Like many, I was glad to see the op-ed by Secretary-designate Denis McDonough in Military Times. Many were surprised by the announcement from the Biden-Harris transition team of Mr. McDonough as secretary-designate for Veterans Affairs. This open letter is not a criticism of him, the selection or the VA.

I have served Virginia’s veterans for the past eight years, and I am also a non-veteran. I appreciate President-elect Biden’s willingness to think outside the box and look forward to learning more about Mr. McDonough’s vision for the future of the VA. Based on my experience building cutting-edge, collaborative programs and services in Virginia, these are six of the top issues that if the VA works into a four-year strategic plan and implements wisely — and with partnerships with DoD, states, veteran service organizations (VSOs) and others — the agency will truly be at the cutting-edge of benefits for our nation’s veterans.

Looking ahead to the next four years and where the VA can go during the Biden administration, I would like to offer six ideas for not just improving the status quo, but taking the VA to the next level and creating a full continuum system to support our nation’s veterans. In Virginia we have led the way in many aspects of support for transitioning service members (TSM), veterans, National Guard, and family members.

First, women veterans. It is no secret that many were hoping for a woman to lead DoD or VA. Women have served honorably since the Revolutionary War. Secretary-designate McDonough should reach out early and often to women veterans, and work to ensure each state has created staff positions dedicated to supporting women veterans. Women veterans are less likely to refer to themselves as veterans — unless another woman veteran comes alongside them as a support. Then they are more active and utilize the benefits they have earned at higher percentages than male veterans. In Virginia, we hold regular “round table” discussions (pre-COVID) and an annual conference to share and gather information and provide a supportive networking space for women veterans. VA medical centers (VAMC) and community based outpatient clinics (CBOCs) need to continue to focus on providing the care that women veterans need and in a professional setting that makes them feel comfortable accessing that care.

Second, the VA should partner with functional medicine doctors, “biohackers,” leading university health researchers and Silicon Valley tech entrepreneurs on cutting-edge health, nutrition and scientific advancements and integrate those practices, technologies and nutritional strategies into VA care. Additionally, veterans who utilize these cutting-edge technologies, nutritional supplements, and alternative therapies such as yoga and mindful meditation, should be rewarded with stipends that encourage positive, healthy behaviors, reducing the strain on the health care system, improving their lives, while not financially penalizing healthy choices. Right now, the system rewards those who need higher disability ratings and are in need of regular medical care. This is bad for the veteran, bad for agency efficiency and morale, and bad for the American taxpayer.

Third, the VA should continue and expand efforts to integrate health care and records systems with DoD. The two agencies not sharing this valuable information or working collaboratively across military hospitals and VAMCs and CBOCs costs the taxpayer billions of dollars and creates frustration, confusion and chaos for transitioning service members and veterans. Medical files and other health records should travel from one agency to the other with the veteran, just like a DD214 or DD2. DoD/VA partnerships such as the integration of the former Naval Health Clinic Great Lakes and the former North Chicago VA Medical Center into the Capt. James A. Lovell Federal Health Care Center, should be replicated every community with a major military installation and veterans population.

Fourth, dovetailing with the above recommendations, is to work with DoD to improve nutrition, training and resiliency practices for active-duty service members. The healthier our military is while serving — physically, mentally, emotionally — the longer they will be able to serve, and the less need there will be for VA services once they separate and become veterans. This is also a fiscal savings to the American taxpayer, as it will reduce recruiting costs and strain on the active-duty side of the house.

Fifth, continue to focus on suicide prevention, bolstering efforts of nonprofits and the states. Virginia built cutting-edge continuum of care systems to support veterans in need of rehabilitative and behavioral health services by partnering with local agencies, nonprofits, VSOs and universities to create a whole-community approach to supporting and serving our veterans.

These issues are too big to leave on the VA’s doorstep. Additionally, the VA and DoD should create a joint “reintegration boot camp” where transitioning service members receive specialized training and support. In the 1940s, President Roosevelt instituted a pilot program for service members after receiving an alarming amount of mail from families saying the boys coming back from WWII were ill-equipped to return to civilian life. The masterful director John Hughes even created a short film, “Into the Light,” highlighting that program. You can’t have someone spend years in the military system, which is like no other society on earth, then have them spend 20 minutes filling out paperwork, shake their hands and say “Thank you for your service,” and expect everything to be good when they get home. Native American communities, especially the Lakota Sioux, have ritual ceremonies and systems of reintegration of their warriors to have time to cleanse and decompress before reentering the village after fighting wars. We could learn a great deal from them.

And lastly, focus on strategic planning and analyzing veterans’ programs in the states, within VSOs and other nonprofits and let the “cream rise to the top.” Federal-state partnerships and public-private partnerships should be encouraged. The job of assisting the transition from active-duty to veteran status and the lifelong support of veterans is too big for any one agency, state or group. The VA should work with Congress to create block grants or other funding to the states to replicate innovative solutions, such as Virginia’s Transition Assistance Programs (VTAP and V3) that provide world-class, hands on assistance to transitioning service members and veterans, and also trains companies, state and local government agencies, and nonprofit organizations on the best processes for recruiting, hiring and retaining veteran employees. These programs have led to over 50,000 veterans landing good-paying, high-quality jobs in Virginia and having successful, healthy, supported transitions out of the military and back into civilian life.

All six of these efforts will lead to healthier, happier veterans and will provide real, fiscally responsible solutions.

Carrie Ann Alford is co-founder of Torii Coaching & Consulting.

Editor’s note: This is an Op-Ed and as such, the opinions expressed are those of the author. If you would like to respond, or have an editorial of your own you would like to submit, please contact Military Times managing editor Howard Altman,

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