Texas
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 23.5 million veterans.  In 2007, about 5.5 million people were treated in VA health care facilities, 3.6 million veterans and survivors received VA disability compensation or pensions, more than 500,000 used GI Bill education benefits and more than 2.2 million owned homes purchased with GI Bill home loan benefits.  More than 100,000 veterans and family members were buried in VA’s national cemeteries and more than 360,000 headstones and markers were provided for veterans’ graves worldwide.

VA spent nearly $6 billion in Texas in 2007 to serve more than 1.7 million veterans who live in the state.  In 2006, 309,411 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Texas.  VA provided 42,705 veterans, reservists or survivors education benefits through the GI Bill; 270,522 owned homes with active VA home loan guarantees originally valued at $8.3 billion.  Texas veterans held more than 89,000 VA life insurance policies worth more than a billion dollars.  More than 10,000 veterans were interred in Texas’s six national cemeteries in 2007.

• Health Care:  One of the most visible of all VA benefits is health care.  VA has 153 hospitals, 731 community-based outpatient clinics, 209 Vet Centers, 135 nursing homes, 47 residential rehabilitation treatment programs and 121 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 more than 55 million outpatient visits to VA health care facilities this year.

VA operates ten major medical centers in Texas – Amarillo, Big Spring, Bonham, Dallas, El Paso, Houston, Kerrville, San Antonio, Temple and Waco – that along with dozens of outpatient clinics last year provided care for veterans, with nearly 55,000 inpatient admissions and nearly 3.9 million outpatient visits.

VA's medical centers provide basic medical services to veterans, maintain specialty programs such as spinal cord injury centers and transplant centers, oversee community-based outpatient clinics, assist VA's nursing homes, domiciliaries and homeless programs, affiliate themselves with the state's major medical schools and with nearby military health care facilities, and operate research programs benefiting all Americans.

The Amarillo VA Health Care System is an acute care facility with five community-based outpatient clinics in Lubbock, Childress and Stratford; Clovis, N.M.; and Liberal, Kan.  It provides acute, primary and long-term care in the areas of medicine, surgery, cardiology, mental health, physical medicine and rehabilitation, neurology, oncology, dentistry and geriatrics.  The facility is affiliated with the Texas Tech University Health Sciences Center Schools of Medicine and Pharmacy, plus other Texas institutions offering a variety of educational opportunities in optometry, nursing and various allied health programs.

In Big Spring, the West Texas VA Health Care System offers intermediate care, intensive care and geriatric care while overseeing community-based outpatient clinics in Abilene, Odessa, Fort Stockton, Stamford and San Angelo, Texas, and Hobbs, N.M.  It has active affiliations with the Texas Tech Health Sciences Center in Lubbock.  Nursing affiliations are established with Howard College in Big Spring and other educational facilities, while other academic affiliations provide training for dietetic interns, medical lab technologists, physical therapists and radiology technologists.

In Bonham and Dallas, the VA facilities are organized as the VA North Texas Health Care System (VANTHCS).  The Dallas VA Medical Center (VAMC), the referral center for VANTHCS, has cared for America's military veterans for over half a century. Through its long-standing partnership with the University of Texas Southwestern Medical Center at Dallas it has become a major teaching and medical research center. Housed on an 84-acre campus, the Dallas VAMC includes a 300-plus-bed acute care medical center, multi-specialty outpatient clinics, 116-bed transitional care unit, 40-bed domiciliary unit, 30-bed spinal cord injury center, and a 59-bed psychiatric residential rehabilitation treatment program.  The Sam Rayburn Memorial Veterans Center (SRMVC) in Bonham provides primary health care, nursing home care and long-term rehabilitative care to eligible veterans.  Located on a 78-acre site, this facility provides a full range of primary and geriatric care programs for the rapidly growing population of aging veterans.  Together, VANTHCS handled more than one million outpatient visits in 2006, and admitted 14,719 patients. 

In El Paso, VA operates a modern ambulatory care center that provides primary care, mental health services, social work, audiology, radiology, ophthalmology, podiatry, orthopedics, dental, cardiology, dermatology, urology, laboratory services, pharmacy and ambulatory surgery.  It uses the most current medical equipment in the Southwest, including an automated prescription-filling machine, a filmless radiology system, and the latest in ultrasound and CT technology.  VA's El Paso facility has extensive sharing agreements with William Beaumont Army Medical Center.  El Paso also serves the second-largest city in New Mexico with its community-based outpatient clinic in Las Cruces.

In Houston, the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) serves as the primary health care provider for nearly 117,000 veterans in southeast Texas.  Veterans from around the country are referred here for specialized diagnostic care, radiation therapy, surgery, and medical treatment, including cardiovascular surgery, gastro-intestinal endoscopy, ophthalmology, nuclear medicine, and treatment of spinal cord injury and diseases.  It is home to a mental illness research, education, and clinical center; a post traumatic stress disorder clinic; an award-winning cardiac surgery program; and one of VA’s six Parkinson’s disease research, education, and clinical centers.  For more than 50 years, the MEDVAMC has provided clinical training for health care professionals through affiliations with the Baylor College of Medicine and 85 other educational and research institutions.  VA operates satellite clinics in Lufkin and Beaumont and, in 2005, opened new outpatient clinics in Galveston and Texas City. 

In Kerrville and San Antonio, the VA facilities are allied as VA's South Texas Veterans Health Care System.  Together they provide acute medical, surgical, psychiatric, geriatric, and primary care services for veterans residing locally, regionally and nationally, with specialties including bone marrow transplantation, open-heart surgery, magnetic resonance imaging and positron emission tomography.  The San Antonio center is ranked as the ninth-largest VA research program, with continuing projects on aging, cardiac surgery, cancer and diabetes.  South Texas provided more than 856,000 outpatient visits and admitted 12,344 patients in 2006.

In Temple and Waco, the VA facilities are organized as the Central Texas Veterans Health Care System, which includes a large stand-alone outpatient clinic in Austin and four community-based outpatient clinics in Brownwood, Bryan, Palestine and Cedar Park.  Comprehensive health care includes surgery, psychiatry, physical medicine and rehabilitation, neurology, oncology, dentistry, geriatrics and extended care.  The Waco facility is a major psychiatric hospital providing long-term care and acute psychiatric care, while also operating a blind rehabilitation center and a post-traumatic care residential program.  In 2006, Central Texas had more than 8,600 inpatient admissions and 800,000 outpatient visits.

• 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 five years following separation for any health problem possibly related to wartime service.  Some 300,000 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 Texas, nearly 8,000 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 Amarillo, Austin, Corpus Christi, Dallas, El Paso, Fort Worth, Houston (two), Laredo, Lubbock, McAllen, Midland and San Antonio.  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 9.2 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 provides a full array of programs, both inpatient and outpatient, to Texas veterans aged 65 and older.  VA has nursing-home units at each of the 10 medical centers and major domiciliaries at six sites.  A geriatric, research, education and clinical center (GRECC) operates in San Antonio.

VA also offers outpatient and home-based programs to support geriatrics, such as home-based primary care, homemaker and home health aides, contract home care, adult day health care, day hospital, day treatment center and psychogeriatric day programs.

Four state veterans homes were recently built with the assistance of VA.  The state homes in Bonham and Temple are co-located on VA medical centers' campuses and the third is a short distance from the San Antonio medical center.  A fourth is located about two miles from the Big Spring medical center.  In addition, VA has established a "snow birds" community-based outpatient clinic in McAllen to deal with the winter influx of retirees to the area.

• 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.

Research conducted by VA personnel throughout Texas ensures veterans access to cutting-edge medical and health care technology.

In Houston, VA's research and development (R&D) program is supported with more than $17 million annually.  The R&D program is an integral part of the medical center’s mission and includes four components: biomedical laboratory research and development, clinical science research and development, rehabilitation research and development, and health services research and development.  Collectively, these services support research covering biomedicine, clinical trials, rehabilitation and health services.

In Dallas, VA staff physicians and service chiefs also are faculty members at the University of Texas Southwestern Medical School.  This strong relationship is one of the main reasons Dallas ranks among VA’s top R&D programs. The Dallas VA Research Corporation was created in 1989 as a private non-profit foundation to support the research mission of VANTHCS.  In 2006, there were 91 active research principal investigators and 325 active research projects at Dallas VA Medical Center with research funding from VA, NIH, and industry sources totaling over $9.7 million.  R&D supports projects in such diverse fields as heart disease, hypertension, diabetes, AIDS and Alzheimer's disease. 

At the San Antonio VA, more than 600 research projects are ongoing with a budget of nearly $8.7 million for 2006.

• 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 regional offices in Houston and Waco serve veterans and their survivors in Texas who are seeking VA financial benefits.  In fiscal year 2006, these offices processed 61,013 disability compensation claims, including 18,820 veterans applying for the first time and 42,193 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  Nearly 11,000 Texas veterans participated in VA’s Vocational Rehabilitation and Employment program in 2006.

• Homeless:  About 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 20,000 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 $300 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's mission to help homeless veterans rejoin society as productive citizens is accomplished through numerous programs.  Homeless programs in Houston, Dallas, San Antonio, Amarillo and El Paso actively assist homeless veterans by providing referrals to shelters, halfway houses and domiciliaries.  Texas also sponsors stand downs that provide medical screening, food, clothing, dental care, job services, spiritual counseling, referrals for substance abuse treatment, mental health treatment and legal advice to the homeless.

The Dallas and Bonham medical centers support homeless domiciliaries, complemented by the Veterans Industries and Therapeutic Residences, Social Security assistance and VA's health care for homeless veterans (HCHV) program.  Throughout the state, VA provides housing, medical care and counseling for chronically mentally ill and veterans with substance abuse problems.  The Compensated Work Therapy (CWT) program finds veterans jobs and homes in the community.  A major component has been the Veterans Industries sheltered work-for-pay program that employs veterans through contracts with private sector businesses.

The VA North Texas Health Care System in Dallas was the first in VA to establish a comprehensive homeless program, which helps mentally and physically ill homeless veterans rejoin the community as productive citizens.  This program includes Veterans Industries and CWT, the day resource veterans rehabilitation program and the domiciliary care program.  CWT and Veterans Industries are therapeutic work programs that provide vocational retraining in a compensated work environment, whereby homeless veterans prepare to re-enter the workforce while earning income.  The day resource veterans rehabilitation program combines compensated work therapy with substance abuse treatment.  The domiciliary care program is a comprehensive assessment, treatment and rehabilitation program specifically 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 six national cemeteries in Texas.  Dallas-Ft. Worth National Cemetery had 3,093 burials in 2007; Houston National Cemetery had 2,705; Ft. Sam Houston National Cemetery in San Antonio had 3,565; and Ft. Bliss National Cemetery had 1,242.  Kerrville National Cemetery, which buries only eligible family members, had no burials in 2007.  San Antonio National Cemetery buries family members and cremation remains but had no burials.  In 2007, VA awarded Texas an $8 million grant to establish a state veterans cemetery in Abilene.  Texas also opened a state cemetery at Mission, though construction continues.  In 2007, VA provided 25,227 headstones and markers for the graves of veterans in Texas.  Approximately 11,000 Texas survivors of veterans received a Presidential Memorial Certificate.