Improving Culturally Competent Care for Veterans

Grantee Name

New York Legal Assistance Group; Columbia University’s Teachers College

Funding Area

Veterans’ Health

Publication Date

September 2021

Grant Amount

$98,430 to NYLAG; $123,243 to Columbia University’s Teachers College

Grant Date:

December 2018- September 2020

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In recent years, veterans have started to rely increasingly on private health care providers.

Between 2008 and 2015 community health centers saw a 43% increase in visits by veterans. This increase occurred at the same time that the Department of Veterans Affairs (VA) increased its reliance on the private sector as a result of the passage of the CHOICE Act in 2014, resulting in the VA referring a third of its appointments to health care providers outside of its network. Despite the influx in veterans accessing care outside of VA, the private sector is not fully ready to meet the needs of the veteran population. A 2018 NYHealth-funded study conducted by the RAND Corporation found that only 2.3% of private providers in New York State fully met readiness criteria for effectively serving the veteran population. To improve provider readiness, the RAND analysis recommended providers include screening for veteran status, increase engagement with VA, and strengthen their familiarity with military culture and service-connected health conditions.

In 2018, NYHealth awarded the New York Legal Assistance Group (NYLAG) a grant to train and educate private, non-VA health providers about the unique health and social needs of veterans and appropriately refer them to resources in the community. To further build on this work, NYHealth awarded a grant in 2019 to Teachers College, Columbia University, for its Resilience Center for Veterans and Families to implement a veteran cultural competency training program for New York State health care providers.

Outcomes and Lessons Learned

Under this grant, NYLAG:

Created a training to inform clinicians and medical professionals about legal issues affecting veterans, including access to service-connected benefits, discharge upgrades, VA pensions, VA health care, and housing,
Partnered with LegalHealth to organize a pilot group comprising attorneys, paralegals, and social work interns to determine the effectiveness of the training and modify it based on the feedback provided by clients.
Trained 269 private health care providers, exceeding its goal of training 200 providers, at Montefiore Medical Center, Jamaica Hospital, Settlement Health Community Health Clinics, the NYC Health + Hospital health care system, and the William F. Ryan Community Health Center.
Captured pre- and post-survey data on providers’ ability to screen for veteran status and successfully make referrals to veterans service organizations:
- In pre-training surveys, 46% of respondents indicated they were not at all knowledgeable with the eligibility requirements for veterans benefits.
- In the post-training surveys, 99% of respondents indicated that they were somewhat or very knowledgeable of these requirements; 89% of respondents in the follow-up surveys reported that they were still somewhat or very familiar, indicating that knowledge was retained in the months following the training.
- 15% of respondents reported they had made 1–5 referrals to VA health care.

Under this grant, the Resilience Center for Veterans and Families:

Provided 5 training sessions to 422 medical professionals in Syracuse, Rochester, Albany, and New York City, focused on increasing familiarity with military culture and improving veteran cultural competency.
Found an improvement in veteran cultural competency in providers when comparing pre-training survey results with results collected one month after training. Surveys also found an increase in providers’ ability to implement screening procedures that ask for veteran status.
Created a one-hour, abridged version of the veteran cultural competency training and provided it through webinars to an additional 1,405 medical professionals to respond to the evolving COVID-19 pandemic and meet the demand for training professionals.
Established several valuable partnerships with organizations, including the New York State Psychiatric Association, the VA’s Integrated Service Network covering the 12 VA medical centers in the NY/NJ region, and the Governor’s Challenge to Prevent Suicide in New York State.
Generated three peer-reviewed journal articles, focusing on the importance of veteran culture competency, the impact of expanding these services in New York State, and the results from a randomized controlled trial assessing the work of the Resilience Center. One article was published in Frontiers in Psychology, “Expanded Roles and Recommendations for Stakeholders to Successfully Reintegrate Modern Warriors and Mitigate Suicide Risk.”

Co-Funding and Additional Funds Leveraged: The project at the Resilience Center for Veterans and Families, Columbia University’s Teachers College, was co-funded by Bloomberg Philanthropies ($150,000).

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