Nevada
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 110,000 veterans and family members were buried in VA’s national cemeteries and 355,000 headstones and markers were provided for veterans’ graves worldwide.

VA spent nearly $698 million in Nevada in 2006 to serve more than 244,000 veterans who live in the state.  In 2006, 33,301 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Nevada.  VA provided 3,948 veterans, reservists or survivors education benefits through the GI Bill; 33,775 owned homes with active VA home loan guarantees originally valued at $1.2 billion.  Nevada veterans held more than 11,000 VA life insurance policies worth $118 million.

• Health Care:  One of the most visible of all VA benefits is health care.  VA has 153 hospitals, 881 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 Nevada treated more than 65,000 patients, accounting for nearly 5,200 inpatient admissions, while providing 676,316 outpatient visits.  In Nevada, VA operates two major health care systems -- the VA Sierra Nevada Health Care System in Reno and the VA Southern Nevada Healthcare System in Las Vegas – and six clinics.  Access to outpatient care was greatly enhanced by community-based outpatient clinics in Minden (serving northeastern California and northwestern Nevada) and Auburn, Calif.  In addition, the VA Rocky Mountain Network in Denver, Colo., is responsible for veterans health care in the eastern Nevada counties of Elko and White Pine.  A contract community-based outpatient clinic is located in Ely.

VA Southern Nevada Healthcare System (VASNHS) participates in a joint venture with the Department Of Defense 99th Medical Group at the Mike O’Callaghan Federal Hospital (MOFH) at Nellis Air Force Base.

The Las Vegas ambulatory care center was closed in June 2003 due to structural issues with the building.  Services were moved to leased sites located throughout the Las Vegas metropolitan area until a new facility can be built.  In May 2004, VA announced approval of the final Capital Asset Realignment for Enhanced Services (CARES) plan, which included the recommendation to construct a new VA medical center complex in Las Vegas that would include a 90-bed inpatient hospital, 120-bed nursing home care unit, and a large outpatient clinic to meet future demand.  Ground was broken for that facility in October 2006.

VASNHS has two community-based outpatient clinics, in Henderson and Pahrump, a Psychiatric Day Treatment Center, and a community-based outreach center for Homeless veterans.  VASNHS’s leading challenges include the dynamic population growth in Southern Nevada, as Las Vegas is one of the fastest growing cities in the nation, and the need for additional health care services to meet that demand.

The clinical facility in Reno houses acute inpatient beds and primary care clinics, relocated from an older building constructed in the 1940s.  Significant clinical construction activities include the installation of a new MRI, moving surgical and medical specialties into new and larger space and the installation of a cardiac catheterization laboratory.  A new parking structure was completed in 2006.  Renovations in the design stages include an emergency room expansion, primary care expansion and radiology expansion.  The Sierra and Southern Nevada systems have extensive affiliations with schools, including the University of Nevada, Southern California College of Optometry, Clark County School of Dental Hygiene and the Graduate School of Social Work.  The Reno VA also has an affiliation with the University of California, San Francisco, East Bay Surgical Program.

• 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 Nevada, more than 2,400 active duty service members and veterans of the Global War on Terror have sought VA health care.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Las Vegas and Reno and at Nellis Air Force Base.  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 Nevada, nearly 27,000 veterans 65 years old or older received medical care in 2006.  The geriatric and extended care program in Reno provides a range of rehabilitative, transitional, palliative and long-term care programs for a significant elderly population.  Geriatric primary care, respite care programs, as well as contract programs in both nursing home and adult day care supplement these programs.  VA’s Southern Nevada Healthcare System partners with local nursing homes to provide nursing home and hospice care.  Nevada recently opened a 180-bed state nursing home near Las Vegas, and VASNHS continues to expand its geriatric and extended care 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.

VA Sierra Nevada Health Care System has a funded research and development program, including cooperative studies in cardiovascular disease, including congestive heart failure, hypertension, angina pectoris and the pathogenesis of arteriosclerosis; and clinical trials in oncology, pulmonology and cardiovascular disease.  In fiscal year 2006, dozens of active research projects were ongoing a VA research budget reaching nearly a million dollars.

VA Southern Nevada Healthcare System also has research programs in endocrinology, primary care, oncology, cardiology and surgery.  Expansion of their research program is expected with the construction of a comprehensive medical care complex.

• 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 Reno Regional Office serves veterans and their survivors in Nevada who are seeking VA financial benefits.  In fiscal year 2006, the Reno Regional Office processed 5,131 disability compensation claims, including 1,704 veterans applying for the first time and 3,427 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 600 Nevada 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.

Homeless veterans in Nevada are supported through a variety of outreach programs.  These include standdowns aimed at providing services for homeless veterans, VA benefits and eligibility counseling, dental and medical exams, food, clothing and grooming, as well as referrals to community services.  VA maintains a tracking system to ensure that veterans discharged from mental health care are supported with follow-up in the community.

In Reno, incentive and compensated work therapy programs to prepare veterans to re-enter the job market are also available.  The Reno VA homeless program supports extensive outreach to Nevada’s rural communities.  The Reno VA is the lead organizer of community resources for homeless people through two annual standdowns.

VA Southern Nevada Healthcare System has an innovative partnership with private, state and federal agencies serving the homeless, including VA's first outreach clinic solely dedicated to homeless veterans.  More than 4,400 homeless veterans are served each year.  The staff in this clinic partner with local police on “ride-alongs,” where homeless people are identified and provided assistance, not arrested.  They also regularly drive to outlying desert area communities to check on homeless who purposefully distance themselves from society, many due to mental illness.  They developed a partnership with a local convenience and car-washing chain that provides jobs for homeless veterans.

• 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 124 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.

Nevada has no national cemeteries but has two state veterans cemeteries that received VA grants.  The Northern Nevada cemetery, in Fernley, had 393 burials in 2006, while the Southern Nevada cemetery, in Boulder City, had 1,711.  VA awarded an expansion and improvement grant for the Southern Nevada cemetery in 2004.  VA provided 2,492 headstones and markers for the graves of veterans in Nevada and sent 1,187 Presidential Memorial Certificates to Nevada survivors of veterans.