Office of Veterans' Services

REPORT TO THE TWENTY-SEVENTH LEGISLATURE

STATE OF HAWAI`I

2013

PURSUANT TO SR6 SD1 2012

REQUESTING THE OFFICE OF VETERANS SERVICES

TO DEVELOP

COMPREHENSIVE PROGRAMS AND SERVICES TO ADDRESS THE NEEDS OF

WOMEN VETERANS AND WOMEN ON ACTIVE DUTY

Executive Summary

 

The Hawai`i Military Women’s Task Force has met since April 2012 every month. It has concluded that military women face multiple inter-related complex problems; among them a high rate of Military Sexual Trauma (MST) and for Veterans the related re-entry issues of adequate health care, high rates of Post-Traumatic Stress Disorder, homelessness and joblessness. Our findings are preliminary and will require further in-depth study.

 

I. The Establishment of a Task Force

a. Introduction:

Senate Resolution No. 6 S.D.1 directed the United States Department of Veterans Affairs (VA) and the Hawai`i Office of Veterans Services to develop comprehensive programs and services to address the needs of women veterans and women on active duty[1]. The Hawai`i Office of Veterans Services created a task force comprised of 13 women veterans and active duty women currently serving in the military from the community, named the Hawai`i Women Military Veterans Task Force (HWMVTF), to address the unique needs of women Veterans in April 2011. The women, whom many have served in combat, represented all eras, services and professions.

The mission of the task force is “to improve the lives of women who are serving or have served in the military, to identify and address the unique needs of women veterans, and to harness the power of women, influencing change.” The members unequivocally believe in the strength of empowering women veterans through education and opportunities to improve and increase resilience.

b. Task Force Members:

Kathleen Eisenbrey (Chair), Roxanne Bruhn (Vice Chair), Rachel James (Secretary), Chelsea Fernandez (Treasurer), Maxine Cavanaugh, Noe Foster, Ann Freed, Ann Greenlee, Anji Lowe, Monica Ojeda Lynch, Patricia Matthews, Terii Perez, and Raquel Ramos.

c. Composition by Service and Status: US Navy: 3 retired (veterans); US Army:

3 retired (veterans); US Air Force: 2 active duty, 2 retired (veterans), 2 Air National

Guard; US Coast Guard: 1 retired (veteran).

 

II. Women Veterans in Hawai`i

a. Current reports estimate there are between 9,502[2] and 11,744[3] women veterans who reside in Hawai`i.

b. Reported number of National Guard and Reservist presently activated:

Army National Guard and Reservist: 40,732

Navy Reservist: 5,098

Marine Corps Reservist: 2,368

Air Force National Guard and Reservist: 8,020

Coast Guard Reservist: 647

Total Number: 56,865

 

III. Decisions 2012

Focus on Military Sexual Trauma (MST): MST is epidemic in the military and in returning veterans and exacerbates other issues such as health, homelessness, and employment.

MST Women Veterans and Soldiers

a. Background:

MST remains an egregious problem for individuals currently serving and for those who have served in the military. The HWMVTF focused on addressing services to victims of MST. Reports from Department of Defense estimates as many as one in three (about 34%) women experience MST[4], while less than 14% of victims report this crime. Research indicates that only a mere 8% of those who are raped report to authorities[5]. In FY 2011, there were 3,158 reported cases of assault to the Department of Defense[6]; it has been estimated that the actual number of attacks approaches 19,000 per year. In FY 2011, less than half of the 3,158 reported cases were referred for possible disciplinary action, and only 191 military members received convictions[7].

Women recruits are now far more likely to be raped by a fellow soldier than killed in combat.

 b. Incidence:

Current estimates indicate one in five women veterans who use VA for health care screen positive for MST. In 2011, 19.4% of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) female veterans reported a history of MST when screened by a VA health care provider compared with 0.9% of OEF/OIF/OND male veterans; rates of MST reported among all veterans screened at the VA were 23.0% among females and 1.2% males in FY 2011[8].

MST has been associated with increased risk of depression, PTSD and substance use. Women who experience MST are more than four times more likely to have PTSD and are at six-fold increased risk for having three or more mental health conditions. Research indicates that at least one-third of rape victims develop PTSD, depression, panic attacks, anxiety and physical health problems[9].

Research indicates women who enter the military at younger ages and those of enlisted rank appear to be at an increased risk for MST. In addition, women who have had sexual assaults prior to military service report higher incidences of MST.

 

c. Association between MST & Homelessness:

MST among homeless women veterans has recently become an emergent issue.

According to Marya Grambs, Executive Director of Mental Health America of Hawai`i (MHA-Hawai`i), “It is a little-known fact that women Veterans are the fastest growing segment of adults faced with homelessness.” The Veterans Health Administration (VHA) estimates that 39-53% of homeless women veterans screened positive for MST in FY 2010[10]. According to the Hawai`i office of the United States Veterans Initiative (U.S.VETS), approximately 5% of 1,100 veterans – 55 women veterans – experienced homelessness in the State of Hawai`i in FY 2011.

 

IV. Current Community Program(s) relating to MST:

a. The VetCenter(s) have a fulltime female licensed psychologist on staff for womenwith MST and her primary function is to serve these clients. The center is truly concerned for these women and is open to suggestions and ideas for improving services.

b. Kapiolani Medical Center for Women and Children has a Sex Abuse Treatment Center at 55 Merchant Street, 22nd Floor, Honolulu, Hawai`i. The hospital provides expertise in adult sexual assault, adults molested as children, and child sexual abuse services. The hospital also provides assistance in filing compensation claims, criminal justice support advocacy, crisis counseling, crisis hotline counseling, follow-up contact, personal advocacy and therapy. However, the Kapiolani Medical Center does not provide specialized services for MST survivors. This is a recognizable gap in services; it is worth investigating Kapiolani Medical Center’s capability to address and respond to the unique needs to MST survivors.

c. A Joyful Heart Hawai`i – Mariska Hargitay’s Foundation.

Agency Type: Private non-profit with Board of Directors. Not a crisis center or emergency services provider.

Hawai`i Advisory Commitee: Valli Kalei Kanuha, Co-Chair, Jamee Miller, Co-Chair

Phone: (808) 531-3520

Services:

 

• Heal

Week Long Retreats provide restoration; These week long retreats in Kona (Hawai`i) and Bimini (Bahamas) offers survivors the opportunity to explore creative and healing techniques individually and as a community.

Hawai`i Local Retreats reflect our commitment to survivors in the Hawaiian community by creating programs based on our week long retreat model.

Urban Retreats provide inspiration and local resources; survivors come together to explore different healing techniques provided by local professionals in a safe and open environment.

Heal the Healers replenishing the care givers; we recognize the profound work of professionals and create programs that aim to restore and renew them.

• Educate

Website and Resources: Joyful Heart is a conduit for survivors, professionals and the community to find the assistance and resources they are seeking.

Education and Awareness Campaigns: we work to shed light and dismantle the shame that surrounds issues of violence and abuse to increases trust and safety for survivors to seek services, change societal attitudes and inspire action.

• Hope Shining: we are a proud partner of a growing national movement to increase awareness, prevention and support services for children, families and communities impacted by violence and abuse.
• Empower

Coalition Building Partnerships: We link individuals to organizations that provide assistance to those in need and act as a coalition building entity to help programs nationwide connect and learn from each other.

The Power Program integrates self-care and healing into the lives of those we work with by providing regular workshops in domestic violence shelters.

V. Current Department of Defense (DOD) Programs:

a. The Sexual Assault Prevention & Response (SAPR) program reinforces the DoD’s

commitment to eliminate incidents of sexual assault through awareness and prevention training, education, victim advocacy, response, reporting and accountability. The DoD promotes sensitive care and confidential reporting for victims of sexual assault and accountability for those who commit these crimes.

b. Military One Source program: Military OneSource is a free service provided by the Department of Defense (DoD) to active duty, Guard and Reserve service members, and their families with comprehensive information on every aspect of military life including deployment, reunion, relationships, grief, spouse employment and education, parenting and child care, and much more.

c. Garrison Mental Health Programs: Provides outpatient mental health care to active duty personnel only. Refers dependents to civilian therapists with payment through the TRICARE program or to Tripler Army Medical Center.

d. “Safe Place” program at Tripler Army Medical Center (TAMC) assists sexual assault victims. U.S. and Foreign service members and their family members, and civilians may utilize the Safe Place program. The three-year-old program includes a multidisciplinary team that has the ability to coordinate comprehensive medical exams, victim advocate services, chaplain services, social work services and law enforcement. Anyone requesting service receives a comprehensive evaluation, including blood work and sexually transmitted disease testing. Also, psychological care is provided and follow-up care is offered two to four weeks after the initial visit. Patients can talk to medical professionals about treatments to prevent pregnancy and infections. Safe Place also provides information to the public on how to be aware of the dangers of sexual assault, as well as where and when assault is most likely to occur.

 

VI. VA Programs:

a. Every VA healthcare facility has providers knowledgeable about treatment for problems related to MST. Because MST is associated with a range of mental health problems, VA’s general services for post-traumatic stress disorder (PTSD), depression, anxiety, substance abuse, and others are important resources for MST survivors. In addition, many VA facilities have specialized outpatient mental health services focusing specifically on sexual trauma. Vet Centers also have specially trained sexual trauma counselors.

b. VA has almost two dozen programs nationwide that offer specialized MST treatment in a residential or inpatient setting. These programs are for Veterans who need more intense treatment and support.

c. Because some Veterans do not feel comfortable in mixed-gender treatment settings, some facilities have separate programs for men and women. All residential and inpatient MST programs have separate sleeping areas for men and women.

d. Residential Treatment Facilities:

1) Women’s Mental Health Center, Women’s Trauma Recovery Program (WTRP)

VA Palo Alto Health Care System

Menlo Park Division, 795 Willow Road, Menlo Park, CA 94025

Military Sexual Trauma (MST) Co-Coordinator

Shannon Newton

(831) 883-3800 ext. 43848

The WTRP is an intensive 60-day residential program with a strong emphasis on enhancing interpersonal functioning through psycho-education and skill building classes. Classes focus on the development of coping skills such as emotion regulation, relapse prevention, anxiety management, and effective communication.

2) The Women’s Trauma Recovery Center (WTRC) is located at the Central Texas Veterans Health Care System in Temple, Texas. It opened in July 2007, and is the fourth residential treatment program to exclusively treat women Veterans diagnosed with Post Traumatic Stress Disorder (PTSD) as a result of Military Sexual Trauma (MST).

Contact: Women’s Trauma Recovery Center, Program Support Assistant,

Phone: 254-743-1711

The WTRC was created to improve the quality of life and physical/emotional health of women Veterans with a history of MST by providing appropriate, compassionate, and high quality mental healthcare services. The center is committed to achieving and maintaining excellent health, welfare, and dignity of female Veterans by ensuring equitable access to timely, sensitive, and high quality mental health care.

The WTRC is an intensive 7-week, patient-centered, residential treatment program for women Veterans with a history of MST. Women Veterans are admitted to the WTRC in classes, or cohorts, of no more than eight. Women from any state in the USA are eligible for admission. The first week involves comprehensive psychological and psychosocial assessments to assist with treatment planning. Treatment includes trauma focused treatment, skills training, therapeutic recreation, relapse prevention, and aftercare planning.

The Veterans complete a short psychological assessment following the termination of treatment and are re-assessed 6 months post-treatment.

 

VII. Advocacy Groups:

a. SWAN (Service Women’s Action Network) https://servicewomen.org

SWAN’s mission is to transform military culture by securing equal opportunity and freedom to serve without discrimination, harassment or assault; and to reform veterans’ services to ensure high quality health care and benefits for women veterans and their families.

They accomplish their mission through:

Policy Reform

Media Advocacy

Litigation

Direct Services: Helpline for Legal and Social Service Referrals 1-888-729-2089

 

b. Protect our Defenders https://www.protectourdefenders.com

Mission:

Protect Our Defenders is a human rights organization. They honor, support and give voice to the brave women and men in uniform who have been raped or sexually assaulted by fellow service members. They seek to fix the military training, investigation and adjudication systems related to sexual violence and harassment — systems that often re-victimize assault survivors by blaming them while failing to prosecute perpetrators. Our troops protect us and we must protect them.

Work: Our effort is directly informed by our work with victims, survivors, their families and retired military.

They research and expose dysfunction in the military training, investigation, adjudication and veterans service systems related to rape, sexual assault and harassment.

They educate the public and policy makers on the problems related to these issues along with potential solutions.

Sexual violence in the military is often not adequately investigated or prosecuted and victims are often blamed, pushed out of the service and denied benefits. They amplify survivors’ voices, enabling them to share their stories with the American people, elected representatives and military leadership.

They collaborate with Burke PLLC to advance lawsuits filed against the DoD and service academies for repeatedly ignoring rape, sexual assault and harassment, failing to prosecute perpetrators and retaliating against the victim.

They help survivors find appropriate services and support initiatives to improve victim and survivor care through a survivor support network, forums and e-library.

They provide opportunities for these individuals, their families and advocates to organize and support each other through community building projects and events. They mentor and provide small grants to enhance these efforts.

And finally – They support policy initiatives to fundamentally reform how the Department of Defense deals with sexual harassment, rape and sexual assault.

 

c. Office of Veterans Services

The single office within the State Government responsible for the welfare of all

veterans and their dependents. Provides these individuals with assistance in filing

claims with the Department of Veterans Affairs as well as state services which

include short-term counseling, information and referral, Notary Public, legal name

change assistance, discharge upgrade assistance, special housing for disabled

veterans, obtaining certified copies of vital documents, and burial assistance for

unclaimed veterans and veterans and their family members.

 

VIII. Other Issues for Women Veterans: Include medical and mental health care, child-care services, housing and financial assistance, among others. These are serious issues and also need to be addressed. The Task Force intends to continue its study to include these issues.

a. Unemployment among women veterans is of increasing concern as women veterans

face challenges translating their military experience into civilian jobs. Post 9/11

women veterans are twice more likely to be unemployed than women who have not

served in the military[11]. According to the Bureau of Labor Statistics report released in

February 2012, the national unemployment rate is 17.3% for women who have served

in the military after 9/11 compared to 8.10% for women who have not served in the

military. The Veteran Unemployment Rate is 8.3% compared to the 6.7% for the

entire State of Hawai`i[12]. Although the total number of unemployed women veterans

in Hawai`i remains unknown, there are 335 unemployed women veterans registered in

HireNet Hawai`i[13].

 

b. The Mental Health America of Hawai`i (MHA-Hawai`i), a non-profit agency, and The

Strategist, a private firm that designs healthcare transformations, partner on a project

called POWER Up! to assist women veterans experiencing homelessness secure jobs.

POWER Up! is a local, grassroots program funded by a three-year grant from the U.S. Department of Labor; this unique program supports women veterans and veterans with families to obtain employment while coordinating with MHA- Hawai`i to provide a comprehensive array of services that address the complex problems facing homeless women veterans. The Strategist team coordinates with MHA-Hawai`i to identify and connect with women veterans experiencing homelessness, assist drafting resumes, practice job interviews, and match their skills with job opportunities, among others.

“Since July 2010, we’ve helped more than 525 homeless Veterans and their families get jobs, of which, nearly half are women Veterans.” stated Noe Foster, CEO of The Strategist and a member of the Hawai`i Women Military Veterans Task Force. “We meet them at one of the darkest moments in their lives, houseless, unemployed, and worried about how to feed their children. Then we help them re-boot and power-up to get back to work and into a home of their own. It’s thrilling to see these same Veterans transform their lives and begin to thrive.”

 

c. Women of Power Stand Down

On July 12, 2012, about a hundred women veterans gathered together for the first Women of Power Stand Down in Hawai`i. Women veterans returning home from war are at high risk for combat related injuries, unemployment and homelessness. theStrategist, a private firm that specializes in designing healthcare transformations that save lives and money, organized and led the event. The U.S. Department of Labor funded part of the event.

Stand Down is a military term. It’s a safe position off of the combat zone where weary soldiers retreat to rest, reboot and re-energize. Women of Power Stand Down focused on teaching practical how to’s to help women veterans thrive in a new career out of uniform. At the Women of Power Stand Down, women Veterans shared their experiences, struggles and triumphs in transitioning from a military career to life after combat.

One women Veteran commented about the Women of Power Stand Down, “It was very informative, motivating and inspirational for women Vets. All speakers were excellent, supportive mentors.” Another remarked, “Very positive, uplifting day! Loved the words of encouragement from fellow female vets.”

A panel discussion, made up of women who are part of the Hawai`i Women’s Military Veterans Task Force, explained a wide variety of Veteran Affairs benefits and other support services for women Veterans. They answered questions and encouraged women Veterans to not give up when seeking benefits they have earned as a result of their military service.

“Stand Down makes me feel proud to be a Vet. I was impressed with the speakers,” stated a women veteran. “It gave me continued encouragement to pursue my goals.”

Noe Foster, CEO of theStrategist and a member of the Hawai`i Women’s Military Veterans Task Force, commented, “For the first time ever, so many women Veterans came together to share their stories of triumph after tough adversities in the combat zone and at home. Women veterans inspiring other women veterans … that’s electric. That’s Women of Power.”

 

d. The State of Hawai`i Department of Health has programs for mothers and their

children, pregnancy, drug use/abuse and homelessness; however, the Hawai`i DOH

does not have any specific programs for women veterans or programs that specifically

address women if they are not experiencing either motherhood or preparing for

motherhood via pregnancy. This is a recognizable gap in services; it is worth

investigating the Hawai`i DOH’s capability to create, design and serve women

veterans and women service members.

 

IX. What remains to be done in Hawai`i. Our recommendations

a. Request for resource/funding support to send two representatives to attend the annual National Association of State Women’s Veterans Coordinators Conference to learn and provide feedback on national issues. One member will be the appointed Women’s Veteran Coordinator within the Office of Veterans Services; the other will be the chair of the Hawaii Military Women Veterans Task Force.

b. Support federal legislation aimed at reforming the military treatment of women who have experienced MST and/or sexual harassment

c. Require the University of Hawai`i to include training/certification in MST for medical professionals as well as social work professionals, and individuals who offer services to veterans. (Over 50% of medical professional’s intern at the VA Medical Center, yet few have such training.)

d. Continue to use and build upon the newly established hiwomenvets.org website to organize, publicize, and to archive work being accomplished

e. Explore the feasibility of full funding for a Women’s Veterans Coordinator for the State to work and address issues between all agencies to include the legislative branch. Presently the individual serves as an additional duty.

f. Plan, fund and organize a Women’s Veterans Conference in conjunction with a State Veterans Summit to focus in on and to address specific issues affecting Women Veterans

g. Recommend the HWMVTF become a subordinate-State board reporting to the State Veterans Advisory Board

[1]Div. of Labor Force Statistics, BLS, (Jim Walker)

[2] 2011 American Community Survey (U.S. Census Bureau)

[3] The Daily Beast using DoD statistics, February 15, 2011

[4] Draft Report VA, Women Veteran’s Task Force 2012

[5] Vanessa Williamson and Erin Mulhall. 2009. “Invisible Wounds: Psychological and Neurological Injuries Confront a New Generation of Veterans.” New York: Iraq and Afghanistan Veterans of America. Erick Eckholm, “Surge Seen in Number of Homeless Veterans,” The New York Times, November 8, 2007.

---