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As more women enlist in military service, VA health-care system sees changes

After meeting with female veterans and healthcare providers, Blunt walks to the VA Women's Clinic in St. Louis.
Durrie Bouscaren | St. Louis Public Radio

More than 38,000 veterans who live in Missouri are women, and that number continues to grow rapidly.

That means changes are in store for the Veterans Health Administration, a network of hospitals and clinics that provide care to active duty service members and discharged veterans. Serving more women means expanding the VA’s capacity to offer gynecological exams, services surrounding childbirth, and counseling related to military sexual trauma.  

“Women are becoming the fastest growing segment of the military,” said Eve Holzemer, who manages the Women Veterans Program in the St. Louis region. “In the military, it’s been in the past primarily comprised of men. So it’s a real change in culture and a real change in mindset.”

According to a nonprofit called Disabled American Veterans, only a third of VA health centers had a gynecologist on staff in 2013. 

Missouri Sen. Roy Blunt toured the VA Women’s Clinic in St. Louis Monday. A meeting beforehand included female veterans and St. Louis healthcare providers.

The GOP senator said he received feedback on why some veterans avoid seeking care at the VA after a sexual assault when they were in service. But when asked how the system should change in response, Blunt quickly pivoted into the issue of mental health:

“It’s an important issue that gets to where I am on mental health generally, which is that we should deal with mental health like we deal with any other health problem,” Blunt said. “Frankly, if you do that I think that even within the healthcare space, from a cost perspective, you probably save money.”

In an anonymous survey conducted by the VA, one in four female veterans reported experiencing sexual assault while in the military.

Additional protections for survivors who report sexual abuse and the expansion of a Special Victims’ Counsel are included the latest iteration of the national defense spending bill for fiscal year 2016, which Sen. Claire McCaskill, D-Mo, has championed. Though Blunt has voted in favor of the provision for sexual assault victims, he was was among the ‘nay’ votes for the full bill when it reached the Senate floor last month. It has since been sent back to committee. 

Overall, Blunt said he had two major issues with the implementation of last year’s VA Accountability Act, the latest overhaul of the nation's VA health systems. The legislation was sparked by reports of preventable deaths at VA hospitals, artificially long wait times and other patient safety issues. The Act provides funding for a choice program that allows veterans to seek treatment outside the VA health system.   

“The VA has not been able to address this with the kind of results you want to see, and they’ve looked for every possible way to avoid giving veterans choices,” Blunt said. “I think it’s a disappointment the way the Veteran’s Administration has responded.”

Meanwhile, leaders of the VA have sent letters to Congress requesting that funding be transferred out of the choice program and back to the VA health system, threatening that VA hospital operations would have to cease if program funds are not authorized by the end of the month.

Holzemer said that in her experience, the law actually made the process more complicated for clinics to authorize veterans to access care outside of the VA.

“It’s caused a delay in getting our patients care on the outside when they need it. That’s particularly important for women veterans because gynecological surgeries are not yet done here at the St. Louis VA,” Holzemer said.

Holzemer said she expects those surgeries will be completed by VA doctors in the next few years, another example of how the system is adjusting to cover all of the veterans they serve. 

This article has been changed to clarify that Blunt has previously voted in favor of a defense bill provision relating to protections for survivors of sexual assault.