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Lawmaker urges better treatment of women vets

When Sen. Patty Murray, D-Wash., asked Veterans Affairs Department officials about her bill to provide better health care for female combat veterans, they brought up several concerns:

* Providing child care for women seeking mental health counseling could take away from direct care for VA patients.

* There’s no need for a study of female veterans’ needs because VA is already working on one.

* Staffing requirements for health care workers who can handle military sexual trauma would force VA to take a “cookie-cutter” approach.

But at a Senate Veterans’ Affairs Committee hearing Wednesday, four veteran’s groups provided their support for just those provisions.

“It’s consistent with research and the VA women’s advisory committee,” said Joy Ilem, assistant national legislative director for Disabled American Veterans. “If we’re really looking at these barriers, then what’s the point if we’re not going to do something about it?”

Murray said the provisions are important because women do not use VA health care at the same rates as men, in part because VA historically has catered to the needs of male combat veterans.

“Because the conflicts of today have no clear front lines, women, like all of our service members, are always on the front lines — riding on dangerous patrols, guarding pivotal checkpoints and witnessing the horrors of war firsthand,” Murray said.

For that reason, thousands of women will be eligible for care relating to war wounds or combat stress, and Murray said they need to feel comfortable in VA facilities — and many don’t.

“Some told me they had been intimidated by the VA and viewed their local VAs as male-only facilities,” Murray said. “Others simply told me they couldn’t find someone to watch their kids so that they could attend a counseling session or find time for other care.”

She questioned VA Principal Under Secretary for Health Gerald Cross, saying he had acknowledged those gaps in care in the past and that she was “surprised” that he objected to a pilot program for child care.

Cross said that would divert funds from direct patient care.

“Women are not getting the care ... because they cannot get child care,” Murray countered.

Ilem said DAV staffers have talked to many female vets who say that if they don’t have child care, they won’t go to long-term counseling.

She then asked why VA is opposed to the study of female war vets. Cross said VA launched a mortality and morbidity study of veterans in 2007, though he acknowledged that it’s not specific to women, and does not include active service members.

Murray asked why VA wouldn’t look at future patients as well as current patients.

“The objection is logistics,” Cross said. “Of course, our focus at the VA is the veterans.”

Cross also said VA opposes staffing standards for military sexual trauma therapy, which has become an issue since post-traumatic stress studies have found that women may have a higher rate of PTSD because of prior sexual trauma or attacks that occurred in the line of duty.

Murray said women are often reluctant to talk about sexual trauma and that counselors need special training.

Cross said physicians already screen veterans for sexual trauma, and directly ask them about the possibility of those experiences.

“I think we’re doing an adequate job of training our primary providers and specialty providers,” he said, adding that staffing needs to be tailored to each facility.

Ilem said the issue is more complex than it seems. Care providers who focus on military sexual trauma have a high “burn-out” rate because it’s complex and time-consuming, she said.

And once such a therapist leaves, it’s difficult to replace him or her, Ilem said.

“They need proper training and cultural understanding,” she said, adding that she’d like to see VA’s numbers on who has been properly trained to provide that kind of therapy.

Joseph Wilson, assistant director for health policy for the American Legion, said small changes can make a big difference in whether a woman receives care at a VA facility. For example, in 2005, he visited a VA facility in Puget Sound, Wash.

At that time, it didn’t have a separate entrance for women seeking care for military sexual trauma. In 2007, it did, and it helped because women who have been sexually assaulted have difficulty walking into a waiting room full of men.

He found that not having child care was also a deterrent.

“Any little issue would turn them away,” Wilson said.

“The last thing we want is for them to choose not to seek care,” Murray said.