[Federal Register Volume 78, Number 88 (Tuesday, May 7, 2013)]
[Notices]
[Pages 26698-26700]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-10781]


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DEPARTMENT OF VETERANS AFFAIRS


Report: Strategies for Serving Our Women Veterans

AGENCY: Department of Veterans Affairs.

ACTION: Final notice.

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SUMMARY: On May 14, 2012, the Department of Veterans Affairs (VA) 
published a notice in the Federal Register inviting public comment on 
the Draft Strategy Report (DSR) titled, Strategies for Serving Our 
Women Veterans. This document responds to the public comments received 
and affirms as final, with two identified changes, to the DSR.

FOR FURTHER INFORMATION CONTACT: Irene Trowell-Harris, RN, Ed.D., 
Director, Center for Women Veterans, Department of Veterans Affairs, 
810 Vermont Avenue NW, Washington, DC 20420.

SUPPLEMENTARY INFORMATION: In a notice published on May 14, 2012 [FR 
Vol. 77, No. 93], VA presented its DSR, Strategies for Serving Our 
Women Veterans. VA is committed to transformation, with the aim of 
becoming an increasingly Veteran-centric, results-driven, and forward-
looking 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, WVTF developed this DSR to solicit stakeholder 
feedback on its initial findings and recommendations. Following public 
comments to this draft, WVTF will develop a detailed operating plan for 
implementation.
    We received 32 comments on the DSR through the Federal Register. 
The majority of comments involved one or more of the following topics: 
Veterans Benefits Administration (VBA) disability ratings policies; 
recommendations for collaboration between Department of Defense (DoD) 
and VA in outreach to women Veterans, including outreach prior to 
separation from service; need for DoD to enhance its efforts in 
military sexual trauma (MST) prevention; privacy in regard to MST 
treatment and other issues related to MST treatment, including 
recommended change in questions asked during National Security 
Clearance process; need for full-time women Veterans coordinators; need 
for expanded child-care; need for specific treatment for homeless women 
Veterans; importance of culture change across VA with regard to women 
Veterans; disparities in care for women Veterans; need for specific 
goals, metrics, and accountability to ensure successful implementation 
of the recommendations in the draft report; need for more research and 
data; concerns about how the Task Force was constituted; and 
opportunities for collaboration with non-governmental organizations 
(NGO) and other Federal and state agencies.
    Other comments related to gaps and recommendations laid out in the 
strategy report, editorial corrections, and citations. One included a 
report of alleged criminal activity (identity theft) at a specific VA 
facility. Based on subject matter, most of the comments can be grouped 
into several categories: VA claims and benefits; collaboration for 
proactive outreach to women Veterans; MST; access to VA services 
(access to VA health care); homeless women Veterans; culture change; 
data; and WVTF integrity and accountability. We have organized our 
discussion of the comments accordingly.

Comments Concerning VA Claims and Benefits

    There were a number of comments regarding VA's disability ratings 
policies and procedures and the length of time it takes to decide a 
case. One commenter expressed concern that her claim was not properly 
rated because she suffered from a difficult-to- diagnose disease. 
Others expressed that VA's disability rating system is still largely 
intact despite not having been updated in 50 years, and that major 
renovations are needed for today's medical evaluations. These comments 
are beyond the scope of this particular report. We, therefore, make no 
changes to the DSR based on those comments.
    The majority of commenters believed that VA should more closely 
collaborate with DoD in providing transition services to women 
Veterans. One commenter believed that DoD and VA need to collaborate 
consistently and more comprehensively to achieve outreach and education 
goals as described in the DSR.
    Multiple commenters believed that Servicemembers need to be 
provided with information regarding VA services and benefits for which 
they may be entitled or eligible at the time of their discharge or 
release from active duty or service. One commenter believed it 
essential that VA fully recognizes and reaches out to nonprofits that 
are conducting important work in helping women Veterans not only to 
secure employment but also to have fulfilling long[hyphen]term careers 
in civilian life, and the commenter recommended that VA conduct an 
external mapping of the services being provided by nonprofit and 
community organizations for women Veterans. Other comments concerned 
opportunities for collaboration with NGOs, local community 
organizations, and other Federal agencies to provide training, 
services, outreach, research, and opportunities for women Veterans. 
These comments are outside the scope of this strategy report; we, 
therefore, do not make any changes to the DSR based on those comments.

Military Sexual Trauma

    One commenter expressed concern regarding question 21 of 
the National Security Clearance Questionnaire that asks about mental 
health treatment. The commenter suggested that treatment for sexual 
assault counseling be excluded from disclosure and that VA advocate 
changing the question across the Federal Government. No changes to the 
DSR are made based on this comment, which is beyond the scope of the 
report.
    Many commenters recounted personal experiences regarding sexual 
assault and MST they experienced. They also commented on DoD and VA's 
processes for treatment and benefits for those who experienced MST, the 
lack of VBA Women Veteran Coordinators' contact information at Veteran 
outreach events, and a lack of interest--both in DoD and VA--in 
minimizing the re-traumatization of women Veterans reporting or filing 
claims for MST.
    These comments are beyond the scope of this report. As such, we do 
not make any changes to the DSR.

Access to VA

    One commenter commended VA's efforts pertaining to delivery of 
services and benefits to women Veterans through the Center for Women 
Veterans, Women Veterans Health Strategic Health Care Group, Office of 
Mental Health Services, and women Veterans coordinators. The commenter 
expressed that proposed efforts need to be monitored and tracked in a 
comprehensive way to ensure that, together, they are succeeding in 
meeting the goals and outcomes set by VA. The commenter further 
suggested that VA ensure that there is no duplication of effort and 
that all programs and offices work together. The final suggestion of

[[Page 26699]]

the commenter is that VA may want to consider streamlining aspects of 
these efforts to make sure they are coordinated, surveyed, and reviewed 
regularly for their ongoing success. We thank the commenter for these 
thoughtful comments (and noted support of VA women Veterans programs) 
but conclude that we need not make any changes to the DSR based on 
them.
    Other comments involved requiring full-time availability of certain 
staff that provides direct assistance to women Veterans such as the 
women Veterans coordinators at regional offices; suggesting that 
employees should be Veterans and be able to relate to other women 
Veterans; ensuring that female nurse practitioners or doctors should be 
on full-time staff at women's health clinics; and adding child-care 
options to women's clinics. Another commenter wished to clarify that 
women do not decline services offered by VA but simply do not know 
about the range of services offered, making the outreach goal (p. 15 of 
the DSR) vital. The commenter recommended that VA add an objective 
defining the best channels through which women Veterans can and will 
receive messages.
    We thank all of the commenters for taking the time to respond and 
submitting their comments and suggestions. Because these comments go 
beyond the scope and purpose of the DSR, we respectfully make no 
changes to the report as a result of those comments. We will, however, 
forward these comments to the responsible program offices to help 
inform their current efforts.

Homeless Women Veterans

    One commenter addressed the challenges homeless women Veterans may 
face in getting assistance, especially when they have children. The 
commenter stressed the importance of focusing on the mental health of 
these particular women Veterans since they have the added stress of 
being responsible for dependents thus further compounding their 
desperate situation. To address this, the commenter suggested the 
following: Require homeless Veterans coordinators to network with 
counterparts in private and other public sectors; require VA to 
identify or acquire more transitional housing for homeless women 
Veterans-for those who are suffering with mental health issues and 
substance abuse, as well as those who are not; provide transitional 
housing programs that provide funding for providers/stakeholders that 
allow children of various ages and gender to be housed with their 
mother. In addition, the commenter states that such transitional 
housing programs should offer child-care options to enable the Veteran 
to attend college or to secure a job that will lead her to self-
sufficiency.
    We thank the commenter for these comments. Access to care and 
services for homeless women Veterans is a focus of the findings of the 
report. However, these specific recommendations go beyond the scope of 
the report. We respectfully decline to make changes to the DSR. We 
will, however, forward these comments to appropriate program offices 
for their consideration.

Culture Change

    One commenter stressed the importance of culture change in VA to 
improve women Veterans' total experience using VA. Suggestions for 
improvement included instituting a national campaign supported by every 
level of leadership and all VA employees and updating the written 
regulations to legitimize cultural changes that are adopted. We 
acknowledge the concerns of the commenter and note that the core 
concern is already reflected in the DSR; therefore, no changes are 
required based on this comment.
    Another commenter shared her impressions of VA staff's attitudes 
about women Veterans at a particular medical center, which she 
suggested has led to disparities in care for women Veterans. Examples 
provided include doctors and medical staff providing different 
treatment for women due to a bias that women Veterans are more 
emotional than male Veterans, and staff appearing uncomfortable with 
providing emergent care for gender-specific problems. There was also 
mention of the lack of prosthetics designed for women, as well as 
suggestions to increase depression-screening for female Veterans and to 
identify innovative approaches and best practices to reduce the 
perceived disparities in care at the medical center. We thank the 
commenter for these comments. Finding they go beyond the scope and 
purpose of the report, however, we make no changes to the DSR.

Data

    There were comments concerning a need for more research and data to 
fully understand the challenges that women Veterans face and to 
identify how to adequately address them. A commenter expressed concern 
that one key area of missing data is information from employers on how 
they meet the needs of women Veterans, and what employers need to know 
in order to hire and successfully integrate women Veterans into their 
businesses. The commenter also suggested that VA consider the research 
already done by private and nonprofit organizations.
    We thank these commenters for taking the time to comment. Although 
we decline to make any changes to the DSR based on those comments, we 
found these comments informing and will consider them as we develop our 
Operating Plan.

WVTF Integrity and Accountability

    Several comments concerned the composition of WVTF and the methods 
that will be used to measure the effectiveness of WVTF at carrying out 
its charge. Some questioned how the members of WVTF were selected and 
if men were included. Specifically, the commenter stated that WVTF 
needs to establish outcomes that indicate success in meeting 
established objectives and to develop metrics that adequately assess 
progress toward the desired outcomes. Others believed the Task Force 
should have included community women Veterans service providers to 
obtain a broader view of these issues from experts (and resources) at 
the grass roots level. We thank the commenters for their comments. 
Comments were solicited on the report findings and recommendations. 
Concerns related to the composition of the Task Force are beyond the 
scope of the report. We respectfully decline to make any changes based 
on these comments.

General Comments

    A majority of the comments recounted very specific and personal 
experiences and impressions of women Veterans or their family members; 
asked questions about the data presented; asked specific questions 
about medical treatment; requested a comparison with other Veterans 
populations; and made requests for timelines on deliverables identified 
in the strategic plan. Other comments expressed concerns about specific 
women Veteran subpopulations, such as the women who served in Fort 
McClellan and those who experienced certain ailments. One commenter 
conducted an informal survey on a VA medical center's accessibility and 
services and provided results of her personal assessment. Various 
commenters provided their personal impressions of VA facilities where 
they receive treatment and services. We thank these commenters for 
their comments. Finding they go beyond the scope and purpose of the 
DSR, we respectfully decline to make any changes based on the comments.

[[Page 26700]]

    One comment involved the role the Center for Women Veterans has in 
VA's administration of services to women Veterans. The commenter 
asserted that VA needs to re-evaluate the Center for Women Veterans' 
authority--which the commenter believed has diminished over time--to 
speak for women Veterans across the programs of VA. The commenter 
expressed that the organizational chart should indicate that the 
Director of the Center for Women Veterans reports directly to the 
Secretary. It was suggested that such placement would reflect the 
Department's commitment to, and understanding of, the level of 
importance and contributions of women Veterans.
    Although we will not amend the DSR based on these comments (which 
suggest changes beyond the scope and purpose of the report), we found 
these comments informing and will consider them as we develop our 
Operating Plan.

Employment and Training

    One commenter found the objectives throughout the DSR to be well-
balanced insomuch as they are both strategic and measurable. There was 
a suggestion that VA work with organizations with expertise in 
providing employment mentoring and training for women Servicemembers to 
obtain those organizations' expertise to better assist women Veterans 
with the same sort of services. We thank the commenter for taking the 
time to comment and for the commenter's support of this DSR. We make no 
changes to the report based on these comments.
    Another commenter concurs with the Task Force's goal to increase 
employment and retention of women Veterans by leveraging public and 
private sector resources and improving synergy, integration, and 
collaboration. The commenter recommended that VA pursue collaborative 
efforts with states, encourage the sharing of best practices, and 
challenge regional chambers of commerce to host Veterans hiring 
conferences in the coming year. The commenter also concurs with the 
Task Force's goal to enhance marketability and professional development 
of women Veterans through career development/workforce training, noting 
their receipt of specialized job training and/or career or professional 
credentials is critical to their future employment success. The 
commenter encouraged institutions providing this training--community 
colleges and universities--to provide a supportive environment for 
Veterans. The commenter also noted that support services are critically 
needed to serve younger women Veterans, especially those who experience 
multiple deployments. The commenter recommended that VA expand the 
number of VetSuccess Programs on campus program sites to increase the 
number of supportive campus environments that can help ensure women 
Veterans achieve their educational goals.
    We appreciate the supportive comments and thank the commenters. 
With respect to the suggested additional recommendations, we do not 
make any changes to the report because they go beyond the scope and 
purpose of the DSR.

Data Collection and Evaluation of Services

    One commenter recommended that VA ensure that its indicators 
identify root-causes of identified problems and track women Veterans 
across ``the life-cycle of service.''
    In conclusion, many comments that we received provide valuable 
insights that we will take into account in our future implementation 
efforts particularly with respect to conducting a detailed analysis of 
needs. Other comments recommend resources that the implementing VA 
program offices can evaluate for use in those efforts.
    Comments that we forward to the appropriate lead Administration 
(i.e., the Veterans Health Administration (VHA), VBA, or the National 
Cemetery Administration) will in turn be forwarded, as appropriate, to 
that Administration's subordinate offices for consideration generally 
or in connection with current or planned program initiatives within VA 
to prevent duplication of efforts. For example, comments that we 
received relating to homelessness among Veterans in the Greater Los 
Angeles area will be forwarded first to VHA and, subsequently, to the 
leaders of the VA Greater Los Angeles Healthcare System.
    Comments related to DoD and its programs or to outside entities are 
not within VA's purview to address.
    The comments overwhelmingly affirm the intent and recommendations 
of the DSR and particularly the need for urgent, systemic, and 
sustained action to address the gaps in services and benefits 
identified in the report.
    We, therefore, make no changes to the DSR based on the comments 
received, except for the following two editorial changes:
     On page 4, a citation will be added for the survey 
mentioned in the following statement: ``By 2009, about 30 percent of 
women Veterans surveyed did not think they were eligible for VA 
benefits.'' The citation to be added is as follows: National Survey of 
Women Veterans. Women Veterans Health Strategic Healthcare Group and VA 
HSR&D SDR-08-270. 2008-2009.
     On page 7, the following sentence will be deleted due to a 
lack of a definitive reference: ``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.''

Conclusion

    For the foregoing reasons, we adopt the DSR with two changes.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Jose D. 
Riojas, Interim Chief of Staff, Department of Veterans Affairs, 
approved this document on April 30, 2013 for publication.

    Dated: April 30, 2013.
Robert C. McFetridge,
Director of Regulation Policy and Management, Office of General 
Counsel, Department of Veterans Affairs.
[FR Doc. 2013-10781 Filed 5-6-13; 8:45 am]
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