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Tuesday, July 14, 2009

Senate Veterans' Affairs Committee Holds Hearing on VA Gaps in Female Client Care

While most in Washington have been busily paying attention to the Sotomayor hearings this week, the Senate Veterans Affairs' Committee met Tuesday morning to consider the quality of VA care provided to our nation's 1.8 million female veterans.

Some, but certainly not all, of their concerns regarding access to their health benefits reflect the same frustrations felt by their male counterparts. Carrie Wells, McClatchy News:

The Department of Veterans Affairs often fails to provide adequate medical care to female military veterans, five of them told the Senate Veterans Affairs Committee Tuesday.

A Veterans Affairs official agreed.

"At the root is a system that has not been responsive to the needs of women veterans," said Patricia Hayes, the department's national director of women's health care.

The five veterans said women sometimes aren't properly informed upon discharge that health benefits are still available. They described how dealing with government is frustrating and confusing, and that often their unique needs, such as child care and sexual assault counseling, aren't understood by government officials.

"I looked to the VA for help when I most needed it, but never succeeded in completing my enrollment, let alone actually receiving the care I needed," said Genevieve Chase, the founder and executive director of the American Women Veterans organization.

Hayes agreed. "Women don't really know about VA services," she said.

More coverage in extended.

The proceedings, Women Veterans: Bridging the Gap, lasted about two hours and can be viewed in full at the link.

In educational interest, article(s) quoted from extensively.


Department representatives acknowledged Tuesday that they're struggling to adapt to the unique needs of female veterans. The idea that the military should provide pap smears and mammograms is still somewhat new, they said.

Chase recalled how, when serving in the Army in Afghanistan in 2006, her truck was hit by an improvised explosive device, "nearly disintegrating" the vehicle. Upon her discharge, she was given only a list of Web addresses and a five-minute briefing about the health care services she qualified for.

Seeking help for her post-traumatic stress disorder and traumatic brain injuries, Chase was frustrated by what she said was an "unclear" veterans' government Web site and "unfriendly" phone advice.

"In communicating with other veterans, I have found that I am hardly alone in this," she said. "Veterans should not need a third party to help them navigate the VA system."

The department officials pledged to do more, and described other problems that need fixing.

In addition to combat-related PTSD, at least 20 percent of women veterans must deal with mental issues from being sexually assaulted in the military, VA officials said.

In a recent assessment of the treatment women get through their department, Veterans Affairs officials found few of their facilities offered women-only counseling. Most women who have experienced sexual assault wouldn't want to attend co-ed group therapy, said Randall B. Williamson, the director of health care for the VA. Most clinics didn't have full-time gynecologists, it also found.

In May, the committee approved the Women Veterans Health Care Improvement Act [HR-1211], designed to address these problems. The full Senate has yet to take any action on the bill.

The House of Representatives passed similar legislation in June. The Tuesday hearing was to give the Senate more information on problems with access to health care at the department.

Rep. Stephanie Herseth Sandlin [D-South Dakota] took to the House floor to talk about the legislation she introduced:

Adam Levine, CNN, reports on a recent GAO study:

[T]he Government Accountability Office -- full report [pdf] | highlights [pdf] -- found wide variation in the medical centers' facilities and programs for female veterans.

Investigators visited 18 veterans' facilities and found that basic services, like pelvic examinations, were being provided and that patients had access to female providers for gender-specific care. But the facilities were lacking in some simpler accommodations, such as the configuration of exam rooms and privacy in check-in areas.

The department says it is taking comprehensive steps to improve, including programs for primary care and mental health care for female veterans, along with having a female veterans' program manager in each of its medical facilities.

But Veterans Affairs faces hurdles in its efforts to improve its services and facilities, the department's chief consultant for women's medical care testified before Congress on Tuesday.

"Moving to a more comprehensive primary care delivery model could challenge VA clinicians, who may have dealt predominantly with male veterans and sometimes have little or no exposure to female patients," said Patricia Hayes of the department's Women's Veterans Health Strategic Healthcare Group.

Only one-third of veterans' facilities offer a separate space for women to receive gynecological, mental health and social work services, according to Hayes. There is a goal to have a gynecologist available at every facility by 2012, she said. ...

While noting that the department has taken steps to upgrade its services and facilities to meet the needs of female veterans, investigators found that it stumbled on some more basic elements.

None of the facilities visited was fully compliant with the department's standards for privacy, investigators found, including privacy in the check-in area.

"In most clinical settings, check-in desk or windows were located in a mixed-gender waiting room or on a high-traffic public corridor," the report explained. In a majority of the clinics, "check-in desk were located in close proximity to chairs where other patients waited for their appointment."

In one facility, it said, investigators observed other patients lining up immediately behind the patient trying to check in.

The government investigators also found that exam tables were not oriented away from the door or shielded properly by curtains, as is required, and there was a lack of toilets near the facilities where gynecological examinations were conducted.

And only two of the facilities provided sanitary napkin dispensers in at least one public restroom for women.

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