United States Department of Veterans Affairs

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. In 2012, the proposed budget for Veterans Affairs was $132 billion. The VA 2014 Budget request for 2014 is $152.7 billion. This includes $66.5 billion in discretionary resources and $86.1 billion in mandatory funding. The discretionary budget request represents an increase of $2.7 billion, or 4.3 percent, over the 2013 enacted level.

It is administered by the United States Secretary of Veterans Affairs.

History
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.

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 close of 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. In addition, during the late 1940s the VA had to contend with aging World War I veterans. During that time, "the clientele of the VA increased almost five fold with an addition of nearly 15,000,000 World War II veterans and approximately 4,000,000 World War I veterans." Prior to World War II, in response to scandals at the Veterans Bureau, programs that cared for veterans were centralized in Washington DC. This centralization caused delays and bottlenecks as the agency tried to serve the World War II veterans. As a result the VA went through a decentralization process, giving more authority to the field offices.

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 nearly a century before.

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.

Further educational assistance acts were passed for the benefit of veterans of the Korean War, the Vietnam Era, the introduction of an "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 Act of 1988 (Pub.L. 100-527) changed the former Veterans Administration, an independent government agency established in 1930, primarily to see to the needs of World War I veterans, into a Cabinet-level Department of Veterans Affairs. It was signed into law by President Ronald Reagan on October 25, 1988, but actually came into effect under the term of his successor, George H. W. Bush, on March 15, 1989.

The Department of Veterans Affairs was created in direct response to the Supreme Court of the United States case of Rose v. Rose. The failure to perform apportionments by the previous Veterans Administration was identified under Title 38 of the United States Code. The Supreme Court ruled the existing language of 38 USC §211 did not provide sole authority, did not include state courts and only included eligibility questions. As a huge point the Court said the language didn’t even obligate the VA to do its job.

From the disgrace and failures of the Veterans Administration for not performing apportionments, Congress responded with extreme magnitude in comparison to previous cases. After Hisquierdo v. Hisquierdo for railroad retirement and McCarty v. McCarty, for military retirement only a brief addition of family law to the USC was needed. For veterans and their families Congress responded with the Department of Veterans Affairs Act of 1988 and a complete rewrite of Title 38. Congress addressed the issue of exclusive and sole authority over payments. The language of the new §511 applies to all courts, not just federal. It precludes the States from making any decisions which affect these benefits not just the eligibility ''process. It obligates the USDVA to assert this authority and perform their duties.

In their major reform period of 1995–2000, the Veterans Health Administration (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.



Functions Of The Organization
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 Retired U.S. Army 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. 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:


 * Veterans Health Administration – (VHA) responsible for providing health care in all its forms, as well as for biomedical research (under the Office of Research and Development, Community Based Outpatient Clinics (CBOCs), and Regional Medical Centers


 * Veterans Benefits Administration – (VBA) responsible for initial veteran registration, eligibility determination, and five key lines of business (benefits and entitlements): Home Loan Guarantee, Insurance, Vocational Rehabilitation and Employment, Education (GI Bill), and Compensation & Pension


 * National Cemetery Administration – responsible for providing burial and memorial benefits, as well as for maintenance of VA cemeteries

Benefits
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.

Costs for care
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 his budget proposal for fiscal year 2009, President George W. Bush requested $38.7 billion&mdash;or 86.5% of the total Veterans Affairs budget&mdash;for veteran medical care alone.

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
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. 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 and 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 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).

National Cemetery Administration
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.

Related legislation

 * 1944 – Mustering-out Payment Act PL 78-225
 * 1944 – Servicemen’s Readjustment Act PL 78-346
 * 1944 – Veterans' Preference Act PL 78-359
 * 1952 – Veterans' Readjustment Assistance Act PL 82-550
 * 1974 – Vietnam Veterans' Readjustment Assistance Act
 * 1988 – Department of Veterans Affairs Act PL 100-527
 * 2006 – Veterans Benefits, Health Care, and Information Technology Act of 2006 PL 109-461