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The Department of Veterans Affairs (VA) provides healthcare services to its veterans across the USA including territories and possessions. Healthcare services are delivered through 18 geographically divided administrative areas called Veterans Integrated Services Networks (VISN). The County layer is the base geographic unit of the VISN-Market-Submarket-Sector-County hierarchy. The key attribute in this data set is the FIPS which is defined as a string of 5 characters with unique alphanumeric combinations for each site. The first 2 are the State FIPS code and the next 3 designate the County FIPS code. Example: '01031' is the FIPS for Coffee County, Alabama. 
VISNs are composed of VHA markets. Therefore, VISN boundaries align with the outer edges of their constituent markets’ boundaries. Markets cross state borders wherever it is necessary to keep outpatient clinics (e.g. CBOCs) and their catchment areas in the same market as their parent medical centers. Thus, VISN boundaries also cross state borders.
In 2016 senior leadership considered the challenge of conforming VISN boundaries to MyVA Districts, which coincide with state boundaries. It was agreed that VHA would not separate outpatient clinics from their parent medical centers due to added complexity. Many outpatient providers hold clinics at their mother facilities, clinics are on the same health record as their parent facilities.
VISN and market maps created by VHA Policy and Planning conform to these principals and are the official maps for VHA VISNs and markets.
While the Planning Systems Support Group (PSSG) develops the feature classes depicting the various VHA geographies, the PSSG does not have the authority to modify or reorganize the boundaries. The boundaries are developed at higher levels of the VHA and passed to the PSSG to be translated into spatial features.
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