Ohio
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 $2.7 billion in Ohio in 2006 to serve more than a million veterans who live in the state.  That same year, 118,578 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Ohio.  VA provided 13,946 veterans, reservists or survivors education benefits through the GI Bill; 66,790 owned homes with active VA home loan guarantees originally valued at $2 billion.  Ohio veterans held more than 58,000 VA life insurance policies worth $629 million.  In 2006, 2,579 were interred in the Dayton and Ohio Western Reserve 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.

VA operates medical centers in Cincinnati, Cleveland, Chillicothe and Dayton, as well as a large independent outpatient clinic in Columbus.  Of the approximately one million veterans in Ohio, more than 286,989 have enrolled for care, and services were provided to 201,896 users in fiscal year 2006, resulting in 22,244 inpatient admissions and 2,367,522 outpatient visits.

For Ohio veterans living 30 miles or more from a medical center, VA has 28 community-based outpatient clinics, which provide both mental health and primary care services.  A network-wide Nurse Telephone Triage program provides medical advice to veterans 24-hours a day.  Technological advances include a computer assisted design-computer assisted manufacture system used to manufacture artificial lower limbs, which provides amputees with a perfectly fitted limb almost immediately and shortens rehabilitation.  VA “programs of excellence” include:  open heart surgery, geriatric evaluation and management, substance abuse care, care of the homeless, care of the seriously mentally ill, and spinal cord injury care.

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 Ohio, more than 7,200 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 Cincinnati, Cleveland, Cleveland Heights, Columbus, Dayton and Parma.  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.

A variety of extended care services are offered to nearly 91,000 Ohio veterans who are patients aged 65 or older.  Services include 797 VA nursing home beds, community nursing home care, state veterans homes, respite care, hospice and palliative care, contract adult day health care, homemaker and home health aide, home-based primary care programs as well as our newest, care coordination home tele-health.  Cleveland’s Geriatric Evaluation Management program is a center of excellence.  Veterans may be moved from one program to another as their needs change in a seemingly seamless environment.  Comprehensive medical care, including occupational and physical therapy and recreational activities, are provided.  All extended care programs focus on helping veterans reach their optimum level of functioning, allowing them to stay in their homes and communities as long as possible.  A strong emphasis is placed on pain management and end of life care, thereby preserving dignity and the quality of life for veterans.  The Dayton VA Medical Center’s (VAMC’s) hospice program was recently identified as a model for “best practices” within VA.

• 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 Cincinnati VAMC’s extensive research program involves state-of-the-art biomedical and clinical research.  Nearly $3 million in VA funding was budgeted in 2006 for research programs.  Research areas include cardiovascular diseases and prevention, diabetes causes and treatments, oncology and cancer cachexia, substance abuse, smoking cessation, mental health issues, nephrology, stroke, infectious diseases, tendon engineering and repair, immunology of asthma and cytokine interactions. 

The Cleveland VA Medical Center maintains a broad and comprehensive research program with about $12 million in VA research funding.  This medical center is the site of two VA Rehabilitation Research Centers of Excellence, the Functional Electrical Stimulation Center and the Advanced Platform Technology Center.  Other rehabilitation research projects involve the study of neuroplasticity in patients recovering from strokes.  The Cleveland VAMC Geriatrics Research, Education, and Clinical Center is involved in studies to improve the care of our elderly veterans.  The health services research portfolio includes a study of the use of telemedicine in the management of patients with diabetes.  There are several biomedical and laboratory projects that address issues in diabetes, heart disease, and emerging pathogens and antibiotic resistance.  The clinical science program includes research into causes of visual loss, eye movement disorder and visual neurosciences.  Cleveland researchers participate in several VA cooperative studies dealing with conditions such as AIDS, heart failure, diabetes management, vascular diseases and heart surgery.

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 Cleveland Regional Office serves veterans and their survivors in Ohio who are seeking VA financial benefits.  In fiscal year 2006, the Cleveland Regional Office processed 18,007 disability compensation claims, including 5,179 veterans applying for the first time and 12,828 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 2,200 Ohio 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 offers a wide array of special programs and initiatives designed to help homeless veterans in Ohio live as self-sufficiently and independently as possible.  Care for homeless veterans is comprehensive and easily accessible, with a homeless veteran coordinator located at each medical center.  They coordinate with shelters, community organizations, and state, county and local governments to provide care and referral services to veterans and their families who are homeless or at risk of becoming homeless.

Ohio homeless programs are based in Chillicothe, Cincinnati, Cleveland, Columbus and Dayton.  The Cleveland Comprehensive Homeless Center is a VA “center of excellence.”  The Healthcare for Homeless Vets program is located at Cincinnati, Cleveland, Columbus and Dayton.  Compensated work therapy programs, which train, house and find employment for homeless veterans are located in Chillicothe, Cincinnati, Cleveland, Columbus and Dayton.  A variety of non-profit organizations in Cincinnati, Cleveland and Columbus were awarded VA grants and per diem payments to establish transitional housing and job training 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 2.9 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 two national cemeteries in Ohio.  In 2006, the Dayton National Cemetery had 884 burials.  The Ohio Western Reserve National Cemetery in Rittman had 1,695 burials.  VA provided 14,468 headstones and markers for the graves of veterans in Ohio and, Presidential Memorial Certificates were sent to 15,707 Ohio survivors of veterans.