Traumatic brain injury program extended through 2017

Assisted Living Pilot Program

The Department of Veterans Affairs awarded 20 contracts for the Assisted Living Pilot Program for Veterans with Traumatic Brain Injury (AL-TBI). Originally slated to end in 2014, the Veterans Access, Choice, and Accountability Act of 2014 (VACAA) extended this program through October 2017.

“We are pleased to extend this valuable program and provide specialized assisted living services to eligible veterans with traumatic brain injury that will enhance their rehabilitation, quality of life and community integration,” said Dr. Carolyn Clancy, VA’s interim Under Secretary for Health. “TBI is one of the prevalent wounds of the recent wars in Iraq and Afghanistan and VA remains committed to taking care of those veterans suffering from TBI.”

Under the AL-TBI program, veterans meeting the eligibility criteria are placed in private-sector TBI residential care facilities specializing in neurobehavioral rehabilitation. The program offers team-based care and assistance in areas such as speech, memory and mobility. Approximately 202 veterans participated in the AL-TBI Pilot Program in 47 facilities located in 22 states.

Currently, 101 veterans participate in the pilot as VA continues to accept new eligible patients into the program. In October, VA issued a request for proposal for vendors wishing to participate in the program. In accordance with the RFP, VA has awarded 20 contracts to facilities located in 27 states.

The contracts went into effect on April 1. The program is effective through October 2017, in accordance with VACAA. For more information about the TBI program, visit For information about VA’s work to implement the Veterans Access, Choice, and Accountability Act of 2014, see

Effectiveness of VA Treatment

Understanding and identifying risk factors among patients who receive care is a top priority for clinicians and researchers in VA’s Veterans Health Administration (VHA).

This is especially true when developing and analyzing the effectiveness of treatment for those most susceptible to suicide. In the past eight years, VHA has enhanced mental health services across its system and supplemented it with specific programs for suicide prevention – like the Veterans Crisis Line.

However, until recently information on suicide among all veterans was not available. Earlier this month, a study on the changes in suicide rates for veterans and non-veterans was published that included indications that VHA patients were experiencing positive outcomes from care.

Most importantly, according to Dr. Robert M. Bossarte, the numbers — which were compiled from data provided by 23 states and VA’s Suicide Repository — pinpoint the population that is best helped by care and outreach initiatives.

In this case: women veterans. While suicides among women veterans increased by 40 percent from 2000 to 2010, compared to a 13 percent increase in women non-veterans, the study shows that among women veterans, those who use VA care have suicide rates as much as 75 percent lower than those who do not. Male veterans also saw reduction in suicide rates, about 20 percent, for those who used VHA services.

Blast impact on aging

VA scientists have discovered signs of early aging in the brains of Iraq and Afghanistan war veterans caught near roadside bomb explosions, even among those who felt nothing from the blast. Years after coming home from war, veterans are showing progressive damage to the brain’s wiring, according to a study published online in Brain, A Journal of Neurology.

Equally troubling is the lack of awareness of a blast injury. Many veterans studied said they never felt concussion-like symptoms such as dizziness, headaches or loss of consciousness. Others complained of those symptoms, but eventually saw them go away and military doctors concluded they had fully recovered. Yet in both cases, brain scans years later showed signs of degeneration and early aging.

The results expand on VA research published in November that reported a lack of communication between areas of the brain according to scans taken of troops who had been within 30 feet of an explosion.

An estimated 2.7 million Americans served in Iraq and Afghanistan. Nearly 1.9 million are now veterans, about 60% of whom have or are receiving VA treatment, according to the agency. An undetermined number of Americans were exposed to up to 47,000 IED bomb attacks in Iraq and Afghanistan, according to the U.S. military’s Joint Improvised Explosive Device Defeat Organization.

More than 3,000 troops were killed by IEDs in Iraq and Afghanistan and 10 times that number required medical treatment. Many troops wearing body armor and traveling in armored vehicles reported getting “blown up,” or surviving bomb blasts that occurred close by. Many veterans say that over the course of several deployments the number of explosions they survived rose into double digits.

Vietnam and Brown Water Veterans

The inland waterways of Vietnam are often referred to as “brown water” because of their muddy color. The naval vessels operating on them are referred to as the Brown Water Navy and/or Mobile Riverine Force. Those who made brief visits ashore and/or served on a ship that was operated on the inland waterways of Vietnam are often referred to as “Brown Water Veterans.”

Blue Water Veterans

The deep offshore waters of Vietnam are often referred to as “blue waters” and naval vessels operating on them are referred to as the Blue Water Navy. Blue Water Veterans are not presumed to have been exposed to Agent Orange or other herbicides unless they actually set foot in Vietnam (including for liberal leave or work detail) or served aboard ships on its inland waterways between January 9, 1962 and May 7, 1975. The Blue Water Navy operated large ships which were used to carry out their missions along the Vietnam coastal waters. Some offshore ships including hospital ships, harbor repair ships, mine sweepers, seaplane tenders, and destroyers sent crew members ashore. Veterans aboard these ships who can show they were on shore will be eligible for the presumption of exposure.

U.S. Navy & Coast Guard Ships In Vietnam

VA maintains an evolving list of U.S. Navy and Coast Guard ships associated with military service in Vietnam and possible exposure to Agent Orange based on military records. This includes ships of the Brown Water and Blue Water Navy that operated on Vietnam’s inland waterways, docked to shore or pier in Vietnam, or that delivered supplies or troops ashore. The alphabetized ships list is available at index.asp.

Korean Demilitarized Zone

Veterans who served in a unit operating along the Korean demilitarized zone anytime between April 1, 1968 and August 31, 1971, and who have a disease VA recognizes as associated with Agent Orange exposure, are presumed to have been exposed to herbicides.

Thailand Military Bases

Vietnam-era Veterans, including U.S. Air Force and Army Veterans, whose service involved duty on the perimeters of military bases in Thailand anytime between February 28, 1961 and May 7, 1975 may qualify for VA benefits.