A publication of Vietnam Veterans of America, Inc. ®
An organization chartered by the U.S. Congress
April 2002/May 2002
Working For Women Veterans:
An Interview with Irene Trowell‑Harris, The Director Of The Center for Women VeteransOn January 21, Irene Trowell‑Harris, the newly appointed Director of the VA's Center for Women Veterans, attended VVA's Women Veterans Committee meeting. She was interviewed by Marsha Four, chair of VVA's Women Veterans Committee. Pat Eddington, staff liaison for the committee, was also present during the interview.
Marsha Four: Please describe the qualifications you bring to the Center for Women Veterans.
Irene Trowell‑Harris: First, I have been in the military for 38 years, five months, and 26 days and have worked with DACOWITS [Defense Advisory Committee on Women in the Services] about eight years. Also, I helped the Air Force conduct a survey to assess access to care for women and women's issues. That gave me a great background. Being a nurse with a doctorate and working in medical centers and dealing with women's issues added a lot.
In addition, I was in the VA's Office of Health Care Inspections for nine years that included visits to medical centers, including the clinics, looking at the quality of care. As part of that, we looked at the women's clinics and women's issues.
Between my military and civilian experiences, I feel I bring a lot to women's issues. Being a female veteran myself, having gone through some of the same experiences that women are going through now, gives me knowledge of what needs to be done.
Four: Could you comment on the situation that DACOWITS is in now?
Trowell‑Harris: We received some information earlier that there was a question if there was going to be support for its continuation. Later, we received an e‑mail from Col. [Patricia L.] Nolin, who is the military director there, stating the administration supported DACOWITS and the committee was going to go on.
DoD did come up with a press release stating that DACOWITS would continue and that they are very supportive.
[On February 28, the Pentagon announced it would not renew the authorizing charter of DACOWITS. Rather, it would rewrite the charter; however, some type of women's advocacy group would survive. –ed.]
Four: How do you view your role as the Director of the Center for Women Veterans?
Trowell‑Harris: I view my role as being very important and very crucial for addressing women's issues when it comes to legislation, administrative issues, and systems and programs.
I'm working with Carole Turner [Director] of VHA's Women Veterans Health Program and Lynda Petty [Women Veterans Coordinator, Veterans Benefits Administration]. When issues come to us, sometimes you need several people jointly working on various aspects of them. So, we have been meeting in groups, making sure we can address all of the issues.
Between October 15 and January 20, my office responded to 193 inquiries from veterans. That included congressionals, benefits issues, health care, “How do I find my records?” “Where do I put this uniform?” “How can I get help for my mother or my father?” “I was denied a claim, how can I get that readdressed?” So, there are numerous issue that need to be addressed. My philosophy is to address every issue immediately with accurate, up‑to‑date information.
Four: And it's being tracked in a database?
Trowell‑Harris: Absolutely. I have my 193 issues by category‑‑whether it's health, loans, school, education, or cemetery.
Four: What incentives for women veterans would you like to initiate as the Director?
Trowell‑Harris: There are some things I would like to improve. The first thing: Everything for women veterans would be in support of the Secretary's One‑VA goal. He wants every veteran to have high‑quality care and the same benefits and services. We are talking about being equitable. He wants every female to have the same benefits the males have. And, in receiving those benefits, we want to make sure there is no discrimination against women.
What I would really like to see is that one day we would not need special programs for women. That's a long‑term goal. But initially, I would like to see us do a better job with outreach, especially to rural areas, to the minority population‑‑any areas where historically they have not been able to get those veterans. We have several programs to look at that. We are working with the local VAMCs, VSOs, Health and Human Services, and other agencies to address that.
I have given nine keynote speeches; I have ten scheduled. I am trying to go to areas where people have not gone. Among those involved are the TAP programs. We will be going to different military bases looking at the TAP programs.
Four: Referring back to your concern about reaching women veterans in rural areas, some veterans have come to us with concerns‑‑specifically women veterans of the Southeast, Native American women, who are so far removed from access to any health care because of the distance they have to travel; also the cultural concerns and issues.
Trowell‑Harris: My second week in office I ran out to Muskogee, Oklahoma. I had a chance to meet with the VISN coordinator for women's issues and also the physician assistant who covers nine clinics in the whole area. This particular lady is a marvelous person. She was able to have a meeting that brought many of the Native American veterans out there. She also is a consultant for the VA. She goes to states with high numbers of Native Americans.
Four: Arizona, New Mexico?
Trowell‑Harris: Right. She is going to New Orleans; she is going all over. She is one of our great contacts. I also work with a young man at VACO who is Native American. He knows people all over the country. He gave me names and I contacted those people. We are setting up programs in various areas now. I am depending on the coordinators out there to let me know where they are and to invite me. That's what they have been doing recently.
Four: And communication with the Bureau of Indian Affairs?
Trowell‑Harris: Oh, absolutely, in coordination with them. Because there are certain benefits they get from the Bureau of Indian Affairs, whether it be health or whatever, and certain ones they're getting from VA. So, we are working together on that.
Four: Hopefully within the next several weeks, you will have an Associate Director at the Center. What will be the role of that Associate Director?
Trowell‑Harris: The main thing we need that person for now is to assist me with the excessive requests for travel and for speaking. But I also think she can help us address those 50 to 60 inquiries every week from women veterans. I want to make sure you understand that some are from men, too. About 5 percent of the calls we get are from male veterans asking for information. Sometimes they want to know, “You know, I have an elderly mother or sister or someone who is a veteran, and I want to know how I can get benefits for them.”
Recently, someone called and said, “My grandmother is very elderly. She is waiting to go into a veterans nursing home. In the meantime, I need help at home.” So, what I have done is coordinated with the Department of Health and Human Services, the Aging Division. They have a 1‑800 number where they can evaluate a person immediately and help get assistance locally. By collaborating with other agencies, we are trying to really take care of the entire veteran. We are talking about quality of life.
Four: Communication to the veterans is very important, and I wonder about the web site the Center uses. Will any changes or new information be added to it?
Trowell‑Harris: We just upgraded and revised it a couple of weeks ago. But we are looking at another contract, if possible, to make it even more user friendly and more comprehensive. We just attached the VHA Women's Health Program to our web site.
Also, I would like people to realize there are numerous linkages to that web site, like “How to Apply for Benefits.” The benefits are listed on there, where to go; the medical center phone numbers, addresses; the health coordinators; the benefits coordinators; even the state coordinators are listed. And there are numerous linkages to the military, to the National Records Center in St. Louis. Applications are there, e‑mail addresses, DACOWITS and WIMSA are on there.
Four: You mentioned the women veteran coordinators. How do you envision their role?
Trowell‑Harris: They are really the most important people we have, because they are in the field. This is where they interact daily with the women, whether it be health care, whether it be with benefits, or loans, or getting a claim reevaluated.
I was so pleased to get Carole Turner's new web site. When I need to, I pick the phone up, I look at the e‑mail, and I call that person and say, “I have this veteran and this is her concern, this is what she is telling me. Would you immediately investigate, evaluate, and get back to me?” And that's what they do, immediately.
Four: Do you feel women coordinators have appropriate time allocations in order to effectively perform their jobs? And what do you think should be done to alter or increase the time allocations that are given to them? Many would like to see some validation given to the job they do.
Trowell‑Harris: It's a very complex question. My second week in my job I met with Dr. Susan Mather, who is in charge of all the women's programs, and with Carole Turner. We addressed this issue. They have a draft program coming out soon that gives time commitments, criteria, and performance measures which should really improve that program. They want the new under secretary to take a look at it before they send it out to the world. But it is a revised, updated policy on women veteran coordinators.
I have had certain concerns expressed to me that they needed more time and that the directors out there sometimes promised and did not stick to their promises. So, they wanted something more substantial. And that's what Dr. Mather has done.
Four: Do you feel this will be embraced by the VISN directors?
Trowell‑Harris: They told me they've gotten their support already. But, my own opinion is I would like to see the outcome, and if there are issues, I would like to immediately address them. We know with budgetary constraints sometimes things do get reduced and cut. But I would like to know their specific concerns, that we get those concerns out.
But I am very optimistic. I am willing to do what I can to help make sure they keep their promises.
Four: There are so many community‑based outpatient clinics (CBOCs) being set up across the country, in some cases in a rather hurried fashion. How do you see the ability of those outpatient clinics to deal with the sexual‑trauma issue? Personnel training is needed because the veterans who come into those clinics are going to present themselves without prior notification.
Usually those veterans who are seeking care for sexual trauma can't be put off with, “Let's see if we can get you in next week downtown.” Additionally, will the right questions be asked or will the issues be identified or even addressed, if training on this matter is not required of staff?
Trowell‑Harris: I should say the CBOCs have been growing at a very, very rapid rate. I can't speak to all of the staff, because there are so many different kinds; there's the VA staff, there's contractor staff, and there is the combined contractor staff. That was one of Dr. Kaiser's priorities: to get the clinic and health care in the community where the veterans were. And that's what they've tried to do.
Some of them may not have the expertise initially to treat women with military sexual trauma.That's the reason we have these specialized centers. But they do have teams trained at most medical centers. If this is an issue, I need to know about it.
Four: I am aware it is difficult to have all services at all locations. I guess the most important thing would be a program in all CBOCs that would provide training to handle these cases and how to take them to the next level for care. What kind of oversight will be done to insure that sensitivity training is in place?
Trowell‑Harris: The Secretary's One‑VA is part of the sensitivity. Everybody has a certain amount of sensitivity training, and with our Doctor Makers Program, with the CBOCs, and the Sexual Trauma Center, they do a lot of that. Every CBOC does not have a team at this point, but there's something like 710 CBOCs. The primary goal was to have primary care, and anytime you need specialized care, you get referred to a medical center. The issue is staffing. Every CBOC doesn't even have a psychiatrist. This is something that the new under‑secretary is going to be working on. We had a long talk about what his priorities were as far as women. He is very pro‑women; he is most interested in the military sexual conduct program.
Four: There are a few national centers in the VA system providing residential treatment and care for women veterans who suffered the aftermath of post‑military sexual trauma. Their need for separate gender specific‑treatment locations is understood. Will you seek the institution of other treatment centers?
Trowell‑Harris: The centers have teams at various medical centers. I don't have the list of those, but I believe it is on Carole Turner's website, http://www.va.gov/womenvet.
Four: Would more VA sexual trauma residential programs for women veterans at least be on the table for discussion since these residential treatment centers are so few nationally?
Trowell‑Harris: I think they are calling them teams now. That's something I will check with Carole Turner, but I know they increased the number of teams. The last time I checked with them, they have them in major medical centers‑‑not in every CBOC and not in every clinic, though.
Four:I am speaking of the VA residences where the women veterans come and actually reside.
Trowell‑Harris: I'll have to check that.
Four: Many of these women veterans, because of the issues at hand, may have PTSD complicated by substance abuse, and compounded, in many cases, with homelessness. Once they complete the VA Residential Program, they can be linked into transitional programs for further support in the community. Are they?
Trowell‑Harris: I think there is a program that started in Long Beach, California, called the CHANCE Program. They have right now, I think, around eight of those. It's a combined funding source from VA, DOD, HUD, HHS, Catholic Charities, and the Salvation Army. They take people in‑‑whether its PTSD or sexual trauma‑‑and they take them all the way to independent living. They even take homeless women with kids.
They are using a Navy base in Long Beach, California; this base is closed. On campus is single living, apartment living; there I is a school with grades 1‑8; they have a recreation center for after school; they have their own training programs, they've got computers and jobs. Also, they have 22 staff members from VA on campus there. So, they are actually doing treatment, job training, and taking care of the kids.
The CHANCE Model is a great program. I went out there and spent three days walking through the buildings observing the programs and going to that little school just to see how that worked.
Four: Could you give us an update on the status, future appointments, budget restraints, and effectiveness of the Women Veterans Advisory Committee?
Trowell‑Harris: The Secretary's Advisory Committee on Women Veterans now has 14 members. This committee is one of the most valuable and most important committees for women veterans.
Think about it: These are highly qualified men and women from around the country who are bringing in the crucial issues. They are the ones who help us get that national agenda to address women's issues‑‑again, whether it be legislative, administrative, program, or assistance issues.
It is very important to have this committee meet. Normally it meets twice a year, with one site visit to a medical center. So I'm very glad we finally got the packages completed. The charter, by the way, which is renewed every two years, was just signed off by the White House. So we are full steam ahead now.
Four: Everybody is taking a bite on the budget. I am wondering how that will impact the site visits of the Advisory Committee.
I know there are some that say, “Why do you tell them you are coming ahead of time? You need to go see the real deal." But these visits are a way of evaluating what is going on out in the field, seeing programs first hand and having town meetings with women veterans who use the VA system. This activity can bring forth a very poignant message, not only to the Advisory Committee, but to those who actually provide services.
Trowell‑Harris: The actual budget, however, is already planned and got budgeted for two regular meetings and a site visit. We may request additional funding later. I believe in being there. Go out there, see them in action, talk to the veterans, talk to the women coordinators out there, and see for yourself.
So every time I go around the country to do a speech, I visit the Women's Wellness Center or the clinic. I talk to the people, and I want to talk to the veterans. I want the facts on the spot.
Four: The Advisory Committee compiles a report every two years and one wasput together for 2000. Could you tell us where it is in the process and if or when it's going to be delivered to Congress?
Trowell‑Harris: Before I came to the office, I heard about that report, and I have been asking for it, even before I got appointed to the position. Initially it had gone to the printers, but when I reviewed it, there were a lot of errors in there.
Four: With the new legislation, the VA Homeless Veterans Advisory Committee will soon be in place. Has there been any input from your office on assurances someone will be appointed to the Homeless Veteran Advisory Committee with knowledge of the needs, issues, and services specific to women veterans?
Trowell‑Harris: I've been coordinating with Pete Doughtery. He is the director of the homeless program for the VA. We communicate all the time on the issues out there. Recently, we have been reading in The Washington Post and other papers about the increase in homeless women and women with families. So this is a great concern to us.
Four: I suspect because of the VA's inability to work with children of veterans, there will be increased collaboration with community agencies so there can be joint ventures to help and assist those veterans‑‑not only female, but also males who have children.
Trowell‑Harris: The CHANCE Program is just one of the models. But also Doughtery is in charge, he is the liaison for faith‑based programs. In the beginning, it was not so popular and didn't really go too far. But based on what I got from the White House, that's being revised again, and I am most interested in that.
Because when I read the proposal, we can work with numerous organizations like Catholic Charities or the Salvation Army, who do some marvelous things. And Health and Human Services. And we can really get some great benefits for the veterans. There are some great models out there in places like Philadelphia, New Orleans, and right in Maryland. So, we know where the models are. I've looked at them.
Four: Do you foresee an increased collaboration between federal agencies and providing the funding through grants, i.e., HHS and VA for veterans, homeless veterans, services for veterans?
Trowell‑Harris: I would hope so. They have right now, I believe, ten different places. That's a joint VA, DOD, Health and Human Services, Catholic Charities, Salvation Army, and a few others that work together. The reason that they work together is because of the veterans out there. All the people they find homeless are not veterans, and they don't want to turn anybody down, so as a consortium they can take everybody. That's the reason I like that model, though, because it takes care of all the homeless people. But, again, its like initial treatment to total independence. This is taking care of the husband, the wife, and the kids.
Four: What do you recognize as your greatest challenge?
Trowell‑Harris: The greatest challenge is making sure that every veteran, especially every female veteran, receives the benefits and services they deserve and receive high‑quality care with sensitivity.
Four: Do you have any message you'd like to impart?
Trowell‑Harris: I would just like to mention three areas where we can all work together to help us serve the Vietnam veterans better. Number one is to help us educate the coordinators and the veterans locally to work together.
Many times you talk to veterans, and they have not contacted their local persons. A part of that is they need to keep good records of what stuff they have been going through. If they can't get treatment or they have a rejection letter, keep copies of that and send us a copy. That way we can specifically deal with the issues.
The second is, we get a lot of requests to come out and speak. They send some e‑mails. But they don't tell us the state they are in; they don't tell us when or where they want us to come.
They just say, “Will you come and speak?” It would be nice if I knew the location, the date, time, and any special requests. But our e‑mail gets filled up. So, if they could just tell us exactly what they want and where they are.
Number three, it would help us if people could be pro‑active at the local level supporting the legislation that we send out, that somebody had sent out. This is, I'm talking about, on the local level, with your state legislature, with the governors and their congressional reps. That'll help a lot.
Sometimes they can get things done that we can't get done in Washington. So, if they could just help us, by helping be more active. That's the way you all can help us to do a better job with the Vietnam veteran.
Pat Eddington: One of the things that we're concerned about, generally speaking, are future generations. You've got two Vietnam veterans in the room with you right now. And, of course, we have an entirely new generation of women veterans being created.
One of the biggest concerns we have is that the Department of Defense is not doing a good job of pre‑ and post‑deployment health screening for the troops. Obviously, this is of great concern when you are talking about going someplace like Afghanistan or anywhere else in Central Asia.
Trowell‑Harris: Is this a historical issue or a phase?
Eddington: Have you had discussions about the need for VA to put more pressure on DOD to get it right up front? Because it can be an absolute bear to try to substantiate an illness or a problem if it's not been properly documented up front in the veteran's records. Is this a topic that has come up in conversations?
Trowell‑Harris: No, that has not come up in the VA arena. But that did come up at the DACOWITS Committee, because they've got concerns about people not being appropriately screened prior to going. Because you don't know what the pre‑existing illnesses are or the status. And once a person goes, you need to re‑evaluate them when they come back and know what the status is then. That way you can determine if there was a pre‑existing issue, and you can determine what really happened over there.
This is something that any of us can raise for the agenda. These are open meetings and anybody can attend. And anybody can submit a recommendation. This is something that maybe you should bring up.
Eddington: Is there anything else from a legislative standpoint that the administration is contemplating that would have an impact on women veterans?
Trowell‑Harris: Not at the moment. The list they have right now is for all veterans. But looking specifically at issues related to women, the new ones I brought could be of interest to women. But it's for all veterans, not anything specifically related to women.
I met with the legislative people about a month ago. I met with one yesterday to see if we had any new agenda items for women because the process for submitting new legislation comes up in about two months. And, I want to make sure if there is anything out there, that we get on the ground floor and make sure they are properly researched first.
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