The Vatour A Worldwide Government Scientific Research Institute

The Department of Veterans Affairs (VA) is a cabinet-level department of the U. S. federal government that provides a service and benefit system with a primary focus on supporting and caring for all U. S. veterans (Top 25, 2018). The VA ranks in at #17 amongst 25 of other world class research institutions and this is due to it’s extensive healthcare research that is supported by a variety of advanced laboratories, focused clinics, and cutting edge medical facilities. In addition, the VA has a lengthy origin as it has been a definitive part of American history from the very beginning. Department of Veterans Affairs has multiple bureaus within its organization that have specific roles within their respective areas of responsibility, which involves the utmost scrutiny due to the origination of funding. Taxpayers are funding these programs that were put into place for the heroes of this great nation.

Cost for proper care is expensive, time is essential, and at every turn it seems as though politicians are against the entire program. Not everyone sees eye to eye about Veterans benefits and some refuse to take responsibility for those that were promised closure before making the ultimate sacrifice. The struggle is real and constant since the very beginning. Being that the Veterans Affairs primary interest is to support those that have served in the United States Military, it shouldn’t be a surprise that it has a long history. In fact, it all started in 1663 when the Pilgrims of Plymouth Colony passed a law stating all disabled soldiers would have support from the colony after serving. This was during the time when they were at war with the Pequot Indians. More than a hundred years later Continental Congress needed troops to support the Revolutionary War, and they enacted an effort to encourage enlistment by providing pensions to disabled soldiers. At the same time, it was standardized that individual states and communities would provide any or all direct medical care to Veterans. The 19th century made significantly more progress in adding benefits to the program. The first federal government domiciliary and medical facility was built for Veterans in 1811 and later a new Veterans Assistance program expanded benefits to widows and dependents of veterans. In 1921, Congress had included multiple programs like disability compensation, insurance, vocational rehabilitation programs, and many other benefits were made available to disabled soldiers.

August 9, 1921 the Veterans Bureau was established. There was still significant concern over the long-term side effects that were never expected but were becoming a predominantly common as a result of chemical exposure during WWI. Sulfur mustard was destined to cause almost 400,000 casualties during the war, many more than any other chemical agent (Gilchrist, 1928). Due to how many veterans were in need of specialized care after the war, and inability to prove any different, otherwise benefits for veteran’s health care was expanded to cover issues that weren’t service related. President Herbert Hoover signed Executive Order 5398 on July 21, 1930 which officially granted federal administration status for the Veterans Bureau, aligning the National Homes Agency and the Pension Bureau Agency to become an all encompassing bureau. Brig. Gen. Frank T. Hines was the first Administrator of Veterans Affairs, followed by Dr. Charles Griffith. Veteran population continued to grow as a result from World War II and this lead to the WWII G. I. Bill, which was signed into law June 22, 1944. The program covered education, training, hospital care, continuation of military-pay compensation, veterans preference in employment within the civilian sector, along with better pension and overall expansion of all the present VA programs (VFW, 1994). At this moment there was an interesting change of events that occurred. Coming out of the “Great Depression”, it was said that the G. I. Bill was extremely innovative in the way that its innovation resuscitated the housing industry by taking the risk out of offering loans to returning veterans who never would have qualified for home financing (Leepson, 2007).

Quoted from va. org the Veterans Benefits Administration claimed that they have “helped guarantee 14 million home loans between 1944-1993, with an accumulative value of these homes said to be worth over $433 billion”. These numbers have since continued to grow. Veterans benefits offered by the VA are designed to take care of those that have served in the Armed Forces. This includes everything from initial entry into service through to honoring the fallen. During Lincoln’s presidency, Congress enacted legislation for the purchase of cemeteries which would be utilized as authorized burial locations for all honorably discharged Veterans. The National Cemetery Administration (NCA) maintains 135 cemeteries nationwide, with new cemeteries in development. Since the Revolutionary War there has been over 3. 5 million people, including Veterans of every war and conflict honored by burial in NCA cemeteries. The amount of graves is cause for concern due to mismanagement of processes over the years. One particular example of this comes from the over 2000 unmarked graves at the Green-Wood Cemetery in Brooklyn NY. These graves are from the remains of Civil War veterans. The VA is under pressure from museums, historians, and many Veterans Associations because the NCA regulation states that only direct ancestors can request a headstone. This poses a significant issue because decedents of these Civil War heroes are difficult to track down could quite possibly not be alive to grant the request. Many people believe that all veterans deserve to have their final resting spot marked and honored with a headstone and this is especially true of our Civil War veterans (Schumar, 2013). The VA listened to the people and proposed a change to the regulation on October 1, 2014. This proposed revision published a final rule on March 2, 2016 defining who may apply for a headstone or marker. This new rule expands the types of authorized individuals requesting markers:

• Any family decedent.
• Any designated representative to include Congressionally-chartered Veterans Service Organization.
• An employee of a state or local government whose official responsibilities include serving Veterans.

If the dates of service of the veteran ended prior to April 6, 1917 authorization includes any individual who is responsible under the laws of a state or locality for the disposition and memorialization of the unclaimed remains of the decedent or any individual. The final rule was made effective on April 1, 2016, but unfortunately there is no evidence concluding that the new regulation has ever been placed into effect (Israel, 2016: Gibson, 2016). To place things into perspective the VA has over 21K acres of land devoted to the memorialization of those who served. These areas of responsibility continue to grow along with the amount of veterans eligible for this benefit. The nations service members should at the very least feel a sense of security when it comes to dealing with a final resting place.

The United States Department of Veterans Affairs has undergone continuous change. While the largest of the three departments is the Veterans Health Administration (VHA), which has grown to over 1,600 health care facilities today, including 144 VA Medical Centers and 1,232 outpatient sites providing care of varying and advanced complexity (Affairs, 2005). The challenge with this department is the demand. They serve over 9 million enrolled Veterans each year and this number continues to grow along with the complex issues they are facing. With demand for care rises, the VHA is faced with multiple issues but nothing more significant than budget constraints. The budget dictates the amount of skilled technicians employed, competitive pay with the civilian sector, technology along with R&D advancements, and of course accurate records keeping. An alternative to raising the nearly maxed out budget was to allow Veterans the choice to be seen at a local hospital vs. traveling over great distances to a designated VA hospital. During Donald Trump’s campaign for presidency, he promised to let veterans use private health care. Paul Rieckhoff, CEO and founder of Iraq and Afghanistan Veterans of America (IAVA. ) was quoted saying, “Everyone wants VA reform. How best to do it is the issue that has divided many people outside of the Veterans service organizations”. There isn’t any political support to expand privatization and in fact most politicians stand against it. There is an obvious problem with how the system is working and it seems as though there is a force deliberately complicating services to the vets. An example of this problem came as a realization when the VA healthcare budget was barely into the 3rd quarter of fiscal year 2018 and ran out of funds. This shows that vets are in need of care but not even privatized healthcare can support the demand.

They are in need of services and the government is ill equipped to fulfill promises made to individuals who serve this great nation. A recent attempt to combat VHA issues was to educate people on how to take care of themselves. Bringing to light the reality, which is nothing more than the truth. Out of the United States $2. 5 trillion annual health care budget, 75% of the cost originated from chronic disease. In many cases these situations are said to have been preventable and the focus should have been on catching the symptoms early on to prevent additional complications. In partnership with a multidisciplinary health care Patient Aligned Care Team (PACTs) and a coalition of other Service Lines, the HPDP Program helps to put the Veteran in the ‘driver’s seat”, by providing skill building programs, tools and resources, and most importantly Veterans and their families can create and/or sustain self-management and healthy lifestyle behaviors (VA, 2013).An official change occurred when only a few months ago President Trump signed the VA Mission Act 2018, allowing Veterans access to their choice of healthcare facilities. The new law gives VA an additional $5. 2 billion to continue Choice through May 2019 while the department implements the new, consolidated community care program (Ogrysko, 2018). Although funding details have yet to be worked out, it is said to be a step towards the right direction as serious matters of concern continue to plague the lives of vets. The National Veterans Outreach Office (NVO) coordinates efforts through the Department of Veterans Affairs.

Chapter 63 of Title 38, U. S. C. , defines the outreach mission while providing information and awareness to Veterans and family members. This is to make sure they have the proper tools to access VA benefits and services. The outreach is an attempt to combat many issues to include the suicide epidemic amongst vets. This is a serious mental health issue and hasn’t seen the necessary representation on the level at which it deserves until recently. Reports say that twenty veterans die each day from suicide. Between 2001 and 2014, veteran suicide rates increased by 32%, whereas suicide rates among adult civilians increased by 23% (VA, 2016). Even one death is too many. The VA has engaged with many Occupational therapy practitioners to understand the depths of the issue for each person. The promotion of adaptive coping strategies, such as meaningful relationships with friends and family, and access to mental health care can help reduce feelings of social isolation and lack of belonging associated with suicide (Lusk, 2015). Within this research is the cutting edge innovation for the future. The VA is on the cusp of strengthening occupational competency by continuing the proper research, filling literary gaps, and training practitioners to give the best methods of support for suicide awareness. It is going to take a collective effort from occupational therapy practitioners, researchers, and leaders because they have a professional responsibility to play a role in filling the literature gap, to articulate how the profession can contribute to addressing the mental health needs of veterans, and to advocate at the state level for suicide prevention training as a required professional competency (Kishawa, 2017).z