Fully Recognize and Improve Services for Women Vets

Women are currently the fastest growing population in both the military and veteran communities, and their numbers have been growing steadily since the 1970s. And while more women are joining the military and are finally being given unprecedented roles in combat and greater responsibilities in leadership, veteran services and benefits often treat them as second-class veterans. Women currently comprise nearly 20 percent of new recruits, 15 percent of the 1.4 million active duty force, 18 percent of the 850,000 reserve component and there is one female officer for every 4.2 female enlisted personnel, compared to one male officer for every 4.8 male enlisted. To date, 280,000 women have served in Iraq and Afghanistan. In 2001, women were estimated to make up about six percent of the veteran population. By 2020, it’s estimated they’ll represent 11 percent. Twenty percent of IAVA members and 35 percent of IAVA’s leaders are women. Women are leading the way in every single aspect of what we do.

Historically, women have played a critical role in the military, but those contributions were generally overlooked. While women have served on the front lines, the Department of Defense (DoD) only recently officially opened combat posts to women, and the effort to integrate this change across the services is ongoing. These new roles will likely attract more women to the military and we will see more women leading our military in the years to come. Yet even as the military offers new opportunities for women to serve, many deterrents remain, including a culture that often doesn’t recognize their contribution or veteran status, and a system that was designed without their particular needs and experiences in mind.

Excellent health care is critical for our returning warriors, but the Department of Veterans Affairs (VA) is failing to provide it for women veterans. In last year’s IAVA Member Survey, 13 percent of IAVA women veterans surveyed reported that the VA did not provide an adequate number of women practitioners; only 41 percent believed the VA provided an adequate number of doctors specializing in women’s care; and only 34 percent said the VA adequately provided specialized facilities. In addition, one in four of the women veterans felt the VA did not adequately provided information and resources relating to women women’s health care.

Beyond health care, women veterans are more likely than their male peers to face economic and personal challenges. Women veterans have consistently higher rates of unemployment, are more likely to be homeless, and are more likely to be single parents. It’s critical that we focus our resources on policies that address the unique employment, housing and child care needs of our women veterans.

Finally, it’s essential that we improve care and services for our women warriors, but that can’t happen until we recognize the tremendous contributions of women in the military. In both military and civilian communities, women often find their service questioned because of preconceived notions of what a veteran looks like. Until the country fully recognizes women veterans for their contributions, and acknowledges the growing diversity across the services, these misperceptions and disparities in care and services will continue to impede women’s success after service.

2.1: Improve Care and Benefits for Women Veterans
2.2: Improve Employment, Housing and Child Care Benefits and Services
2.3: Strengthen Public Awareness and Research about Women Veterans
2.4: Improve Evaluation and Research on Issues Confronting Women Veterans

2.1: Improve Care and Benefits for Women Veterans

The Department of Veterans Affairs (VA) has made progress improving women-specific care for women veterans, such as embedding a designated women’s health care provider in each of the 140 VA health systems with primary care services, establishing Women’s Health Centers at over 80 VA Medical Centers and Community-Based Outpatient Clinics and providing direct assistance and outreach to women veterans through the VA women veterans call center. However, significant gaps in the quality of care available to women veterans at the VA remain. For example, IAVA continues to hear from women veterans about the challenges they face in seeking care from gynecologists at the VA. According to a 2014 DAV report Women Veterans: The Long Journey Home, one third of VA medical centers do not have a gynecologist on staff, and so refer women veterans to community providers for this care. This can cause additional challenges in coordinating care for those veterans.

In the 2014 IAVA Member Survey, only one out of three women veterans said they felt somewhat to very positive about the VA’s care and treatment of women veterans. Changing this response will require establishing clear standards, training VA staff to meet these standards, and investing in appropriate facilities, women practitioners and doctors who specialize in women’s health. Facilities and providers must regularly be evaluated to ensure they meet the standards our veterans deserve.

As the VA improves the quality of care, it must also improve communications with women veterans to make them aware of the services available to them. Only 58 percent of IAVA women veterans surveyed had been contacted by the VA or had seen VA advertisements about women’s eligibility for VA services and benefits.

IAVA Recommendations:
I. Ensure funding for all Vet Centers and VA medical facilities includes an emphasis on women practitioners, outreach specialists and doctors who specialize in women’s health and mental health.

II. Reauthorize the VA Readjustment Counseling Services women veterans retreat program and study the program to determine its effectiveness and success factors.

III. Establish standards requiring that all staff at each VA facility be able to provide basic standards of quality care to women veterans and set deadlines for compliance with those standards.

IV. Assure compliance in all VA facilities with the best practices for safety and privacy outlined in the March 2010 Government Accountability Office report on VA women’s health care policies and oversight.

V. Ensure that all VA medical centers have appropriate facilities and are fully staffed to support the needs unique to women veterans, including women’s clinic and reproductive services.

VI. Evaluate the quality of care provided by the VA and VA-purchased care for women veterans, particularly in mental health care and peer-support programs.

VII. Continue to evaluate Veterans Integrated Service Network (VISN) executives on the availability and quality of care for women veterans.

2.2: Improve Employment, Housing and Child Care Benefits and Services

Veteran transition support doesn’t end with health care. Homeless women veterans generally face more difficulties than their male counterparts in finding emergency and temporary housing, particularly when they also need shelter for their family. Moreover, women veterans tend to have a higher unemployment rate than their male counterparts. At the close of 2014, the Bureau of Labor and Statistics reported that the unemployment rate at the end of CY 2014 for post-9/11 male veterans was 6.9 percent compared to 8.5 percent for post-9/11 women veterans. As the number of women veterans increases, these disparities will only become more amplified. The differences are outrageous and we need to ensure that women have the same access to care and benefits that their male counterparts are afforded.

IAVA Recommendations:
I. Expand child care services at all VA facilities and in local communities to ensure child care does not prevent veterans from seeking care or finding meaningful employment.

II. Expand VA housing and assistance programs for homeless and displaced women veterans and their families.

III. Develop structured pilot programs that build on promising practices from Department of Labor Career one-stop service centers focusing on the employment needs of women veterans.

IV. Fund non-profit womens’ programs at the national and local levels.

2.3: Strengthen Public Awareness and Research about Women Veterans

Women are the fastest growing population within the veteran community, but the American public still does not understand the extent of their contributions. This lack of understanding not only impacts their reception when seeking health care from the Department of Veterans Affairs (VA), but throughout their transition home. For example, when searching for jobs, employers often don’t appreciate the value that women veterans can offer from their experience and training.

While women were formally barred from combat roles before 2013, women have served in combat throughout the wars in Iraq and Afghanistan. They are returning home and are ready to lead—as evidenced by the fact that four women veterans of Iraq and Afghanistan were elected to Congress in 2014—but they face an uphill battle. Outdated notions of women’s service pervade the culture and the stories of women veterans are rarely told, which contributes to the lack of understanding of their roles. It’s past time for the nation to understand the changing face of our military and recognize the strength, determination, skills and leadership that our women veterans embody.

Finally, the VA must get ahead of the curve and invest in research to understand and project the future needs of women veterans to ensure the system of care is ready to support them.

IAVA Recommendations:
I. Conduct a comprehensive public awareness campaign, similar to the IAVA/Ad Council PSA campaigns, to bring greater cultural understanding of the increasing contributions of women service members.

II. Appropriate funding for a VA outreach and advertising campaign directed at women troops and veterans to help inform them of their eligibility for VA services, benefits and availability of the Women Veterans Coordinator and Clinics.

III. Ensure that a diverse veteran population is represented in all VA outreach and promotional materials to inform veterans of their eligibility for services and benefits, including women and minority veterans, and veterans with disabilities.

IV. Foster an internal culture within the VA that welcomes women veterans by strengthening the role of the women veterans’ program manager and ensuring this position is given the authority necessary to implement policies.

V. Ensure that patient advocates are trained and prepared to handle complaints at every VA medical facility related to harassment or individuals creating a hostile environment for minority veteran populations, including women.

VI. Develop training to improve the VA staff’s understanding of women veterans, their range of military service experience and their unique needs.

VII. Ensure that peer support programs represent the diversity of the veteran population, to include women peer mentors.

VIII. Expand the American public’s understanding of the contributions of military and veteran women by including women veteran characters in movies, television, and fiction and nonfiction writing.

2.4: Collect, Analyze and Share Data on Services for Women Veterans

Without good data there is no way to know the extent to which women veterans are underserved, nor will there be a way to see if we are making progress in changing these systems. To design precise policy solutions and to hold accountable every agency in the continuum of care we need robust data collection, sharing, analysis and publication.

IAVA Recommendations:
I. Ensure that federal government agencies, including the Departments of Labor (DOL), Health and Human Services (HHS), Housing and Urban Development (HUD), VA and DoD incorporate gender and minority analyses in all reports to identify gaps in services and programs.

II. Ensure that the VA’s Veteran Benefits Administration (VBA) tracks and analyzes all rating decisions by gender to ensure accurate, timely and equitable decisions by rating specialists.

III. Evaluate the quality of care provided by the VA and VA-purchased care for women veterans, particularly in mental health care.

IV. Evaluate current VA housing and assistance programs for homeless and displaced women veterans and their families to identify gaps in housing support provision.

V. Report disaggregated data on every agency’s services and programs for veterans to the public for external analysis.

VI. Continue to study the specific post-deployment health needs of women and evaluate existing VA services, particularly regarding health concerns, such as breast cancers, osteoporosis and heart disease, which often impact women at a higher rate.

VII. Fund independent research to better understand the needs of women veterans like RAND’s 2008 Invisible Wounds Report.