.  In addition to nursing homes, VA provides home-care services through its home-based primary care and visiting nurse programs.  Throughout Massachusetts, VA programs are directed toward achieving the highest quality of life and maintaining veterans in their homes and communities.

The VA Boston Healthcare System hosts one of 25 nationally-recognized Geriatric Research, Education and Clinical Center (GRECC) programs, based at the Bedford, Jamaica Plain and West Roxbury medical centers.  Offering inpatient and outpatient care, the center also conducts research in the areas of Alzheimer's disease and dementias.  In addition to medical care, the GRECC outpatient clinic evaluates elderly patients who are at risk of developing cognitive impairments that may compromise treatment of medical problems and lead to limitations in the future.

The Bedford facility is a university-affiliated center that specializes in geriatrics.  Bedford provides a 100-bed Alzheimer's unit, residential care, long-term care, psychiatric services, adult day health care, bone and joint disease treatment and medical research.  In addition, the GRECC program is nationally recognized for its innovative approaches to the care of patients with Alzheimer’s disease.  GRECC was created to enhance the care of aged veterans through a comprehensive and integrated program of basic and applied research, development and evaluation of new clinical models and education.  The focus of the program is to increase knowledge of the aging process, share that knowledge with other health-care providers and improve the overall quality of care for elderly veterans.  The program also provides outpatient services and inpatient respite care program for caregivers.  The adult day care treatment center uses a holistic approach to restore, maintain and stimulate each participant’s capacity for independence.  The GRECC staff has affiliations with Boston University School of Medicine, Tufts University and Boston College School of Nursing.  It provides clinical experiences for social work, occupational therapy, nursing and medical students and physician and psychology trainees.

The Northampton Medical Center has extended care services, including a 66-bed nursing home care unit.

• 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.

Research is an integral part of VA’s mission and plays a key role in enhancing the health care services provided to the Massachusetts veterans.  With about $25 million in VA funding devoted to research annually, the Brockton, West Roxbury and Jamaica Plain facilities combined have one of the largest and most active research programs in VA.

The three facilities are participating in a major diabetes research effort with the Joslin Research Project, funded through the Department of Defense.  The Brockton campus has major research efforts in the neurophysiology of mental illnesses including schizophrenia, alcoholism, substance abuse and behavioral disorders, and sleep problems associated with mental disorders.

Research at West Roxbury includes endocrinology, gastrointestinal motility disorders, cardiology and cardiovascular diseases, hematology, pulmonary medicine, neurology and neuroscience, spinal cord injury, genetics and rehabilitation.  Surgical research conducted at West Roxbury encompasses urology, orthopedic surgery, gastrointestinal surgery and cardiothoracic surgery.

The Jamaica Plain campus, in conjunction with the Boston outpatient clinic, has research projects on homeostasis, aphasia, language and memory disorders, post-traumatic stress disorder, epidemiology and infectious diseases.  In addition, Jamaica Plain has an extremely active environmental hazards resource program and conducts numerous studies in collaboration with the Department of Defense.

Investigators at both Brockton and Jamaica Plain are participating in geriatrics research and major VA investigation of Gulf War veterans and their families.  There are several special emphasis programs and research centers at the VA Boston Healthcare System, including the Massachusetts Epidemiology Research and Information Center (MAVERIC), the Normative Aging Study, the Dental Longitudinal Study, and a National Center for PTSD.  VA Boston also has rehabilitation research and development, and health services research and development programs.

At the Bedford medical center, there were research projects for medical and health services research.  Research centers include a Geriatric Research Education Clinical Center (GRECC), a Health Sciences Research and Development national field office, and a satellite Mental Illness Research Education and Clinical Center (MIRECC).  Research is conducted on health care delivery and outcomes, as well as geriatric research that focuses on the experimental pathology of Alzheimer's disease.

• 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 Boston Regional Office serves veterans and their survivors in Massachusetts who are seeking VA financial benefits.  In fiscal year 2006, the Boston Regional Office processed 7,062 disability compensation claims, including 1,761 veterans applying for the first time and 5,301 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 900 Massachusetts 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.

From shelters and abandoned buildings to soup kitchens, VA provides medical, psychiatric care and substance abuse treatment to homeless veterans at the Boston, Brockton, Bedford, Lowell and Worcester facilities.  VA’s Domiciliary Care for Homeless Veterans program prepares veterans for re-entry into communities.  Partnering with nonprofit, community-based organizations, VA provides housing, medical care and counseling for chronically mentally ill veterans.  The Western Massachusetts Shelter for Homeless Veterans, privately operated by the United Veterans of America, Inc., has been located on the Northampton VA Medical Center campus since 1994.  The shelter provides housing for 155 veterans.

The Bedford medical center has one of the largest Compensated Work Therapy programs within VA.  The program helps disabled veterans maintain employment and independence by providing work experiences.  The program addresses the vocational needs of veterans through assessment, counseling and on-the-job training, while helping veterans plan for rehabilitation and recovery.  It is incorporated into treatment planning for both inpatients and outpatients.

• 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 one national cemetery in the state.  The Massachusetts National Cemetery in Bourne had 2,319 burials in 2006.  The state cemetery at Agawam, built with a VA grant, interred 593 people in 2006.  Another state cemetery, at Winchendon, conducted 191 burials in 2006.  VA provided 10,414 headstones and markers for the graves of veterans in Massachusetts and sent 8,540 Presidential Memorial Certificates to Massachusetts survivors of veterans.