D.34 Health Care for Women Veterans 02.pdf

DEPARTMENT OF VETERAN AFFAIRS (VA)

SALT LAKE CITY HEALTH CARE SYSTEM

Salt Lake City, Utah

MEMORANDUM 11.78 November 30, 2016

HEALTH CARE FOR WOMEN VETERANS

1. PURPOSE:

To establish policy for providing comprehensive health care to women veterans at the VA Salt Lake City Health Care System (VASLCHCS).

2. POLICIES:

a. It is the policy of the VASLCHCS to provide comprehensive health care for all eligible women veterans. Women veterans will have access to breast care, gynecological care, and gender-specific health care services, as well as a full continuum of primary care and mental health care. Women veterans will be given sufficient privacy and safety during the administration of this care.

b. The VASLCHCS Women’s Service will have an active Women Veterans Advisory Committee to address all issues related to meeting the unique needs of women veterans. This committee will include representation from services in the VASLCHCS that interface with women veterans.

c. The VASLCHCS Women’s Service has a full-time Women Veterans Program Manager (WVPM) and Women’s Health Medical Director (WHMD) who collaborate to execute comprehensive planning for women’s health issues and that improves the overall quality of care provided to women veterans. The WVPM and WHMD report to the Chief of Staff. The WVPM is responsible for chairing the Women Veterans Advisory Committee and other duties as outlined in the position description. The WHMD is responsible for co-chairing the Women Veterans Advisory Committee and maintaining clinical competencies of the Women’s Service as well as others duties as outlined in the position description.

3. PROCEDURES:

a. Women veterans who apply for medical benefits and are determined eligible will be afforded comprehensive health services in the VASLCHCS.

b. It is a VHA goal that all enrolled women veterans receive comprehensive primary care from a designated Women’s Health Primary Care Provider (WH PCP) who is interested and proficient in the delivery of comprehensive primary care for women.

D.34 HEALTH CARE FOR WOMEN VETERANS

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c. Upon evaluation, the examining clinician will determine the most appropriate method of treatment for the veteran’s medical condition within any applicable statutory limitations of care. Clinical staff privileged to perform physical examinations on women veteran patients includes physicians, residents, nurse practitioners, and physician assistants. Proficiency will be augmented through continuing education and collaboration with attending physicians providing coverage in Women’s Clinic.

Women Veteran patients will receive history and physical examinations, breast and pelvic examinations, including both a speculum and bi-manual exam, screening mammography and Pap screening according to the national standards of care.

d. Both screening and diagnostic mammography services will be provided under fee- basis arrangements. Pap tests will be processed through Pathology and Laboratory Medicine to an outside laboratory contract, maintaining corroboration with the primary care or OB/GYN provider and the

WHMD/WVPM.

e. Quality assurance activities will be conducted in accordance with Women

Veterans Program QA Plans based on the VHA Handbook 1330.01, VHA Services for Women Veterans section 10. Quality assurance activities will be supported by the Information Technology Center and provide the data for assessment on a quarterly basis to ensure appropriateness of care. Quality assurance activities will be reported to the WVPC and reviewed in the Women Veterans Advisory Committee. Recommendations will be forwarded to the Manager, Primary Care Clinical Services regarding corrective action and follow-up for non-compliance.

f. Women veterans will be entitled to VASLCHCS care for pregnancy and parturition per VHA Handbook Maternity Health Care and Coordination

1330.03 and VHA Handbook Services for Women Veterans 1300.01 sections 19 section, part b.

g. Gynecological services and/or specialized mammography procedures which are not available through the Veterans Health Administration or other federal facilities in the geographic area will be accomplished under the Non VA Services program.

4. REFERENCES:

VA Regulations 17.48e, 17.50a, 17.50b and 17.51 M-1, Part I, Chapter 4 Directive 10-91-101 M-2, Part I, Chapter 29 G-5, M-2, Part I

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VHA Directive 10-92-030 Public Law 102-585, Women Veteran Healthcare Act VHA Handbook 1330.01, VHA Services for Women Veterans VHA Handbook Maternity Health Care and Coordination 1330.03

5. RESCISSION: Center Policy Memorandum 111.11, "Health Care for Women Veterans," dated May 21, 2016.

6. RECERTIFICATION: This policy is scheduled for recertification on or before the last working day of November 2019.

7. FOLLOW-UP RESPONSIBILITY: Women Veterans Program Manager (11)

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SHELLA STOVALL

Acting Director