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Department of Veterans Affairs
|Seal of the Department of Veterans Affairs|
|Formed||July 21, 1930
(Cabinet rank 15 March 1989)
|Preceding agency||Veterans Administration|
|Jurisdiction||Federal government of the United States|
|Headquarters||810 Vermont Avenue NW., Washington, D.C., United States
|Annual budget||$87.6 billion (2009)|
|Agency executives||Eric Shinseki, General USA, Ret., Secretary
W. Scott Gould,
The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level status. It is the United States government’s second largest department, after the United States Department of Defense. With a total 2009 budget of about $87.6 billion, VA employs nearly 280,000 people at hundreds of Veterans Affairs medical facilities, clinics, and benefits offices and is responsible for administering programs of veterans’ benefits for veterans, their families, and survivors.
It is administered by the United States Secretary of Veterans Affairs.
The Plymouth colony first cared for veterans beginning in 1636. The Plymouth Colony was, along with Jamestown, Virginia, one of the earliest successful colonies to be founded by the English in North America and the first sizable permanent English settlement in the New England region. Aided by Squanto, a Native American of the Patuxet people, the colony was able to establish a treaty with Chief Massasoit which helped to ensure the colony's success. It played a central role in King Philip's War, one of the earliest of the Indian Wars. Ultimately, the colony was merged with the Massachusetts Bay Colony and other territories in 1691 to form the Province of Massachusetts Bay.
The Continental Congress of 1776 encouraged enlistments during the American Revolutionary War by providing pensions for soldiers who were disabled. Direct medical and hospital care given to veterans in the early days of the republic was provided by the individual states and communities. In 1811, the first domiciliary and medical facility for veterans was authorized by the federal government, but not opened until 1834. In the 19th century, the nation's veterans assistance program was expanded to include benefits and pensions not only for veterans, but also their widows and dependents.
After the Civil War, many state veterans homes were established. Since domiciliary care was available at all state veterans homes, incidental medical and hospital treatment was provided for all injuries and diseases, whether or not of service origin. Indigent and disabled veterans of the Civil War, Indian Wars, Spanish-American War, and Mexican Border period as well as discharged regular members of the Armed Forces were cared for at these homes.
Congress established a new system of veterans benefits when the United States entered World War I in 1917. Included were programs for disability compensation, insurance for servicepersons and veterans, and vocational rehabilitation for the disabled. By the 1920s, the various benefits were administered by three different federal agencies: the Veterans Bureau, the Bureau of Pensions of the Interior Department, and the National Home for Disabled Volunteer Soldiers.
In 1922, Henry Ford began a relationship with the disabled war veterans that continues to this day. For nearly 90 years, Ford Motor Company and the Disabled American Veterans (DAV) have been working together to help the nation's wounded military veterans. Henry Ford organized a cross-country caravan of 50 Model T Fords to take disabled veterans to the 1922 DAV national convention in San Francisco.
Henry Ford laid the foundation for disabled veterans to be welcomed as employees of Ford Motor Company. The company's leadership in the employment of persons with disabilities continued through the years. In the 1970s, Henry Ford II was a founding member of the National Business and Disability Council, long before the U.S. government enacted laws requiring equal opportunity for persons with disabilities.
In recent years, Ford has donated hundreds of vehicles to the VA and DAV Transportation Network. Ford recently donated another $200,000 for the purchase of eight new vehicles for the DAV Transportation Network. The DAV Transportation Network provides free rides for veterans to medical appointments at VA Medical Centers. A new Ford Explorer was also donated to the DAV Washington Headquarters.
The establishment of the Veterans Administration came in 1930 when Congress authorized the president to "consolidate and coordinate Government activities affecting war veterans." The three component agencies became bureaus within the Veterans Administration. Brigadier General Frank T. Hines, who directed the Veterans Bureau for seven years, was named as the first Administrator of Veterans Affairs, a job he held until 1945.
The VA health care system has grown from 54 hospitals in 1930 to include 171 medical centers; more than 350 outpatient, community, and outreach clinics; 126 nursing home care units; and 35 domiciliaries. VA health care facilities provide a broad spectrum of medical, surgical, and rehabilitative care. The responsibilities and benefits programs of the Veterans Administration grew enormously during the following six decades. World War II resulted in not only a vast increase in the veteran population, but also in large number of new benefits enacted by Congress for veterans of the war. The World War II GI Bill, signed into law on June 22, 1944, is said to have had more impact on the American way of life than any law since the Homestead Act more than a century ago. Further educational assistance acts were passed for the benefit of veterans of the Korean War, the Vietnam Era, the introduction of the "All-Volunteer Force" in the 1970s (following the end of conscription in the United States in 1973), the Persian Gulf War, and those who served following the attacks of September 11, 2001.
The Department of Veterans Affairs (VA) was established as a Cabinet-level position on March 15, 1989. President George H.W. Bush hailed the creation of the new department saying, "There is only one place for the veterans of America, in the Cabinet Room, at the table with the President of the United States of America."
In their major reform period of 1995–2000, the VHA implemented universal primary care, closed 55% of their acute care hospital beds, increased patients treated by 24%, had a 48% increase in ambulatory care visits and decreased staffing by 12%. By 2000, the VHA had 10,000 fewer employees than in 1995 and a 104% increase in patients treated since 1995, and had managed to maintain the same cost per patient-day, while all other facilities' costs had risen over 30% to 40% during the same time frame.
The Department of Veterans Affairs is headed by the Secretary of Veterans Affairs, appointed by the President with the advice and consent of the Senate. The current Secretary of Veterans Affairs is Ret. General Eric Shinseki. The primary function of the Department of Veterans Affairs is to support Veterans in their time after service by providing certain benefits and supports. A current initiative in the Department of Veterans Affairs is to prevent and end Veterans' homelessness, with the VA working with the United States Interagency Council on Homelessness to address these issues. Celebrities are making major headway in solving the homeless veteran population which has reached crisis levels in the United States. In May 2011 the Washington Post reported that home prices hit their lowest level since April 2009. United States analysts concluded that prices had fallen by more than they did during the Great Depression. The news report that elevated the crisis was supported by Standard & Poor’s Case-Shiller index. The Case-Shiller report found that single-family home prices fell 4.2 percent nationally in the first quarter from the previous quarter. Secretary Shinseki sits on the Council, and is committed to the goal of ending Veterans homelessness by 2015 as laid out in Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, which was released in 2010.
The Department has three main subdivisions, known as Administrations, each headed by an Undersecretary:
The benefits provided include disability compensation, pension, education, home loans, life insurance, vocational rehabilitation, survivors’ benefits, medical benefits, and burial benefits. The VA currently breaks down benefits in an easy to understand benefits booklet. Benefits and topics include; VA Health Care Benefits, Veterans with Service-Connected Disabilities, VA Pensions, Education and Training, Home Loan Guaranty, VA Life Insurance, Burial and Memorial Benefits, Reserve and National Guard, Special Groups of Veterans, Transition Assistance, Dependents and Survivors Health Care, Dependents and Survivors Benefits, Appeals of VA Claims Decisions, Military Medals and Records, and Other Federal Benefits.
Gary Sinise is most often thought as a celebrity who shows reverent support of war veterans. Since his depiction as an injured war veteran in the movie Forest Gump, Sinise has dedicated himself to build homes for severely wounded veterans with the Gary Sinise Foundation. In May 2011, country music artist Tim McGraw raised the bar by announcing new support for returning war veterans by providing 25 mortgage-free homes to war veterans of the United States.
Many celebrities which have also worn the uniform of the US Armed Forces include NFL player Pat Tillman, Hit music artist Elvis Presley, Hollywood actor Jimmy Stewart, Comedian Bill Cosby, Celebrity voice Mel Brooks, Television screenwriter Gene Roddenberry, Magazine publisher Malcome Forbes, Hollywood Actor and former President of the United States Ronald Reagan, Chef Julia Child, Hollywood actor and former Mayor Clint Eastwood, Wendy's Restaurant founder Dave Thomas, and Television host Ed McMahon.
As is common in any time of war, recently there has been an increased demand for nursing home beds, injury rehabilitation, and mental health care. VA categorizes veterans into eight priority groups and several additional subgroups, based on factors such as service-connected disabilities, and one’s income and assets (adjusted to local cost of living).
Veterans with a 50% or higher service-connected disability as determined by a VA regional office “rating board” (e.g., losing a limb in battle, PTSD, etc.) are provided comprehensive care and medication at no charge. Veterans with lesser qualifying factors who exceed a pre-defined income threshold have to make co-payments for care for non-service-connected ailments and pay $9 per 30-day supply for each prescription medication. VA dental and nursing home care benefits are more restricted.
Reservists and National Guard personnel who served stateside in peacetime settings or have no service-related disabilities generally do not qualify for VA health benefits. In recent years, the VA has opened hundreds of new convenient outpatient clinics in towns across the United States, while steadily reducing inpatient bed levels at its hospitals.
VA’s budget has been pushed to the limit in recent years by the War on Terrorism. In December 2004, it was widely reported that VA’s funding crisis had become so severe that it could no longer provide disability ratings to veterans in a timely fashion. This is a problem because until veterans are fully transitioned from the active-duty TRICARE healthcare system to VA, they are on their own with regard to many healthcare costs.
The VA has worked to cut down screening times for these returning combat vets (they are now often evaluated by VA personnel well before their actual discharge), and they receive first priority for patient appointments. VA’s backlog of pending disability claims under review (a process known as “adjudication”) peaked at 421,000 in 2001, and bottomed out at 254,000 in 2003, but crept back up to 340,000 in 2005.
No copayment is required for VA services for veterans with military-related medical conditions. VA-recognized service-connected disabilities include problems that started or were aggravated due to military service. Veteran service organizations such as the American Legion, Veterans of Foreign Wars, and Disabled American Veterans, as well as state-operated Veterans Affairs offices and County Veteran Service Officers (CVSO), have been known to assist veterans in the process of getting care from the VA.
In the 2011 Costs of War report from Brown University, researchers projected that the cost of caring for veterans of the War on Terror would peak 30–40 years after the end of combat operations. They also predicted that medical and disability costs would ultimately total between $600 billion and $1 trillion for the hundreds of thousands treated by the Department of Veterans Affairs.
The new GI Bill authored by Sen. Jim Webb (D-VA) doubled GI Bill college benefits while providing a 13-week extension to federal unemployment benefits. Emergency flood relief provided $2.7 billion in flood relief for Midwest along with billions for Louisiana levee repairs, anti-drug enforcement, and food aid. The package was signed into law in June 2008 by President George W. Bush.
The new GI Bill doubled the value of the benefit to roughly $90,000 up from $40,000. In-state public universities essentially are covered to provide full scholarships for veterans under the new education package. For those veterans who served at least three years a monthly housing stipend was also added to the law. Upon passage of the new GI Bill President George W. Bush stated "Our nation has no greater responsibility than to support our men in women in uniform - especially because we're at war," ... "This bill shows the American people that even in an election year, Republicans and Democrats can come together to support our troops and their families," which highlighted that the new GI Bill had been overwhelmingly supported by both parties in the U.S. Congress.
President Barack Obama extended the new GI Bill in the August of 2009 at the cost of roughly $70 billion over the next decade. Upon passing the GI Bill extension President Obama stated his support of the fighting forces of the United States by saying; "Over the last eight years, they have endured tour after tour of duty in dangerous and distant places," ... "They've experienced grueling combat, from the streets of Fallujah to the harsh terrain of Helmand province. They've adapted to complex insurgencies, protected local populations and trained foreign security forces."
The Pentagon worked closely with Congressional lawmakers to ensure military families were protected in the expansion of the law. In doing so, military officials worked non-stop to add a provision to extend the GI Bill to the surviving spouse and children of servicemembers killed while in combat. This provision was highly favored by the Pentagon which authorized the Department of Defense (DoD) to allow individuals who, on or after August 1, 2009, have served at least 6 years in the Armed Forces and who agree to serve at least another 4 years in the U.S. Armed Forces to transfer unused entitlement to their surviving spouse. Servicemembers reaching 10 year anniversaries could choose to transfer the benefit to any dependent(s) (spouse, children).
In May 2006, a laptop computer containing unencrypted social security numbers of 26.5 million U.S. veterans was stolen from a Veterans Affairs analyst’s home. The analyst violated existing VA policy by removing the data from his workplace.
On 3 August 2006, a computer containing personal information in the clear on up to 38,000 veterans went missing. The computer has since been recovered and on 5 August 2006, two men were charged with the theft. In early August 2006, a plan was announced to encrypt critical data on every laptop in the agency using disk encryption software.
Strict policies have also been enacted that require a detailed description of what a laptop will be used for and where it will be located at any given time. Encryption for e-mail had already been in use for some time but is now the renewed focus of internal security practices for sending e-mail containing patient information.
Arguably the single-largest public-private partnership during World War II was with the United States and Henry Kaiser. Henry Kaiser established the Kaiser Shipyard which built Liberty ships during World War II. The Kaiser shipyards would be the birthplace of the fictional character known as “Rosie the Riveter” as the ideal woman worker: loyal, efficient, patriotic, and pretty. Henry Kaiser eventually created health care programs at the shipyards under the name of Kaiser Permanente.
In late 2009 and early 2010 the VA and Kaiser Permanente created a pilot medical data exchange program in San Diego. The medical data exchange program enabled clinicians from Kaiser Permanente and the US Department of Veterans Affairs (VA) obtain veterans electronic health record information.
The health care network giant Kaiser Permanente and the U.S. Department of Veterans Affairs successfully shared patient electronic health records (EHR) in a first-of-its-kind public-private partnership. The goal was to align the VA and DoD on a single agreed upon Nationwide Health Information Network (NHIN) and Electronic Health Record. In applause Sec'y Shinseki said, "The Department of Veterans Affairs and the entire administration are encouraged by the opportunities that electronic health record interoperability provides for Veterans, Service Members and their dependents," ... "We are proud to join in this effort with Kaiser Permanente and to achieve the benefits of health data exchange, including improved quality, patient safety, and efficiency."
Reports state that over half of US war veterans and active-duty Servicemembers receive health care outside of VA and/or Department of Defense facilities.
In 1973, the Veterans Administration assumed another major responsibility when the National Cemetery System (NCS) (except for Arlington National Cemetery) was transferred to the Veterans Administration from the Department of the Army.
The VA was charged with the operation of the NCS, including the marking of graves of all persons in national and State cemeteries (and the graves of veterans in private cemeteries, upon request) as well and administering the State Cemetery Grants Program. The VA's National Cemetery Administration maintains 131 national cemeteries in 39 states (and Puerto Rico) as well as 33 soldier's lots and monument sites.
The Department of the Army maintains two national cemeteries, the Arlington National Cemetery and the U.S. Soldiers' & Airmen's Home National Cemetery. Many states have established state veterans cemeteries. The American Battle Monuments Commission maintains 24 overseas military cemeteries that serve as resting places for almost 125,000 American war dead; on Tablets of the Missing that memorialize more than 94,000 U.S. servicemen and women; and through 25 memorials, monuments and markers. Fourteen national cemeteries are maintained by the National Park Service.
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In 1998, the Institute of Medicine began a series of studies to respond to requests from the U.S. Department of Veterans Affairs and Congress for an examination of the health effects of potentially harmful agents to which Gulf War veterans might have been exposed.