1. 1 Update on Legislation Related to Women Veterans, and Update on 2008 Report (Recommendation 5) Presentation by Joan Evans Assistant Secretary for Congressional and Legislative Affairs

2. 2 AGENDA Current Outlook Member Interests How Legislative about Women Veterans is Formed Pending Legislation Update on 2008 Report GAO Report Summary Questions

3. 3 Current Outlook The number of Women accessing VA care between 2006 to 2008 grew by 12 percent VA recognizes we need to prepare for the population of Women Veterans accessing VA care to grow by a projected 17 percent by 2033 VA leadership is committed to working with Congress, VSOs, and the media to transform VA culture so it is more welcoming to Women VA leadership acknowledges that Women Veterans serve in combat areas and suffer from combat-related issues

4. 4 Member Interest Major Areas of Member Focus: –Assessing services VA is providing for Women Veterans –Improving the claims process for Women so their combat service is not questioned –Providing child care so all Veterans are able to seek care at VA –Proving medical care for newborn children of Women Veterans –Ensure VA delivers coordinated, comprehensive primary Women’s health care at every VA facility –Ensuring mental health care is integrated into the primary care model –Cultivate and enhance capabilities of all VA staff with regard to the needs of Women –Promote and incentivize innovation in care delivery –Ensure the Women Veteran Program Managers are effective

5. 5 How Legislation is Formed Hearings Roundtables Site Visits Meetings/Briefings GAO Reports Constituent communications VSO Input

6. 6 Pending Legislation

7. 7 Sponsor: Rep. Herseth-Sandlin, Stephanie [SD] (introduced 2/26/2009) Latest Major Action: Passed in House and Referred to Senate Veterans Affairs Committee on 6/24/2009 placed in S 252 Political Analysis: Will likely pass with S 252. Detailed Description: –Study of barriers for women veterans to health care from the Department of Veterans Affairs. –Develop a comprehensive assessment of women’s health care programs of the Department of Veterans Affairs. –Provide medical care for newborn children of women veterans receiving maternity care. –Provide training and certification for mental health care providers of the Department of Veterans Affairs on care for veterans suffering from sexual trauma and post-traumatic stress disorder. –Develop a pilot program for provision of child care assistance to certain veterans receiving certain types of health care services at Department facilities. –Add women that were recently separated women and minority veterans to serve on advisory committees. VA Position: –Supported the assessment and study provision with a different start date to ensure the contractor would be able to draft a plan for the study and research –VA supports a 7 day period of VA-provided care for new borns –VA does not support mandates for MST and PTSD training because this is duplicative of ongoing efforts within the Department –VA did not support the child care pilot but is reevaluating this position HR 1211 Women Veterans Health Care Improvement Act

8. 8 S 252 (companion to HR 1211)* Sponsor: Sen. Akaka, Daniel [H] (introduced 1/15/2009) Latest Major Action: 7/24/09 reported to the full Senate for action Political Analysis: Positive floor vote in Senate is likely so it has a high probability of becoming law Detailed Description: –Report on barriers to receipt of health care for women veterans. –Plan to improve provision of health care services to women veterans. –Conduct an independent study on health consequences of women veterans of military service in Operation Iraqi Freedom and Operation Enduring Freedom. –Provide training and certification for mental health care providers on care for veterans suffering from sexual trauma. –Develop a pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces. –Report on full-time women veterans program managers at medical centers. –Add women with service on certain advisory committees of women recently separated from service in the Armed Forces. –Develop a pilot program on subsidies for child care for certain veterans receiving health care. –Provide care for newborn children of women veterans receiving maternity care. *S 597 (Murray) language was merged into this legislation.

9. 9 S 1237 – Reintegration of Homeless Women Veterans Sponsor: Sen. Murray, Patty [WA] (introduced 6/11/2009) Latest Major Action: Introduction (included in the 6/21/09 legislative hearing) Political Analysis: Anticipate favorable report out of the Senate Veterans Affairs Committee and will move to floor vote. It could wrapped in with S 252 for a vote. Summary of Legislation: –Establishes a grant program for reintegration of homeless –women veterans and homeless veterans with children. The –services include: Job training Counseling Job placement services, including job readiness, literacy, and skills training Child care VA Position: –VA supports allowing any eligible entity providing services to special needs populations to apply for special needs grants by eliminating the requirement that recipients also be a grant and per diem recipient. –VA also supports making the provision recognizing homeless Veterans with dependent children as a special needs population gender neutral because it would allow VA to directly provide equal services to all homeless Veterans with dependents.

10. 10 HR 293 - Homeless Women Veterans and Homeless Veterans with Children Reintegration Grant Act of 2009 Sponsor: Rep Buyer, Stephen [IN] (introduced 1/8/2009) Latest Major Action: Introduction Political Analysis: Will likely not be reported out of committee this session. Currently, legislation does not have any majority co- sponsors. Details: –Directs the Secretary of Labor to carry out a grant program to provide reintegration services through programs and facilities that emphasize services for homeless women veterans and homeless veterans with children VA Position: –No position because it falls within the Department of Labor

11. 11 Update on 2008 Report (Recommendation #5)

12. 12 Recommendation #5 Recommendation: VA supports legislation regarding entitlement of newborns born to Women Veterans received maternity care benefits. These infants, who are not statutory beneficiaries, should be treated as eligible beneficiaries for the purposes of initial neonatal care. Current Status: HR 1211 and S 252 language addresses this recommendation: (a) In General.—The Secretary may furnish health care services described in subsection (b) to a newborn child of a woman veteran who is receiving maternity care furnished by the Department for not more than 7 days after the birth of the child if the veteran delivered the child in— (1) a facility of the Department; or (2) another facility pursuant to a Department contract for services relating to such delivery. (b) Covered Health Care Services.—Health care services described in this subsection are all post-delivery care services, including routine care services, that a newborn requires.

13. 13 GAO Report Update Areas VA has made significant progress: –Making the Women Veterans Program Manager (WVPM) a permanent position –Establishing a system-wide comprehensive primary care model for Women Veterans at every VAMC and CBOC

14. 14 Areas GAO Reviewed with Outcomes AREAOUTCOME On-site availability of health care services for Women Veterans Overall, basic gender specific services where available on site VAMCs offered at least some specialized services and CBOCs typically referred patients to other VA facilities or provided fee basis care Is VA following the established internal policies?Medical facilities had not fully implemented VA policies pertaining to delivery of health care services for women veterans. Key challenges facilities are experiencingSpace constraints Hiring primary care providers with the specific training and experience needed for Women Veterans services Hiring mental health providers the training and experience in treating MST and PTSD Establishing the Women Veterans Program Manager as a full-time position has some implementation issues

15. 15 Summary Questions