Oregon
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 $1.2 billion in Oregon in 2006 to serve more than 357,000 veterans who live in the state.  In 2006, 52,399 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Oregon.  VA provided 5,965 veterans, reservists or survivors education benefits through the GI Bill; 19,201 owned homes with active VA home loan guarantees originally valued at $720 million.  Oregon veterans held more than 20,000 VA life insurance policies worth nearly $222 million.  In 2006, 4,078 were interred at Oregon's 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.

Throughout the state, VA had 10,395 inpatient admissions in 2006 and nearly 905,000 outpatient visits.  In Oregon, VA operates major medical centers in Portland, Roseburg and White City.  The Portland VA Medical Center (VAMC) has a second campus in Vancouver, Wash., that serves veterans from the southwest region of that state.  In addition to its two main campuses, the Portland VA Medical Center also operates community-based outpatient clinics (CBOCs), in west Portland, Camp Rilea, Salem and Bend.

The Portland VA Medical Center has 149 acute care beds in Portland and 72 nursing home beds in Vancouver.  The Portland VA serves as the referral center for Oregon, southern Washington and parts of Idaho.  In conjunction with Oregon Health and Science University (OHSU), its major academic partner, the medical center operates the only in-house VA liver transplant program west of the Mississippi River.

The medical center is oriented toward training future health care and health administration professionals.  The facility’s resident training positions are part of the affiliation with Oregon Health and Science University.

The 755-bed VA Southern Oregon Rehabilitation Center and Clinics (SORCC) in White City assists underserved special populations, including the homeless, chronically mentally ill and substance abusers.  It provides residential treatment in psychiatry, addictions, medicine, and bio-psychosocial, physical and vocational rehabilitation.  Primary outpatient medical and mental health care is offered to veterans in southern Oregon and Northern California, both in White City and at the Klamath Falls CBOC.  Specialized rehabilitation and therapeutic services include dedicated case management, a substance abuse treatment program for both residents and outpatients, an experiential learning program (for those inpatients with psychosocial rehabilitation potential), a comprehensive employment program, a day treatment center, an expanding outpatient and inpatient group visits presence, and a mental health clinic offering individual, group and family therapies.

The VA Roseburg Health Care System serves veterans in southern Oregon and northern California.  The medical center consists of a 68-bed medical, surgical and psychiatry facility, outpatient clinics and a 55-bed nursing home, which includes a 15-bed Alzheimer's unit.  CBOCs are strategically located to offer services within a radius of 300 miles for veterans who live in the service area.  Locations include Bandon, Brookings and Eugene.  Primary care teams follow patients through ambulatory and preventive health and inpatient care to provide a continuum of care for veterans.  Specialty services provided include cardiology, neurology, infectious diseases, optometry, ophthalmology, urology, renal, gerontology, pulmonary, gastroenterology, general surgery, gynecology, podiatry, audiology and dermatology.

• 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 Oregon, more than 3,700 active duty service members and veterans of the Global War on Terror sought VA health care in 2006.  At the Portland VA Medical Center and its clinics, doctors treated 2,682 returning veterans; in White City and Klamath Falls, 312; and at Roseburg and its clinics, 760.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Eugene, Grants Pass, Portland and Salem.  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.

Oregon VA facilities cared for more than 38,000 veterans age 65 and older in 2006.  At all three major facilities--White City, Roseburg and Portland--VA supports long-term care units, amounting to more than 300 beds.  The Vancouver, Wash., division of VAMC Portland hosts a nursing skilled-care unit, as well as a nationally recognized adult day health and chemical addiction rehabilitation service.  VA also provides contract nursing home care, homemaker and home health program and community residential care.  The primary focus is to assist veterans to reach their optimum level of functioning at home for as long as 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.

The Portland medical center is the leading VA research institution for the state of Oregon and was among the leading VA medical centers in total VA research funding for 2006.  Portland’s researchers frequently report results of studies with important implications for health care.  Programs of note include:

The VA Portland Alcohol Research Center:  Scientists here are among leaders in the quest to tease out the complex interplay between heredity and alcoholism, tracking down genes that may either increase or decrease risk.

National Institutes of Health (NIH)-funded cancer center, with affiliate OHSU:  The Northwest Veterans Affairs Cancer Research Center houses joint projects of the Portland VA and OHSU, many of them on the frontiers of research to forge an entirely new generation of cancer treatments—“smart bombs” that target only cellular abnormalities underlying cancers, sparing normal tissue that can be damaged by radiation and standard chemotherapy.

National Center for Rehabilitative Auditory Research:  People are often surprised to learn that the most common service-connected disability is hearing loss.  This is the only center in the VA dedicated to addressing needs of veterans with hearing loss and tinnitus, the mysterious ringing in the ears suffered by millions of Americans.

Mental Illness Research Education and Clinical Center:  A collaboration with the VA Puget Sound Health Care System, this center focuses on understanding basic mechanisms, developing better treatments and improving health services for post-traumatic stress disorder and schizophrenia—two devastating problems common among our nation’s veterans.

Research Enhancement Awards Program in Multiple Sclerosis:  This group is seeking new weapons against multiple sclerosis, a disabling disorder suffered by about 350,000 Americans.  A recent study found that a combination treatment of estrogen and a vaccine developed by the Portland team could prevent a similar disease in female mice—a finding the researchers hope to translate to humans.

Research Enhancement Awards Program in Hepatitis C:  Investigators here are at the forefront of the battle against hepatitis C, a life-threatening disease that is especially common among veterans.  Many recent Portland advances include progress in work to design a vaccine and the discovery that genetic factors in the donor liver may influence whether severe liver disease recurs in hepatitis C patients who have had a liver transplant.

Parkinson’s Disease Research Education and Clinical Center:  The Portland VA was named a VA center specializing in Parkinson’s disease, a debilitating neurological disorder that afflicts 1.5 million Americans.  Research projects include studies to determine whether deep brain stimulation can reduce symptoms of Parkinson’s disease, to find ways of regenerating brain cells damaged by the disorder, and to sort out the cause of Parkinson’s-associated cognitive problems.

Portland had approximately 100 funded investigators in fiscal 2006, with a research budget of $15.3 million in VA funds, plus additional funding from NIH grants, foundation and society funding, and industry and pharmaceutical funding.

• 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 Portland Regional Office serves veterans and their survivors in Oregon who are seeking VA financial benefits.  In fiscal year 2006, the Portland Regional Office processed 10,739 disability compensation claims.  The total includes 3,386 veterans applying for the first time and 7,353 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 2,400 Oregon 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.

Nearly one third of Oregon's homeless people are veterans.  The Portland medical center, in a unique sharing agreement with the city of Vancouver, leases land on its Vancouver campus for a 124-bed apartment complex for homeless veterans.  The Roseburg VA campus also houses a similar facility.  More than 70 percent of all applicants for admission to White City are homeless.

• 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 three national cemeteries in Oregon.  Willamette National Cemetery in Portland had 3,252 burials in 2006.  The cemetery in Eagle Point had 668 burials.  The cemetery in Roseburg, which buries only eligible family members and cremation remains, had 158 burials.  VA provided 6,779 headstones and markers for the graves of veterans in Oregon and sent 2,518 Presidential Memorial Certificates to Oregon survivors of veterans.