From the U.S. Government Accountability Office, www.gao.gov

Transcript for: Watchdog Report #12: VA Health Care Services for Women
Veterans
Audio interview by GAO staff with Randy Williamson, Director, Health
Care
Associated Report Number: GAO-10-287

Released on: April 7, 2010

[ Background Music ]

[Narrator:] Welcome to GAO's Watchdog Report, your source for news and
information from the Government Accountability Office. It's April 7th,
2010. As more women veterans return home, the Department of Veteran's
Affairs or VA faces challenges in providing the physical and mental
health care services they need. A group led by Randy Williamson, a
Director in GAO's Health Care team, examined the provision of health
care services for women veterans at VA medical facilities. GAO analyst
Jeremy Cluchey sat down with Randy to learn more.

[Jeremy Cluchey:] Women veterans are a growing subgroup of the American
military veteran population. To what extent are their medical needs
currently being addressed by VA medical centers?

[Randy Williamson:] Overall, VA has made good progress in providing a
full array of primary care and generous specific services for women
veterans. VA still has a ways to go, however. At the 19 facilities we
visited, for example, we found that VA still has not fully implemented
its comprehensive primary care initiative that would allow women to
receive primary care services, including gender-specific services, from
a single provider at one location. This one-stop model would obviate the
need for women to make multiple stops to several primary care providers.

[Jeremy Cluchey:] Can you talk about some of the challenges that VA
medical centers face in providing health care services for women
veterans?

[Randy Williamson:] One challenge is a difficulty in hiring primary care
providers with specific training and experience in women's health. For
example, officials at many VA facilities we visited noted they had
difficulty attracting mental health care providers with experience in
treating post-traumatic stress disorder and military sexual trauma,
which are prevalent amount women veterans. This difficulty stems from
the nationwide shortage of mental health care providers. To help obtain
more primary care physicians that can serve the health care needs of
women veterans, VA has initiated internal training for its provider
staff to train them to better serve the health care needs of women
veterans. Another challenge is related to space constraints. For
example, at some facilities a shortage of available exam rooms limits
the ability to provide care efficiently.

[Jeremy Cluchey:] Did GAO identify any privacy concerns regarding
treatment of women veterans at VA medical centers?

[Randy Williamson:] Privacy is a major concern at virtually all of the
VA facilities we visited. For example, simple things are missing, such
as positioning exam tables away from the door, having bathrooms adjacent
to exam rooms, and configuring waiting rooms to better ensure the
privacy of women veterans as they're checking in. Even today, we found
that planned renovations and new construction at some VA facilities were
not always incorporating the privacy needs of women.

[Jeremy Cluchey:] You mentioned military sexual trauma or MST, which is
of particular concern among this population. One in five women veterans
screened positively for MST in fiscal year 2008. Can you talk about this
condition and discuss what GAO found regarding its treatment at VA
medial menters?

[Randy Williamson:] Military sexual trauma results from sexual
harassment or sexual abuse of veterans, both men and women, were
subjected to during their military service. VA has adopted a number of
ways to screen, identify, and treat MST among veterans visiting VA
facilities. This includes counseling by trained mental health care
providers in an outpatient or residential treatment setting. However as
I said before, obtaining mental health care providers, particularly
those trained to treat MST, is difficult. Also, VA has not set standards
for how much training is needed by providers treating veterans with MST,
and the amount of provider training in MST varied at the facilities we
visited.

[Jeremy Cluchey:] What steps does GAO recommend the Department of
Veterans Affairs take to improve health care for women at VA medical
centers?

[Randy Williamson:] GAO has recommended VA take action in several areas.
For example, we think that VA needs to clarify and strengthen the role
of the Women's Veteran Program Manager to provide them ready access to
senior management at each facility. Also, we have recommended the
training requirements for mental health care providers treating MST
should be clarified and strengthened. We believe VA should also be more
proactive in ensuring that its policies to ensure privacy for women
veterans during their visits to VA facilities are carried out. Finally,
assuring that construction and renovation plans adequately address the
privacy and safety needs of women veterans is another recommendation
we've made.

[ Background Music ]

[Narrator:] To learn more, visit GAO's Web site at gao.gov, and be sure
to tune in to the next edition of GAO's Watchdog Report for more from
the congressional watchdog, the Government Accountability Office.