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79 Chapter 7 CONCLUSION At the time of this writing (2010), the issue of mobility for our veterans is characterized by A large number of veterans with substantial transportation needs, VA transportation expenses that are rapidly approaching $1 billion per year, and Numerous opportunities for improvements. The Department of Veterans Affairs offers some trips, primarily for medical purposes, to veterans who meet certain qualifications including degree of impairment, length of service, and financial status; veterans need other non-VA means of transportation for other (nonmedical) trips. VHAâs costs for medical transportation have quintupled since FY 2001; its current costs of approximately $750 million per year make its Beneficiary Travel program the third-largest federal program for persons with special travel needs. VBAâs Automobile Assistance program currently adds about another $66 million per year to VAâs total expenses for transportation for veterans. A number of innovative community efforts for mobility improvements offer inspiration for possible approaches for large mobility improvements elsewhere. These efforts include special fares for veterans, joint dispatching, service contracts, feeder services, sharing vehicles, training drivers, and
80 others. Above all, community transportation providers will need to be proactive in reaching out to veteransâ organizations if significant improvements in coordination with veteransâ transportation programs are to be achieved. More immediate improvements can be initiated and implemented by local transportation providers. Instances of coordination of transportation services between community transportation providers and VA or VSOs are extremely limited at this time; where they do occur, they suggest the possibility of substantial benefits for all parties. There are significant opportunities for community transportation providers to increase their services to veterans, a market segment that they now seldom serve, and there are substantial opportunities for the VA and other groups serving veterans to increase the cost-effectiveness of their services. All of these improvements could substantially increase the mobility of veterans. To improve the mobility of veterans, broad scale, long-term efforts will be needed from key stake- holders at all levels: local, state, and federal. The continued involvement of relevant federal agencies is suggested. The new attention of the Coordinating Council on Access and Mobility to the issue of improving mobility for veterans is beneficial. States and localities can assist by supporting and expanding the kinds of innovative programs already under way.
81 Bibliography 2001 National Survey of Veterans (NSV), Department of Veterans Affairs, Washington, DC. Tables 6-16 and 6-17 (no date). http://www1.va.gov/vetdata/docs/NSV%20Final%20Report.pdf , accessed February 23, 2010. Burkhardt, J., et al. (2011). TCRP Report 144: Sharing the Costs of Human Services Transportation. (Transit Cooperative Research Program, Transportation Research Board, The National Academies.) Washington, DC. Burkhardt, J., Nelson, C.A., Murray, G., and Koffman, D. (2004). TCRP Report 101: Toolkit for Rural Community Coordinated Transportation Services (Transit Cooperative Research Program, Transportation Research Board, The National Academies.) Washington, DC. http://www.trb.org/publications/tcrp/tcrp_rpt_101.pdf Community Transportation Association of America. (Summer/Fall 2009). From the American Legion. Community Transportation, 27:4, pp 10- 11. Department of Veterans Affairs (2009). âBeneficiary Travel Benefitsâ Fact Sheet 16-2, June 2009, http://www4.va.gov/healtheligibility/Library/pubs/BeneficiaryTravel/BeneficiaryTravel.pdf, accessed December 9, 2009. Department of Veterans Affairs (no dates). âBeneficiary Travel Frequently Asked Questions,â http://www4.va.gov/healtheligibility/Library/FAQs/BeneTravelFAQ.asp , accessed December 9, 2009. Department of Veterans Affairs (2010 ). âFederal Benefits for Veterans, Dependents and Survivors: 2010 Editionâ http://www1.va.gov/opa/publications/benefits_book/benefits_chap01.asp , accessed January 11, 2010. Department of Veterans Affairs (2009). âReport to Congress: PL 110-387, Section 401: Veterans Beneficiary Travel Program,â December, 2009. Department of Veterans Affairs (no dates). âVA Health Care Eligibility Enrollment Special and Limited Benefitsâ http://www4.va.gov/healtheligibility/coveredservices/SpecialBenefits.asp#Auto, accessed May 5, 2010. Department of Veterans Affairs. (no dates; reviewed updated July 23, 2010). âVeterans Health Administrationâ http://www2.va.gov/directory/guide/division_flsh.asp?dnum=1. On January 23, 2002, the Department of Veterans Affairs (VA) announced the merger of VISN 13 and 14 into new VISN 23. This decision merged two health care networks that provided
82 services to veterans in Iowa, Nebraska, Minnesota, South Dakota, North Dakota, and portions of western Illinois, western Wisconsin, and eastern Wyoming. Department of Veterans Affairs (2006). State Summary: Washington and the U.S. Department of Veterans Affairs. Available at http://www.dva.wa.gov/PDF%20files/USDVAwastatesummary.pdf , accessed on May 14, 2010. GovTrack (2010) âS. 658: Rural Veterans Health Care Improvement Act of 2009â http://www.govtrack.us/congress/bill.xpd?bill=s111-658, accessed May 18, 2010. GovTrack (2010) âS. 1146: Rural Veterans Health Care Improvement Act of 2007â http://www.govtrack.us/congress/bill.xpd?bill=s110-1146&tab=summary, accessed January 19, 2010. âHouse Committee Examines How Federal Dollars Get to Local Veterans for Health Care,â House Committee on Veteransâ Affairs, December 7, 2009, http://veterans.house.gov/news/PRArticle.aspx?NewsID=510, accessed January 7, 2010. Lasfargues, J. âEvaluation of Existing Capacity and Unmet Need for Medical Transportation with the Veteran Population,â draft report prepared for the Community Transportation Association of America, Washington, DC, March 2005, p. 1. K.H. Seal, et al. (2007). Bringing the War Back Home: Mental Health Disorders Among 103,788 US Veterans Returning from Iraq and Afghanistan Seen at Department of Veterans Affairs Facilities, Archives of Internal Medicine, 167( 5), 476-482. Miller, L. J. ( June 2001). âImproving Access to Care in the VA Health System: A Progress Report,â Forum, A publication of the Veterans Administration Office of Research & Development. Richardson, C. and Waldrop, J. (2003) Veterans 2000, Census 2000 Brief http://www.census.gov/prod/2003pubs/c2kbr-22.pdf, accessed on May 21, 2010 Rural Veterans: A Special Concern for Rural Health Advocates, National Rural Health Association, Kansas City, Missouri (July 2004). Tanielian, T. and L. Jaycox, eds. (2008). Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. http://www.rand.org/pubs/monographs/2008/RAND_MG720.pdf (accessed January 18, 2010). United States General Accounting Office (June 2003). Transportation Disadvantaged Populations: Some Coordination Efforts Among Programs Providing Transportation Services, but Obstacles Persist, Washington, DC, GAO-03-697. VA Benefits & Health Care Utilization, Department of Veterans Affairs, Office of Policy and Planning, National Center for Veterans Analysis and Statistics, February 1, 2010, http://www1.va.gov/vetdata/docs/4X6_winter10_sharepoint.pdf, accessed March 2, 2010. The VA Health System web page currently says that there are â. . . over 1,400 medical centers and clinics across the nation.â See http://www4.va.gov/healtheligibility/, accessed January 11, 2010.
83 U.S. Census Bureau (no dates). State and County Quick Facts available at http://quickfacts.census.gov/qfd/states/53000.html , accessed on May 5, 2010 âVeterans: 2000 Census Brief.â U.S. Census Bureau, U.S. Department of Commerce, Economics and Statistics Adm., May 2003: 5. Veterans Health Administration (April 2000). A Report by the Planning Systems Support Group, A Field Unit of the Veterans Health Administration Office of Policy and Planning-Geographic Access to Veterans Health Administration (VHA) Services in Fiscal Year 2000: A National and Network Perspective. Veterans Medical Care Benefits (no date). Hospitalization and Medical Services, Department of Veterans Affairs, VA Health Administration Center, Washington, DC. Veterans Transportation: âHow It Works and How You Can Help,â CTAA presentation quoting 2008 VA statistics. Walsh, M. J., Annual Report, 89th National Convention of the Disabled American Veterans, http://www.dav.org/volunteers/documents/AnnualReport.pdf, accessed November 22, 2010.
84 Author Acknowledgments This report responds to the statement of transportation research needs developed by the transit community for TCRP Project J-6 Task 74. We would like to thank the staff of TCRP; Lyn Hellegaard of the Missoula Ravalli Transportation Management Association, the Chair of our Working Group; and all members of the Working Group for their advice and assistance throughout this project. We thank Rex Gilmore of the Department of Veterans Affairs for his assistance in providing information and reviews of our materials. We appreciate the time and insights given to us by the many governmental officials and public and private transportation providers who care deeply about improving the mobility of our veterans.