[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 131 Reported in Senate (RS)]
Calendar No. 185
113th CONGRESS
1st Session
S. 131
[Report No. 113-106]
To amend title 38, United States Code, to improve the reproductive
assistance provided by the Department of Veterans Affairs to severely
wounded, ill, or injured veterans and their spouses, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 24 (legislative day, January 3), 2013
Mrs. Murray (for herself, Mr. Begich, Mr. Tester, and Mr. Blumenthal)
introduced the following bill; which was read twice and referred to the
Committee on Veterans' Affairs
September 17, 2013
Reported by Mr. Sanders, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to improve the reproductive
assistance provided by the Department of Veterans Affairs to severely
wounded, ill, or injured veterans and their spouses, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>
<DELETED> This Act may be cited as the ``Women Veterans and Other
Health Care Improvements Act of 2013''.</DELETED>
<DELETED>SEC. 2. CLARIFICATION THAT FERTILITY COUNSELING AND TREATMENT
ARE MEDICAL SERVICES WHICH THE SECRETARY MAY FURNISH TO
VETERANS LIKE OTHER MEDICAL SERVICES.</DELETED>
<DELETED> Section 1701(6) of title 38, United States Code, is
amended by adding at the end the following new subparagraph:</DELETED>
<DELETED> ``(H) Fertility counseling and treatment,
including treatment using assisted reproductive
technology.''.</DELETED>
<DELETED>SEC. 3. REPRODUCTIVE TREATMENT AND CARE FOR SPOUSES AND
SURROGATES OF VETERANS.</DELETED>
<DELETED> (a) In General.--Subchapter VIII of chapter 17 of title
38, United States Code, is amended by adding at the end the following
new section:</DELETED>
<DELETED>``Sec. 1788. Reproductive treatment and care for spouses and
surrogates of veterans</DELETED>
<DELETED> ``(a) In General.--The Secretary shall furnish fertility
counseling and treatment, including through the use of assisted
reproductive technology, to a spouse or surrogate of a severely
wounded, ill, or injured veteran who has an infertility condition
incurred or aggravated in line of duty in the active military, naval,
or air service and who is enrolled in the system of annual patient
enrollment established under section 1705(a) of this title if the
spouse or surrogate and the veteran apply jointly for such counseling
and treatment through a process prescribed by the Secretary.</DELETED>
<DELETED> ``(b) Coordination of Care for Other Spouses and
Surrogates.--In the case of a spouse or surrogate of a veteran not
described in subsection (a) who is seeking fertility counseling and
treatment, the Secretary may coordinate fertility counseling and
treatment for such spouse or surrogate.</DELETED>
<DELETED> ``(c) Construction.--Nothing in this section shall be
construed to require the Secretary--</DELETED>
<DELETED> ``(1) to find or certify a surrogate for a veteran
or to connect a surrogate with a veteran; or</DELETED>
<DELETED> ``(2) to furnish maternity care to a spouse or
surrogate of a veteran.</DELETED>
<DELETED> ``(d) Assisted Reproductive Technology Defined.--In this
section, the term `assisted reproductive technology' includes in vitro
fertilization and other fertility treatments in which both eggs and
sperm are handled when clinically appropriate.''.</DELETED>
<DELETED> (b) Clerical Amendment.--The table of sections at the
beginning of chapter 17 of such title is amended by inserting after the
item relating to section 1787 the following new item:</DELETED>
<DELETED>``1788. Reproductive treatment and care for spouses and
surrogates of veterans.''.
<DELETED>SEC. 4. ADOPTION ASSISTANCE FOR SEVERELY WOUNDED
VETERANS.</DELETED>
<DELETED> (a) In General.--Subchapter VIII of chapter 17 of title
38, United States Code, as amended by section 3, is further amended by
adding at the end the following new section:</DELETED>
<DELETED>``Sec. 1789. Adoption assistance</DELETED>
<DELETED> ``(a) In General.--The Secretary may pay an amount, not to
exceed the limitation amount, to assist a covered veteran in the
adoption of one or more children.</DELETED>
<DELETED> ``(b) Covered Veteran.--For purposes of this section, a
covered veteran is any severely wounded, ill, or injured veteran who--
</DELETED>
<DELETED> ``(1) has an infertility condition incurred or
aggravated in line of duty in the active military, naval, or
air service; and</DELETED>
<DELETED> ``(2) is enrolled in the system of annual patient
enrollment established under section 1705(a) of this
title.</DELETED>
<DELETED> ``(c) Limitation Amount.--For purposes of this section,
the limitation amount is the amount equal to the lesser of--</DELETED>
<DELETED> ``(1) the cost the Department would incur if the
Secretary were to provide a covered veteran with one cycle of
in vitro fertilization, as determined by the Secretary;
and</DELETED>
<DELETED> ``(2) the cost the Department would incur by
paying the expenses of three adoptions by covered veterans, as
determined by the Secretary.''.</DELETED>
<DELETED> (b) Clerical Amendment.--The table of sections at the
beginning of chapter 17 of such title, as amended by section 3, is
further amended by inserting after the item relating to section 1788
the following new item:</DELETED>
<DELETED>``1789. Adoption assistance.''.
<DELETED>SEC. 5. ANNUAL REPORT ON PROVISION OF FERTILITY COUNSELING AND
TREATMENT FURNISHED BY DEPARTMENT OF VETERANS
AFFAIRS.</DELETED>
<DELETED> (a) In General.--Not later than one year after the date of
the enactment of this Act and not less frequently than once each year
thereafter, the Secretary of Veterans Affairs shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a report on the
fertility counseling and treatment furnished by the Department of
Veterans Affairs during the year preceding the submittal of the
report.</DELETED>
<DELETED> (b) Elements.--Each report submitted under subsection (a)
shall include, for the period covered by the report, the
following:</DELETED>
<DELETED> (1) The number of veterans who received fertility
counseling or treatment furnished by the Department of Veterans
Affairs, disaggregated by era of military service of such
veterans.</DELETED>
<DELETED> (2) The number of spouses and surrogates of
veterans who received fertility counseling or treatment
furnished by the Department.</DELETED>
<DELETED> (3) The cost to the Department of furnishing
fertility counseling and treatment, disaggregated by cost of
services and administration.</DELETED>
<DELETED> (4) The average cost to the Department per
recipient of such counseling and treatment.</DELETED>
<DELETED> (5) In cases in which the Department furnished
fertility treatment through the use of assisted reproductive
technology, the average number of cycles per person
furnished.</DELETED>
<DELETED> (6) A description of how fertility counseling and
treatment services of the Department are coordinated with
similar services of the Department of Defense.</DELETED>
<DELETED>SEC. 6. REGULATIONS ON FURNISHING OF FERTILITY COUNSELING AND
TREATMENT AND ADOPTION ASSISTANCE BY DEPARTMENT OF
VETERANS AFFAIRS.</DELETED>
<DELETED> (a) In General.--Not later than 540 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
prescribe regulations--</DELETED>
<DELETED> (1) on the furnishing of fertility treatment to
veterans using assisted reproductive technology;</DELETED>
<DELETED> (2) to carry out section 1788 of title 38, United
States Code, as added by section 3; and</DELETED>
<DELETED> (3) to carry out section 1789 of such title, as
added by section 4.</DELETED>
<DELETED> (b) Limitation.--Notwithstanding any other provision of
law, during the period beginning on the date of the enactment of this
Act and ending on the date on which the Secretary prescribes
regulations under subsection (a), the Secretary may not furnish--
</DELETED>
<DELETED> (1) to a veteran any fertility treatment that uses
an assisted reproductive technology that the Secretary has not
used in the provision of a fertility treatment to a veteran
before the date of the enactment of this Act;</DELETED>
<DELETED> (2) any fertility counseling or treatment under
section 1788 of title 38, United States Code, as added by
section 3; or</DELETED>
<DELETED> (3) any assistance under section 1789 of such
title, as added by section 4.</DELETED>
<DELETED> (c) Assisted Reproductive Technology Defined.--In this
section, the term ``assisted reproductive technology'' has the meaning
given the term in section 1788 of such title, as added by section
3.</DELETED>
<DELETED>SEC. 7. COORDINATION BETWEEN DEPARTMENT OF VETERANS AFFAIRS
AND DEPARTMENT OF DEFENSE ON FURNISHING OF FERTILITY
COUNSELING AND TREATMENT.</DELETED>
<DELETED> The Secretary of Veterans Affairs and the Secretary of
Defense shall share best practices and facilitate referrals, as they
consider appropriate, on the furnishing of fertility counseling and
treatment.</DELETED>
<DELETED>SEC. 8. FACILITATION OF REPRODUCTION AND INFERTILITY
RESEARCH.</DELETED>
<DELETED> (a) In General.--Subchapter II of chapter 73 of title 38,
United States Code, is amended by adding at the end the following new
section:</DELETED>
<DELETED>``Sec. 7330B. Facilitation of reproduction and infertility
research</DELETED>
<DELETED> ``(a) Facilitation of Research Required.--The Secretary
shall facilitate research conducted collaboratively by the Secretary of
Defense and the Secretary of Health and Human Services to improve the
ability of the Department of Veterans Affairs to meet the long-term
reproductive health care needs of veterans who have a genitourinary
service-connected disability or a condition that was incurred or
aggravated in line of duty in the active military, naval, or air
service, such as spinal cord injury, that affects the veterans' ability
to reproduce.</DELETED>
<DELETED> ``(b) Dissemination of Information.--The Secretary shall
ensure that information produced by the research facilitated under this
section that may be useful for other activities of the Veterans Health
Administration is disseminated throughout the Veterans Health
Administration.''.</DELETED>
<DELETED> (b) Clerical Amendment.--The table of sections at the
beginning of chapter 73 of such title is amended by inserting after the
item relating to section 7330A the following new item:</DELETED>
<DELETED>``7330B. Facilitation of reproduction and infertility
research.''.
<DELETED> (c) Report.--Not later than three years after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
submit to Congress a report on the research activities conducted by the
Secretary under section 7330B of title 38, United States Code, as added
by subsection (a).</DELETED>
<DELETED>SEC. 9. REQUIREMENT TO IMPROVE DEPARTMENT OF VETERANS AFFAIRS
WOMEN VETERANS CONTACT CENTER.</DELETED>
<DELETED> The Secretary of Veterans Affairs shall enhance the
capabilities of the Department of Veterans Affairs women veterans
contact center--</DELETED>
<DELETED> (1) to respond to requests by women veterans for
assistance with accessing health care and benefits furnished
under laws administered by the Secretary; and</DELETED>
<DELETED> (2) for referral of such veterans to community
resources to obtain assistance with services not furnished by
the Department.</DELETED>
<DELETED>SEC. 10. MODIFICATION OF PILOT PROGRAM ON COUNSELING IN
RETREAT SETTINGS FOR WOMEN VETERANS NEWLY SEPARATED FROM
SERVICE IN THE ARMED FORCES.</DELETED>
<DELETED> (a) Increase in Number of Locations.--Subsection (c) of
section 203 of the Caregivers and Veterans Omnibus Health Services Act
of 2010 (Public Law 111-163; 38 U.S.C. 1712A note) is amended by
striking ``three locations'' and inserting ``14 locations''.</DELETED>
<DELETED> (b) Extension of Duration.--Subsection (d) of such section
is amended by striking ``2-year'' and inserting ``four-
year''.</DELETED>
<DELETED> (c) Authorization of Appropriations.--Subsection (f) of
such section is amended--</DELETED>
<DELETED> (1) by striking ``Secretary of Veterans Affairs
for each'' and inserting the following: ``Secretary of Veterans
Affairs--</DELETED>
<DELETED> ``(1) for each'';</DELETED>
<DELETED> (2) in paragraph (1), as designated by paragraph
(1), by striking the period at the end and inserting ``; and'';
and</DELETED>
<DELETED> (3) by adding at the end the following new
paragraph:</DELETED>
<DELETED> ``(2) for each of fiscal years 2013 and 2014,
$400,000 to carry out the pilot program.''.</DELETED>
<DELETED>SEC. 11. PROGRAM ON ASSISTANCE FOR CHILD CARE FOR CERTAIN
VETERANS.</DELETED>
<DELETED> (a) Assistance for Child Care for Certain Veterans
Receiving Health Care.--</DELETED>
<DELETED> (1) In general.--Subchapter I of chapter 17 of
title 38, United States Code, is amended by adding at the end
the following new section:</DELETED>
<DELETED>``Sec. 1709B. Assistance for child care for certain veterans
receiving health care</DELETED>
<DELETED> ``(a) Program Required.--The Secretary shall carry out a
program to provide, subject to subsection (b), assistance to qualified
veterans described in subsection (c) to obtain child care so that such
veterans can receive health care services described in subsection
(c).</DELETED>
<DELETED> ``(b) Limitation on Period of Payments.--Assistance may
only be provided to a qualified veteran under this section for receipt
of child care during the period that the qualified veteran--</DELETED>
<DELETED> ``(1) receives the types of health care services
described in subsection (c) at a facility of the Department;
and</DELETED>
<DELETED> ``(2) requires travel to and return from such
facility for the receipt of such health care
services.</DELETED>
<DELETED> ``(c) Qualified Veterans.--For purposes of this section, a
qualified veteran is a veteran who is--</DELETED>
<DELETED> ``(1) the primary caretaker of a child or
children; and</DELETED>
<DELETED> ``(2)(A) receiving from the Department--</DELETED>
<DELETED> ``(i) regular mental health care
services;</DELETED>
<DELETED> ``(ii) intensive mental health care
services; or</DELETED>
<DELETED> ``(iii) such other intensive health care
services that the Secretary determines that provision
of assistance to the veteran to obtain child care would
improve access to such health care services by the
veteran; or</DELETED>
<DELETED> ``(B) in need of regular or intensive mental
health care services from the Department, and but for lack of
child care services, would receive such health care services
from the Department.</DELETED>
<DELETED> ``(d) Locations.--The Secretary shall carry out the
program in no fewer than three Veterans Integrated Service Networks
selected by the Secretary for purposes of the program.</DELETED>
<DELETED> ``(e) Forms of Child Care Assistance.--(1) Child care
assistance under this section may include the following:</DELETED>
<DELETED> ``(A) Stipends for the payment of child care
offered by licensed child care centers (either directly or
through a voucher program) which shall be, to the extent
practicable, modeled after the Department of Veterans Affairs
Child Care Subsidy Program established pursuant to section 630
of the Treasury and General Government Appropriations Act, 2002
(Public Law 107-67; 115 Stat. 552).</DELETED>
<DELETED> ``(B) Direct provision of child care at an on-site
facility of the Department of Veterans Affairs.</DELETED>
<DELETED> ``(C) Payments to private child care
agencies.</DELETED>
<DELETED> ``(D) Collaboration with facilities or programs of
other Federal departments or agencies.</DELETED>
<DELETED> ``(E) Such other forms of assistance as the
Secretary considers appropriate.</DELETED>
<DELETED> ``(2) In the case that child care assistance under this
section is provided as a stipend under paragraph (1)(A), such stipend
shall cover the full cost of such child care.''.</DELETED>
<DELETED> (2) Conforming amendment.--Section 205(e) of the
Caregivers and Veterans Omnibus Health Services Act of 2010
(Public Law 111-163; 38 U.S.C. 1710 note) is amended by
inserting ``but not after the date of the enactment of the
Women Veterans and Other Health Care Improvements Act of 2013''
before the period at the end.</DELETED>
<DELETED> (3) Clerical amendment.--The table of sections at
the beginning of such chapter is amended by inserting after the
item relating to section 1709A the following new
item:</DELETED>
<DELETED>``1709B. Assistance for child care for certain veterans
receiving health care.''.
<DELETED> (b) Assistance for Child Care for Certain Veterans
Receiving Readjustment Counseling and Related Mental Health Services.--
</DELETED>
<DELETED> (1) In general.--Subchapter I of chapter 17 of
such title, as amended by subsection (a)(1), is further amended
by adding at the end the following new section:</DELETED>
<DELETED>``Sec. 1709C. Assistance for child care for certain veterans
receiving readjustment counseling and related mental
health services</DELETED>
<DELETED> ``(a) Program Required.--The Secretary shall carry out a
program to provide, subject to subsection (b), assistance to qualified
veterans described in subsection (c) to obtain child care so that such
veterans can receive readjustment counseling and related mental health
services.</DELETED>
<DELETED> ``(b) Limitation on Period of Payments.--Assistance may
only be provided to a qualified veteran under this section for receipt
of child care during the period that the qualified veteran receives
readjustment counseling and related health care services at a Vet
Center.</DELETED>
<DELETED> ``(c) Qualified Veterans.--For purposes of this section, a
qualified veteran is a veteran who is--</DELETED>
<DELETED> ``(1) the primary caretaker of a child;
and</DELETED>
<DELETED> ``(2)(A) receiving from the Department regular
readjustment counseling and related mental health services;
or</DELETED>
<DELETED> ``(B) in need of readjustment counseling and
related mental health services from the Department, and but for
lack of child care services, would receive such counseling and
services from the Department.</DELETED>
<DELETED> ``(d) Locations.--The Secretary shall carry out the
program under this section in no fewer than three Readjustment
Counseling Service Regions selected by the Secretary for purposes of
the program.</DELETED>
<DELETED> ``(e) Forms of Child Care Assistance.--(1) Child care
assistance under this section may include the following:</DELETED>
<DELETED> ``(A) Stipends for the payment of child care
offered by licensed child care centers (either directly or
through a voucher program) which shall be, to the extent
practicable, modeled after the Department of Veterans Affairs
Child Care Subsidy Program established pursuant to section 630
of the Treasury and General Government Appropriations Act, 2002
(Public Law 107-67; 115 Stat. 552).</DELETED>
<DELETED> ``(B) Payments to private child care
agencies.</DELETED>
<DELETED> ``(C) Collaboration with facilities or programs of
other Federal departments or agencies.</DELETED>
<DELETED> ``(D) Such other forms of assistance as the
Secretary considers appropriate.</DELETED>
<DELETED> ``(2) In the case that child care assistance under this
subsection is provided as a stipend under paragraph (1)(A), such
stipend shall cover the full cost of such child care.</DELETED>
<DELETED> ``(f) Vet Center Defined.--In this section, the term `Vet
Center' means a center for readjustment counseling and related mental
health services for veterans under section 1712A of this
title.''.</DELETED>
<DELETED> (2) Clerical amendment.--The table of sections at
the beginning of such chapter, as amended by subsection (a)(3),
is further amended by inserting after the item relating to
section 1709B the following new item:</DELETED>
<DELETED>``1709C. Assistance for child care for certain veterans
receiving readjustment counseling and
related mental health services.''.
<DELETED>SEC. 12. CONTRACTOR USER FEES.</DELETED>
<DELETED> (a) In General.--Chapter 3 of title 38, United States
Code, is amended by adding at the end the following new
section:</DELETED>
<DELETED>``Sec. 323. Contractor user fees</DELETED>
<DELETED> ``(a) Fee Requirement.--Except as provided in subsection
(c) and subject to subsection (d), the Secretary shall impose a fee
upon each person with whom the Secretary engages in a contract for a
good or service as a condition of the contract.</DELETED>
<DELETED> ``(b) Fee Amount.--(1) The amount of a fee imposed upon a
person under subsection (a) with respect to a contract shall be equal
to the lesser of--</DELETED>
<DELETED> ``(A) the amount which is equal to seven percent
of the total value of the contract; and</DELETED>
<DELETED> ``(B) the amount which is equal to the total value
of the contract multiplied by the applicable percentage for
such fiscal year.</DELETED>
<DELETED> ``(2) The applicable percentage for a fiscal year shall be
equal to the percentage by which--</DELETED>
<DELETED> ``(A) the annual estimate of the total value of
contracts for such fiscal year, exceeds</DELETED>
<DELETED> ``(B) the annual estimate of the total cost of
fertility counseling and treatment for such fiscal
year.</DELETED>
<DELETED> ``(3) Before each fiscal year, the Secretary shall
establish, for purposes of this section, the annual estimate of the
total value of contracts for the next fiscal year, which shall be the
Secretary's estimate of what the aggregate value will be of all
contracts in which the Secretary will engage in the next fiscal
year.</DELETED>
<DELETED> ``(4) Before each fiscal year, the Secretary shall
establish, for purposes of this section, the annual estimate of the
total cost of fertility counseling and treatment for the next fiscal
year, which shall be the Secretary's estimate of what the total cost to
the Department will be in the next fiscal year of--</DELETED>
<DELETED> ``(A) furnishing fertility counseling and
treatment, including through the use of assisted reproductive
technology, to individuals under laws administered by the
Secretary in the next fiscal year; and</DELETED>
<DELETED> ``(B) making payments under section 1789 of this
title in the next fiscal year.</DELETED>
<DELETED> ``(c) Waiver.--The Secretary may waive the fee required by
subsection (a) for a person as the Secretary considers appropriate if
the person is an individual or a small business concern.</DELETED>
<DELETED> ``(d) Limitation on Collection.--No fee may be collected
under subsection (a) except to the extent that the expenditure of the
fee to pay the costs of activities and services for which the fee is
imposed is provided for in advance in an appropriations Act.</DELETED>
<DELETED> ``(e) Department of Veterans Affairs Fertility Counseling
and Treatment Fund.--(1) There is in the Treasury a fund to be known as
the Department of Veterans Affairs Fertility Counseling and Treatment
Fund.</DELETED>
<DELETED> ``(2) All amounts received by the Secretary under
subsection (a) shall be deposited in the fund.</DELETED>
<DELETED> ``(3)(A) Subject to the provisions of appropriations Acts,
amounts in the fund shall be available, without fiscal year limitation,
to the Secretary for the following purposes:</DELETED>
<DELETED> ``(i) To furnish fertility counseling and
treatment, including through the use of assisted reproductive
technology, to individuals under laws administered by the
Secretary.</DELETED>
<DELETED> ``(ii) To make payments under section 1789 of this
title.</DELETED>
<DELETED> ``(B) Amounts available under subparagraph (A) may not be
used for any purposes other than a purpose set forth in clause (i) or
(ii) of that subparagraph.</DELETED>
<DELETED> ``(4) Amounts received by the Secretary under subsection
(a) shall be treated for the purposes of sections 251 and 252 of the
Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C.
901, 902) as offsets to discretionary appropriations (rather than as
offsets to direct spending) to the extent that such amounts are made
available for expenditure in appropriations Acts for the purposes
specified in paragraph (3) of this subsection.</DELETED>
<DELETED> ``(f) Small Business Concern Defined.--In this section,
the term `small business concern' has the meaning given such term under
section 3 of the Small Business Act (15 U.S.C. 632).''.</DELETED>
<DELETED> (b) Clerical Amendment.--The table of sections at the
beginning of chapter 3 of such title is amended by adding after the
item relating to section 322 the following new item:</DELETED>
<DELETED>``323. Contractor user fees.''.
</DELETED>SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES
CODE.
(a) Short Title.--This Act may be cited as the ``Women Veterans and
Other Health Care Improvements Act of 2013''.
(b) References to Title 38, United States Code.--Except as
otherwise expressly provided, whenever in this Act an amendment or
repeal is expressed in terms of an amendment to, or repeal of, a
section or other provision, the reference shall be considered to be
made to a section or other provision of title 38, United States Code.
SEC. 2. CLARIFICATION THAT FERTILITY COUNSELING AND TREATMENT ARE
MEDICAL SERVICES WHICH THE SECRETARY MAY FURNISH TO
VETERANS LIKE OTHER MEDICAL SERVICES.
Section 1701(6) is amended by adding at the end the following new
subparagraph:
``(H) Fertility counseling and treatment, including
treatment using assisted reproductive technology.''.
SEC. 3. REPRODUCTIVE TREATMENT AND CARE FOR SPOUSES AND SURROGATES OF
VETERANS.
(a) In General.--Subchapter VIII of chapter 17 is amended by adding
at the end the following new section:
``Sec. 1788. Reproductive treatment and care for spouses and surrogates
of veterans
``(a) In General.--The Secretary shall furnish fertility counseling
and treatment, including through the use of assisted reproductive
technology, to a spouse or surrogate of a severely wounded, ill, or
injured veteran who has an infertility condition incurred or aggravated
in line of duty in the active military, naval, or air service and who
is enrolled in the system of annual patient enrollment established
under section 1705(a) of this title if the spouse or surrogate and the
veteran apply jointly for such counseling and treatment through a
process prescribed by the Secretary.
``(b) Coordination of Care for Other Spouses and Surrogates.--In
the case of a spouse or surrogate of a veteran not described in
subsection (a) who is seeking fertility counseling and treatment, the
Secretary may coordinate fertility counseling and treatment for such
spouse or surrogate.
``(c) Construction.--Nothing in this section shall be construed to
require the Secretary--
``(1) to find or certify a surrogate for a veteran or to
connect a surrogate with a veteran; or
``(2) to furnish maternity care to a spouse or surrogate of
a veteran.
``(d) Assisted Reproductive Technology Defined.--In this section,
the term `assisted reproductive technology' includes in vitro
fertilization and other fertility treatments in which both eggs and
sperm are handled when clinically appropriate.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 17 is amended by inserting after the item relating to section
1787 the following new item:
``1788. Reproductive treatment and care for spouses and surrogates of
veterans.''.
SEC. 4. ADOPTION ASSISTANCE FOR SEVERELY WOUNDED VETERANS.
(a) In General.--Subchapter VIII of chapter 17, as amended by
section 3 of this Act, is further amended by adding at the end the
following new section:
``Sec. 1789. Adoption assistance
``(a) In General.--The Secretary may pay an amount, not to exceed
the limitation amount, to assist a covered veteran in the adoption of
one or more children.
``(b) Covered Veteran.--For purposes of this section, a covered
veteran is any severely wounded, ill, or injured veteran who--
``(1) has an infertility condition incurred or aggravated
in line of duty in the active military, naval, or air service;
and
``(2) is enrolled in the system of annual patient
enrollment established under section 1705(a) of this title.
``(c) Limitation Amount.--For purposes of this section, the
limitation amount is the amount equal to the lesser of--
``(1) the cost the Department would incur if the Secretary
were to provide a covered veteran with one cycle of fertility
treatment through the use of assisted reproductive technology
under section 1788 of this title, as determined by the
Secretary; or
``(2) the cost the Department would incur by paying the
expenses of three adoptions by covered veterans, as determined
by the Secretary.
``(d) Assisted Reproductive Technology Defined.--In this section,
the term `assisted reproductive technology' has the meaning given that
term in section 1788 of this title.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 17, as amended by section 3(b) of this Act, is further amended
by inserting after the item relating to section 1788 the following new
item:
``1789. Adoption assistance.''.
SEC. 5. REGULATIONS ON FURNISHING OF FERTILITY COUNSELING AND TREATMENT
AND ADOPTION ASSISTANCE BY DEPARTMENT OF VETERANS
AFFAIRS.
(a) In General.--Not later than 540 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall
prescribe regulations--
(1) on the furnishing of fertility treatment to veterans
using assisted reproductive technology;
(2) to carry out section 1788 of title 38, United States
Code, as added by section 3 of this Act; and
(3) to carry out section 1789 of such title, as added by
section 4 of this Act.
(b) Limitation.--Notwithstanding any other provision of law, during
the period beginning on the date of the enactment of this Act and
ending on the date on which the Secretary prescribes regulations under
subsection (a), the Secretary may not furnish--
(1) to a veteran any fertility treatment that uses an
assisted reproductive technology that the Secretary has not
used in the provision of a fertility treatment to a veteran
before the date of the enactment of this Act;
(2) any fertility counseling or treatment under section
1788 of such title, as added by section 3 of this Act; or
(3) any assistance under section 1789 of such title, as
added by section 4 of this Act.
(c) Assisted Reproductive Technology Defined.--In this section, the
term ``assisted reproductive technology'' has the meaning given the
term in section 1788 of such title, as added by section 3 of this Act.
SEC. 6. COORDINATION BETWEEN DEPARTMENT OF VETERANS AFFAIRS AND
DEPARTMENT OF DEFENSE ON FURNISHING OF FERTILITY
COUNSELING AND TREATMENT.
The Secretary of Veterans Affairs and the Secretary of Defense
shall share best practices and facilitate referrals, as they consider
appropriate, on the furnishing of fertility counseling and treatment.
SEC. 7. FACILITATION OF REPRODUCTION AND INFERTILITY RESEARCH.
(a) In General.--Subchapter II of chapter 73 is amended by adding
at the end the following new section:
``Sec. 7330B. Facilitation of reproduction and infertility research
``(a) Facilitation of Research Required.--The Secretary shall
facilitate research conducted collaboratively by the Secretary of
Defense and the Secretary of Health and Human Services to improve the
ability of the Department of Veterans Affairs to meet the long-term
reproductive health care needs of veterans who have a genitourinary
service-connected disability or a condition that was incurred or
aggravated in line of duty in the active military, naval, or air
service, such as a spinal cord injury, that affects the veterans'
ability to reproduce.
``(b) Dissemination of Information.--The Secretary shall ensure
that information produced by the research facilitated under this
section that may be useful for other activities of the Veterans Health
Administration is disseminated throughout the Veterans Health
Administration.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 73 is amended by inserting after the item relating to section
7330A the following new item:
``7330B. Facilitation of reproduction and infertility research.''.
(c) Report.--Not later than three years after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall submit
to Congress a report on the research activities conducted by the
Secretary under section 7330B of title 38, United States Code, as added
by subsection (a).
SEC. 8. ANNUAL REPORT ON PROVISION OF FERTILITY COUNSELING AND
TREATMENT FURNISHED BY DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Not later than one year after the date of the
enactment of this Act and not less frequently than annually thereafter,
the Secretary of Veterans Affairs shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a report on the fertility counseling
and treatment furnished by the Department of Veterans Affairs during
the year preceding the submittal of the report.
(b) Elements.--Each report submitted under subsection (a) shall
include, for the period covered by the report, the following:
(1) The number of veterans who received fertility
counseling or treatment furnished by the Department of Veterans
Affairs, disaggregated by era of military service of such
veterans.
(2) The number of spouses and surrogates of veterans who
received fertility counseling or treatment furnished by the
Department.
(3) The cost to the Department of furnishing fertility
counseling and treatment, disaggregated by cost of services and
administration.
(4) The average cost to the Department per recipient of
such counseling and treatment.
(5) In cases in which the Department furnished fertility
treatment through the use of assisted reproductive technology,
the average number of cycles per person furnished.
(6) A description of how fertility counseling and treatment
services of the Department are coordinated with similar
services of the Department of Defense.
SEC. 9. PROGRAM ON ASSISTANCE FOR CHILD CARE FOR CERTAIN VETERANS.
(a) Assistance for Child Care for Certain Veterans Receiving Health
Care.--
(1) In general.--Subchapter I of chapter 17 is amended by
adding at the end the following new section:
``Sec. 1709B. Assistance for child care for certain veterans receiving
health care
``(a) Program Required.--The Secretary shall carry out a program to
provide, subject to subsection (b), assistance to qualified veterans
described in subsection (c) to obtain child care so that such veterans
can receive health care services described in subsection (c).
``(b) Limitation on Period of Payments.--Assistance may only be
provided to a qualified veteran under this section for receipt of child
care during the period that the qualified veteran--
``(1) receives health care services described in subsection
(c) at a facility of the Department; and
``(2) requires travel to and from such facility for the
receipt of such health care services.
``(c) Qualified Veterans.--For purposes of this section, a
qualified veteran is a veteran who is--
``(1) the primary caretaker of a child or children; and
``(2)(A) receiving from the Department--
``(i) regular mental health care services;
``(ii) intensive mental health care services; or
``(iii) such other intensive health care services
that the Secretary determines that provision of
assistance to the veteran to obtain child care would
improve access to such health care services by the
veteran; or
``(B) in need of regular or intensive mental health care
services from the Department, and but for lack of child care
services, would receive such health care services from the
Department.
``(d) Locations.--The Secretary shall carry out the program in no
fewer than three Veterans Integrated Service Networks selected by the
Secretary for purposes of the program.
``(e) Forms of Child Care Assistance.--(1) Child care assistance
under this section may include the following:
``(A) Stipends for the payment of child care offered by
licensed child care centers (either directly or through a
voucher program) which shall be, to the extent practicable,
modeled after the Department of Veterans Affairs Child Care
Subsidy Program established pursuant to section 630 of the
Treasury and General Government Appropriations Act, 2002
(Public Law 107-67; 115 Stat. 552).
``(B) Direct provision of child care at an on-site facility
of the Department.
``(C) Payments to private child care agencies.
``(D) Collaboration with facilities or programs of other
Federal departments or agencies.
``(E) Such other forms of assistance as the Secretary
considers appropriate.
``(2) In the case that child care assistance under this section is
provided as a stipend under paragraph (1)(A), such stipend shall cover
the full cost of such child care.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 17 is amended by inserting after the item
relating to section 1709A the following new item:
``1709B. Assistance for child care for certain veterans receiving
health care.''.
(3) Conforming amendment.--Section 205(e) of the Caregivers
and Veterans Omnibus Health Services Act of 2010 (Public Law
111-163; 38 U.S.C. 1710 note) is amended by inserting ``but not
after the date of the enactment of the Women Veterans and Other
Health Care Improvements Act of 2013'' before the period at the
end.
(b) Assistance for Child Care for Individuals Receiving
Readjustment Counseling and Related Mental Health Services.--
(1) In general.--Subchapter I of chapter 17, as amended by
subsection (a)(1) of this section, is further amended by adding
at the end the following new section:
``Sec. 1709C. Assistance for child care for individuals receiving
readjustment counseling and related mental health
services
``(a) Program Required.--The Secretary shall carry out a program to
provide, subject to subsection (b), assistance to qualified individuals
described in subsection (c) to obtain child care so that such
individuals can receive readjustment counseling and related mental
health services.
``(b) Limitation on Period of Payments.--Assistance may only be
provided to a qualified individual under this section for receipt of
child care during the period that the qualified individual receives
readjustment counseling and related health care services at a Vet
Center.
``(c) Qualified Individuals.--For purposes of this section, a
qualified individual is an individual who is--
``(1) the primary caretaker of a child or children; and
``(2)(A) receiving from the Department regular readjustment
counseling and related mental health services; or
``(B) in need of readjustment counseling and related mental
health services from the Department, and but for lack of child
care services, would receive such counseling and services from
the Department.
``(d) Locations.--The Secretary shall carry out the program under
this section in no fewer than three Readjustment Counseling Service
Regions selected by the Secretary for purposes of the program.
``(e) Forms of Child Care Assistance.--(1) Child care assistance
under this section may include the following:
``(A) Stipends for the payment of child care offered by
licensed child care centers (either directly or through a
voucher program) which shall be, to the extent practicable,
modeled after the Department of Veterans Affairs Child Care
Subsidy Program established pursuant to section 630 of the
Treasury and General Government Appropriations Act, 2002
(Public Law 107-67; 115 Stat. 552).
``(B) Payments to private child care agencies.
``(C) Collaboration with facilities or programs of other
Federal departments or agencies.
``(D) Such other forms of assistance as the Secretary
considers appropriate.
``(2) In the case that child care assistance under this subsection
is provided as a stipend under paragraph (1)(A), such stipend shall
cover the full cost of such child care.
``(f) Vet Center Defined.--In this section, the term `Vet Center'
means a center for readjustment counseling and related mental health
services for individuals under section 1712A of this title.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 17, as amended by subsection (a)(2) of
this section, is further amended by inserting after the item
relating to section 1709B the following new item:
``1709C. Assistance for child care for individuals receiving
readjustment counseling and related mental
health services.''.
SEC. 10. COUNSELING IN RETREAT SETTINGS FOR WOMEN VETERANS NEWLY
SEPARATED FROM SERVICE IN THE ARMED FORCES.
(a) Counseling in Retreat Settings.--
(1) In general.--Subchapter II of chapter 17 is amended by
adding at the end the following new section:
``Sec. 1720H. Counseling in retreat settings for women veterans newly
separated from service in the Armed Forces
``(a) In General.--The Secretary shall provide, through the
Readjustment Counseling Service of the Veterans Health Administration,
reintegration and readjustment services described in subsection (c) in
group retreat settings to women veterans who are recently separated
from service in the Armed Forces after a prolonged deployment.
``(b) Election of Veteran.--The receipt of services under this
section by a woman veteran shall be at the election of the veteran.
``(c) Covered Services.--The services provided to a woman veteran
under this section shall include the following:
``(1) Information on reintegration into the veteran's
family, employment, and community.
``(2) Financial counseling.
``(3) Occupational counseling.
``(4) Information and counseling on stress reduction.
``(5) Information and counseling on conflict resolution.
``(6) Such other information and counseling as the
Secretary considers appropriate to assist the veteran in
reintegration into the veteran's family, employment, and
community.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 17 is amended by inserting after the item
relating to section 1720G the following new item:
``1720H. Counseling in retreat settings for women veterans newly
separated from service in the Armed
Forces.''.
(b) Repeal of Superseded Pilot Program Authority.--Section 203 of
the Caregivers and Veterans Omnibus Health Services Act of 2010 (Public
Law 111-163; 38 U.S.C. 1712A note) is hereby repealed.
Calendar No. 185
113th CONGRESS
1st Session
S. 131
[Report No. 113-106]
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to improve the reproductive
assistance provided by the Department of Veterans Affairs to severely
wounded, ill, or injured veterans and their spouses, and for other
purposes.
_______________________________________________________________________
September 17, 2013
Reported with an amendment