1. Women Veterans and the VHA 01/25/13

2. VETERANS HEALTH ADMINISTRATION Rethink Veterans 2

3. VETERANS HEALTH ADMINISTRATION History of Women in the U.S. Military Source: America’s Women Veterans: Military Service History and VA Benefits Utilization Statistics, Department of Veterans Affairs, National Center for Veterans Analysis and Statistics, Nov. 23, 2011; http://www.va.gov/VETDATA/docs/SpecialReports/Final_Womens_Report_3_2_12_v_7.pdfhttp://www.va.gov/VETDATA/docs/SpecialReports/Final_Womens_Report_3_2_12_v_7.pdf 3

4. VETERANS HEALTH ADMINISTRATION As Women Veteran Population Increases, Total Vet Population Declines Source: VetPOP 2007, ADUSH for Policy and PlanningVetPOP 2007 4

5. VETERANS HEALTH ADMINISTRATION Growth is Expected to Continue 12% of OEF/OIF/OND Veterans 18% of National Guard/Reserves 6% of VA health care users 5 years’ free VA health care for OEF/OIF/OND Veterans with service-related issues More women with service-connected disabilities 56% of OEF/OIF women Veterans have used VA care System-Wide Implication: VA is working tirelessly to enhance care and access to serve more women Veterans coming through the door 5

6. VETERANS HEALTH ADMINISTRATION Women VA Patients: Three Peaks Source: Women’s Health Evaluation Initiative (WHEI) and the Women Veterans Health Strategic Health Care Group; SourceBook: Women Veterans in the Veterans Health Administration V1: Sociodemographic Characteristics and Use of VHA Care, 2011. 6

7. VETERANS HEALTH ADMINISTRATION The Changing Face of VA –Young women –Frequent visits –Service-connected disabilities –Maternity care –Working women –Mental health needs 7

8. VETERANS HEALTH ADMINISTRATION –Older women –Largest sub-population –Menopausal needs –Geriatric care –Inpatient/extended stays –Pain management The Changing Face of VA 8

9. Unique Health Risks by Era OEF/OIF/OND Reproductive health issues Mental health issues Vision loss Infectious diseases (e.g., Leishmaniasis) Traumatic brain or spinal cord injury Traumatic amputation Embedded fragments (shrapnel) Multi-drug resistant Acinetobacter Blast injuries (penetrating/blunt trauma, burns) Dermatologic issues Gulf Wars Chemical or biological agents Dermatologic issues Infectious diseases (e.g., Leishmaniasis) Reproductive health issues Depleted uranium exposure Smoke exposures Immunizations Vietnam Agent Orange exposure Hepatitis C Cold War Nuclear weapons testing (Atomic Veterans) WWII/Korea Chemical warfare agent experiments Agent Orange exposure Exposure to nuclear weapons (including testing or clean-up) Cold injury

10. VETERANS HEALTH ADMINISTRATION Women Veterans Health Care 10

11. VETERANS HEALTH ADMINISTRATION Mission Ensure all women Veterans receive equitable, high- quality, and comprehensive health care services in a sensitive and safe environment at all VA facilities Be a national leader in the provision of health care for women Veterans, thereby raising the standard of care for all women 11

12. VETERANS HEALTH ADMINISTRATION Goals, Accomplishments and Continued Efforts Goal 1: Transform health care delivery for women Veterans ▲ Implemented comprehensive primary care ▲ Installed full-time WVPMs at VA facilities nationwide ▲ Launched Women’s Health Evaluation Initiative (WHEI) Eliminating gender disparities – recent reports show progress: www.womenshealth.va.gov/publications.asp#research www.womenshealth.va.gov/publications.asp#research Developing breast cancer registry and mammography tracking Expanding enrollment and access Enhancing privacy, security and environment of care Improving emergency room care Enhancing mental health, homeless services 12

13. VETERANS HEALTH ADMINISTRATION Goals, Accomplishments and Continued Efforts Goal 2: Develop, implement and influence VA health policy as it relates to women Veterans ▲ Revised VHA Handbook 1330.01: Health Care Services for Women Veterans Revising/creating policy on women’s comprehensive care and reproductive health Goal 3: Develop, implement and influence VA education initiatives ▲ Trained nearly 1,500 VA providers in basic and advanced women’s health care Expanding large-scale provider/nursing education programs 13

14. VETERANS HEALTH ADMINISTRATION Goals, Accomplishments and Continued Efforts Goal 4: Drive the focus and set the agenda to increase understanding of the effects of military service on women Veterans’ lives ▲ Sourcebooks offers sociodemographic profile of, and VHA health care utilization trends among, women Veterans Researching effects of military service on women’s lives Outcome: Needs of women Veterans always considered across program offices and in policy and key decisions 14

15. VETERANS HEALTH ADMINISTRATION Women’s Health Education 15

16. VETERANS HEALTH ADMINISTRATION Training Opportunities: Nurses Women's Health Nursing Mini-Residency Pilot – Comprehensive curriculum includes use of simulation equipment, traditional mini-residency format – Will lay groundwork for future initiatives to train VA primary care nurses in basic/advanced women’s health Monthly audio-conferences for primary care nurses – Second Tuesday of the month, 3 p.m. ET More information about training opportunities: http://vaww.infoshare.va.gov/sites/womenshealth/ education/default.aspx 16

17. VETERANS HEALTH ADMINISTRATION Training Opportunities: Primary Care, Emergency Providers Developed, delivered in partnership with EES and SimLEARN Women’s Health Primary Care Mini-Residency Nearly 1,500 providers trained Monthly Provider Audio-Conferences: 3 rd Tuesday of the month noon and 3 p.m. ET Courses available on TMS (Mini-Residency, Emergency Care Core Competencies) Grants for trainings = more trained at regional level 17

18. VETERANS HEALTH ADMINISTRATION Other Education Initiatives VA HSR&D cyber seminar Women’s Health Series Advanced Women Veterans Health Fellowship program enhanced and expanded Developing a system to help providers maintain proficiency Enhanced patient education Ongoing efforts system-wide to deliver the message: “It’s everyone’s job to care for women Veterans” www.womenshealth.va.gov/culture_change.asp www.womenshealth.va.gov/culture_change.asp 18

19. VETERANS HEALTH ADMINISTRATION Changing VA Culture 19

20. VETERANS HEALTH ADMINISTRATION Culture Change Women Veterans Health Care is leading a VA-wide communication initiative to enhance the language, practice and culture of VA to be more inclusive of women Veterans. National Women Veterans Communications Workgroup: – Broad representation across VA – Develops strategies to reach women Veterans and VA employees 20

21. VETERANS HEALTH ADMINISTRATION 21

22. VETERANS HEALTH ADMINISTRATION Women Veterans’ Stories of Service VA videos capture history and illustrate bravery, achievement, and pride http://www.womenshealth.va.gov/stories.asp 22

23. VETERANS HEALTH ADMINISTRATION http://www.womenshealth.va.gov/WOMENSHEALTH/culture_change.asp PSA, New Employee Orientation Video 23

24. VETERANS HEALTH ADMINISTRATION 24

25. VETERANS HEALTH ADMINISTRATION Author 25 Patricia Hayes, PhD Chief Consultant, Women’s Health Services Office of Patient Care Services patricia.hayes@va.gov www.womenshealth.va.gov