New Jersey
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 New Jersey in 2006 to serve about 545,000 veterans who live in the state.  That same year, 59,643 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in New Jersey.  VA provided 5,696 veterans, reservists or survivors education benefits through the GI Bill; 30,837 owned homes with active VA home loan guarantees originally valued at $987 million.  New Jersey veterans held nearly 53,000 VA life insurance policies worth $588 million.  In 2005, 239 were interred at Beverly and Finn's Point 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 2006, VA had 4,949 inpatient admissions and 552,854 outpatient visits in New Jersey.  VA operates two medical centers and 15 outpatient clinics in the state.  The two medical centers, in East Orange and Lyons, offer a full range of medical services, including acute medical, surgical, psychiatric and nursing home care.

Special programs and initiatives include a post-traumatic stress disorder unit and Healthy Aging and Recovery Care Program (HARP) for nursing home residents with mental illness, a comprehensive integrated inpatient rehabilitation program, a substance abuse treatment unit, a homeless domiciliary program, an acquired immunodeficiency syndrome unit, home-based primary care, a Gulf War family support program, a hemodialysis program, women’s health services and a low vision center.

Outpatient clinics are located in Brick, Cape May, Elizabeth, Fort Dix, Gloucester, Fort Monmouth, Hackensack, Jersey City, Morristown, Newark, New Brunswick, Paterson, Trenton, Ventnor and Vineland.  The outpatient clinics offer primary care and behavioral health care for veterans in the communities where they live and work.

The VA medical centers in New Jersey are affiliated with the University of Medicine and Dentistry of New Jersey, New Jersey Medical School and Robert Wood Johnson Medical School, providing training for more than 400 medical residents, interns and 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 New Jersey, nearly 2,500 active duty service members and veterans of the Global War on Terror sought VA health care.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Ventnor, Bloomfield, Jersey City and Ewing.  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.

VA in New Jersey cared for 34,825 veterans aged 65 and over in 2006.  Elderly veterans in New Jersey have access to the full range of services offered to all veterans.  In addition, care of geriatric veterans is a high priority, with several programs specifically targeting their needs.  These programs provide a comprehensive array of services, including the homemaker and home health aid program, which provides home care services through numerous agencies throughout New Jersey.  The community care program also includes the contract nursing home program, home hospice, home respite,  and adult day health care.  Community residential care oversees care for elderly veterans in boarding homes and residential care facilities.  The home-based primary care program provides physician, nurse and therapy services to homebound veterans.

The VA nursing home care unit (NHCU) at Lyons offers a number of programs and services.  The evaluation, management and restoration program provides short-term (up to 90 days) restorative and rehabilitative care.  The respite program offers caregivers a short relief from the daily care they provide to disabled veterans at home.  The Healthy Aging and Rehabilitation Program gives care to mentally ill veterans requiring skilled nursing care.  Additionally, the nursing home offers a full range of consultative services, mental health services, incontinence evaluation and treatment, wound and ostomy evaluation and treatment, chaplain-spiritual support, pain management, ethics committee consultation, advance directive assistance, social service, dietitian services and physical medicine and rehabilitation.

The nursing home is also a central participant in the VA New Jersey Health Care System’s Planetree Initiative.  This cultural transformation highlights resident-centered care and a homelike environment.  The NHCU has made environmental changes, such as new lobby furniture, new furniture in a comfort room for families of palliative care patients, and two new player pianos.  In addition, new activities, such as cookie-baking directly on nursing home units and a restorative care program, are being implemented.  These efforts help veterans feel more at home and make meeting veterans’ needs, not only medically, but socially and emotionally, the central goal of all staff.

End of life care provides palliative care to veterans with a short life expectancy to make them as comfortable as possible.  VA was one of the first institutions in New Jersey to have a palliative care team in the hematology and oncology section.  All inpatient veterans in New Jersey have access to the services of hospice and palliative care consultation teams at the East Orange and Lyons campuses.  The multidisciplinary teams address the needs of veterans with serious illnesses and their families.  These include quality of life, management of symptoms including pain, psychological and spiritual support, help with making decisions and the bereavement process.  Outpatient veterans in need of palliative care are provided similar services in collaboration with community hospice providers and also have access to home hospice care.

Physicians-in-training from different affiliated academic institutions receive patient-based and classroom education from VA geriatricians on how to care for elderly patients.  VA works closely with the state of New Jersey's Department of Military and Veterans Affairs, referring patients, coordinating care, performing inspections of the state nursing homes and administering financial support.  Throughout New Jersey, VA programs are directed toward achieving the highest quality of life and maintaining veterans in the home and community where possible.

• 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.

An extensive VA-funded research and development program exists in New Jersey, with hundreds of research projects and an annual budget of nearly $5 million, in addition to other research funded through the National Institutes of Health, the Department of Defense, state agencies and private research organizations.  The VA New Jersey Health Care System has led the Department of Veterans Affairs in health services research that evaluates clinical practice guidelines for diabetic patients.  Areas of major interest include health services research, cholesterol metabolism, diabetes mellitus, cancer, war-related illnesses, stress and infectious diseases.  The War-Related Illness and Injury Study Center is located at the East Orange campus.

• 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 Newark Regional Office serves veterans and their survivors in New Jersey who are seeking VA financial benefits.  In fiscal year 2006, the Newark Regional Office processed 5,263 disability compensation claims, including 1,576 veterans applying for the first time and 3,687 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 1,100 New Jersey 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.

VA provides extensive programs for homeless veterans in New Jersey, including coordination with shelters, community organizations and local governments to provide care and referral services to veterans and their families who are homeless or at risk of becoming homeless.  The Network Consortium for Homeless Veterans provides innovative, cost-effective partnerships between VA and the New York and New Jersey metropolitan area, providing care for homeless veterans.  It has become a national model for the planning, coordination and integration of such programs.

VA New Jersey Health Care System conducts homeless veterans outreach, and provides treatment, vocational rehabilitation and housing.  The 85-bed domiciliary unit provides treatment and rehabilitation to mentally ill and substance-abusing homeless veterans.  VA has developed 114 units for transitional housing, with another 64 units funded and under development.  Further expansion of the program is planned.

Many community-based jobs have been developed in cooperation with area businesses.  In a unique alliance with Middlesex County Economic Opportunity Corporation, VA’s Veterans Industries program has formed Moving America’s Veterans into Employment and Residences in the Community (MAVERIC).  MAVERIC has opened self-sustaining businesses that exclusively employ formerly homeless veterans.  These businesses include a greenhouse, a golf driving range and learning center and the Veterans Construction Team.  The Foxhole Café, another entrepreneurial venture for Veterans Industries, opened in 2005 and offers light meals and catering services.  These businesses have been described in testimony before the House Veterans Affairs Committee as a model for services.

VA New Jersey Health Care System’s Operation New Hope, staffed largely by formerly homeless veterans, provides support to stand down events and homeless programs throughout the country.  To date, Operation New Hope has distributed well over $100 million in excess Department of Defense clothing and supplies to homeless veterans and programs supporting their needs.

• 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.

New Jersey has two national cemeteries.  Beverly National Cemetery can bury only eligible family members and conducted 194 burials in 2006.  Finn’s Point National Cemetery, in Salem, inters only eligible family members and cremation remains and conducted 45 burials in 2006.  The state's Brig. Gen. W.C. Doyle Veterans Memorial Cemetery at Wrightstown had 2,674 burials in 2006. VA provided 7,233 headstones and markers for the graves of veterans in New Jersey and sent more than 8,462 Presidential Memorial Certificates to New Jersey survivors of veterans.