Key Takeaways:
- North Carolina’s more than 615,000 veterans may face challenges navigating health care and support services.
- Many veterans receive care outside the VA system, making civilian health care providers an important part of the conversation.
- A new statewide report examines opportunities to better connect veterans, military families and caregivers with the resources they need.
By Ashley Fredde
North Carolina is home to more than 615,000 military veterans, but for many, navigating the health care system and finding the services available to them can be a challenge long after their military service ends.
Whether seeking treatment for a service-related injury, finding a health care provider in a rural community or getting support for a family caregiver, veterans can face a complicated network of federal, state and community resources that don’t always work together.
A new report from the North Carolina Institute of Medicine outlines a road map to better connect veterans, their families and caregivers with the health care and support services they need. The report is the culmination of a multiyear effort involving veterans, health care professionals, government officials and community organizations.
The 43-member task force identified gaps in access to care, coordination among service providers and awareness of available resources.
“This important report signifies almost two years of collaborating among veterans, healthcare professionals, state and community leaders, and service organizations who came together to develop robust policy recommendations to improve the healthcare landscape for veterans,” said Dr. Devdutta Sangvai, secretary of the North Carolina Department of Health and Human Services.
“The task force examined real challenges facing this community, and the report provides a road map to move from identifying those challenges to acting on them.”
The report offers eight recommendations and outlines areas of improvement or strategies to achieve better outcomes for veterans and their families. Its recommendations range from improving health care access in rural communities and strengthening caregiver support to better preparing civilian health care providers to recognize and respond to veterans’ needs.
It’s published as North Carolina marks the first anniversary of Ask Me NC, a statewide initiative encouraging health care providers and community organizations to ask people whether they or a family member have served in the military.
A complicated network of care
North Carolina has one of the largest veteran populations in the country, in addition to its nearly 284,000 active-duty service members, National Guard and reserve members, spouses and children with military connections, according to the report.
But military service does not necessarily mean someone gets health care through the U.S. Department of Veterans Affairs. North Carolina has four major VA hospitals, in Durham, Fayetteville, Salisbury and Asheville, along with regional VA Clinics and community-based outpatient facilities.
Fewer than half of veterans are enrolled in the VA health care system, the report noted, making civilian health care providers an important part of meeting their needs. That distinction is important because veterans can have health conditions related to their military service that providers outside of the VA system may not recognize or routinely ask about.
Discussions of veterans’ health often focus on post-traumatic stress disorder and traumatic brain injuries, said state health director Dr. Lawrence Greenblatt about the report. Those discussions sometimes fail to recognize other common conditions such as hearing loss, chronic musculoskeletal pain, substance abuse disorders and illnesses associated with toxic exposures that can also disproportionately affect veterans.
The report noted that civilian providers may lack training in military culture and the health conditions associated with military service — such as back, hip, knee and foot problems associated with carrying heavy packs, or hearing loss that comes along with being exposed to live ordnance. Without that understanding, providers may miss important information about a patient’s medical history or opportunities to connect them with specialized resources.
Kelly Crosbie, assistant secretary of health at N.C. DHHS, said assumptions about veterans’ access to military benefits and health care can contribute to those gaps.
“We all assume the needs are being taken care of. We’re not asking the question. We’re not making sure people know resources. We’re not making sure that we’re developing resources,” Crosbie said.
“But no, everybody does not have TRICARE. No, not everyone goes to the VA for healthcare.”
The task force recommended expanding training for community-based health care providers, improving coordination between civilian and VA systems, and creating a database of health professionals prepared to address veterans’ health needs.
Starting with a simple question
One approach to improving those connections is already underway. Launched in November 2025, Ask Me NC encourages health care providers, social service organizations and other professionals to ask a simple question: “Have you or a family member ever served in the military?”
The initiative is intended to help identify military-connected individuals who may qualify for specialized health care, benefits or community assistance but whose service history may otherwise go unrecognized.
Jocelyn Mitnaul Mallette, secretary of the North Carolina Department of Military and Veterans Affairs, said some former service members do not immediately identify themselves as veterans, sometimes because of difficult or traumatic experiences during their service.
That can make the wording of a question particularly important.
Rather than asking whether someone is a veteran, the initiative encourages professionals and community members to ask about military service more broadly, including service by family members.
“That question may seem small, but it can open the door to life-changing conversations,” Mallette said.
She said identifying military connections can help people access health care, behavioral health services, housing assistance, educational benefits, employment resources and peer support. The task force built on that approach by recommending that health care providers routinely ask patients about military connections and that hospitals and health systems develop processes to improve care for veterans.
The recommendations also call for improving community-based providers’ access to veterans’ health information, recognizing that identifying a military connection is only the first step toward ensuring appropriate care. The goal is not simply to identify someone as a veteran or as a family member related to a veteran, but to better understand how military service may affect their health and what resources could help address their needs.
From recommendations to actions
While the report outlines numerous opportunities to improve veterans’ health and well-being, carrying out its recommendations will require continued collaboration among state agencies, health care systems, community organizations and service members themselves.
Opportunities to improve access to care, coordination between providers and community based groups, and awareness of veteran specific health needs are noted significantly in rural areas across the state. Addressing those needs could require additional resources, workforce development and sustained coordination, with the report noting funding opportunities under the Rural Health Transformation Program.
The task force recommends identifying and sustaining a lead organization to coordinate implementation and maintain attention on veterans’ health after the report’s publication. For Mallette, the release of the report represents a starting point rather than a completion.
“Now is when the real work begins because it’s not cool if we put all this work and time and effort into this task force and then just let it sit on our desk,” she said.
“The celebration is when we actually start doing the things that we’ve recommended to do in the task force.”
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