Prioritizing veterans and their families.

Executive Summary

California has approximately 1.6 million veterans, the nation’s largest veteran population. Most receive some care outside the VA, yet civilian providers lack consistent ways to identify veterans and connect them to support.

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This report draws on California nursing and informatics listening sessions, ANA\California’s statewide survey instrument, and conversations with Scripps, Sharp, Kaiser Northern California, Loma Linda, and UC San Diego.

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Four themes emerged: veteran identification rarely triggers support; patients and families carry disclosure, records, and advocacy burdens; coordination lacks a clear owner and consistent knowledge of VA coverage; and unmet behavioral health and housing needs disrupt care. Authorization delays can stall chemotherapy, while missing service histories obscure PACT-eligible conditions and toxic-exposure risks.

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Seven actions are proposed for 2026 to 2027, with earlier steps supporting later implementation: adopt AAN’s “Have You Ever Served?” identification framework; embed structured EHR fields, flags, and follow-up workflows; establish veteran navigators or VA liaisons; require veteran-specific education for nursing licensure renewal and facility onboarding; make VA-civilian information exchange a routine workflow; formalize behavioral health, housing, and post-acute partnerships; and establish statewide reporting and accountability.

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Health system leaders should implement identification and EHR workflows within twelve months. The Legislature, HCAI, BRN, and CalVet should use existing licensure, reporting, and partnership tools to make the remaining actions standard practice.