Pennsylvania
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 97,000 veterans and family members were buried in VA’s national cemeteries and 335,000 headstones and markers were provided for veterans’ graves worldwide.

VA spent more than $2.7 billion in Pennsylvania in 2006 to care for nearly 1.1 million veterans who live in the state.  That same year, 127,383 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Pennsylvania.  VA provided 13,534 veterans, reservists or survivors education benefits through the GI Bill; 50,483 owned homes with active VA home loan guarantees originally valued at $1.5 billion.  Pennsylvania veterans held more than 84,000 VA life insurance policies worth nearly $889 million.   In 2006, 2,409 were interred at Indiantown Gap, Philadelphia and Alleghenies national cemeteries.

• Health Care:  One of the most visible of all VA benefits is health care.  VA has 153 hospitals, 882 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.

VA operates eight medical centers in Altoona, Butler, Coatesville, Erie, Lebanon, Philadelphia, Pittsburgh and Wilkes-Barre.  More than one million veterans reside in Pennsylvania, and 391,396 were enrolled for care and services in 2006, resulting in 20,783 inpatient admissions and 2,323,887 outpatient visits.

VA works to provide veterans a comprehensive array of health care and social services through ready access to our medical centers and more than 30 outpatient clinics throughout the state.  Services include preventive screenings and checkups, primary and specialty care, inpatient and outpatient surgery, behavioral health care, rehabilitative services, and long-term care.

The state's facilities are also committed to making sure families are involved in every aspect of a veteran's care, whenever appropriate.  Veterans and their families are regularly informed about VA health care benefits and services through various brochures, facility newsletters, the network newsletter, "Veterans First," facility Web sites, and the network Web site, www.starsandstripes.med.va.gov.

In fiscal year 2004, VA health care facilities in Pennsylvania began to re-engineer their behavioral health services to care for veterans who fall within VA’s special emphasis programs, such as assistance to Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans, substance abuse treatment, post-traumatic stress disorder (PTSD) services, supportive employment, and those with serious mental illnesses.

There are eight Readjustment Counseling Service (RCS) centers, or Vet Centers, located in Erie, Harrisburg, McKeesport, Philadelphia (two centers), Pittsburgh, Scranton and Williamsport.  These centers provide group and family counseling, and some personal counseling, along with a host of other referral services.  The Erie, Harrisburg, and Philadelphia centers also have contract-fee programs to provide counseling to veterans not living near a VA facility.

Pennsylvania has three VA “programs of excellence” – the substance abuse treatment unit in Philadelphia, and the renal and dialysis program and the women veterans health program at Pittsburgh.  Also in Pittsburgh is the National Liver and Renal Transplant Center, which in 2004 became the first independent, in-house VA transplant center in the country.

• 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 Pennsylvania, each VA health care facility has designated points of contact to work with DoD to ensure a seamless transition and transfer of care.  Although this initiative pertains primarily to OIF and OEF veterans, transition to VA health care is available for service members returning from other assignments.  In fiscal year 2006, VA health care facilities in Pennsylvania provided care to 2,946 returning service members.

• 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 fiscal year 2006, 156,646 veterans age 65 and older received medical care at VA facilities in Pennsylvania.  Seeking to meet the needs of this group, the state's VA health care facilities rank near the top among all states in the number of nursing home beds available to veterans.  At the same time, these facilities have developed plans to provide alternatives to institutional care by increasing the number of veterans who have access to home- and-community-based care.  These services include adult day health care, home-based primary care, homemaker and home health aide services, respite care, hospice care, as well as skilled home health care and tele-home health services.  The goal is to enhance the quality of life for all veterans.  VA is implementing the largest telemedicine initiative in the country.

VA has partnered with the Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) and the Pennsylvania Department of Military and Veterans Affairs (PADMVA) to improve the provision of long-term care to veterans.  VA and PADMVA’s sharing agreements have resulted in onsite medical and dental care, preventive maintenance of medical equipment, and pharmaceuticals.  In fiscal year 2006, the joint task force involving VA health care facilities and Pennsylvania state veterans’ homes continued its effort to build on this collaboration.

A Geriatric Research, Education, and Clinical Center (GRECC) in Pittsburgh provides support to VA medical centers within Pennsylvania and to other VA facilities in nearby states.  GRECCs are “centers of excellence” designed to increase knowledge of the aging process and improve the overall quality of care for older veterans, with a focus on stroke victims.  Physicians are implementing a new method of treating narrowing of the carotid artery to prevent stroke:  carotid stenting, which is a spring-loaded coil inserted into the artery via a catheter, thus avoiding surgery.

The GRECC has also established the geriatric palliative care unit, a 40-bed, long-term care unit dedicated to providing compassionate care to chronically ill and frail older adults with irreversible medical conditions.  The mobile geriatric unit uses a van staffed by a physician and a nurse to increase access to VA services by underserved populations in the inner city, including a new site on the north side of Pittsburgh.

• 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.

In fiscal year 2006, VA medical centers in Pennsylvania received more than $50 million for research projects, which was used for groundbreaking medical research on Gulf War ailments, hepatitis C, HIV infection, substance abuse, chronic obstructive pulmonary disease, transplant surgery, diabetes and post-traumatic stress disorder.  Nearly 250 clinical investigators are involved in 547 research projects, including the Regional Sleep Center, the Parkinson’s Disease Research, Education and Clinical Center, and the Mental Illness Research, Education and Clinical Center located in Philadelphia.

• 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 regional offices in Philadelphia and Pittsburgh serve veterans and their survivors in Pennsylvania who are seeking VA financial benefits.  In fiscal year 2006, the these offices processed 20,334 disability compensation claims, including 6,092 veterans applying for the first time and 14,242 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 2,600 Pennsylvania 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.

Since 1987, VA has provided services to homeless veterans in Pennsylvania with a continuum of care that is comprehensive and easily accessible.  Three original Health Care for the Homeless teams were established at Pittsburgh, Lebanon and Wilkes-Barre in 1987, and with the addition of a team in Philadelphia in 1994, they are able to provide outreach services to homeless veterans in shelters, at soup kitchens and on the streets.  VA homeless programs include domiciliaries for the homeless, comprehensive work therapy and therapeutic residence programs, supportive housing initiatives, and VA grant and per diem facilities.

Pennsylvania is a leader in developing new programs for homeless veterans.  In 1988, the VA homeless program at Pittsburgh partnered with the American Legion to open the first supported housing facility in VA.  The American Legion purchased a group of row houses where homeless veterans were placed to reintegrate them into the community.

Since that time, several new homeless programs have been established, including the homeless dental initiative and the comprehensive work therapy program at Wilkes-Barre; a new outreach program for seriously mentally ill veterans at Pittsburgh; and the therapeutic employment, placement, and support programs at Philadelphia and Pittsburgh.  The Butler VA Medical Center (VAMC), Butler County Housing Authority, and Butler County Catholic Charities have developed a cooperative transitional housing program for veterans and community residents.  This 10-bed, single occupancy building is located on station and provides housing and clinical care management services.

• 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 125 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.

VA has three national cemeteries in Pennsylvania with one more planned.  In 2006, Indiantown Gap National Cemetery in Annville had 1,800 burials.  The national cemetery in Philadelphia, which buries eligible family members and cremation remains, had 44 burials.  The National Cemetery of the Alleghenies, near Pittsburgh, had 565.  VA is selecting a site for a future cemetery in the Philadelphia area.  The Soldiers and Sailors Home Cemetery in Erie, which received a VA grant, had three burials in 2006.  Also in 2005, VA provided 13,149 headstones and markers for the graves of veterans in Pennsylvania.  Presidential Memorial Certificates were sent to 21,607 survivors of veterans.

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