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Shannon L. Middleton

Shannon L. Middleton, Veterans Affairs and Rehabilitation Commission, Deputy Director for Health, American Legion

Mr. Chairman and Members of the Subcommittee:

Thank you for this opportunity to submit The American Legion’s views on VA’s programs addressing women and minority veterans. The American Legion commends the Subcommittees for holding a hearing to discuss these very important issues.

Programs Serving Women and Minority Veterans

The Center for Women Veterans and the Center for Minority Veterans were established by Congressional mandates to ensure that the needs of the growing populations of women and minority veterans are reflected in policies implemented and services and benefits provided by the Department of Veterans Affairs (VA).  Through these offices, VA has improved access to benefits and services for women and minority veterans and shaped policy addressing the provision of health care for female veterans. 

The Center for Women Veterans’ activities include monitoring changes in VA policy to ascertain the impact of the changes on the delivery of services to homeless women with children, rural and elderly women veterans, and minority women veterans; ensuring that active duty women are provided access to information on VA benefits and services available to them, prior to their release from active duty; conducting outreach to allow women veterans to express their needs and concerns; ensuring that VA research initiatives include adequate consideration for the effects of the military experience on women veterans; and working with Veteran Service Organizations (VSO) to disseminate information.  The Center for Women Veterans also serves as a conduit through which the Advisory Committee on Women Veterans makes recommendations to the Secretary of VA. 

The Center for Minority Veterans’ activities include ensuring that minority veterans are aware of VA programs, benefits, and services; conducting outreach initiatives to allow minority veterans to voice concerns; making VA benefits and healthcare services more accessible to minority veterans; and making recommendations on how VA can better serve minority veterans.  The Center for Minority Veterans also supports an advisory committee and works with the Center for Women Veterans to address concerns faced by minority women veterans.

The VA offers a full continuum of comprehensive medical services to include disease prevention, primary care, women’s gender-specific healthcare, acute medical/surgical, substance abuse and mental health treatment, domiciliary, rehabilitation and long-term care options.

Present and Future Needs

The current Global War on Terror illustrates a few deficiencies in services provided for women veterans.  Never before have women service members been engaged in constant combative environments.  Participation in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) has forced them to expand their military roles to ensure their own survival, as well as the survival of their units.  They sustain the same types of injuries that their male counterparts endure.  Any future women veterans’ research conducted by VA will need to take into consideration the physical effects of combat on women veterans, not just mental effects of combat and military sexual trauma (MST). 

Since women veterans are sometimes the family’s sole care givers, services and benefits designed to promote independent living for combat-injured veterans will need to consider other needs – like child care during rehabilitation.  This dynamic should also be considered more when designing domiciliary and homeless women veteran programs.  Not making provisions that would accommodate the children of homeless women veterans would bring more devastation to an already unstable home life and may actually be a deterrent for seeking assistance from the VA. 

Providing quality health care in a rural setting has proven to be very challenging, given factors such as limited availability of skilled care providers and inadequate access to care. Even more challenging will be VA’s ability to provide treatment and rehabilitation to rural veterans, to include women veterans, who suffer from the signature ailments of the on-going Global War on Terror – traumatic blast injuries and combat-related mental health conditions. VA’s efforts need to be especially focused on these issues.

Gaining access to the nearest facility providing gender-specific services can prove even more of an obstacle, since the nearest facility may be a Community Based Outpatient Clinic (CBOC) which may not offer these services. 

The American Legion believes veterans should not be penalized or forced to travel long distances to access quality health care because of where they choose to live. Women veteran who reside in rural areas need to have improved timely, access to gender-specific care.  We urge VA to improve access to quality primary and specialty health care services – to include gender-specific services – using all available means at VA’s disposal, for veterans living in rural and highly rural areas.

Some minority veterans, especially those who suffer from combat-related injuries, have to rely on family and friends as caregivers.  In this situation, communication can literally be a matter of life, or death.  Some of these caregivers may not speak English as their first language.  When there is a language barrier, there is a great chance that the veteran may not be informed of benefits and services to which he/she may be entitled and coordinating rehabilitation or care becomes daunting. 

VA has made the effort to have several of its brochures printed in Spanish and is attempting to make staff and health care providers more knowledgeable about cultural diversity.  However, given the diverse make-up of the veteran population, materials and outreach have to address more than Spanish-speaking populations. The American Legion believes that VA needs to remove any hindrance that prevents veterans from obtaining the care they have earned through their military service.   

VA Outreach Efforts

The Center for Women Veterans outreach activities include: a National Summit on Women Veterans Issues to address emerging needs facing female veterans and provide information about VA benefits and services that female veterans have earned through their military service; creation of the Women Veterans Frequently Asked Questions pocket guide; and conducting town hall meetings and community forums.

The Center for Minority Veterans provides veteran outreach through minority veteran program coordinators, who inform minority veterans of VA benefits and services on the local level; collaboration with VA’s Office of Small and Disadvantage Business Utilization (OSDBU) to co-sponsor business outreach activities to sponsor business and entrepreneurial outreach conferences for minority and disabled veterans;  and through the Advisory Committee for Minority Veterans, conducts site visits and town hall meetings.

The VA utilizes opportunities to address veteran service organizations (VSO) to disseminate information.  These opportunities or information exchanges include: participating in VSOs annual conventions and training conferences; collaborating in writing informative articles for membership magazines and newsletters; and inviting VSOs to participate in focus groups/work groups and planning for outreach activities.  By participating in activities sponsored by the various VSOs, VA provides information to advocates who directly work with and for veterans to ensure that they receive the quality of care and benefits to which they are entitled.

The Center for Women Veterans, the Center for Minority Veterans and the Office of Research and Development eagerly participate in The American Legion’s annual Convention and training conferences.  They provide speakers to address specific topics affecting women and minority veterans.

Again, thank you for allowing the American Legion this opportunity to present its views on women and minority veterans. We look forward to working with the subcommittees and VA to improve access to quality health care for all veterans.