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> October 2007

# 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](http://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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**For additional state summaries see:**
**http://www.va.gov/opa/fact/statesum/index.asp**.