Wyoming
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 $195 million in Wyoming in 2006 to serve about 54,000 veterans who live in the state.  That same year, 7,817 veterans and survivors received disability compensation, dependency and indemnity compensation, or pension payments in Wyoming.  VA provided 1,072 veterans, reservists or survivors education benefits through the GI Bill; 6,420 owned homes with active VA home loan guarantees originally valued at $207 million.  Wyoming veterans held more than 2,700 VA life insurance policies worth nearly $32 million.

• 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 Wyoming, VA operates major medical centers in Cheyenne and Sheridan, plus community-based outpatient clinics (CBOCs) in Casper, Gillette, Green River, Powell, Newcastle, Riverton, and Rock Springs.  In fiscal year 2006, VA facilities in Wyoming had 2,788 inpatient admissions and provided 204,081 outpatient visits.

Cheyenne VA Medical Center (VAMC) also supports community-based outpatient clinics in Greeley and Fort Collins, Colo., and a contract clinic in Sidney, Neb.  The Cheyenne facility has 21 medical and surgical beds, outpatient mental health services, and a 50-bed nursing home care unit.  In fiscal year 2006, Cheyenne had 1,066 inpatient admissions and 111,839 outpatient visits.  The Cheyenne VAMC provides a home-based primary care program to coordinate and deliver primary health care to eligible veterans in their homes.  Eligible veterans within a 30-mile drive of Cheyenne will be considered for the program.  TeleHealth care in both primary care and psychiatry disciplines are provided in various locations throughout southern Wyoming.  The Cheyenne VA is affiliated with the University of Wyoming family practice residency program and the University of Colorado Medical School.  A VA and Defense Department sharing agreement between Cheyenne and the Air Force has been in place since 1983 and serves as a model for interagency cooperation.

The Sheridan VA Medical Center serves a veteran population that extends to Montana, Colorado, Utah and Idaho.  The facility has 199 beds, including 46 psychiatry and 23 medical beds.  A 50-bed nursing home care unit and a 40-bed mental health residential rehabilitation unit provides specific treatment for post-traumatic stress disorder, seriously mentally ill, and substance abuse patients.  A 40-bed domiciliary for homeless veterans opened in February 2006.  The Sheridan VAMC has community-based outpatient clinics in Casper, Riverton, Rock Springs, Powell and Gillette.

• 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 Wyoming, nearly 1,200 active duty service members and veterans of the Global War on Terror have sought VA health care.  At the Cheyenne VA Medical Center and its clinics, doctors have treated 731 returning veterans; 449 at Sheridan.  Many veterans from the conflict in Iraq and Afghanistan have visited VA counseling centers in Casper and Cheyenne.  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 Wyoming, more than 11,000 veterans age 65 and older received health care from VA in fiscal year 2006.  A wide range of geriatric, rehabilitation and extended care services are available in Wyoming, and programs continue to expand to meet the growing needs of the state's elderly population.  Both the Cheyenne and Sheridan medical centers have nursing home care units with a total of 100 beds: 50 at Cheyenne and 50 at Sheridan.  Additionally, VA provides home-based primary care, homemaker and home health aide programs on-site and through contracts, adult day care, and hospice and palliative care.  The Sheridan medical center supports the state veterans home in Buffalo, and Cheyenne provides assistance to the state veterans home in Scottsbluff, Neb.

• 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 Cheyenne VA Medical Center was awarded a telepsychiatry project grant to determine the clinical and cost effectiveness of using telepsychiatry in rural and frontier areas.  With the funds, connections were expanded from the already existing links in Fort Collins, Colo., and Scottsbluff, Neb., to sites in Greeley, Colo.; and Rawlins, Laramie, Torrington and Evanston, Wyo.  Services include medication management and monitoring, ego supportive therapy, case consultation, and staff and patient education. The Cheyenne VAMC also provide primary care telemedicine services to Laramie, Wyo.

Telemedicine initiatives at the Sheridan VAMC include the provision of TeleMentalHealth services to Casper, Riverton, Gillette and Powell CBOCs.  In addition, a joint venture between the Sheridan VAMC and the state of Wyoming provides TeleMentalHealth services to veterans residing at the Wyoming Veterans Home in Buffalo.

In addition to the depression and congestive heart failure modules currently being used, the Sheridan VAMC had received funding to develop a Post-Traumatic Stress Disorder (PTSD) module for this system.  The Sheridan VAMC has also received funding from VA Rocky Mountain Network for a collaborative effort with the University of Colorado Health Sciences Center American Indian and Alaskan Native Program to provide TeleMentalHealth to native Americans with PTSD who reside on the Wind River Indian Reservation in Wyoming.  Psychiatric support for the project comes from the University of Colorado Health Sciences Center via a telemedicine link with the Riverton CBOC.

• 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 Denver Regional Office operates an office in Cheyenne that serves veterans and their survivors in Wyoming who are seeking VA financial benefits.  In fiscal year 2006, the Denver and Cheyenne offices processed 2,223 disability compensation claims, including 940 veterans applying for the first time and 1,283 cases where veterans reopened a claim, usually to seek an increase in their disability rating for higher payments.

• 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.

The Cheyenne VA Health Care for Homeless Veterans program serves southern Wyoming, northern Colorado and western Nebraska veterans.  Transient veterans make up a high percentage of the program’s clients.  The program provides outreach to homeless veterans on the street, in shelters and through referral from social service agencies.  Additionally, VA works with the community to refer veterans to state veterans homes for those who need long-term care, and helps organize and administer homeless veteran stand downs.

The Sheridan facility has a full-time homeless veteran social worker who provides case management and referrals for job and life skills 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.

Wyoming has no national cemeteries.  The Oregon Trail State Veterans Cemetery in Evansville, which received a VA grant, had 151 burials in 2006.  Last year, VA provided 499 headstones and markers for the graves of veterans in Wyoming and 548 Presidential Memorial Certificates to Wyoming survivors of veterans.