 And thank you for joining. I'm Elizabeth Tapampe with DAV, and I'm joined today by three very special guests to mark 100 years of progress in health care for women veterans at the Department of Veterans Affairs. In 1919, hospitalization and medical care for women who served as army or Navy nurses during World War I was first authorized. But it wasn't until September 14th, 1923, that the National Home for Disabled Volunteer Soldiers, the precursor to the Veterans Health Administration, approved the first hospital spaces for women veterans. The number of women served at the time was small, but the historic move signified that female veterans had the same claim to government medical assistance as their male counterparts. Since then, the need for gender-specific health care has grown exponentially. Just this past June, we celebrated 75 years of the Women's Armed Services Integration Act, which allowed women to serve as permanent regular members of all branches. Today, women make up more than 16% of active duty military and 10% of veterans and are the fastest growing demographic. In response, the VA has invested significantly in improving access to comprehensive quality health care for all women veterans. That care also recognizes the unique needs of and challenges faced by women, including reproductive health care and military sexual trauma. Here to discuss the past, present, and future of health care for women veterans Naomi Mathis, a retired Air Force veteran of the Iraq War and a former DAB benefits advocate. Naomi now serves as DAB's assistant national legislative director and is a fierce advocate for women and underserved veterans. We're also joined by Air Force veteran and the executive director of the VA Center for Women Veterans, Loris Tiglow. Loris serves as primary advisor to the VA secretary on department policies, programs, and legislation that affect women veterans. Lastly, we have Dr. Chelsea Morgan, director of comprehensive health for the Office of Women's Health at VNHA. In this role, Dr. Morgan has led initiatives to increase resources for women's health programs, including funding for women's health providers and gender specific health care equipment. Thank you all so much for being here today. Quite a bunch. Thank you so much. So we often talk about how historically women veterans have been underserved, right? The VA was built and designed in large part for men. So I think some people will be surprised here that we're celebrating a hundred years of health care for women veterans. So this question goes to all of you. What does this anniversary represent to you and why do you think it's important that we mark the occasion? Naomi, if you wanna start us off? Yeah, I'll go ahead and start. To quote Winston Churchill, those that fail to learn from history are doomed to repeat it. And so we don't, it's so important that women veterans have gender specific care. We come with so many different issues and comorbidities and we just have different autonomy than men. And so it shouldn't be that there's this institution that is, or this healthcare system which it is designed for men and dominated by men. But we shouldn't have where we're just kind of shoving in women. It's important to really show how far we've come and how much further we have to go. Laura, does how about you? What does this anniversary mean? Thank you. I think I wanna piggyback a little bit on what Naomi said which is not only does it signify making sure that we're providing gender specific care but also acknowledging and recognizing and addressing the unique needs and the contributions of women veterans who have served in the military. Me coming to the United States as an immigrant and joining the Air Force as an immigrant, I certainly had different needs and different experiences than others. And I can just imagine that women veterans and history earlier than me when they had to hide that there were women in order to just serve. So those needs weren't being addressed until the time that we were actually even recognized as part of the armed forces. And so though the VA has been in existence for many, many years beyond a hundred years, a hundred years is definitely a milestone of not only where we've come from but also where we have progressed and where we're still going. And I'm really excited to be able to talk about some of that progress later. Yeah, and talking about some of that progress, what do you think have been some of the most significant changes whether in recent years or more historically that have helped the VA better provide for women veterans? And I'll let Dr. Morgan, if you wanna chime in on that and what this anniversary means for you. Yeah, thank you for having me. And I think of anniversaries as a time to just reflect and I agree with all the other comments made as I'm not a woman veteran. So this is a time for me to think back that it's more than a hundred years of women serving. So thank you all for your contributions and being a healthcare provider is my opportunity to say thank you. And a hundred years is a long time and we've made a lot of progress because I can't imagine a hundred years ago they were doing maternity care coordination and women's mental health groups and women's only whole health groups. So we've really done a lot in this time but we have a long way to go. When I think about something that really jumps out in our history around 2008, this is more of an internal operation but there was a memo signed within VHA in 2008 that required all medical centers to have a woman veterans program manager. And I can't even imagine what VA women's health would be without this position. We also call them WVPMs for short because it's a mouthful but a woman veteran program manager is at every medical center and they are really our point person. They help us coordinate care for women veterans. They oversee outreach to make sure that the women veterans that are participating in the program are really reflective of the women veterans in the community. And they look at our numbers. Are we doing enough pap smears at this location? Is this location doing enough cervical cancer screening, breast cancer screening, all of those different things. And it really brings a unique flavor to what's happening at each location. So we really appreciate them and that's been a huge leap forward since 2008. Lord, as an AME, I saw a lot of nodding, talking about the women veterans program managers. If you can maybe add to why that's so important or other changes that you think have been more significant. Yeah, absolutely. I actually wanted to jump in a little bit on from just some of the legislation that's come forward most especially is the Debra Sampson Act which has been this sweeping landmark legislation that has really changed the environment, the face and the landscape of women veterans healthcare from intimate partner violence, to sexual harassment and assault, making sure that we are addressing some of those issues as well as addressing some of the inequities that have happened in the past with when we didn't have women veteran program managers and advocates within the VA healthcare system to make sure that women veterans are receiving equitable healthcare not only from an access but the quality of the care that we receive. And this administration has been doing a phenomenal job of having their foot on the pill and not letting up and it's credit to all of the people who work at VA who are passionate in the work and really recognize women veterans as equal and a natural part of the veteran community. That's not always been the case and it's not always been the way the society has looked at women veterans. And so I think just even having a whole society approach and seeing that women veterans are like when you think about veterans that women also come as part of that immediate thought process that is an entire culture change. That is a change in the way that we think in the way that we look at who a veteran is and who are part of the military system. And I credit like a lot of the people who have done firsts within the women veteran space as well as those who are continuing to break ceilings who are still in the military. Lord, as you mentioned legislation like the historic Deborah Sampson Act. Naomi, can you explain for folks what role DAV has played over the years and because I know legislation is a huge piece of that and making sure that we're providing quality comprehensive healthcare for women. Oh, absolutely. DAV continues to beat the drum on Capitol Hill and have conversations with VA and find out exactly where the gaps are, what do they need and then bring it forward to Capitol Hill to staffers and really let them know this is what the VA needs. This is what our community needs. And so we have the MAMO Act. We have the Kate Hendricks Thomas Service Act which makes it more accessible for women to get mammograms, I always do that, to get mammograms particularly for those that are toxic exposed. It's 20 years since the beginning of the Iraq war and so, or the OIF, OEF war. And so we know that where we don't know, I should say exactly what effects those toxic exposures have on us. And so it is so important that we continue to monitor and continue to have access to our women veterans and find out exactly what's going on and help treat those issues. And so we won't know unless they're getting those diagnostics. So I would say those are two pieces of recent legislation that have passed that are absolutely critical. And even the MAMS who served act taking care of our women veterans that are still in the reproductive age and are having children and being able to really identify, again, now we look at these exposures that they have and all these comorbidities that they have and compound that with possible mental health issues and all these other things. And so it's so, so important that we continue to do research on, we have the million veterans program where they take blood samples from each veteran and they have this, it compiles this huge database of genetic database and helps guide research on, these are things that women veterans or veterans in general have been exposed to and these are things that they're dealing with and these are the outcomes of these exposures. And so really instead of being reactive, try to be a little bit more proactive. And so I think those pieces of legislation are super important. And DAV started out back, we produced two reports, 2014 and 2018 women veterans reports. And those have, if you look at those reports, there is legislation where we have, that was included from those reports. And so those, they actually helped guide current policy that exists today. And there are still issues that have not been addressed and we will continue to beat that drum and ensure that women veterans have the access and the quality, high quality evidence that they have been subjected to. Yeah, and I think you talk about being proactive, not reactive. And I think that's where that partnership between an organization like DAV and VA becomes even more imperative, so that we can stay ahead of those things. I also, you mentioned the 2014 and 2018 DAV reports on women veterans. You can find those at dav.org slash women dash veterans along with lots of other resources for women veterans. I wanna open this question really to all of you, but let's talk about what the VA does really well. Let's remind folks that a lot of women veterans have a lot of great experiences with the VA and there are a lot of great programs to highlight. Maybe if I can start with you, Dr. Morgan, what do you think the VA does really well when it comes to women veterans? As I mentioned earlier, I think many people don't think about maternity care and some of these other things that we do with NVA. And not only are we trying to make people aware of those things, but I think we're doing a great job of just coordinating care and getting people the support that they need. So we don't provide full spectrum maternity care. We connect people with obstetricians in the community, but just like Naomi mentioned with the protecting moms who serve, we are expanding our maternity care coordination, so what does that mean? If someone is pregnant and they are participating in VA care, we help connect them to their community obstetrician, but we have care coordinators who are nurses that check in throughout their entire pregnancy and now an entire year after they deliver. So this is a great opportunity for us to just make sure that everything is going okay. After people deliver, sometimes you can get some stresses to your mental health. Maybe you need some coordination with other materials. Maybe you need a splint, a back brace, or something else like that. NVA is really stepped up in making sure that we have those maternity care coordinators in place, ready to get you whatever you need or coordinate you back to your VA provider when you finish delivery to just seamlessly keep you in care. That's just one example. And I think a couple other things I wanna shout out really quickly is we have Whole Health. Whole Health is one of our initiatives that make sure that we see you as a whole person. You're not just a body, you're not just a blood pressure. You are someone with a mind, body, and spirit. So that's an approach that we use with our providers, but we also help coach you all as our veterans to adopt a Whole Health mindset. So when you're trying to overcome different barriers, we have Whole Health coaches, we have mental health providers that help you really embrace your mind, body, and spirit connection to help you heal, whether it's from chronic pain or mental health or problems with weight. There's so many different ways to use that Whole Health approach and that's available at VA as well. I could talk all day but I'll let some other people jump in. Lord, a similar question. I wanna reframe it just a little bit. You know, DAV certainly believes as many do that the VA is uniquely and best position to provide the best healthcare for all veterans and I think including women veterans. Why do you think the VA is in that kind of best position to do so? So one thing that I think most folks don't realize is that the VA is probably the only institution that follows a person's life cycle from the beginning to the end. Once they know your history from when you were there and we have benefits and services all the way to the end of life. I don't know of any other institution here in the United States that follows you all the way through in that fashion and working in a very collective and collaborative fashion so that we know if you're accessing education, if you're starting a new phase of life if you're starting a family. And so knowing all of those other external factors that affects someone's health is extremely important and I wanna tie that back into our military service and something that Naomi said about the PACT Act. But the VA knowing about the history of someone's career in the military, it allowed us to create these presumptives based on that history. And so again, I don't know of any other institution here in the United States that sees that from whole way through from career to end of life. And the other thing that I think that also helps is we're always working towards being better. Like it's never like we're done. It's always how, what is the next step? What is the next part? And one of the things that I wanted to highlight on this is our work on trying to change the culture both internally and externally. One by acknowledging women veterans internally here in VA we've got naming spaces and naming place initiative. I will be in St. Cloud, Minnesota sometime mid month. So and they're going to be renaming one of their corridors after a woman veteran. Why is that important? Because women veterans want to see others that look like them, others that are like them. One thing that I like to say is like women cannot be what they cannot see whether they see it in their mind or they see it in a physical space. And so seeing that there are others like them that we're normalizing that women veterans are part of this community is extremely important. Internally, the other thing that VA is doing is we've been really working towards equitable outcomes for women veterans. So instead of an equity action team we have the credit to O-R-M-D-I the Office of Resolution Management Diversity and Inclusion they've been spearheading the idea council as well as the I-STAN idea which is about making sure that it's we're having an inclusive culture within VA and the I-STAN is really working towards mitigating and preventing sexual harassment and assault. And each of these things on its own may not seem like it's a big thing but collectively when we are all working towards that same goal of making sure that all women veterans feel safe. All women veterans feel like they belong. All women veterans feel they can trust VA in their journey throughout their veteran journey all the way to the end of life as well as their families. That is what we strive for is to earn that trust keep earning that trust as a learning organization. Thank you, Lourdes. I had to give a shout out to a past DAV national commander Delphi MacFoster. Naomi, I have a feeling you thought of this too. She would always always says a child cannot be what a child cannot see. So to your point about representation just how important that is. So certainly lots to celebrate in terms of what the VA is doing well. What are some of the existing gaps and challenges or what challenges does the VA have in filling those gaps and more importantly what are the solutions? Lourdes, would you like to start us off with that one? Ooh, okay. I will try to be short on this one to make room for others. I think one of the things that we have a gap on is engagement with women veterans, especially in research. Women veterans, so when I'm thinking about research not only in medical research but even in just self-identification with the Library of Congress there's like over 100,000 stories about veterans and maybe seven to 8,000 are women veterans. And for our million veteran program which is on about research for medical for being more targeted in the medical services that the VA provides there's not enough representation of women veterans. So there's gap in engagement. There's gap in research for women veteran representation. Another gap that we have is I think just and we're actively working towards addressing them which is really access and especially access in rural communities. And I think that that's not necessarily unique to VA. I think that's just a consequence of geographic barriers when we're talking about rural areas and when I talk about geographic barriers I wanna make sure that I'm stressing it's not just here in the United States but it also includes our territories as well as our women veterans who live in other countries because women veterans are everywhere. They are global, not just here in the United States. So I'd say geographic boundaries, research and engagement. And I'd say the biggest hurdle that we have right now is getting women veterans to self-identify. So that's why we have these collaborations with all of our VSO, MSO, Specialty DAB who's kindly hosting this year. And I think that self-identifying part that goes back to the culture, right? Dr. Morgan, is there anything else that you'd like to add in terms of what gaps still exist and maybe how we can address those? One thing I'd like to add. So in terms of trying to make sure we have enough providers in care especially in our rural areas, I do think that it's an issue at VA and outside of VA before COVID we were already trying to make sure we get enough providers. But since COVID, I think there's even more of a healthcare shortage not just with our providers but with our nursing staff or ultrasound techs. And we've really designed some outstanding programs in VA but without the bodies and without the staff and without the dedicated hard workers, it's really hard for us to bring that to you. One of the things that I've thought about is that many people don't think about VA as an employer when you want to serve women. So if you want to serve women and you're a healthcare provider that's doing mental health or if you're doing social work you don't necessarily think I should apply to VA and I'll have the opportunity to care for women as a maternity care coordinator or as a social worker that is dedicated to women. And we do have those positions here in VA. I know we've been doing a lot of hiring but we still need people who are willing to come and really focus on you all women. So we're ready for you. And if anyone who's on the line today or if anyone knows anyone who is a nurse who is a physical therapist that wants to work with women please apply to VA and consider us. Lord, as you've already, you've spoken and thank you Dr. Morgan for that. Lord, as you've spoken about culture quite a bit. In my mind, I think culture takes everyone. Certainly it starts at the top and starts with leadership. Is there anything that just the general public or the veterans at large can do to help be part of a better, more inclusive culture at VA? Oh, that's an interesting question. I think just in general, what the general, what the public can do, right? And this is maybe an exercise that anyway, is to be mindful that when they see a woman whether they're parking in a parking lot where it says for veterans only, don't make assumptions that they're not the veteran. Make the assumption that they are the veteran. Because I think it's easier to, if you are incorrect in that assumption, I think it's easier to say like, I'm sorry, that instead of making the assumption that they're not because again, it's one of those things where in isolation, it may seem like it's innocuous, but do you repeat that experience 100,000 times in a woman veteran's life? And it slowly erodes their sense of self and their sense of value and sense of, was my military service enough? Am I not enough to be called a veteran? And it's one of the things that I think is, I think within our general society, we still need to work harder towards. The other thing I think that I would say, let's say for anyone who's out there in a private sector, if you have any affinity groups out there, if you don't have a veteran affinity group, consider creating one. Because I'm sure, again, when I said, there are women veterans everywhere, I literally mean that. There are probably veterans women veterans in organizations that you don't even know that they are there. And those touch points are potential connections to maybe connect them to VA services, now that you're listening to us here, to connect them to VA services, if they didn't know about it. The other thing to think about is in the course of your general work or general life. Let's say you're going to a PTA meeting. I'm sure there are parents out there who are veterans or women veterans who are taking their children to school. Think about who the people are in those nontraditional spaces who are probably veterans and you just might not know it. And it's a space to be able to not only spark a conversation, but only to normalize the acceptance that women veterans are a part of our community. They are a part of society. Make them feel welcome and make them feel like your service is not only acknowledged but it's also celebrated. And it's celebrated with the same fervor, with the same honor and with the same pride that you see our brethren veterans as well. And I think that's one of the things that is inequities that we are really still working hard to fight is making women veterans not feel that they have to fight to prove their worth. That's part of the reason why they don't even stand up to call themselves a veteran is because every time they are asked or they are questioned about their veteran status or where did you serve or did you deploy or not? Like there is less than 1% of this entire nation's population who serve in uniform, only a fraction of that 1% are women veterans. And I think that when we are thinking about the burden of this nation's defense rests on that 1%, each one of those people have earned their benefits and earned those services. So let's honor that service by making sure that they don't feel like less than. Absolutely. You know, kind of on the same note, something that I've heard from a lot of women veterans, I'm not a veteran myself. I've had the great honor through DAV to meet and talk with a lot of women veterans. And one of the experiences I hear often is that they feel dismissed when they seek out the healthcare that they're just not listened to or taken seriously. I don't think this is an issue unique to VA. I think in the private sector as well, people and including women have felt dismissed which can be very deflating and can stop people from seeking care in the future. Is this something that VA is tuned into? And if so, how is it being addressed, Dr. Morgan, if I can start with you? Yes, thank you for bringing it up. And I agree with what you're saying and the comments that Lord has made as well. This is a cultural problem. And when we say cultural problem, this is something that includes not only the providers but also includes everyone that's in the VA that day. So it includes other veterans. It includes their partners that are coming with them, their visitors. Everyone who is there is responsible for helping us shape the culture that we want. And so another opportunity for us to think about this 100th anniversary is what are we gonna do in these next 100 years? So this culture change that we're moving towards is one that everyone is not only respected because that's the baseline but everyone is also celebrated and we appreciate everything that you've done. One thing that we're doing within the Office of Women's Health, we have designated women's health providers. So when people come to VA and you are a woman veteran, you have a designated women's health provider that has had training in certain areas that not only have they had training before they came to VA, but within VA, we also make sure that they are up to snuff on a lot of different things related to women. So not only pap smears and breast cancer care, but we're talking about, are you looking at your internal bias as a provider? We provide training to our designated women's health providers on social determinants of health, on health equity, making sure that they are sitting with that person and really looking at them as an entire individual. Our goal is to train them to provide care that's comprehensive, not just prescribe a medicine and move on. And another thing that we're doing within the Office of Women's Health is we have monthly campaigns. We have monthly campaigns that talk about heart health and bone density, but also every single month, we have a campaign dedicated to culture change. And so if you all are sitting in a waiting room and you see some of those different posters around, those are just primers to remind people, if someone has a bad remark that they're saying, if someone has an inappropriate way that they address someone, that's not the expected culture here in VA. Every VA has a different phone number, so you should be reaching out to either a phone number posted on the wall or maybe you can ask the receptionist if you do encounter something that's inappropriate because there is a mandated reporting structure because we want to hear about these things because we need to identify if there's certain places that we need to double down and figure out if we need to address things in a different way because that's not the next 100 years of women's health in VA. All right, I want to jump in a little bit on that one because one thing that she mentioned was how we are making sure that our providers are culturally competent. I want to just bring up bystander intervention training that is an effort for VA to make sure that it's not just staff members or employees, but it's also other patients who are there in the spaces, if they see something happening, making sure that they feel empowered and know how to not only work also potentially to intervene or at least stop the activity to make sure that that particular activity doesn't continue. And so bystander intervention training actually empowers anyone who is within that space of that woman veteran to step in, to stop, to act and not just let something go. I agree. I actually, myself as a veteran, took the bystander intervention training. It actually was very good and it gave some very real examples, examples of that I myself years ago had experienced when I first came into the VA and it is very interesting in trying to teach people how to get started even with just the language that's being used or being sensitive to who's around you, just when you're in the waiting room or if you see something happen, say something or maybe try to assist that veteran. Battle buddies, right? You have your battle buddy, we're all always looking for out for each other. So look out for that veteran that, and also understanding that there could be a mental health component with some people and being mindful of that. So it's very interesting and I highly recommend it myself as a veteran to take that. I'm so sorry, I'm gonna one last plug on that mental health suicide prevention month. And so I wanna make sure that I really just wanna make a plug that each of these potential negative encounters could be the straw that breaks the camel's back. And so let's make sure that when we see something, we offer that support because sometimes that one last activity or action that doesn't get stopped may be the thing that pushes someone over the edge. So as we think about suicide prevention month this month, let's make sure that we're thinking about how to be good battle buddies. Thank you, Lardis, for adding that. I think unfortunately we have to also acknowledge that one in three women veterans have reported experiencing military sexual trauma. One in a hundred men have reported as well. We know that those numbers tend to be under reported. But so you have a lot of women veterans going through VA who have already experienced some kind of harassment or assaults. And I just think that's something to everyone's point that we need to be tuned into and aware of. And I think we've kind of answered this in talking about what the VA is doing, but you have a lot of women veterans who maybe their first experience with the VA was in the 80s or 90s and maybe they had a negative experience. And once that trust is broken, it's really hard to gain back. What would you say to those women who maybe tried the VA in a different decade, didn't have a great experience? What would you say to them now? Well, I'll jump in. So this is not your grandfather's VA anymore. This is not the VA that you experienced back in the 80s and 90s. Just as we are changing as a culture here, even in America, Steven's starting with the Me Too movement and all of that. But so is the VA. And the VA really has, I will say, has worked very hard in making changes. So not only is there a women's health for you, right? You have the women's health clinic that you can go to. There's a provider that provides women health services, but I myself, believe it or not, I don't go to the women's health clinic gasp. I know, right? But what happened, see what happened was, I actually started in a regular clinic because I was transferring in from another visit. And so I had to go for, because I'm a chronic patient. So I had to go for a follow-up coming from my old VA, from my old visit. And so they said, okay, well, we'll put you in the regular clinic until we can get you an appointment with the women's health. And sure, not a problem. I ended up loving my doctor and my clinic. Shout out to the yellow clinic here at DC. I ended up loving my doctor and my clinic so much that I stayed there. And so I think that that speaks to, I feel included. I am being treated, not just, oh, you know, she's a woman veteran. Let's throw her in the women's health clinic and keep her there and keep me siloed. But also I feel included in a regular clinic. I feel as a veteran and that's all I want. You don't have to specifically, of course, there should be, if there are veterans that prefer to go to the women's health clinic, the option is there. And that is phenomenal and that is fantastic. And I think that it is critical, it's important. But I just wanted to kind of give a shout out to the fact that while the women's health clinic is available, sorry, Dr. Morgan. The women's health clinic is available. I chose to stay with a regular clinic and my treatment has been fantastic. Yeah, thank you for sharing that. And I think we can all agree, like that's the ideal, right? Is that any veteran can walk into any VA facility and feel taken care of, feel safe and get connected to the care that they need. If you're just now tuning in, we are discussing the past, present and future of healthcare for women veterans next Thursday, September 14th marks 100 years of healthcare for women veterans. You can learn more about the history of healthcare for women veterans at women'shealth.va.gov slash history, lots of great information there, great timeline, breaks everything down. Speaking of timelines, so the center for women veterans was created in 1994 and the office of women's health was officially established in 2021. Lorde and Dr. Morgan, can you talk a bit more about how your departments serve women veterans and how your two offices work together? Let me offer Dr. Morgan first. Well, in the office of women's health, we are located within VHA and we're really focused on the healthcare arm of things. So we do depend on Lorde's and her team to help just keep us in touch with what is the pulse of women veterans and things that are external to healthcare, we kind of leave to her team. So we are focused on making sure that we're meeting the things that are expected of healthcare providers, not only within women's health, but outside of women's health. If you're in a non women's health clinic, we're still tracking your health progress as well. We're making sure that we're meeting all of the screenings, the flu shots, the COVID shots, making sure that there's no disparities when we look at women because women are a numerical minority you have to take some time to step away from things and really examine, is there equality there? And if there's any areas where women's numbers are drooping below male veterans, we kind of pause and say, what do we need to do to address that? So it's not only that we are focused on breast and cervical care, but we're looking at the entire woman and making sure that there's true equity in the way that VA is providing care to the veterans. And that's so critical because I don't think it's been said, but women are the fastest growing cohort within the veterans community, right? So as far as the whole population of veterans, women veterans are the fastest growing numbers within the population. So that's super important. Okay. Absolutely. And thank you for saying that Naomi, because that's one of the reasons that VA, just one of the reasons that VA has really doubled down on its focus on making sure that women veterans needs are being addressed in a very holistic fashion. I will say that Office of Women's Health has been our partner in crime and all things women veterans. The difference between the Office of Women's Health and Center for Women Veterans, I think it is a little bit of a two-fold. They are the technical experts on all things women veterans healthcare, like the technical expert. I will never claim, nor CWB will ever claim to be those technical experts. We go to them for their technical expertise. The Center for Women Veterans actually looks at a little bit more of a holistic fashion. So we, because we sit under the Office of the Secretary and we report to the Office of the Secretary, our work actually transcends to three administrations. So we can reach into VHA, VBA and NCA to address any of the programs or legislations or any inequities or disparities that are maybe being tracked or found to help not only support them to address it and then mitigate in the future, but also to be trusted partners so that the voice of the women veterans are actually part and parcel of the way that they look at policies, that they look at programming. So within the Center, there are four things that we really work on. One part is advocacy, not only advocating internally within the department for women veterans and representing the voice of women veterans and so that all of the policies and programs are looked at for their gendered lens. The other part, this is a huge part, is actually a great, I can't speak, outreach and education. And so our outreach team, both Anna and Michelle, they do a phenomenal job being out there within the community across the United States to make sure that all of the women veterans, whether they're in small rural areas or they're in large urban areas, that those women veterans, their families, their friends and the ecosystem that surrounds women veterans, that they know about the services, the benefits and the updated policies that actually increases access for women veterans to be able to reach into VA for all of those services. We also work collaboratively across the triadministration. And the one thing that I'll say is, there is no one office, there is no one agency that can be the panacea for everything and that is the same for VA. We are just one agency across all of the various agencies. Here in the United States, it's working towards supporting and making sure that our women veterans across the nation and beyond the borders of the United States get the services and the benefits that they've earned. So part of the work that we do is working with both local state federal agencies, also with private sector NGOs, MSOs and working with DAV on programs like this, making sure that the folks know that we are a trusted partner and collaborator. We are your voice. We are the brick glass. If you cannot find anything, if you are a woman veteran out there, I will say this, if you are a woman veteran out there and you have gone round and round and do not know where to go, www.va.gov, reach out to us and we will figure out how to untangle whatever it is that you find yourself in knots for. The last part that I wanna make sure that I hit on is empowerment. So there has been always an adage that VA needs to help with this. VA needs to make sure that you do this. But one of the narratives I'm really trying to fight against is that the veterans are broken and that they next, like veterans just need an opportunity to be able to serve our communities and how can VA be a part of that journey to help them get to that goal that they have put for themselves in their lives to be there in our community with their whole selves. So it's not about us trying to fix something. It is us being a trusted partner to help them get to whatever their goals are and being a facilitator or being a supporter in that journey. The collaboration between CWB and OWH, like I said, they're the technical experts. We're there to kind of wrangle and integrate all of these different facets of whether it's legislation, whether it's policies or programs, et cetera. We're there to help wrangle everything together, integrate it in a cohesive way and be that voice not only internally, all the way up to the secretary and the various senior leaders, but also externally, be the voice for our women veterans. The one thing I'm really proud of is that we are now, we now have five VA medical centers named after women veterans. And one of the fastest ones that I heard about was the state director for Alaska heard a speech that I gave one year and three days later. That allows the anchorage, VAMC has been named after Colonel Mary Rasmussen based off of that one speech that he heard about the disparity. That's awesome. Thank you for sharing that and gives me a chance to remind people, like this is why we believe sharing your stories is so important. You share your story, you don't know who you can educate, who you can inspire. And I think that illustrates that. I also just wanna note, talked about empowerment, that's very much GAV's mission as well is to empower veterans, whether it's helping them in securing their benefits and the healthcare they need, or it's connecting them with meaningful employment, connecting them with resources as an entrepreneur or volunteer opportunities. And it really is about empowering the veteran to advocate for themselves and to kind of find their new purpose and mission. So we've talked about kind of access or outreach to women veterans and making sure they know of these resources. I think we've touched on a lot of kind of how we can do that. We know that according to the VA only 44% of women veterans are enrolled in VH healthcare but I wanna look at another number. So among women veterans who used VA healthcare in fiscal year 2020, 89% of them were returning users. So they came back from the year prior and continued to use VA. What, and Dr. Morgan, I'll direct this to you. What does that number say to you? Yeah, I think that's, it really shows that people that give us a try or at least maybe try it again recently because we talked about how VA has changed. Many people have given VA a try in the past, it wasn't meeting your needs. And that's where we're really here to listen and try to improve. We're all about constantly improving but also making sure that we're addressing things that may be outside of women's health. Like we mentioned, we're talking about culture change. We're talking about things that extend beyond you just sitting in a room with a women's healthcare provider. We know the experience is so much more than that. And we think that the 89% is reflecting that people are coming back. They are happy with the care that they're receiving. And they're also communicating with their provider if there's additional things that they need. I want to kind of connect this back to something else you mentioned earlier with many people having experienced military sexual trauma or traumas outside of the military. We acknowledge that. And we also know that within women's health we need to set aside additional time and effort to train our providers to make sure that we're caring for women veterans the best way. We do something called trauma informed care. And I think a lot of people are happy with that. What is trauma informed care? What that is is whenever we're interacting with a veteran, whether it's an intimate exam where we're doing maybe a pelvic exam like a pap smear or something that's not an intimate exam, we're just doing a knee exam or an abdomen exam. We are approaching this person as if they may have had trauma. We know trauma is invisible. Many people may be carrying that invisible trauma and they don't tell us. And we don't even really need to ask every time. Every patient of mine gets treated with trauma informed care. And what that means is I'm checking in. Is this okay? Is it all right if we lift our shirt to expose your abdomen? Would you like for us to continue with this exam today? Would you like for us to stop? Did you want to come back? And maybe we could do this another time. So that approach, that trauma informed care I really think makes people feel comfortable with VA providers. And they know that we understand what's going on and we're really tuned in. So we've covered a lot. And I think Laura's what you alluded to before. Sometimes it can, there can maybe be an overwhelm of resources. So for a woman veteran who is seeking VA healthcare for the first time, what's a good place for her to start? I'll say three things. Okay. First, the My Welcome Kit. I can't put it in here, but www.va.gov slash welcome-kit. This provides a step-by-step checklist on how to apply, how to find your discharge papers and other important items. I highly, highly encourage everyone to head over there if you are just kind of starting with VA in general. The other thing I wanted to highlight I know it says women's health transition training, but I just want to emphasize that this is for any woman veteran, not just someone who's just getting out of the military or who just got out of the military. So the women's health transition training is an online self-paced training module available for service women and women veterans to take anytime, any place. Literally you can do it now. I've been out since 2007. So even I like having been gone that long, I can go in and access that module. What is that going to give you? It's going to give you how VA healthcare is designed to serve women veterans. It's going to provide available healthcare services, maternity care, cancer screening, whole health, mental healthcare services, among other things. It'll tell you how to process, how the process works and the eligibility requirements for the enrollment, how to connect with other women veterans through women veteran specific networks, resources, programs. And then the last part is how it also provides a way to how to find your local VA facility and resources for additional support. I cannot, cannot recommend the WHTT program highly enough. The last one I was going to say is, find a veteran veteran service officer like the Fixed VA to help walk you through. If you're in your area at VA.gov, we have an actual page for accreditation as well. Those are like the big three things. I'd say if you don't know where to start, those are the first three things. Or if you literally just don't know, come over to us, www.va.gov, women that. Awesome. Thank you, lawyers, for giving folks some starting points. Naomi, we've already spoken a bit about legislation that DAV has helped advocate for and get across the finish line. I'm talking about protecting moms who served, Deborah Samson Act. Legislation related to MST that we've championed. Can you tell folks how they can, where they can find out more about legislation that DAV supports and maybe how they can be part of the advocacy? Absolutely. Please go to DAVcan.org. It's DAVcan, like DAVcan.org and sign up there. Once you sign up there, you put in your address, you put in obviously where you are. And then every time DAV has an alert that we want to set up a piece of legislation that we want you to know about, it will have the actual piece of legislation. It will have an explanation of what the legislation does and why DAV supports it and how we're able to support it. And then it will have a letter that you can actually send to your representatives. And it's three clicks. You click on there and you can edit it if you want to make it personalize it to you. I know for mine, I generally put in the subject line from a combat veteran. I'll put in the subject line just to maybe catch their attention and send that letter off to your representative. So many times we have heard when we're talking to staffers and we're talking to different members of Congress, we have heard, oh yes, we heard about this piece of legislation that you would like us to co-sponsor because we got all of the letters from your members and they really and truly do make a difference, especially, and I'll talk about the biggest one that's just recently passed and that's the PACT Act. We used the DAV CAN network to alert our members that, hey, we're almost there, we're about to go over the finish line. Let's go ahead and contact your representatives today. And so you can do that through DAV CAN network and really stay informed on what's happening with legislation because as we know, when you were in the military, the only thing really, when it came to legislation you worried about was one, are we going to war? Two, what's my raise gonna be this year, right? That's the only really, this is really the only legislation that we cared about. But as you become a veteran, you find that, wow, every piece of legislation that comes out that has to do with veterans directly affects me. It directly affects my health care. It directly affects my benefits. It directly affects my bank account. I mean, it directly affects things that I'm able to access and not access. And so we encourage veterans to really get involved with that and to sign up and we'd love to see you. Yeah, yeah, certainly. I think veterans advocating for themselves and their fellow veterans, there's nothing more powerful. Again, I'm not a veteran as a civilian. I use DAV CAN network. And like you said, it's an easy few clicks and you can support something really important. So again, DAV CAN.org. Before we wrap up, I wanna let our viewers know about an event coming up next week. On Thursday, September 14th at 1pm Eastern Standard Time, the Office of Women's Health will host VA Secretary Dennis McDonough to commemorate this 100th anniversary of Women Veterans Healthcare at the VA. Learn more, including how to watch the event live. I think we're gonna drop a link, a direct link in the comments. If not, you can visit the Office of Women's Health website. We'll get that link up as well. Okay, so time for some closing thoughts. And I wanna open this up for everyone. When we're talking about Women Veterans Healthcare, what's that stake here? Why is it critical that we get this right? And I wanna start with Dr. Morgan. Well, as we mentioned earlier, women veterans are one of the largest demographics within VA. And so if women veterans are such a small group right now and we are not taking this seriously, and if we were not to make sure that we're crossing our T's and dotting our I's, as the women veteran population grows, we're not going to be able to keep up. So that's why right now, while women veterans are on their upward trajectory in our population, we are getting ahead of things. We're hiring more care coordinators. We're doing the maternity care. We're getting more mammogram machines. We're doing all of those things so that we can anticipate the growth. And really, there's a lot of women veterans that are just not integrated into VA care. And so we're preparing space for you all so that you have a place to come and we'll have appointments ready for you. That's our goal. So the access is really open to embrace everyone. And if you haven't already connected with VA or if you have connected with VA and you have something you wanna share, I also wanna make sure everyone has the women veteran call center number. We have a special call center just for women veterans within VA. The number is 855-829-6636. And you can text it too. So you can call or text and they are really just in tune with women veterans in here to talk to you. Thank you for having me. Thank you so much. Lord, what's at stake here? And if you have any additional closing thoughts, please share. Yeah, absolutely. So plus one to everything that Dr. Morgan said. But also, I think what's at stake is the trust. The trust of not just the primary audience we're currently getting, which is like our women veterans, but it's also the trust of this nation that we can deliver what we promise. I know that the secretary speaks about, this is probably the most noble and most sacred mission that we have within the nation, which is to serve those who have fought for our nation. So trust, but also when young girls, young women look at the women veterans and how VA is treating them. That is what they have to look forward to if they are thinking about joining the military. And so if we don't get this right and we don't serve our women veterans, not just from a moral and ethical standpoint that it's the right thing to do, but then this becomes an issue for our military of recruitment. If they see that they're not being treated while at the back end, why would they even join? And so we have a part that we must play to make sure that from a moral standpoint and ethical standpoint and to make sure that we keep the defense of this nation that we not only meet the expectation but to exceed the expectation and always be an introspective, a transparent organization, call us when we need to be called out but certainly let's celebrate the stories where we're getting it right. Thank you. Naomi, what's at stake here and any closing thoughts you have? Lorna stole my thunder. She stole every single point I was about to make. That's right, you can just second. Second. No, seriously, it is true. It does affect the generations that we have coming up behind us and really, like you said, Lordus, recruitment and it is the right thing to do. It is so important that we get the care and to know that when we go from being active duty and being told that we have to take this shot, you gotta get this, you gotta get that, right? That when we get out, all those things that happened to us and all of those things that we're exposed to, that we're gonna get the healthcare that we deserve because we would not have been in that area or we would not have been stationed there or this would not have happened to us. Had it not been for our military service, I'm way different than someone that maybe I went to high school with all those things being people. My, what I deal with on a daily basis is quite different and so it's important that we have a system that is designed for us and VA does have those wraparound services that are so critical for us and are available for us when we walk in the door at VA. So yes, that is absolutely. Women contribute greatly to the armed forces and it would be a shame to not have that talent to pull from if we don't get this right now, but a hundred years, wow. Right? Naomi, Lourdes and Dr. Morgan, thank you all so much for your service to veterans, for advocating for women veterans and thank you so much for being here today. To those watching, you can learn more about the work that VAV does for women veterans at dav.org slash women dash veterans. You can also find VA's information resources for women veterans through the center for women veterans at va.gov slash women vet and the office of women's health at women's health va.gov. Again, we'll try to get those links in the comments so you all can bookmark those. Again, thank you all so much and thank you all for watching.