At the VA, It Is Perception vs Reality
Posted by Greg in 
It’s official! Write down this date: 13 May 2011. On this historic day the VA declared victory over its longtime struggle to provide adequate healthcare services to women. The Marine Corps Times reported that “a new era for women has dawned at the Veterans Affairs Department.”
“We’ve changed the culture of the VA,” said Patricia Hayes, chief consultant for the Women Veterans Health Strategic Health Care Group in the department. “Women can’t just be sort of an invisible second thought.”
“This is a new VA,” said Stacy Garrett-Ray, a deputy director in the Office of Patient Care Services. “We’re here to provide the best care that we can for women veterans.”
For those of us who use the VA regularly for our healthcare, this sounds like one of those fake news stories you would read in The Onion. But this is no joke, and the unfortunate truth is for many women veterans, these grandiose statements by VA officials don’t square up with the realities of the average VA experience.
Declare Victory and Go Home
We can look forward to more of this. The VA is now giving monthly updates to the press on its ever improving support for women. This month the VA is touting such women-centric programs as:
- Providing family planning counseling to couples
- Creating resources like “The Purple Book” — an information guide about prenatal and maternal care
- Training its health care providers who may not be used to dealing with women’s health issues
- Distributing thumb drives loaded with websites and documents that veterans would need to reach the VA and get the services they need
VA officials admit they have no idea how many women utilize these initiatives, so they basically have no way of measuring whether or not these new changes have any impact at all. From a management standpoint, that is ridiculous. How can you possibly conclude things are getting better when you aren’t even paying attention to how or if the veterans use your ideas?
Although improvements to women’s services at the VA are happening, they are happening incrementally and too slowly to keep pace with the ever-increasing influx of patients and claimants due to the continued wars overseas, including increasing numbers of women. A closer look at the issue reveals that the implementation of changes are inconsistent and the quality and availability of services for women varies way too much depending on the VA facility being used for officials to make any broad declarations of success. For some women veterans, just getting to a facility presents a monumental obstacle to care, requiring endless hours of travel by car or bus, and in far too many VA hospitals and clinics, women veterans find their specific treatment needs unavailable, ignored or neglected.
And it’s not just a lack of basic women’s health services. Women veterans say that the VA demonstrates this neglect in much more pragmatic ways, like not ensuring women have private exam spaces, or not providing changing tables for women who have to bring their children to the clinic with them, or not hiring doctors who have experience in treating women’s health issues, or not training the staff so they don’t assume a woman walking through the VA wandered in off the street looking for the shopping mall or is a veteran’s daughter or a veteran’s spouse, or not providing childcare, or not ensuring a safe environment that protects women veterans from a panoply of sexual harassment that ranges from leering stares to vulgar comments to wandering hands. Many times women literally have to run a gauntlet of harassment and hostility to get to their appointments.
Meanwhile, in the Courts…
A mere three days before the VA took this back-patting victory lap in front of the press, the 9th Circuit Court of Appeals handed down a verdict in a two-year long court case against the VA brought by two veterans groups. Veterans for Common Sense and Veterans United for Truth sued the VA on behalf of the tens of thousands of veterans who have suffered terribly and needlessly due to delays in getting access to mental health services and benefit claims processed.
The Court ruled in favor of the veterans, citing “unchecked incompetence” at both the Veterans Health Administration and Veterans Benefits Administration. The court acknowledged that, as early as 2001, the VA had not only no budget for the rise in claims from the Iraq and Afghanistan wars, the VA had no plan for handling the increase. And even today, the VA is still flying by the seat of its pants and has no strategic plan for the rising number of patients or the growing pile of backlogged claims.
In a blistering ruling, the Court stated: “The unchecked incompetence at the VA has gone on long enough; no more veterans should anguish and perish while the government fails to perform its obligations. Having chosen to honor and provide for our veterans by guaranteeing them the mental health care and other critical benefits to which they are entitled, the government may not deprive them of that support through unchallengeable and interminable delays.” [read the ruling here].
The ruling further states that the VA was given the opportunity by the Court following oral argument to consider a practical solution through mediation with the veterans groups, but refused outright. That attitude did not sit well with veterans or with the Court who, as part of the damage award, is appointing a judge to supervise the VA as it goes about fixing its broken systems, and is requiring that the VA include the valuable input of veterans groups as part of the process.
Political Will on the Hill
It is unfathomable and shameless that the VA would call a press conference to tell everyone how awesome they are a mere 3 days after a federal court has ruled them incompetent and responsible for veterans killing themselves while waiting for treatment. In spite of what the VA thinks of itself and its self-proclaimed new era for women, outrage from veterans and continual pressure from veterans advocacy groups in recent years has brought about tremendous results. Lawmakers are taking action on behalf of constituent veterans. A quick search on GovTrack reveals that so far this year, Congress has introduced more than 700 pieces of legislation that would have a direct impact on the care and benefits that veterans receive. It is crucial for everyone including active duty military (future veterans), current veterans, veteran groups, supporters of the military and those who enjoy freedom because of the military support these legislative efforts to the fullest.
Two crucial bills that would have an immediate impact and provide long term solutions to the issues identified by the 9th Circuit Court are H.R. 809, introduced by Congressman Bob Filner that would establish and require every VA facility to adopt and display a Women’s Veterans Bill of Rights guaranteeing 24 basic healthcare rights for women; and H.R. 930, introduced by Congresswoman Chellie Pingree that would help break through the logjam of backlog benefit claims by speeding up the processing of claims for veterans who experienced military sexual trauma by standardizing what is currently an unfair and arbitrary evidentiary standard.
Going Forward
This landmark legal ruling and landslide of legislation is the first time in recent history that the judiciary and the Congress are simultaneously putting the squeeze on the VA to end its long history of incompetence, to stop the unjustified delays and never-ending excuses, and to get recently returning and older veterans their benefits and treatment they desperately need and deserve.
George Washington once said, “The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive the Veterans of earlier wars were treated and appreciated by their nation.” The leadership of this nation has a long history of demanding unequivocal support for war, but then completely forgetting the needs of the people who fought in those wars. The proof of that is in the budget: The average cost of deploying one US servicemember to Iraq for one year is $390,000. The average disability compensation paid to one US veteran for one year is $8,615.
The truth to Washington’s statement is now clearly evident. Service in the military has been steadily declining, from a time during the American Revolution when it was expected that every citizen was a soldier, to the current wars where only 1% of America bears the burden for ensuring the other 99% of the population remains free.
And here are some more sobering numbers that show the human toll on our nation’s neglect: There are 25 million veterans in America today. 1 in 3 veterans are homeless, 13,000 of those are homeless women. 28% of veterans are clinically depressed, and over 300,000 Iraq war veterans suffer from PTSD. Studies show that veterans are twice as likely to commit suicide, and suicide rates among veterans under 20 years old have doubled since 9/11. Every day 18 veterans commit suicide and 1000 veterans attempt suicide.
We all need to do more to support their veterans than just thank them for their service and change our Facebook status. We need to do three things: Locally, we need to reach out to the veterans in our community; Nationally, we need to support the Veteran Service Organizations that provide services and advocate on veterans issues, and for long term solutions, we need to demand that our elected leadership ensure that the government institutions set up to care for veterans do so in a fair, timely and just manner with the finest care available, and that includes increasing access to civilian hospitals through fee based care programs. No more excuses. We need to step up and defend our veterans just as fervently as they stepped up and fought for us, then let the veterans decide when a new day has dawned.
VA Says It’s Working Harder to Serve Women – Marine Corps News
Ninth Circuit Court of Appeals Ruling
H.R.809 – To Direct the Secretary of Veterans Affairs to Display in Each Facility of the Department of Veterans Affairs a Women Veterans Bill of Rights – U.S. Government Printing Office
H.R.930 – To Amend Title 38, United States Code, to Improve the Disability Compensation Evaluation Procedure of the Secretary of Veterans Affairs for Veterans with Post-Traumatic Stress Disorder or Mental Health Conditions Related to Military Sexual Trauma, and for Other Purposes – U.S. Government Printing Office
