A new GAO report shows VA Health Administration (VHA) is still failing to comply with basic standards to give women veterans adequate health care.
The Government Accounting Organization (GAO) concluded VA is still weak in many areas of providing women veterans with health care that have been known for many years.
The recommendations from GAO sound like a broken record for the past eight years, and really since VA tried to provide women with access to health care for many years before.
What surprises me is that the most gender conscious president in history was still unable or unwilling to improve health care access for women in a manner consistent with civilians standards while increasing care availability for transgender veterans. Up until the days after Donald Trump was elected, VA was still prepared to start gender reassignment surgeries.
Does that seem strange to anyone? Why are women veterans still facing access issues? Should VA just abandon health care to women in favor of outsourcing it to care providers with more experience?
Recommendations For Women Veterans Health Care
GAO recommended that VA provide environmentally safe inspection processes. It also recommended VA monitor women’s access to sex-specific care. Apparently, the investigation revealed VA hospitals had been left largely to their own devices to report problems related to women veteran health case and failed to report problems as required.
Does this surprise anyone? That VA would fail to follow policies for accountability related to health care quality?
Why GAO Did Investigation
The GAO did the study because:
In 2010, GAO found a number of weaknesses related to care for women veterans at VA medical facilities. GAO was asked to update that study. This report examines (1) the extent that VA medical centers complied with requirements related to the environment of care for women veterans and VHA’s oversight of that compliance; (2) what is known about the availability of VHA medical providers who can provide sex-specific care for women veterans at VA facilities; and (3) VHA’s efforts to provide and monitor access to sex-specific care for women veterans through Choice. To do this work, GAO reviewed VHA data on environment of care deficiencies; the number, location, and availability of VHA and Choice medical providers; women veteran enrollment; and Choice access-related performance measures. In addition, GAO inspected the environment of care for compliance with VHA policy at a nongeneralizable sample of six VA medical centers, which were selected to achieve variation in different care models, the size of the women veterans’ population, and geographical locations. GAO also interviewed VHA Central Office and VA medical center officials.
What GAO Found
The watchdog organization found VA still lacked adequate safety measures and staffing to ensure women veterans receive adequate and timely access to quality health care:
The Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA) does not have accurate and complete data on the extent to which its medical centers comply with environment of care standards for women veterans. VHA policy requires its medical facilities, including VA medical centers, to meet environment of care standards related to the privacy, safety, and dignity of women veterans. VHA Central Office relies on medical centers to conduct regular inspections and to report instances of noncompliance, which are compiled in a VHA database. However, almost all the noncompliance GAO identified through inspections at six VA medical centers it visited had not been reported or recorded in the VHA database, and compliance rates ranged from 65 percent to 81 percent. For example, GAO found a lack of auditory privacy at check-in clerk stations and a lack of privacy curtains in examination rooms, as required by VHA policy. GAO also found weaknesses in VHA’s oversight of the environment of care for women, including a lack of thorough inspections and limited verification of facility-reported data which results in inaccurate and incomplete data. As a result, the privacy, safety, and dignity of women veterans may not be guaranteed when they receive care at VA facilities. Federal internal control standards for monitoring call for management to establish activities to monitor the quality of performance over time and promptly resolve any identified issues.
GAO’s analysis of VHA data shows that nationally the number of VHA full-time employee equivalent gynecologists and the number of women’s health primary care providers—VHA primary care providers specially trained in women’s health care services, such as breast exams—increased by 3 percent and 15 percent respectively, from fiscal year 2014 through fiscal year 2015, and those percentages exceeded the 1 percent growth in women veteran enrollment during the same period. However, about 27 percent of VA medical centers and health care systems lacked an onsite gynecologist and about 18 percent of VA facilities providing primary care lacked a women’s health primary care provider, according to VHA data. VHA officials said not all facilities require onsite gynecologists and facilities may authorize gynecological services from non-VA providers. They acknowledged a shortage of at least 675 women’s health primary care providers and have a plan to train at least 535 providers by the end of fiscal year 2016.
The Veterans Choice Program (Choice) is a primary option for veterans to receive care from non-VA providers in the community if care cannot be provided at VA facilities. While the number of obstetricians and gynecologists under Choice has increased, some areas lack these providers, according to a VHA analysis. While VHA monitors access-related Choice performance measures (such as timely appointment scheduling) for all veterans, it does not have such measures for women veterans’ sex-specific care, such as mammography, maternity care, or gynecology. VHA’s data show poor performance on access-related performance measures for all veterans, and GAO found cases where women veterans’ maternity care was significantly delayed, suggesting that veterans, including women, face challenges receiving timely access to care. Federal internal control standards for monitoring call for management to establish activities to monitor the quality of performance over time and promptly resolve any identified issues.
I likely speak for a lot of veterans in expressing my disappointment that VA has continued to fail women veterans.
President Obama could have resolved this through various mandated reporting but we all know VA was not worried about providing more accountability through reporting but less after getting caught up in the wait list scandal.