Veterans’ Health

Grantee Name

RAND Corporation

Funding Area

Veterans’ Health

Publication Date

January 2020

Grant Amount

$370,000

Grant Date:

January 2017 - November 2017

Veterans represent a special population of men and women who have served their country and have faced extraordinary health risks during their deployments. Because many of them have served on overseas missions—including combat—veterans with service-connected health issues are a clinically complex and potentially vulnerable population. Although the U.S. Department of Veterans Affairs (VA) aims to meet the health care needs of all eligible veterans, many seek care outside of the VA, in part because of a personal preference to receive care from community-based, private, non-VA providers. However, only a small percentage of civilian mental health providers are prepared to offer culturally competent care for veterans.

In 2017, NYSHealth awarded RAND Corporation a grant to understand the current state of New York’s health care workforce in providing high-quality health care to veterans in private, community-based settings.

Outcomes and Lessons Learned

  • Developed and administered a survey to assess civilian providers’ readiness and capacity to address the health-related needs of veterans and their family members.
  • Developed a seven-point criteria to define provider “readiness” and assessed three main factors:
    • Whether providers can accept and schedule new patients within two weeks.
    • If the care provided is culturally competent (e.g., whether providers are familiar with military culture and how that might shape veteran preferences for care).
    • The quality of care veterans receive from private services (e.g., whether providers regularly screen for conditions that are more common among veterans, such as suicidal ideation).
  • Fielded the Web-based survey to 746 licensed health care professionals (such as physicians, physician assistants, psychologists, psychiatrists, mental health counselors, social workers, and physical and occupational therapists) within New York State to assess their knowledge, attitudes, perceptions, and behaviors with respect to treating veterans and providing high-quality care for service-related health problems.
  • Analyzed survey findings to produce a research brief, “Ready or Not? Assessing the Capacity of New York State Health Providers to Meet the Needs of Veterans,” in which RAND found that:
    • Only 2.3% of providers in New York meet RAND’s readiness criteria for delivering culturally competent care to veterans.
    • 25% of providers reported receiving some training from VA and only 13% indicated that they had participated in any formal training regarding military and veteran culture, despite the fact that 4 out of 5 providers reported having veterans in their case loads.
    • 65% of providers feel that they are “somewhat” or “well prepared” to manage care for at least one-half of conditions common among veterans.
    • Only 17% surveyed were registered as VA Community Care providers.
    • Only 1 in 5 providers screened their patients for any military or veteran affiliation and less than half screened for common conditions among veterans.
    • Less than half of providers who have not received specialty training to address the needs of veterans expressed interest in receiving additional training.
    • Only 1 in 5 providers have an understanding of programs and services available to support healthy adjustment for military-affiliated patients.
    • Less than one-third of providers reported knowing how to refer a patient to VA.

The report recommends four steps to improve private providers’ readiness to treat veterans:

  1. Increase familiarity with and preparedness related to military culture and service-connected health conditions.
  2. Improve screening.
  3. Improve engagement with VA and available resources for veterans.
  4. Institute quality monitoring.

Upon completion of the survey and analysis, RAND briefed the following policymakers on its findings: Congressional staffers for the Veterans Affairs and Health Committees; the VA Deputy Under Secretary for Health; and the majority and minority staff of both the Senate and House VA Committee.

NYSHealth continues to support a range of efforts to help health care providers offer culturally competent, coordinated care for veterans, including grants to Union Community Health Center, Resilience Center for Veterans and Families, and New York Legal Assistance Group.

Co-Funding and Additional Funds Leveraged: N/A