Washington
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 $1.7 billion in Washington in 2006 to serve nearly 618,000 veterans who live in the state.  That same year, 102,267 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Washington.  VA provided 12,638 veterans, reservists or survivors education benefits through the GI Bill; 68,594 owned homes with active VA home loan guarantees originally valued at $2.7 billion.  Washington veterans held nearly 35,000 VA life insurance policies worth $384 million.  In 2006, 2,366 interments were conducted at Tahoma National Cemetery.

• 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.

In fiscal year 2006, VA facilities in Washington State provided more than a million outpatient visits, including community outpatient care.  In Washington, VA operates major medical centers in Walla Walla and Spokane, as well as a two-division facility, the VA Puget Sound Health Care System, in Seattle and Tacoma.  The Portland VA Medical Center also has a campus in Vancouver.

The Jonathan M.  Wainwright Medical Center in Walla Walla provided care to 14,439 veterans in 2006.  The service area includes veterans in a 42,000 square-mile area in parts of southeastern Washington, northeastern Oregon and western Idaho.  The medical center also operates community based outpatient clinics (CBOCs) in Richland and Yakima, Wash.; a 16-bed substance abuse residential rehabilitation treatment program and a psychiatric residential rehabilitation treatment program.

The Walla Walla medical center is affiliated with Washington State University, Walla Walla College and Walla Walla Community College to provide training for nursing, audiology and social work students.  Affiliations are also in place with the University of Washington to provide training for physician assistants planning a career in a rural health environment, Pacific University's optometry residency and internship programs, Southern College of Optometry and Illinois College of Optometry.

The Spokane medical center is a 36-bed general medical and surgical facility with a 38-bed rehabilitation-orientated nursing home care unit that also provides hospice and respite care, with emphasis on preventive health screening and chronic disease management.  The service area includes veterans in a 60,000 square mile area encompassing parts of eastern Washington, northern Idaho and western Montana.  Much of the service area is classified as "medically underserved" by the Department of Health and Human Services, and VA Spokane operates a unique mobile clinic program to deliver care in 12 remote areas.  Spokane provides treatment to approximately 1,800 inpatients per year.  Hospice and respite care programs are available in the nursing home.

Spokane provided more than 206,000 outpatient visits in 2006.  The Spokane medical center is affiliated with the University of Washington and area colleges and universities, providing training in a full range of health-related professions.  VA officials work closely with the staff of the Department of Defense hospital at Fairchild Air Force Base to share medical expertise and conduct joint operations.

VA Puget Sound Health Care System, located in Tacoma at American Lake, and in Seattle on Beacon Hill, is the largest and most comprehensive VA facility in the region.  VA Puget Sound provided care to nearly 67,000 veterans in 2006, which equates to more than 8,000 inpatient admissions and 624,000 outpatient visits (including care provided in community facilities).  VA Puget Sound is the major referral medical center, serving veterans from Alaska, eastern Washington and Idaho.  Veterans from other VA medical centers are referred to Puget Sound's nationally recognized spinal cord injury center of excellence, rehabilitation program, prosthetics and limb loss prevention program, mental illness research, education and clinical center, geriatric research, education and clinical center, substance abuse treatment and education and the health services research and development program.

VA Puget Sound has 512 beds, 131 nursing home beds, 60 domiciliary beds and 30 residential rehab beds.  VA Puget Sound operates a community-based outpatient clinic in Bremerton and contracts primary care with the University of Washington Physicians Network clinics in Shoreline, Federal Way and Woodinville.  Outpatient clinics provide primary and in some cases mental health care, specialty care is provided at the medical center.

• 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 Washington, more than 7,600 active duty service members and veterans of the Global War on Terror have sought VA health care.  At the VA medical center in Spokane, doctors have treated more than a thousand returning veterans; at the Puget Sound, nearly 6,000; and at Walla Walla, 626.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Bellingham, Everett, Seattle, Spokane, Tacoma and Yakima.  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 Spokane and Walla Walla, approximately 16,000 veterans aged 65 and older received medical care from VA in 2006.  VA Puget Sound Health Care System is responsive to the needs of the state’s rapidly aging veteran population and leads the region in programs studying the genetic basis of aging and aging-related diseases.

In conjunction with the University of Washington, VA Puget Sound Health Care System manages the Alzheimer's disease research center.  Under the umbrella of the Geriatric Research and Education Clinical Center (GRECC), national and international recognition has focused on the discovery of two of the genes known to cause Alzheimer’s disease and fronto-temporal lobe dementia.  The center's research, training and clinical care programs emphasize aging, diet and memory loss, the cognitive and neuroendocrine responses to estrogen replacement in postmenopausal women with Alzheimer's disease, advanced patient care directives and end of life decision making.

• 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.

As an affiliated medical center of the University of Washington School of Medicine, VA Puget Sound has a robust and aggressive research program.  Based on an academic medical model in which physicians care for patients, teach medical students and residents, and engage in their own research, VA Puget Sound has a national and international track record of scientific discoveries that have benefited veterans and the general population.

Through a national competition, VA Puget Sound was awarded special program emphasis creating the Geriatrics Research and Education Clinical Center, Mental Illness Research and Education Center, the Epidemiologic Research and Information Center, the Rehabilitation Research and Development Center of Excellence for Limb Loss Prevention, the Center for Excellence in Substance Abuse Treatment and Education and Health Services Research and Development.

• 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 Seattle Regional Office serves veterans and their survivors in Washington who are seeking VA financial benefits.  In fiscal year 2006, the Seattle Regional Office processed 15,166 disability compensation claims, including 4,972 veterans applying for the first time and 10,194 cases where veterans reopened a claim, usually to seek an increase in their disability rating level for higher payments.  More than 2,700 Washington 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 Puget Sound Health Care System’s  Comprehensive Homeless Veterans Program provides extensive outreach, physical and psychiatric assessment, treatment and social service referrals including housing.  The domiciliary for homeless veterans is a residential rehabilitation program for motivated, homeless veterans and provides VA-subsidized housing, health care for homeless veterans, compensated work therapy and job training.  Veterans Supported Housing is a Department of Housing and Urban Development and VA program that provides long-term, affordable housing with case management for homeless veterans with emotional or substance abuse problems.  A comprehensive work therapy program assists in the continuing sobriety and abstinence of homeless veterans by providing rehabilitative work training in the medical center and at locations throughout the Puget Sound region.

The Spokane homeless veterans program has provided services and resources to thousands of veterans at geographically remote stand downs in rural areas such as Libby, Mont., and Colville, Wash., and three Indian reservations.  Partnerships have been forged with community organizations to enhance the ability to serve both the severely chronically mentally ill and dually diagnosed veteran. 

• 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 one national cemetery in Washington.  Tahoma National Cemetery in Kent had 2,366 burials in 2006.  The state has two veterans cemeteries that received no federal development funds.  Last year, VA provided 3,659 headstones and markers for the graves of veterans in Washington and 5,079 Presidential Memorial Certificates to Washington survivors of veterans.