2012 Report

Strategies for Serving Our 

Women Veterans 

Department of Veterans Affairs

Women Veterans Task Force

Draft for Public Comment • May 1, 2012
“We, at VA, must be visionary and agile enough to anticipate and adjust not only to the 

coming increase in women Veterans, but also to the accompanying complexity and 

longevity of treatment needs they will bring with them.”

Secretary Shinseki, July 16, 2011

Preface

This draft strategy report was developed by the Women Veterans Task Force

(WVTF) of the Department of Veterans Affairs (VA). The task force, which was 

called for by Secretary Shinseki in July 2011, is chaired by the VA Chief of Staff with 

the three Under Secretaries serving as a governing board. 

In preparation for the task force’s effort, background on the “as is” state of services 

and benefits for women Veterans was documented in the fall of 2011 by a working 

group with representatives from all VA administrations. The WVTF, which 

commenced work in February 2012, consists of subject matter experts from across 

VA, representing the Veterans Health Administration (VHA), Veterans Benefits 

Administration (VBA), National Cemetery Administration (NCA), and VA 

headquarters (VACO). Full membership of the WVTF is shown in Appendix A.

This draft report is an interim deliverable, representing the work of the WVTF 

emerging from a four-day offsite in March. Public comments on this draft are 

welcome through June 14, 2012 and should be submitted through the Federal 

Register Web site www.regulations.gov.

Following the comment phase, a revised strategy report will be developed 

presenting the task force’s recommendations for continuously improving services 

for women Veterans across the entire Department. In addition to the strategy 

report, the task force will develop an action plan for implementing the 

recommended strategies, specifying costs, work plans, performance measures, 

organizational accountabilities, and associated risks. The action plan will update and 

inform VA’s approach to women’s issues within the health care, benefits, and 

cemetery administrations, and will guide the agency in planning and 

implementation of programming, budgeting, education and training. The task force 

is posting the draft strategy plan/report for public comment at an early stage in 

order to elicit the creative thinking and expert opinions of a wide range of 

stakeholders. 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 1

Draft for Public Comment, May 1, 2012

2012 Report

Strategies for Serving Our Women Veterans

Table of Contents

INTRODUCTION ..........................................................................................................2

CAPACITY AND COORDINATION OF SERVICES............................................................14

ENVIRONMENT OF CARE AND EXPERIENCE................................................................16

EMPLOYMENT AND TRAINING ..................................................................................18

DATA COLLECTION AND EVALUATION OF SERVICES ...................................................20

ORGANIZATIONAL ACCOUNTABILITY, COLLABORATION, AND TRANSPARENCY..........21

CONCLUSION ............................................................................................................22

APPENDIX A..............................................................................................................23

APPENDIX B..............................................................................................................24
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 2

Introduction

The Department of Veterans Affairs (VA) is committed to transformation, with the 

aim of becoming an increasingly Veteran-centric, results-oriented, and forwardlooking organization. In line with this commitment, Secretary Shinseki called for the 

formation of a Women Veterans Task Force (WVTF) in July 2011, to be charged with 

developing a comprehensive VA action plan for resolving gaps in how our 

organization serves women Veterans. As an interim deliverable, the WVTF 

developed this draft strategy report to solicit stakeholder feedback on its initial 

findings and recommendations. Based on public comments to this draft, the WVTF 

will finalize its recommendations and develop a detailed action plan for 

implementation.

The urgency of this effort is acute, given the rapid growth of the women Veteran 

population. Consider these facts, which Secretary Shinseki cited in announcing the 

formation of the WVTF:

Fully 14 percent of active duty and 18 percent of National Guard and 

Reserves forces are now women. In contrast, the percentage of women in 

uniform was just 2 percent in 1950.

The nature of warfare places women in hostile battle space in everincreasing numbers, with ever-increasing opportunity for direct-fire combat 

with armed enemies.

Women are sustaining injuries similar to their male counterparts, both in 

severity and complexity.

Women are now the fastest growing cohort within the Veteran community. In 2011, 

about 1.8 million or 8 percent of the 22.2 million Veterans were women.1 The male 

Veteran population is projected to decrease from 20.2 million men in 2010 to 16.7 

million by 2020. In contrast, the number of women Veterans will increase from 1.8 

million in 2011 to 2 million in 2020, at which time women will make up 10.7

percent of the total Veteran population. 

The population of women Veterans has grown steadily over the last decade because 

of the increasing number and proportion of women entering and leaving the 

military, the more favorable survival rate of women compared to men at any given 

age, and the younger age distribution of women Veterans compared to male 

Veterans. In 2010, the estimated median age of female Veterans was 48, compared 

to 62 for male Veterans. 

 

1 Department of Veterans Affairs, VetPop07, at http://www.va.gov/vetdata/

Note: The 2010 American Community Survey reported that 1.6 million or 7 percent of the 21.8 million Veterans were 

women. VetPop07 figures are projections based on Census data through 2006.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 3

Building on Our Accomplishments

Providing high-quality care and benefits for America’s Veterans is at the heart of VA

core values. “Because I CARE, I will” articulates who we are at VA: professionals who 

seek to embody the values of Integrity, Commitment, Advocacy, Respect, and 

Excellence in our service to Veterans. It calls us to action across VA, recognizing that 

living these values requires continuous improvement, based on a resolve to identify 

weaknesses and rigorously correct them. 

When it comes to the treatment of women Veterans, we at VA have been working 

diligently to deliver on our I CARE values. Our efforts at continuous improvement 

are informed by a series of reports issued over the past 25 years by the Secretary’s 

Advisory Committee on Women Veterans, the Government Accountability Office 

(GAO), Congress, and internal VA groups that have identified gaps in access to and 

delivery of services and benefits for women Veterans. The history of 

recommendations and VA responses is summarized in Appendix B. Despite 

considerable progress over the years, gaps do remain and VA continues to strive to 

identify and resolve them. 

Fortunately, we have a strong foundation to build on. Efforts under way across VA 

pertaining to delivery of services and benefits to women Veterans include:

Collaborative outreach efforts led by the Center for Women Veterans (CWV) 

to build awareness among women Veterans of the benefits and services 

provided by VA, and to champion cultural transformation within VA.

Initiatives led by the Women Veterans Health Strategic Health Care Group

(WVHSHG) within VHA that have resulted in implementation of

comprehensive primary care for women Veterans, training of VA providers in 

basic and advanced women’s health care, launching of the Women’s Health 

Evaluation Initiative, revision of the VHA Handbook 1330.01: Health Care 

Services for Women Veterans, installation of full-time Women Veterans 

Program Managers (WVPMs) at VA facilities nationwide, enhancement of 

mental health and homeless services for women Veterans through 

collaboration across program offices, and ramped-up communications to and 

about women Veterans.

The development by the Office of Mental Health Services of an Military Sexual 

Trauma (MST) Support Team and MST program; and the implementation of 

national MST training for primary care and mental health providers.

The designation by VBA of Women Veterans Coordinators (WVCs) to 

outreach to women Veterans, to promote the use of VA benefits by women 

Veterans and to assist women Veterans in developing claims, especially those 

claims involving issues of a sensitive nature such as MST. As of August, 2010, 

VBA reported having a total of 73 WVCs nationwide. All regional offices 

(ROs) have at least one individual designated to serve as the WVC and larger 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 4

offices have two or three employees assigned to the task. WVCs are also 

located in national call centers and out-based locations. 

Another resource is the Secretary’s Advisory Committee on Women Veterans 

(ACWV), established in 1983, which has reporting requirements to the Secretary 

and to Congress. The Committee’s role is to provide advice to the Secretary on the 

needs of women Veterans with respect to health care, rehabilitation, benefits, 

compensation, outreach, and other relevant programs administered by VA. The 

ACWV develops recommendations to address unmet needs that have implications 

for the entire women Veterans population, based on information presented during 

briefings at Committee meetings and site visits. 

Thanks to all of these initiatives, measurable gains were achieved in recent years. 

For example:

More women are now aware of and benefiting from VA services than ever 

before. The first VA-commissioned survey of women Veterans in 1985 

revealed that 57 percent of women Veterans did not know they were eligible 

for VA services or benefits. By 2009, about 30 percent of women Veterans 

surveyed did not think they were eligible for VA benefits. While this number 

is still unacceptably high, it does represent a marked improvement in 

awareness levels.

VA outperforms the private sector in breast and cervical cancer screenings. In 

2008, 87 percent of women Veteran patients received breast cancer 

screenings and 92 percent received cervical cancer screenings compared to 

commercial health care, which scored 69 percent and 82 percent, 

respectively.2

Current Status of Women Veterans

VA has made significant progress in serving women Veterans, but work remains to 

be done. Not all of our systems are equipped to address the comprehensive needs of 

women Veterans or to provide certain services and benefits for which women 

Veterans have a greater need relative to their male counterparts. Many women 

Veterans still do not know about or think they are eligible for services. Some 

gender-based health disparities continue to exist. Data collection gaps hamper our 

understanding of women Veterans' needs and their utilization of VA benefits and 

services. We can do better in providing an inviting and secure environment of care, 

matching capacity to women’s health care needs and demands, and ensuring that 

high-quality services are rendered in a respectful and sensitive manner. It is the 

desire to achieve systemic improvements in addressing such issues that prompted 

formation of the WVTF by Secretary Shinseki.

 

2

State of Health Care Quality Report, 2008, www.ncqa.org
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 5

In health care, in particular, the VA has the opportunity to become a national model 

for service delivery that successfully addresses gender-specific needs. Recent 

research indicates that health programs that are gender-responsive — taking 

gender issues into account in health policy, planning, practice, and research — are 

not only more effective in reducing health inequities, but also exhibit greater 

efficiency.3

Available data reveal several characteristics of women Veterans that should be 

considered in ensuring gender-responsive services and benefits:

Higher physical and mental health needs.

4 A higher proportion of female Veterans 

(22 percent) are diagnosed with mental health problems than male veterans.5 The 

most common diagnoses among women Veterans seeking care are PTSD, 

hypertension, depression, high cholesterol, low back pain, gynecologic problems, 

and diabetes. Studies show that 31 percent of women Veterans have both medical 

and mental health conditions compared with 24 percent of male Veterans. Among 

women Veterans with diabetes, 45 percent have a serious mental illness or 

substance use disorder. In FY 2009 and FY 2010, PTSD, hypertension, and 

depression were the top three diagnostic categories for women Veterans treated by 

VHA.6 

Higher incidence of Military Sexual Trauma (MST). One in five women Veterans who 

use VA for health care screen positive for MST. 

7Women who enter the military at 

younger ages and those of enlisted rank appear to be at increased risk for MST. In 

addition, women who have had sexual assaults prior to military service report 

higher incidences of MST.8 MST has been associated with increased risk of 

depression, PTSD and substance use. Females experiencing MST are more than four 

times more likely to have PTSD and are at six-fold increased risk for having three or 

more mental health conditions. In FY 2011, the most recent year for which data are 

available, 19.4 percent of OEF/OIF/OND female Veterans reported a history of MST 

 

3

Guidelines for the analysis of gender and health. Liverpool School of Tropical Medicine, Gender and Health Group

4

Report of the Under Secretary for Health Workgroup: Provision of Primary Care to Women Veterans. Women 

Veterans Health Strategic Health Care Group. November 2008

5

VA Office of Inspector General, “General Combat Stress in Women Receiving VA Healthcare and Disability 

Benefits.”

6 Women Veterans Health Workload Report. October 2010

7

The definition of MST used by the VA is given by U.S. Code (1720D of Title 38): “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.” MST includes any sexual activity where someone is involved against his or her will—he or she may 

have been pressured into sexual activities (for example, with threats of negative consequences for refusing to be 

sexually cooperative or implied faster promotions or better treatment in exchange for sex), may have been unable 

to consent to sexual activities (for example, when intoxicated), or may have been physically forced into sexual 

activities. MST includes unwanted sexual touching or grabbing; threatening, offensive remarks about a person’s 

body or sexual activities; and threatening and unwelcome sexual advances.

8

A. Suris and L. Lind, “Military Sexual Trauma: A Review of Prevalence and Associated Health Consequences in 

Veterans,” Trauma Violence Abuse Vol. 9, No. 4 (October 2008) pp. 250-269.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 6

when screened by a VA healthcare provider compared with 0.9 percent of 

OEF/OIF/OND male Veterans. Rates of MST reported among all Veterans screened 

at the VA were 23.0 percent for females and 1.2 percent for males for FY 2011.9

Lower access and enrollment of VA health care. The number of women Veterans 

using VA has increased 83 percent in the past decade, from about 160,000 to over 

292,000 between FY 2000 and FY 2009, compared with a 50 percent increase in 

men.

10 Lifetime female health care expenses are a third higher than male expenses.11

Although the number of women Veterans using VHA has increased over time, it is 

important to note that women Veterans are still approximately 30 percent less 

likely to enroll in VHA than men. 

Gender-based disparities in healthcare quality. Health care quality scores related to 

contributors to cardiovascular disease risk (management of high blood pressure, 

high cholesterol, and diabetes) were worse for women Veterans when compared to 

male Veterans.12 There are also disparities between men and women in preventive 

care statistics. Fewer women Veterans received colorectal cancer screening, 

depression screening, and immunizations (pneumococcal and influenza) compared 

to male Veterans. Pharmacy data indicate that women in VA are more likely to be 

prescribed inappropriate drugs than men.13 Although gender-based disparities in 

health care exist in the private sector as well, VA is in an excellent position to 

understand why the gaps occur and to implement systems of care that can close 

them. 

Higher rates of homelessness. Secretary Shinseki made a commitment to ending 

homelessness among our nation’s Veterans by 2015. In December 2011, VA and the 

Department of Housing and Urban Development announced that homelessness 

among Veterans decreased by 12 percent between January 2010 and January 

2011.14 While the overall number of homeless Veterans is declining, the number of 

homeless women Veterans is increasing. Women Veterans are the fastest growing 

segment of the homeless population and are at higher risk of homelessness than 

their male counterparts.15 Female Veterans also are more than twice as likely to be 

 

9 Military Sexual Trauma Support Team (2012). Military Sexual Trauma (MST) Screening Report, Fiscal Year 2011. 

Washington DC: Department of Veteran Affairs, Patient Care Services, Office of Mental Health Services.

10 Frayne SM, et al. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 1. 

Sociodemographic Characteristics and Use of VHA Care. Women’s Health Evaluation Initiative, Women Veterans 

Health Strategic Health Care Group, VHA. December 2010.

11 Alemayehu B & Warner K. The lifetime distribution of healthcare costs. Health Service Research, June 2004.

12 Wright SM, Lucatorto MA, Yano EM. An analysis of the quality of care provided to men and women in the VA 

health care system. 

13 Systematic Review of Women Veterans Health research 2004-2008, October 2010. VA Health Services Research 

and Development Service.

14 These homeless statistics are drawn from a survey taken each January, known as a “Point-in-Time” counts. The 

January 2011 survey found 67,495 homeless veterans, down from 76,329 one year earlier.

15 “Homelessness Among Women Veterans,” presented at 2011 National Training Summit on Women Veterans by 

Stacey Vasquez.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 7

homeless when compared to female non-Veterans in the United States and female 

Veterans living in poverty are more than three times more likely to be homeless 

than female non-Veterans in poverty.16 Younger Veterans (18–29 years) were at 

higher risk for homelessness, with young, female black Veterans at the greatest risk. 

Need for access to child care. The Secretary’s Advisory Committee on Women 

Veterans recommended in its 2010 report that VA provide childcare options for 

eligible Veterans, utilizing public and private partnerships, in order to facilitate their 

access to quality health care services. Under the Caregivers and Veterans Omnibus 

Health Services Act of 2010 (PL 111-163), Congress required VA to implement a 

two-year childcare pilot in no fewer than three separate Veteran Integrated Service 

Networks (VISN). The law requires that the pilot program assess the feasibility and 

advisability of providing assistance for childcare to qualified veterans receiving VA 

care. Since many Veterans, particularly women Veterans, are the primary caretakers 

for young children, it is hoped these childcare centers will make it easier for such 

Veterans to utilize VA. In a survey, VA found that nearly a third of Veterans were 

interested in childcare services and more than 10 percent had to cancel or 

reschedule VA appointments due to lack of childcare. The intent is to diminish 

barriers for Veterans who have difficulty keeping appointments due to child care 

obligations. The law limits the provision of childcare assistance to these pilot 

programs, and eligibility is defined as being for qualified Veterans receiving VA 

health care services on an outpatient basis at a VA facility. 

Higher level of service-connected disability ratings. In FY 2009, among users of VA 

health care, a higher proportion of women Veterans had service-connected (SC) 

disability ratings than men (55 percent versus 41 percent). Of these, 26 percent of 

women and 19 percent of men had a disability rating higher than 50 percent. The 

fact that more than half of women Veterans now carry an SC disability rating and 

that many are young holds implications for the future as they will be eligible for 

compensation and VHA care for many years.17 

Higher demand for education benefits among OEF/OIF/OND women Veterans.

According to the 2010 National Survey of Veterans, overall 35.2 percent of women 

Veterans used VA education benefits, which was comparable to the 36 percent of 

male Veterans who used such benefits. However, 50.6 percent of females serving in 

OEF/OIF/OND were likely to report using benefits compared to 37.2 percent of

males in OEF/OIF/OND. 

Underrepresentation in memorial services. The Advisory Committee on Women 

Veterans (ACWV) cited concerns that women Veterans may be underrepresented 

 

16 Culhane DP. Prevalence and Risk of Homelessness among US Veterans: A Multisite Investigation. August 2011. 

Available at: http://works.bepress.com/dennis_culhane/107

17 Frayne SM, et al. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 1. 

Sociodemographic Characteristics and Use of VHA Care. December 2010. Pp. 11-12
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 8

among those interred in National and State Veterans’ cemeteries. From 2001 to 

2010, 10.0 percent of male Veterans received burial in a national cemetery, 

compared to 8.8 percent of women Veterans. For Veterans not interred in National 

cemeteries, there is a significant disparity between the percentage of women who 

receive headstones or markers (14.2 percent) compared to men (46.8 percent).
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 9

Defining Priority Themes

In recognition of the growing numbers and needs of women Veterans, Secretary 

Shinseki called for a Women Veterans Task Force in July at the 2011 National 

Training Summit on Women Veterans. The goal of the Task Force is to develop a 

comprehensive VA action plan that will focus on key issues facing women Veterans 

and the specific actions needed to resolve them. The action plan will update and 

inform VA’s approach to women’s issues within the health care, benefits and 

cemetery administrations, and will guide the agency in everything from planning to 

implementation of programming, budgeting, education and training. The task force 

is to develop the action plan for implementation in coordination with VA’s Advisory 

Committee on Women Veterans (ACWV). 

To provide the Women Veterans Task Force a foundation for their work, a VA 

workgroup was formed to develop a better understanding of VA’s current efforts to 

serve women Veterans and collect gender-specific data on women Veterans. While 

initiatives directed towards women Veterans exist in every VA administration and 

service line, they may not be coordinated. A broad survey of VA’s gaps in services 

and current efforts to meet these needs was conducted to inform the way forward 

for the task force. 

The workgroup involved subject matter experts (SMEs) from all the major service 

lines to ensure that all major VA programs targeted to women Veterans were 

included. Administration leads were asked to appoint an appropriate SME designee 

to participate on the workgroup. Next, SMEs who were members of the workgroup 

were asked to submit answers to a list of priority issues facing women Veterans.

The identified issues or needs of women Veterans, as reported by SMEs, included 

the following: 

Underutilization of services

Lack of awareness of benefits or eligibility

Personal privacy and environment of care

Fragmentation and gaps in health care

Access to mental health care services

Access to gender-specific specialty care (OB/GYN)

Gender-based health disparities

Underrepresentation in research; lack of data

Unemployment

Homelessness

Need for child care

Military sexual trauma (MST) and related issues (i.e. PTSD coverage, 

employment, etc)

Domestic violence
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 10

The initial list of priority issues was presented for a roundtable discussion on 

November 4, 2011. 

Participants then discussed how VA has worked to address issues for women

Veterans over the years. Concerns over these efforts could be grouped into several 

themes as well:

Outreach to women Veterans 

Coordination across the department, duplication of services, and need for a 

department-wide strategy to address women Veterans 

Roles and responsibilities of Women Veterans Program Managers (VHA), 

Women Veterans Coordinators (VBA), the Center for Women Veterans

(CWV), and the Advisory Committee on Women Veterans

Need for department-wide planning and programming to meet increased 

demand from the future population of women Veterans.

At the conclusion of the November 4 roundtable, participants prioritized the issues 

as:

Capacity and coordination of services

Women Veterans’ experience of care and environment of care

Employment and training

Data collection and evaluation of services

Evaluation of these themes by the working group informed the efforts of the WVTF 

during its four-day workshop in March 2012. 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 11

Addressing Two Overriding Questions 

Despite the very real progress in recent years and the concerted efforts under way 

throughout VA, gaps persist in our services and benefits to women Veterans. Given 

the projected continued growth in the women Veteran population, it is imperative 

that we make systemic changes within VA to better understand and address their 

unique service and treatment needs.

Two overriding questions have shaped the work of the WVTF:

What is the nature of gaps that persist; and 

What do we need to do differently across VA to eliminate them? 

In evaluating these questions, the WVTF surveyed the 25-year history of VA efforts 

to better serve women Veterans and began to gather available data on “as is” 

conditions across our service lines. To date, the initiatives undertaken pertaining to 

women Veterans have been conducted almost exclusively within the individual VA 

administrations or offices. Data pertinent to women Veterans are not always shared 

and correlated across VA organizational boundaries. As a result, some questions 

about women Veteran’s unique needs and their level of awareness of, access to, and 

satisfaction with VA services and benefits remain unanswered. 

Initial Conclusions

The WVTF concluded that transforming VA to meet the needs of the growing cohort 

of women Veterans will require:

Leadership support and championing of a comprehensive, collaborative crossVA strategy for continuously improving service and benefits delivery to 

women Veterans, based on evidence, ongoing data collection and evaluation, 

performance measures, and significant input from stakeholders. The WVTF 

recommends that four priority themes (defined below) be the focus of the 

first action plan, and that care be taken to leverage, rather than duplicate, 

work related to these themes that is being actively undertaken in other VA 

forums, including the Women Veterans Health Strategic Health Care Group 

(WVHSHG), the VA/Department of Defense (DoD) Employment Task Force, 

the DoD/VA Integrated Mental Health Strategy, the VHA National Leadership 

Council's Veteran Experience Committee, and the VA Homelessness Program.

Enhancing organizational accountability, collaboration, and transparency. 

Despite leadership support, significant efforts made to date, and passionate 

internal and external stakeholders, VA activities to improve services and 

outreach to women Veterans are fragmented. Recommendations to enhance 

the effective delivery, accountability, resource management, and 

sustainability of services and benefits for women Veterans will include 

developing a department-wide integrated plan for meeting the needs of 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 12

women Veterans; analyzing current organizational design, relationships and 

internal accountability measures and mechanisms; identifying organizational 

and business process enablers and barriers throughout VA; identifying 

opportunities for improvement; and formalizing the roles, responsibilities, 

accountability, and reporting mechanisms across the VA organizations 

engaged in addressing the unique needs of women Veterans. 

The WVTF recommends that the initial cross-VA action plan for women Veterans 

address the four priority themes identified by the working group in fall 2011:

Capacity and Coordination of Services. This theme addresses the development 

of systems to ensure appropriate health care staffing projections for primary 

care, mental health care, and relevant specialty care to meet the current and 

projected needs of women Veterans; and the enhancement of efforts to 

coordinate provision of care and services across VA and between VA and 

other federal, state, and community-based organizations. The action plan 

should address specific subpopulations of women Veterans, including racial 

and ethnic minority groups, rural Veterans, OIF/OEF/OND, and homeless 

women Veterans. 

Environment of Care and Experience. This theme focuses on ensuring 100

percent resolution of identified gaps in the Environment of Care (EOC) for 

women at VA facilities, including addressing guidelines to safeguard the 

dignity, respect, and security of women Veterans in inpatient, outpatient, and 

residential VHA environments. The EOC is made up of three basic elements: 

(1) the building space, including how it is arranged and the special features 

that protect patients, visitors, and staff; (2) equipment used to support 

patient care or to safely operate the building space; and (3) people, including 

those who work within the hospital, patients, and anyone else who enters the 

environment, all of whom have a role in minimizing risks.18 This theme also 

addresses the need for culture change across VA to reverse the enduring 

perception that a woman who comes to VA for services is not a Veteran 

herself, but a male Veteran’s wife, mother, or daughter. Women Veterans 

often report feeling that their service in the military is not recognized or 

respected. 19 

Employment and Training. This theme addresses improving employment 

rates among women Veterans who have faced unique challenges in 

transitioning to civilian employment. The plan of action in this area should 

complement current efforts to address Veteran unemployment. Whenever 

possible, efforts to improve the transition process for women should be 

informed by research that evaluates whether women Veterans are 

 

18 http://www/utmb.edu/envcare/

19 Foster LK, Vince S. California’s Women Veterans: The challenges and needs of those who served. California 

Research Bureau. CRB 09-009. August 2009.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 13

maximizing services such as vocational rehabilitation, compensated work 

therapy for Veterans with disabilities, and intervention assistance (e.g., 

tutoring) for those eligible for a VA education benefit; and that measures 

long-term impact of education and training received through the VA or 

Department of Labor programs. 

Data Collection and Evaluation of Services. The task force believes that 

continuous improvements in services and benefits must be data-driven and 

evidence-based, and must rely on robust feedback from customers and 

stakeholders. These continuous improvements must capitalize on existing 

expertise and available data and evaluation initiatives. Challenges will 

include developing the methodologies and systems for collecting and 

evaluating appropriate data, sharing data across organizational boundaries, 

and providing the needed analysis to drive informed strategies and policy 

decisions. 

The following sections of this strategy report introduce each of the four themes to 

be addressed in a cross-VA action plan on women Veterans. Each section includes 

preliminary goals and objectives as the framework for the action plan. The report 

concludes with a section on the organizational accountability, collaboration, and 

transparency that will be needed to ensure successful implementation of the new 

strategic direction regarding women Veterans.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 14

Capacity and Coordination of Services

Problem Statement

Due to the projected increase in demand, VA will need to increase its capacity to 

provide consistent and coordinated access to comprehensive services and benefits 

that meet the unique needs of women Veterans, driving action to achieve the 

optimal resource mix at the appropriate locations to meet this dynamic demand. 

Women Veterans represent 8 percent of the total Veteran population and are 

projected to reach 10.7 percent by 2020. 

Enrolled women Veterans represent 6.7 percent of the total enrolled 

Veterans population.

Approximately 55 percent OEF/OIF/OND women Veterans currently use VA.

Goal 1 Objectives

Provide timely services 

and benefits that meet 

the needs of the growing 

population of women 

Veterans (utilizing 

WVHSHG mission 

strategic plan as a 

model).

1.1: Assess existing VA workforce to determine ability to meet 

the expected increased demand.

1.2: Ensure every site of care has a trained and proficient 

workforce to meet the needs of women Veterans.

1.3: VHA, VBA, and NCA will ensure they have sufficient ability 

to accommodate women Veterans who request access to staff of 

specific gender.

Goal 1 and objectives address the need to appropriately match VA workforce 

capacity to the increased demand for services by women Veterans, to ensure 

proficiency of the workforce, and to accommodate requests for staff of specific 

gender. 

Goal 2 Objectives

VA (VHA, VBA, NCA) 

will collaborate in the 

coordination of 

services and benefits 

that achieve optimal 

outcomes for women 

Veterans. 

2.1: VA will use eBenefits as a platform to provide a central 

pathway for comprehensive VA benefits and services

information that permits women Veterans to craft a Customized 

Individual Plan (CIP). 

2.2: VA will develop an integrated process for every woman 

Veteran who requests services and/or benefits to ensure that 

she is provided the opportunity to create a CIP that addresses 

her specific needs. 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 15

Goal 2 and objectives take on the needs of women Veterans by providing 

individualized care and alternate means of interacting with VA. 

Goal 3 Objective

Enhance the 

coordination and 

integration of outreach 

targeting all women 

Veterans.

3.1: Develop and deploy a One-VA comprehensive (uniform) 

women Veterans services and benefits package for outreach

3.2: Strengthen partnerships with Veterans Service 

Organizations (VSOs) and other stakeholders (federal, state, 

county, and local) to enhance outreach and education to women 

Veterans.

Goal 3 and objectives seek to create a clearly defined, accessible, united core of VA 

benefits and services for women Veterans and to communicate this through a 

collaborative outreach program. 

Outcomes

1. Women Veterans and their families find it easier to access the right benefits 

and health care while meeting their expectations for quality, timeliness and 

responsiveness

2. Increased enrollment by women Veterans 

3. Increased use of benefits and services by women Veterans.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 16

Environment of Care and Experience

Problem Statement

Gaps exist in personal privacy, dignity, security, and respect that impact the overall 

women Veterans' experience in VA.

Given the current population needs and forecasted increase in the number of 

women Veterans eligible for VA services, care, and benefits, it is critical that these 

gaps are addressed immediately.

Goal 1 Objectives

VA will create a women 

Veteran-centric 

environment that 

exceeds VA standards 

for personal privacy, 

dignity, security, and 

respect, in a manner 

consistent with 

applicable law. This 

goal will be 

accomplished in 

collaboration with the 

VA construction office.

1.1: Eliminate or address remaining VHA-identified facility 

deficiencies by 2013.

1.2: Assess VBA and NCA structures for personal privacy, 

dignity, security, and respect compliance.

1.3: Design physical environments that take into consideration 

the changing women Veteran demographics and new concepts 

in Veteran-centeredness.

1.4: Design alternate modalities (e.g., virtual, tele-medicine, 

kiosks, etc.) that take into consideration the changing women 

Veteran demographics and new concepts in Veterancenteredness.

Goal 1 recognizes the need to eliminate or address through interim measures the

remaining environment-of-care deficiencies at VHA facilities and to identify and 

remedy any environmental deficiencies at VBA and NCA facilities. In addition, it 

considers means for ensuring that future facilities and alternate modalities of care 

delivery are appropriately designed.

Goal 2 Objectives

VA will create a women 

Veteran-centric 

environment that 

exceeds their 

expectations for 

services and benefits.

2.1: Invest in innovative and creative means to reach all 

employees (messaging, video), and ensure inclusiveness of 

women Veterans in all relevant training programs, developing 

new training materials as required. Cultural transformation 

efforts with regard to women Veterans should go hand-in-hand 

with the global efforts around VA’s Veteran-Centric 

transformation.

2.2: Increase the total number of women Veterans who are 

aware of VA benefits and services and the steps they must take 

to access them.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 17

2.3: Exceed process and client satisfaction measures for 

eligibility determination, application, approval, and enrollment 

for all benefits and services that VA offers and measures.

Goal 2 reflects importance of increasing women Veterans' awareness of VA benefits 

and services, and of equipping all VA staff to interact respectfully and effectively 

with women Veterans. 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 18

Employment and Training

Problem Statement

Women Veterans continue to face unique challenges in the area of employment. In 

2011, the annual average unemployment rate for women Veterans was 9.1 percent

compared with 8.2 percent for non-Veteran women. Among 18-24 year-olds, the 

unemployment rate for women Veterans was 36.1 percent compared to 14.5

percent for their non-Veteran counterparts. 20

There is a lower percentage of women Veterans with a Bachelor’s degree than nonVeteran women:

Among women aged 17-24, 4 percent versus 10 percent

Among women aged 25-34, 24 percent versus 35 percent (2009)21

There is insufficient integration and collaboration within VA and among external 

resources in the area of employment and career development/workforce training 

for women Veterans.

Goal 1 Objectives

Increase employment 

and retention of 

women Veterans by 

leveraging public and 

private sector 

resources and 

improving synergy, 

integration, and 

collaboration.

1.1: Identify existing employment-related programs and 

perform gap analysis.

1.2: Identify issues specific to women Veterans that impact 

their employment such as Military Sexual Trauma (MST), 

mental health ,homelessness, childcare, dependent care, etc.

1.3: Develop and implement a comprehensive women Veterans' 

employment plan.

Goal 1 seeks to assess available Federal, state, and non-profit programs related to

employment and job retention and to better leverage these programs to improve 

employment levels of women Veterans. 

 

20 Employment Situation of Veterans 2011; Briefing by Bureau of Labor Statistics, March 19, 2012.

21 America’s Women Veterans; Military Service History and VA Benefit Utilization Services, VA National Center for 

Veterans Analysis and Statistics, November 23, 2011.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 19

Goal 2 addresses the need for on-going career planning and development women 

Veterans, which includes navigation to appropriate Federal, state, and local 

education and training resources. 

Goal 2 Objectives

2: Enhance 

marketability and 

professional 

development of women

Veterans through 

career development/

workforce training.

2.1: Increase capacity of women Veterans to market their skills 

and advance their careers.

2.2: Enhance internal VA capacity to effectively deliver career 

development/ workforce training resource information, and 

reintegrate women Veterans in the workplace.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 20

Data Collection and Evaluation of Services

Problem Statement

One challenge VA faces in meeting the ongoing and emerging needs of women 

Veterans is the lack of sufficient and actionable data used to deliver quality benefits 

and services.

Goal 1 Objectives

1: Collect high-quality, 

gender-specific data to 

meet stakeholder 

needs.

1.1: Conduct an initial assessment of stakeholder data needs by 

the end of FY12.

1.2: Develop a coordinated approach for enterprise-wide data 

collection, management, and analysis processes by end of FY12.

Goal 1 addresses the need for an effective approach to enterprise-wide collection, 

sharing, management, and analysis of gender-specific data. Key actions will include 

identifying the data required to answer relevant policy and planning questions, and 

to measure achievements in meeting women Veterans' needs. 

Goal 2 Objectives

2: Use data to evaluate 

services to address 

women Veterans' 

needs.

2.1: Evaluate the needs and measures of success of women 

Veteran programs, services, and benefits and the effectiveness of 

the VA-wide outreach effort specifically to women Veterans by 

the end of FY12.

2.2: Evaluate the needs and satisfaction of Women Veteran 

programs, services, and benefits in terms of capacity, access, 

quality, cost, and utilization by the end of FY13.

Goal 2 addresses how data will be used, measured, and continuously improved, the 

effectiveness of outreach to women Veterans, and their satisfaction with VA 

programs, services, and benefits. 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 21

Organizational Accountability, Collaboration, and 

Transparency

There has been a considerable investment in enhancing VA’s programs, benefits, 

and services for women Veterans but there remain policies, practices, programs, 

and related activities that are not yet fully responsive or sensitive to the needs of 

women Veterans. There is leadership support, significant efforts, and passionate 

internal and external stakeholders; however, these activities remain fragmented.

Throughout VA a variety of organizations perform women Veteran related policy 

development, official information dissemination, internal and external 

communications, outreach to the public, internal and external training and provide 

direct delivery of service to women Veterans. These activities are not always 

effectively communicated or coordinated across the Department.

We must enhance the effective delivery, accountability, resource management and 

sustainability of services and benefits for women Veterans. 

Key Efforts

Develop a department-wide integrated action plan for meeting the needs of 

women Veterans. (This document is the outline of that plan.)

Analyze the current organizational design, relationships and internal 

accountability measures and mechanisms. Identify organizational and 

business process enablers and barriers throughout VA, and identify 

opportunities for improvement.

Formalize the roles, responsibilities, accountability and reporting 

mechanisms across the VA organizations that are engaged in addressing the 

unique needs of women Veterans. 
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 22

Conclusion

At VA, we are committed to providing high-quality services and benefits to America’s 

Veterans. Meeting this commitment requires ongoing adaptation and transformation. As 

Secretary Shinseki explained, “This transformation is demanded by new times, new 

technologies, new demographic realities, and new commitments to today’s Veterans. It 

requires a comprehensive review of the fundamentals in every line of operation the 

Department performs.” In this spirit, Secretary Shinseki has charged the Women 

Veterans Task Force with developing a comprehensive VA action plan in how our 

organization serves women Veterans, a timely effort given the rapid growth in the women 

Veteran population. This draft strategy report represents the first phase in the 

development of such a comprehensive action plan. Public comments are being sought at 

this early stage to ensure that the expertise and experience of our diverse stakeholders and 

partners can inform the ultimate plan. We believe that the strong support demonstrated by 

VA leadership, together with the commitment of our stakeholders, will equip VA with 

the ingredients for success in addressing the unique care and service needs of our women 

Veterans.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 23

Appendix A

Members of the Women Veterans Task Force, Categorized by Working Group 

Capacity and Coordination of Services 

Karen Malebranche, Executive Director, Interagency Health 

Affairs (VHA); Co-Chair 

Michela Zbogar Chief Medical Officer (VHA, VISN 8); CoChair 

Julie Carie, VSO Liaison (VBA, BAS) 

Serena Chu, Program Analyst (VHA, Rural Health) 

Stacy Garrett-Ray, Deputy Director, Comprehensive 

Women’s Health (VHA, WVHSHG)

Amy Marcotte, Team Lead (VHA, Vet Centers)

Jeanette Mendy, Health Systems Specialist (VHA, IHA)

Stephanie Robinson, Program Analyst (OPIA, HVIO) 

Richard Stark, Director, Primary Care Clinic Operations 

(VHA, Primary Care)

Sally Haskell, Acting Director, Comprehensive Women’s 

Health (VHA, WVHSHG)

Data Collection and Evaluation of Services 

Shana Brown, Assistant Director, San Diego RO (VBA); CoChair

Christi Greenwell, Assistant Director (VBA, BAS); Co-Chair

Murielle Beene, Acting Deputy Director for Health 

Infomatics (VHA)

Tom Garin, Program Analyst for OPP (VA)

Kate Hoit, New Media Specialist (VHA)

Candace Ifabiyi, Program Analyst for OPP (VHA)

Michelle Lucatorto, Program Manager (VHA)

Cathy Rick, Chief Nursing Officer (VHA)

Kenneth Wagner, Director for OPP (VA)

Faith Walden, Program Analyst (NCA)

Elizabeth Yano, Co-Director, Center for Excellence (VHA)

Laurie Zephyrin, Director, Reproductive Health (VHA)

Environment of Care and Experience 

Aubrey Weekes, Director, Environmental Program Service 

(VHA); Co-Chair

Abdoulie Jammeh, Bay Pines VAMC Assistant Chief, 

Environment Management Service (VHA); Co-Chair

Sonja Batten, Deputy Chief Consultant for Specialty Mental 

Health (VHA)

Vonda Broom, Deputy Director, Environmental Programs 

Service (VHA)

Anna Crenshaw, Chief, Client Services Outreach (VBA, BAS)

Elizabeth Helm-Frazier, Program Assistant, Office of 

Strategic Planning (VBA)

Kate Hoit, New Media Specialist (OPIA)

Connie LaRosa, Deputy Field Director, WVHSHG (VHA)

Billie Randolph, Deputy Chief Prosthetics Officer (VHA)

Planning for the Future 

Lillie Jackson, Assistant Director, Buffalo RO; Co-Chair

Susan Sullivan, Director of Strategic Planning, (VACO); CoChair

Deborah Amdur, Chief Consultant, Case Management & 

Social Work (VHA)

Lauren Bailey, Acting Deputy Director, Online 

Communications (OPIA)

Ruth Fanning, Director, Vocational Rehabilitation and 

Employment (VBA)

Robin Ficke, Legislative Staff, Compensation Service 

Sarah Goddard 

Patricia Hayes, Chief Consultant (VHA, WVHSHG)

Catherine Trombley, Communications Specialist (VBA)

Carrie Tuning, Learning Consultant (VALU)

Stacey Vasquez, Deputy Director, (OPIA, HVIO)

Stephanie Willis, Strategic Management Group (HRA)

Employment and Training 

Georgia Coffey, Deputy Assistant Secretary for Diversity 

and Inclusion (VA); Co-Chair

Joan Ricard, Director, El Paso VA Health Care System 

(VHA); Co-Chair

Cathy Abshire, Program Manager, VHA Homeless Programs 

(VHA) 

Chanel Bankston-Carter, Program Management Officer 

(VESO) 

Stephanie Birdwell, Director, Office of Tribal Government 

Relations (OPIA) 

Sharon Crowder, LCSW, CPRP, Office of Mental Health 

Operations and Office of Operations and Management 

(VHA) 

Bridget Griffin, Program Analyst (VBA, BAS) 

Betty Moseley-Brown, Associate Director (CWV) 

Annette Taylor, Education Specialist (VALU) 

Angela Wilcher, Program Analyst (VBA, VRE)
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 24

Appendix B

History of VA Efforts to Improve Services and Benefits for Women Veterans 

Women have served in U.S. military efforts since the American Revolution, and were 

first granted a formal role in the armed forces with the creation of the Army Nurse 

Corps in 1901.

22

 The U.S. Code does not make a distinction between male and 

female Veterans. However, the reality is that women have not always had equal 

access to all Veterans' benefits. Beginning in the 1980s and 1990s, as more 

information became available about gender disparities in VA care and benefits for 

women Veterans, VA took a number of action, some mandated by Congress, to 

ensure better access to services and benefits for women Veterans. Milestones in the 

evolution of VA services to women Veterans are highlighted below. 

 

22 Willenz JA (1983). Women Veterans: American’s Forgotten Heroines. New York: The Continuum Publishing 

Company, p.15

VA for Women Veterans Timeline – VA has come a long way 

1972: Public Law 92-540 clarifies that the term “wife” includes the husband of any female Veteran, and the term 

“widow” includes the widower of any female Veteran.

1980: Women comprise less than 2 percent of the Veteran population; 1980 Census finds 1.2 million women 

served in the Armed Forces.

1982: GAO report reveals lack of access to psychiatric care because facilities cannot accommodate women. Also, 

women Veterans received little to no gynecological care.

1983: Secretary’s Advisory Committee on Women Veterans is established with reporting requirements to the 

VA Administrator and to Congress on needs of women Veterans and recommendations for action.

1984: First report of the Advisory Committee identifies the need for strong outreach and the lack of adequate 

privacy and gender-specific treatment for women at VA facilities as the most pressing areas of concern.

1985: First VA-commissioned survey of women Veterans reveals that 57 percent of women did not know they 

were eligible for VA services or benefits. Also, women Veterans reported twice the rates of cancer compared to 

women in the general population, with gynecologic cancers being most common.

1986: Advisory Committee recommendations to improve outreach spur creation of women Veterans

coordinator positions at VBA regional offices and at VA medical centers.

1988: First office to address women’s health issues is created within the Veterans Health Administration.

1992: Sixty percent of VA medical facilities have women clinics offering gynecologic care as well as preventive 

health and counseling services. All domiciliaries are able to admit women. P.L.102-585 authorizes counseling 

for sexual trauma that occurred while on active duty. Four comprehensive women Veteran Health Centers 

established, expanded to eight in 1993.

1994: National training program for women Veteran coordinators. Some full-time coordinator positions added 

at VA medical centers and VBA regional centers. Congress establishes the Center for Women Veterans through 

P.L.103-446. The Center director reports directly to the VA Secretary and ensures VA programs are responsive 

to the needs of women Veterans.

Compensation and Pension Service Advisory Committee on Women’s Issues is created within VBA to review 

policy and procedures regarding benefits delivery for women Veterans.
Draft for Public Comment • 2012 Women Veterans Task Force Report Page 25

VA for Women Veterans Timeline – VA has come a long way (continued) 

GAO reports VA has had great success in improving privacy protections for women Veterans in VA facilities. VA 

completed more than 130 projects to improve facilities and spent more than $672 million.

In 1996, P. L.104-262, authorized the provision of both inpatient and outpatient care to eligible Veterans. In 

implementing this authority, VA defined a medical benefits package that is available to Veterans enrolled in 

VA’s health care system. The package includes comprehensive prenatal, intra-partum and post-partum care to 

eligible women Veterans. 

By 1997, partly through improved outreach, outpatient and inpatient visits among women Veterans increased more 

than 50 percent from 1994 to1997 and the number of women receiving gender-specific services (Pap smears, 

mammograms, reproductive health care) increased more than 40 percent from more than 85,000 to over

121,000 women. 

In 2000, VA supports demonstration programs at 11 locations across the country specifically for homeless 

women Veterans.

2000: Congress authorizes special monthly compensation for women Veterans with a service-connected 

mastectomy and provides benefits for children with birth defects born to Vietnam Veteran women.

2008: Advisory Committee recommends that the position of women Veterans program manager (WVPM) be 

established as a permanent full-time management position in all VA medical centers. Secretary request that 

VAMCs establish WVPM as a full-time position by no later than December 1, 2008. There are currently over 140 

WVPMs. There are 57 designated women Veteran coordinators to help with benefits services in the VBA

Regional Offices. 

The 2010 ACWV report recommends a full-time WVC in Regional Offices with a female Veteran population 

(catchment area) greater than 40,000. 

GAO reports in 2009 and 2010 find that basic gender-specific services, including pelvic exams, were available 

at nearly all facilities visited and that the majority of facilities also offered access to one or more female 

providers. 

2008: VHA reports that VA performs better than private sector on gender-specific measures of breast and 

cervical cancer screening. 

2009: National Survey of Women Veterans indicates outreach efforts have enhanced understanding, but still 

indicate potential for improvement. About 30 percent of women surveyed did not think they were eligible for 

VA benefits, almost half the percentage who thought they were ineligible in 1985. 

2010: Advisory Committee recommends in its 2010 report that VA provide childcare options for eligible 

women Veterans, utilizing public and private partnerships, in order to facilitate access to quality health care 

services. Free drop-in childcare pilots open to Veterans eligible for VA care while at VA appointments are being 

implemented at three VA medical centers: Buffalo, NY; Northport, NY; and Puget Sound, WA.

2011: Veterans Health Administration establishes a National Call Center for Women Veterans.