WASHINGTON — One of the last pieces of legislation to make it through the 116th Congress was the Johnny Isakson and David P. Roe, MD Veterans Health Care and Benefits Improvement Act of 2020—a more than 300-page piece of legislation whose size and scope had it being referred to as the “veterans’ omnibus bill.”
One section of it is being heralded as a sea change for women’s healthcare at the VHA.
The bill is named for Isakson (R-GA), the former head of the Senate Committee on Veterans’ Affairs who retired in 2019 for health reasons, and Phil Roe (R-TN), a physician and former head of the House Committee on Veterans’ Affairs who is retiring after this term. It is made up of a number of different initiatives, including the Deborah Sampson Act, a suite of legislation aimed at improving the experience of women veterans at VA.
“[This act is] the crown jewel in this package and the most comprehensive women veterans’ bill in over a decade,” declared Speaker of the House Rep. Nancy Pelosi (D-CA) during a speech on the House floor last month. “This bill improves the health, benefits, education and VA support system for women veterans, [including] requiring the VA to create the anti-harassment and anti-assault policy, improving women-specific primary care, expanding access to child care and strengthening mental health initiatives.”
Pelosi added that the bill could not be coming at a more needed time, referencing a VA Inspector General’s report released the week prior that outlined VA leadership’s attempt to discredit the complainant in a sexual assault claim at the VAMC.
“Congress will not relent until every servicemember, every veteran, and every woman can live free from the fear of assault or abuse,” Pelosi said.
The Deborah Sampson Act was first put forward by Rep. Julia Brownley (D-CA), chair of the Women Veterans Task Force, in 2019. At the top of its list of requirements is that VA create a dedicated Office of Women’s Health at VA. The office would monitor women’s health initiatives across the department, develop standards of care and monitor and identify deficiencies in those standards. (Deborah Sampson became a hero of the American Revolution when she disguised herself as a man and joined the Patriot forces and was the only woman to earn a full military pension for participation in the Revolutionary Army.)
The legislation went into some detail as to what those standards should be, including having at least one designated women’s health primary care provider at every medical center and clinic and ensuring each facility hold regular public forums and focus groups of women veterans.
The women’s health chief would make recommendations to the under secretary for health regarding the allocation of resources to address the healthcare needs of women veterans. The bill explicitly states that, should the under secretary deny any of those requests, that the appropriate congressional committees be informed within 30 days and be given the reasoning for the denial and any possible alternatives.
The bill also requires the VA secretary to make the physical retrofitting of facilities a priority. While VA has long recognized that women are the fastest growing demographic in their patient population, many facilities have been slow to retrofit their physical plant to better accommodate care. This bill gives VA a one-year deadline to create a plan to address deficiencies in the environment of care for women veterans.
This includes the creation of a uniform environment of care standard across VA, regular inspection of facilities, requiring medical centers to submit a report on their compliance to these standards and requiring the secretary to create a remediation plan for those facilities that fall short.
The legislation also includes substantial language directed at eliminating harassment and assault at VA facilities. While the department has a number of programs geared at addressing harassment, their implementation from facility to facility has been found to be inconsistent. The bill requires VA to create a comprehensive policy that will be implemented uniformly across the department. The scope of the language focusing on harassment has been compared to VA’s recent efforts to eliminate veteran suicide—an attempt to create a departmentwide culture that considers any incident of harassment to be a failure.
That policy would include mandatory training for employees and contractors, a number of clear avenues for veterans and staff to report incidents of harassment and a mechanism of accountability for facilities that do not live up to this standard. That accountability will include a remediation plan for facilities that experience five or more incidents of sexual harassment or assault in any fiscal year.
The bill also includes a focus on helping veterans experiencing intimate partner violence or sexual assault. VA will be required within a year of the bill’s passage to conduct a national baseline study examining the scope of the problem in the veteran community. The report will include recommendations for how VA can expand services to assist these veterans. In addition, VA will be required to create a pilot program to assess how the department can identify veterans who have been or are experiencing intimate partner violence and how they can work with other agencies to help them.