Approximately 19 million veterans live in the United States and many struggle to find the care they need. Community Health Centers are proud to help bridge these gaps by serving over 419,000 patients who identify as veterans increasing since 2020.
To meet this growing demand, health center program stakeholders, like the West Virginia Primary Care Association (WVPCA), are developing strategies and resources to help veterans with the complex health issues they may face from their military service. Veterans are a unique population to care for as their military experience can lead to various physical and emotional injuries.
A personal connection to veteran care
“Many veterans do not receive healthcare from the Department of Veterans Affairs (VA), and in fact turn to community providers who can be less knowledgeable about military-related health concerns such as military environmental exposures, gulf war illness, agent orange, traumatic brain injury, sexual trauma, and women veterans’ health,” said Jessica Dailey Haas, RN, MSN, C-ONQS, Director of Clinical Transformation at WVPCA. “Recognizing that West Virginia (WV) health centers serve 1 in 3 WV residents, the WVPCA has committed to increasing training, resources, and assessments geared toward the veteran population.”
Haas’ motivation to care for veterans stems from her experience with her father, a 24-year U.S. Army Veteran who started experiencing military environmental exposure symptoms roughly 30 days upon returning from deployment.
Haas explains that her father worked round the clock and would not report to the “sick bay” while on deployment. Therefore, his records would not reflect him being subject to “exposure” while in the field. Upon his return, Haas’ father began showing unusual symptoms, and after obtaining lab work along with medical imaging of his thyroid from the local VA, he was instructed to “wait a year and monitor.”
However, Haas was not willing to settle for the “wait and monitor” approach when it came to her father’s health. Instead, they sought a second opinion from their community provider. After listening, reviewing the images and notes, Haas’ father was diagnosed with medullary thyroid cancer and sent to a specialized cancer specialist out of state.
“If the community provider had not taken the time to listen, review, and order additional imaging my father would not be with us today,” Haas said. “This is just one example of how our community providers have saved a veteran’s life.”
Health centers should use a new screening question to identify veterans
WVPCA actively participates in NACHC’s Veterans Interest Group, which seek to educate all health centers on the recommended screening question to best identify if a patient is a veteran.
According to 2023 UDS Data, WVPCA, West Virginia’s health centers and Look-Alikes served over 12, 000 veterans—approximately 20 percent of the state’s veteran population. Using evidence-based wording such as “have you served in the US military, armed forces or uniformed services,” can provide proven results for more accurate reporting on UDS, more robust needs assessment, and more tailored care and services to the veteran patient and their family.
Haas describes other ways WVPCA is improving clinical outcomes for veterans:
“In 2024, we continued our focus of improving veterans’ health in all our small clinical focus groups of colorectal cancer screening, hypertension, and diabetes. This fall, WVPCA joined Emergency Care Research Institute’s (ECRI) Service, Academics, Leadership, Unity, Tribute, and Excellence (SALUTE) Honor Roll Program and discussed the ECRI SALUTE tools in each of the monthly peer groups as well as shared the resources on our WVPCA community learning platform.”
Haas acknowledges that to avoid misdiagnoses of symptoms, like her father experienced, we must ensure that providers and health centers are given the resources to effectively serve this vulnerable population. To do so, we must:
- Ask the right questions—have you served in the armed forces such as the US Army, Marines, Navy, Airforce, Coast Guard, Space Force, or Public Health Corporation?
- Provide screening questions—have you served during combat? Were you exposed to environmental toxins. Burn pits, agent orange? Did you experience traumatic brain injury?
- Provide clinical training on Gulf War Illness, military environmental exposure, agent orange
- Document using appropriate screening such the Center for Disease Control (CDC) and Kansas case definition for gulf war illness
- Provide resources to caregivers
- Provide resources to veterans
“NACHC is committed to supporting health centers serving veterans in their communities,” said Gina Capra, Chief Education Officer at NACHC. “NACHC works with health centers on a range of topics including increasing access to care for veterans and their family members and helping to establish partnerships with the US Department of Veterans Affairs and veteran-focused organizations in local communities.”
Resources from NACHC to improve care for veterans
Haas served as faculty on NACHC’s October 17 national webinar featuring the ECRI toolkit to improve care for military veteran patients in health centers.
Learn more about how health centers provide care to veterans, or access resources and webinars to expand your ability to reach veteran patients.