**Department of Veterans Affairs**

**Advisory Committee on Women Veterans**

**Meeting Minutes**

Lafayette Building, Room 819

811 Vermont Avenue, NW

**Washington, DC 20420**

**February 27 -- March 1, 2007**

# [Advisory Committee Members Present]{.underline}:

  ----------------------------- -----------------------------------------
  COL Shirley Quarles, USAR,    Brenda Moore, USA
  Chair                         

  SFC Gwen M. Diehl, USA,       COL Jacqueline Morgan, USAF, Retired,
  Retired                       Vice-Chair

  Velma Hart, USAR              Lupe Saldana, USMC

  CPO Kathleen Janoski, USN,    CMSgt Sara A. Sellers, USAF, Retired
  Retired                       

  Marlene R. Kramel, USA        Celia Renteria Szelwach, USA

  Mary Antoinette Lawrie, USAF  Joanna Crosariol Truitt

  1SG Pamela Luce, USA, Retired 

                                
  ----------------------------- -----------------------------------------

# [Advisory Committee Member Absent]{.underline}:

  ----------------------------------- -----------------------------------
  Virgil Walker, ANG                  

  ----------------------------------- -----------------------------------

# [Ex-Officio Members Present]{.underline}:

COL Denise Dailey, Military Director, Department of Defense (DoD) --
Defense Advisory Committee on Women in the Services (DACOWITS)

Cheryl Rawls, Director, VA Regional Office, Huntington West Virginia

# [Ex-Officio Members Absent:]{.underline}

Cynthia Morrison, Department of Labor, Veterans' Employment and Training
Service

**[Advisors Present:]{.underline}**

Lindee Lenox, Director, Memorial Programs Service, National Cemetery

> Administration (NCA)

CDR Lucienne D. Nelson, Program Manager, Critical Infrastructure
Protection for Healthcare and Public Health Sector, Department of Health
and Human Services

Linda Piquet, VBA, Program Manager for Women Veterans Outreach Program

# [VA Staff Present:]{.underline}

+--------------------+---------------------------+--------------------+
| **Center for Women | Dr. Irene Trowell-Harris, | Desiree Long       |
| Veterans**         | Director                  |                    |
|                    |                           | Chanel             |
|                    | Dr. Betty Moseley Brown,  | Bankston-Carter    |
|                    | Assoc. Director           |                    |
|                    |                           | Michelle Terry     |
+--------------------+---------------------------+--------------------+
| **Center for       | Lucretia McClenney,       | Renee Allen,       |
| Minority           | Director                  |                    |
| Veterans**         |                           | Juanita Mullen     |
|                    | Earl Newsome, Deputy      |                    |
|                    | Director                  | Alejandro Ramos    |
+--------------------+---------------------------+--------------------+
| **VHA**            | Dr. Patricia Hayes,       | Meri Mallard,      |
|                    | Acting Chief Consultant,  | Deputy Field       |
|                    | Veterans Health           | Director, VHA      |
|                    | Administration (VHA)      | WVHSHG             |
|                    | Women Veterans Health     |                    |
|                    | Strategic Healthcare      |                    |
|                    | Group (WVHSHG)            |                    |
+--------------------+---------------------------+--------------------+

**[Guests:]{.underline}**

Fredrick Burns, Veterans of Foreign Wars of the United States (VFW)

JoAnn Cronin, American Legion Auxiliary

Pamela Gilley, American Legion Auxiliary

Yanira Gomez, VFW

Delores Leon-Saldana

Shannon Middleton, The American Legion

Teresa Morris, VFW

Michelle Saunders, Department of Labor

**[Tuesday, February 27, 2007]{.underline}**

## Meeting was called to order by the Chair. Items discussed included:

-   Introduction of Members & Visitors.

-   Agenda review.

-   Subcommittees' Status Report.

-   Approval of October/November 2006 Advisory Committee meeting
    minutes.

-   Site visit selection.

-   Capitol Hill visit.

**Briefing: Overview of VHA Initiatives, Michael J. Kussman, M.D., MS,
MACP, Acting Under Secretary for Health**

-   OEF/OIF care.

-   Organizational challenges- consistent care nationwide.

-   Budget (accountability/operation using business model).

-   Performance Measures -- effectiveness/tertiary care tracking.

-   Traumatic Brain Injury (TBI), Polytrauma, mental health, PTSD in
    women, VISN rehab.

-   Challenges faced by VA.

-   VA Medical Center, Washington, D. C. developing breast surgery
    clinic.

-   Develop good cadre of healthcare providers with expertise in women's
    health.

-   Relationship with Department of Defense (DoD) and flow of
    information.

**Update: Veterans Benefits Administration, Bradley G. Mayes, Director,
Compensation and Pension Service (C&P)**

-   Discussed recommendations pertaining to veterans' benefits and
    rationale for VBA response to 2006 ACWV report recommendations.

-   VETSNET (Veterans Service Network) is a new VBA corporate repository
    that includes information on denials; previous applications/software
    did not have denial information.

-   Conducting work measurements study (work measurement studies
    conducted every 3 years) involving sexual trauma. Process will be
    included in the sample.

-   C&P Systematic Technical Accuracy Review (STAR) samples claims
    rating for accuracy.

-   Discussed ways to get information from those who are not computer
    savvy.

-   Discussed outreach to family members of reservists during family
    weekend.

-   Discussed Transition Assistance Program (TAP)/Disabled Transition
    Assistance Program (DTAP) briefings.

**Briefing: Lisa Pape and Mary Rooney, Homeless Program/Incarcerated
Veterans**

**Re-entry Initiative**

-   Notice of Funding Availability/call for proposals released in
    February for women veterans with children.

-   Discussed 20^th^ year Anniversary of Homeless Program Services
    (1987).

-   Nationwide, approximately 4-5% of homeless are women veterans,
    according to some studies.

-   Incarcerated veterans outreach program. Each state has
    representative to enroll vets before release from prison.

    -   21 VISN re-entry specialists.

    -   125 stand downs nationally.

-   Discussed special needs funded by community providers.

## Update: 2006 Advisory Committee Report, Dr. Irene Trowell-Harris, Director, Center for Women Veterans (CWV)

An update status of the 2006 ACWV report was given.

-   Report was submitted to the Office of General Counsel for review and
    was cleared.

-   The report was submitted to the Secretary on February 9, 2007 for
    approval and signature.

-   The report will be distributed to members of Congress, VA medical
    centers, VA Administrations, State Departments of Veterans Affairs,
    veterans service organizations, and other veteran-related
    organizations.

-   The report will be published in 2007 and posted to the Center's Web
    site.

**Update: Summit 2008/Center Activities, Betty Moseley Brown, Associate
Director, CWV**

-   Provided a summary of the Center's activities.

-   Provided information on outreach activities.

-   Discussed VA's strategic goals and the Center's performance
    measures.

-   Discussed 2008 Summit.

    -   Friday, March 2, 2008 will be the first Summit conference call.

    -   Group will come up with breakout session and discussion items.

    -   Targeted number is approximately 350-400; target audience is
        those who have an interest in women veterans.

    -   The Summit will be held June 20-22, 2008 in Washington, D. C.

***[Wednesday, February 28, 2007 - Room 819, Lafayette
Bldg]{.underline}***

Meeting called to order by the Chair. Items discussed included:

-   Capitol Hill Visit -- Informal discussion of CWV mission activities,
    as well as ACWV mission/activities and areas of interest.

-   Next ACWV Site Visit, June 3-9, 2007.

-   Discussed proposed dates for fall meeting. Meeting will be timed
    with Women in Military Service for America's 10^th^ Anniversary, if
    possible.

    -   October 8-13, 2007.

    -   October 22-27, 2007.

-   Discussed 2008 Summit.

-   Discussed Washington Post Article regarding Rise in Homeless
    throughout the nation.

**Update: Overview of VA Initiatives/Remarks: The Honorable R. James
Nicholson, Secretary of Veterans Affairs**

-   Group photographs with Secretary Nicholson and Committee.

-   Overview of VA initiatives/legislation.

-   Discussed 2008 budget.

-   Every OEF/OIF veteran seeking healthcare will be screened for
    Traumatic Brain Injury.

-   Discussed stats on women veterans.

-   Stressed the importance of the Advisory Committee on Women Veterans.

**Briefing: Women Veterans Health Strategic Healthcare Group (SHG),
Patricia M. Hayes, PhD, Acting Chief Consultant**

-   Discussed stats on women veterans.

-   Overarching priority is to serve each woman veteran by providing the
    best possible care and service within the most optimal time and in a
    secure and dignified environment.

-   Mental Health priority is provided to veterans with disabilities to
    the greatest extent possible and to improve the quality of their
    lives and that of their families.

-   Primary Care priority is to ensure smooth transition for veterans
    from active service to civilian life.

-   Quality of Care priority is to assure that the veteran is receiving
    the highest quality of care available in America.

-   Research and Development Priority is to continue to support research
    which informs on highest quality care, best practices and effective
    treatments for women veterans.

-   Discussed health system and policy.

**Discussion: Women Veterans Health Program, Meri Mallard, Deputy Field
Director, Women Veterans Health SHG**

-   Discussed annual plan of care and clinical inventory.

-   Discussed 3^rd^ fiscal year data collected.

-   Discussed a web-based tool whereby only the Women Veterans Program
    Manager can enter, edit, and submit information.

-   Over 1000 community based outpatient clinics.

-   Discussed privacy issues.

-   Discussed network performance plan.

**Discussion: Possible Workgroup Recommendations for 2008,
Report/Options for Site Visit, Dr/ Shirley Quarles, Chair, ACWV**

-   Discussed proposed sites.

-   Subcommittees (Health/Benefits) began to work on the 2008 Report.

***[Thursday, March 1, 2007]{.underline}***

## Meeting was called to order by the Chair. The following items were discussed:

-   Site visit.

-   Subcommittees met to discuss 2008 Report.

**Update: Status of Fee Program, Ralph Charlip, FACHE, FAAMA, Director,
VA Health Administration Center**

-   The purpose of the Fee Program is to support VA patients, VA staff,
    and non-VA care providers in the timely access to medically
    necessary services.

-   Fee care should be arranged in advance. However, in case of medical
    emergencies, VA should be notified within 72 hours of admission. Fee
    is not a permanent authorization.

-   Use of Fee services is based on individual needs, capability of the
    VA system, and other factors (such as the special needs for women
    veterans).

-   Discussed claims process with regards to eligibility, authorization
    and payment through Vista Fee System.

-   Will provide stats (drill down) of types of payments.

-   Discussed challenges in retrospective non-VA hospitalization.

-   Discussed billing issues related to Fee care.

-   Discussed improvements in development.

-   Discussed how to improve access and reduce costs.

**Briefing: Overview on Center for Minority Veterans, Lucretia
McClenney, Director, Center for Minority Veterans (CMV)**

-   Discussed Congressional mandate/Public Law. Public Law 103-446
    (November 1994) required the Secretary of Veterans Affairs to create
    the Center for Minority Veterans and establish the Advisory
    Committee on Minority Veterans.

-   CMV acts as a resource center for information, publicize and
    encourage medical research, conduct and sponsor demographic
    research, track complaints and analyze data on minority veterans.

-   The Director, CMV serves as the principal advisor to the Secretary
    on the adoption and implementation of policies and programs
    affecting minority veterans**.**

-   CMV's responsibilities includes identifying barriers to access,
    conduct outreach, site visits, town hall meeting, educational
    forums, veterans stakeholder conferences and meetings, promote the
    use of VA benefits and services, develop statistical data base, and
    propose and encourage medical research.

-   The Center services four minority groups: (1) African Americans, (2)
    Asian Americans, (3) Hispanic Americans, and (4) Native Americans,
    American Indians, Alaska Native, Native Hawaiians, and Pacific
    Islanders.

-   Discussed Center for Minority Veterans' outreach components.

-   Minority Veterans Program Coordinators (MVPC's) Interdepartmental
    program (Approximately 300 coordinators collaterally assigned within
    VHA, VBA and NCA).

    -   Support and initiate activities that educate and sensitize
        internal staff to the unique needs of minority veterans.

    -   Target and participate in outreach activities, educational and
        informational forums utilizing community networks.

-   The Advisory Committee on Minority Veterans advises the Secretary
    and Congress on VA's administration of benefits and health care
    services. They meet with VA officials, veteran service
    organizations, and other stakeholders to assess the Department's
    efforts in providing benefits and outreach. Additionally, they make
    periodic site visits and conduct town hall meetings with veterans to
    address their concerns.

**Briefing: New Psychosocial Rehabilitation and Recovery Services
Program, Robert Gresen, Ph.D., Associate Chief Consultant**

-   Discussed Comprehensive VHA Mental Health (MH) Strategic Plan.

    -   Reduce stigma, promote recovery, ensure equal access and reduced
        variability of care, provide culturally competent care to
        veterans of all ages, races, ethnic groups, and genders.

    -   Be veteran and family-centered, and ensure collaborative care
        models are used in primary care team structure.

    -   Promote research programs based on recovery, employ
        evidence-based population approaches.

-   Transforming the VHA MH system into a recovery-oriented, family and
    consumer-driven system will require:

    -   Leadership/champions at all levels of the organization.

    -   Active involvement of veterans and veteran advocates in all
        aspects of this transformation.

    -   Culture change, program changes, education, family involvement,
        and peer support services.

**Briefing: Domestic Violence, Rachel Kimerling, PhD, National Center
for PTSD, VA Palo Alto Health Care System**

-   Discussed the definition of Intimate Partner Violence (IPV), its
    prevalence, and consequences.

-   Discussed how to detect IPV and the disclosure of current and past
    IPV.

-   Few data for prevalence of IPV among women veterans

-   Resources for IPV in VA common to almost all VA facilities:
    Directives according to The Joint Commission standards for IPV.

-   Lists and contacts for local community resources, staff training
    regarding IPV, VA clinicians experienced in treating trauma, and
    adherence to state reporting requirements (38 states).

**Discussion: Review of Committee Initiatives and Report
recommendations, Dr. Shirley Quarles, Chair, ACWV**

Breakout of subcommittee groups.

**Meeting Adjourned**

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