WOMEN VETERANS BOBBI SIMMS
Background/Quick Facts 1.8 million living Veterans Fastest growing subpopulation of Veterans women Approximately 300,000 receive care in the Department of Veterans Affairs (VA) system 70% of physicians receive a portion of their training in VA Undergraduate Medical Education (UME) and Graduate Medical Education (GME) trainees will be caring for women Veterans inside and outside of the VA
Younger Women Concerns Reproductive Health Flexible Appointments Military Sexual Trauma (MST) Childcare and Elder Care Acute and Chronic Illness 3
Middle-Aged Women Concerns Preventive Care Menopausal Needs Acute and Chronic Illness Mental Health Needs 4
Older Women Concerns Geriatric Care Pain Management Inpatient and Extended Care Grief Counseling Acute and Chronic Illness 5
Mission Ensure all women Veterans receive equitable, highquality, 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
Women Veterans Health Care Initiatives Implementing comprehensive primary care for women Veterans at all care sites Appointing full-time Women Veterans Program Managers at all 144 medical centers Revising and creating VA policy related to women Veterans Retraining providers/large-scale education programs Ramping-up communications to and about women Veterans Enhancing mental health, homeless services Researching affects of military service on women s lives
Medical Diagnoses: Female OEF/OIF/OND Veterans in VA 2002-2011 (Q1=78,083) Diagnosis Musculoskeletal Mental Disorders Nervous System/Sense Organs Digestive System Genitourinary System Respiratory Endocrine System Diseases of Skin Injury/Poisonings Infectious and Parasitic Diseases Percent of Women Presenting 54% 49% 41% 38% 39% 33% 29% 26% 25% 19% 8
Unique Health Risks by Era OEF/OIF/OND Reproductive Health Issues Mental Health Issues Infectious Diseases (i.e., Leishmaniasis) Vision Loss Traumatic Brain or Spinal Cord Injury Traumatic Amputation Embedded Fragments (shrapnel) Dermatologic Issues Multi-Drug Resistant Acinetobacter Blast Injuries (penetrating/blunt trauma, burns) Gulf Wars Chemical or biological agents Depleted uranium Dermatologic Issues Infectious Diseases (i.e., Leishmaniasis) Reproductive Health Issues Exposures to smoke Immunizations Vietnam Agent Orange Exposure Hepatitis C Cold War WWII/Korea Nuclear Weapons Testing (Atomic Veterans) Exposure to nuclear weapons (including testing or cleanup) Chemical warfare agent experiments Cold injury Agent Orange Exposure 9
Military Sexual Trauma (MST) MST Definition: psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty or active duty for training. (from 1720D of Title 38, US Code)
MST has been associated with Increased suicide risk Major depression PTSD Alcohol/drug abuse Disrupted social networks Occupational difficulties Also Strong emotions Feelings of numbness Trouble sleeping Sexual dysfunction Asthma Breast cancer Heart attacks Obesity Menstrual and pelvic pain Somatization Difficulties with attention, concentration, and memory Difficulties in relationships Murdoch et al, 2006; Stein & Barrett-Connor, 2000; Frayne et 11 al, 1999, Kimerling et al, 2010.
VA s Response to MST Every VA facility has a designated MST Coordinator Every VA facility has providers knowledgeable about treatment for the aftereffects of MST. Many have specialized outpatient mental health services focusing on sexual trauma. Vet Centers also have specially trained sexual trauma counselors. Some facilities throughout VA have separate programs for men and women.
Traumatic Brain Injury (TBI) The most common causes of TBI are falls, motor vehicle accidents, assaults/blows and explosive blasts (military). Signs and symptoms of mild TBI may not be readily recognized somatic (headache, tinnitus, insomnia, etc.) cognitive (memory, attention and concentration difficulties emotional/behavioral (irritability, depression, anxiety, behavioral dyscontrol).
Traumatic Brain Injury (TBI) Most patients with mild TBI recover over time, however, some 10-15% of patients may go on to develop chronic post-concussive symptoms. Four VA Polytrauma Rehabilitation Centers and 21 Polytrauma Network Sites treat patients with TBI and musculoskeletal, neurologic or psychological trauma. Patients with milder injuries may present for treatment at other locales, including their local VA's or in their communities.
Benefits
Benefits Available to Eligible Women Veterans Compensation and Pension Health care Women s Clinic, Gyn/OB care, Primary Care, and Specialty Care Vocational Rehabilitation Employment assistance Home Loans GI Bill/Education Life Insurance Survivor and Death/Burial Benefits
VA Eligibility General Guidelines 2 Years of Active Duty Service Deployment in OEF/OIF/OND Military Sexual Trauma Many Special Eligibility Criteria Each Veteran is unique Eligibility can change
Frequently Asked Questions From Women Veterans 1. What services are available to women Veterans? 2. How do I access the system from health and benefits services? 3. Does the VA provide maternity benefits? 4. How can I receive gender-specific services, including Pap smears, mammography, prenatal and childcare? 5. How can I obtain emergency assistance with payment of my delinquent utility bills, rent, mortgage, etc.? 6. How long does it take to get a clinic appointment?
Frequently Asked Questions From Women Veterans - Continued 7. Where can I get treatment for conditions related to sexual assault or sexual harassment I experience while in the military? 8. How do I get my disability compensation claim reevaluated? 9. How do I contact a coordinator for options for women Veterans who are homeless with children? 10. Am I eligible for burial benefits? What are my options? 11. How do I locate my military records or those of a relative? 12. Where can I find information regarding benefits and services for National Guard, Reserves, and Uniformed Services? Questions?
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