VA steps up on women's health care
By: Kathryn Smith
May 1, 2013 05:01 AM EDT
The nation’s imagination may be captured by the expanding combat role of women in the U.S. military. But for the Department of Veterans Affairs, there’s a more pragmatic challenge.

As more women serve in the armed forces, how does a massive health care system that for decades was focused primarily on men make sure women get the health services they need — whether it’s a routine Pap smear or mental health care after a sexual assault?

From 2001 to 2010, the number of women receiving health care from the VA more than doubled, said Patty Hayes, chief consultant for women’s health services for the VA. She said the VA expects it to double again in the next five years: Currently, 15 percent of active-duty service members are women, and they make up 18 percent of the National Guard and Reserve.

“VA is here for the women veterans, VA understands the needs of women veterans, and we’ve changed the culture of the VA to not simply be a male-oriented place,” Hayes said.

In part, that means making sure that vets like Phoebe Gavin can get basic care in a setting that makes them comfortable.

Gavin, a 26-year-old military veteran who served in Iraq, sought out care at a VA health care facility in New York City when she got out of the service in 2008.

“I go into this hospital, and I’m a young woman, and I’m surrounded by these old dudes,” said Gavin, a spokeswoman for the Iraq and Afghanistan Veterans of America. “It’s actually very jarring to go in and be the only woman in the waiting room and be the only person under 30 in the waiting room.”

She was matched up with a female primary-care physician for basic health care, Gavin said, but was still too uncomfortable to seek certain services.

“I didn’t go out of my way to get a Pap smear, a pelvic exam, things that you need to do every year to make sure that you’re healthy,” Gavin said.

Ultimately, Gavin said, she was so dissatisfied by care at the VA that she and her husband moved up their wedding by a few months so she could join his insurance plan.

Of 2.2 million women veterans alive today, 360,000 were patients in the VA system last year. Women make up about 6 percent of the total veteran population receiving care from the VA, according to the VA’s website. (VA eligibility depends, in part, on service history and income.)

Hayes noted the VA has designated and trained 1,500 women’s health providers who offer comprehensive care for women, and 400 others will be trained this summer. They’re now at every VA hospital and more than half of its community-based outpatient health clinics.

“We’ve tried to make the care less fragmented than it has been in the past and to make sure that there are as many of these providers as possible,” Hayes said.

One unfortunate key health need for military women: care for sexual assault.

In its latest annual report, the Department of Defense Sexual Assault Prevention and Response Office found 3,192 reports of sexual assault in 2011. That’s probably significantly understated as the vast majority of incidents go unreported. The office estimated 14 percent of sexual assault incidents were reported in 2010.

Hayes at the VA emphasized that a veteran does not have to prove she is a victim of sexual trauma to immediately access free care, including mental health care. She says the department has worked to ensure there are no wait lists for sexual assault counseling, and that women veterans can get a female health provider for counseling if they need one.

Rep. Louise Slaughter (D-N.Y.), a longtime advocate for health services for servicewomen who’s pushed for counseling and treatment programs at the VA, sees improvement in mental health treatment.

“I think that the VA has made some good changes there,” she said, citing heightened public awareness about mental health needs of returning service members.

Jason Hansman, a senior program manager for health issues at the IAVA, cautioned that instilling any change in the nation’s largest integrated health care system can be slow. “The VA is a huge bureaucracy and it lags behind,” he said.

But he acknowledged in the past two years, the VA has been “a more proactive role” for health care for women. “Increasing these services … is going to bring those female vets in there,” he said. “If you build it, they will come.”

The VA is increasing its advocacy efforts to reach women veterans about the services available to them, in the hopes that they’ll use them more. Last week, it announced a call center to provide women veterans with more information about resources.

One area the VA’s not struggling in? Money. Hayes noted it’s been untouched by sequestration, and its budget has continued to increase in recent years.

“We’re running right along where we need to in terms of funding. And I know other agencies can’t say that,” she said.





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