[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 514 Reported in Senate (RS)]
<DOC>
Calendar No. 536
116th CONGRESS
2d Session
S. 514
To amend title 38, United States Code, to improve the benefits and
services provided by the Department of Veterans Affairs to women
veterans, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 14, 2019
Mr. Tester (for himself, Mr. Boozman, Mrs. Capito, Mrs. Blackburn, Ms.
Stabenow, Mr. Schatz, Ms. Sinema, Ms. Warren, Mr. Menendez, Ms. Hassan,
Mr. Reed, Mr. Whitehouse, Ms. Baldwin, Ms. Duckworth, Mr. Blumenthal,
Mrs. Shaheen, Mrs. Murray, Ms. Cortez Masto, Mr. Van Hollen, Ms.
Harris, Mrs. Gillibrand, Mr. Merkley, Mr. Booker, Mr. Casey, Mr. Brown,
Mr. Peters, Mrs. Feinstein, Mr. Sanders, Ms. McSally, Mr. Markey, Mr.
Sullivan, Mr. King, Ms. Smith, Mr. Kaine, Ms. Hirono, Mr. Moran, Mr.
Cramer, Mr. Coons, Ms. Klobuchar, Mr. Cornyn, Mr. Durbin, Mr. Warner,
Mr. Jones, Ms. Rosen, Ms. Collins, Mr. Wyden, Ms. Murkowski, Mr.
Gardner, Mr. Manchin, and Mr. Bennet) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
September 15, 2020
Reported by Mr. Moran, 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 benefits and
services provided by the Department of Veterans Affairs to women
veterans, 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; TABLE OF CONTENTS.</DELETED>
<DELETED> (a) Short Title.--This Act may be cited as the ``Deborah
Sampson Act''.</DELETED>
<DELETED> (b) Table of Contents.--The table of contents for this Act
is as follows:</DELETED>
<DELETED>Sec. 1. Short title; table of contents.
<DELETED>TITLE I--READJUSTMENT AND RELATED ASSISTANCE
<DELETED>Sec. 101. Provision of reintegration and readjustment services
to veterans and family members in group
retreat settings.
<DELETED>Sec. 102. Expansion of capabilities of Women Veterans Call
Center to include text messaging.
<DELETED>TITLE II--LEGAL AND SUPPORTIVE SERVICES
<DELETED>Sec. 201. Department of Veterans Affairs public-private
partnership on legal services for women
veterans.
<DELETED>Sec. 202. Additional amount for Supportive Services for
Veteran Families grant program to support
organizations that have a focus on
providing assistance to women veterans and
their families.
<DELETED>Sec. 203. Gap analysis of Department of Veterans Affairs
programs that provide assistance to women
veterans who are homeless.
<DELETED>TITLE III--NEWBORN CARE
<DELETED>Sec. 301. Extension of period of eligibility for care for
newborn children from the Department of
Veterans Affairs.
<DELETED>TITLE IV--ELIMINATING BARRIERS TO ACCESS
<DELETED>Sec. 401. Women Veterans Retrofit Initiative.
<DELETED>Sec. 402. Staffing of women's health primary care providers at
medical facilities of the Department of
Veterans Affairs.
<DELETED>Sec. 403. Additional funding for primary care and emergency
care clinicians in Women Veterans Health
Care Mini-Residency Program.
<DELETED>Sec. 404. Establishment of women veteran training module for
non-Department of Veterans Affairs health
care providers.
<DELETED>Sec. 405. Study on staffing of Women Veteran Program Manager
program at medical centers of the
Department of Veterans Affairs and training
of staff.
<DELETED>TITLE V--DATA COLLECTION AND REPORTING
<DELETED>Sec. 501. Requirement for collection and analysis of data on
Department of Veterans Affairs benefits and
services and disaggregation of such data by
sex and minority status.
<DELETED>Sec. 502. Report on availability of prosthetics for women
veterans from the Department of Veterans
Affairs.
<DELETED>Sec. 503. Requirement for Department of Veterans Affairs
internet website to provide information on
services available to women veterans.
<DELETED>Sec. 504. Report on locations where women veterans are using
health care from Department of Veterans
Affairs.
<DELETED>Sec. 505. Report on models of medical facilities of Department
of Veterans Affairs for the treatment of
women.
<DELETED>Sec. 506. Report on staffing of Department of Veterans
relating to the treatment of women.
<DELETED>TITLE I--READJUSTMENT AND RELATED ASSISTANCE</DELETED>
<DELETED>SEC. 101. PROVISION OF REINTEGRATION AND READJUSTMENT SERVICES
TO VETERANS AND FAMILY MEMBERS IN GROUP RETREAT
SETTINGS.</DELETED>
<DELETED> (a) In General.--Section 1712A of title 38, United States
Code, is amended--</DELETED>
<DELETED> (1) in subsection (a)(1)(B)--</DELETED>
<DELETED> (A) in clause (ii), by redesignating
subclauses (I) and (II) as items (aa) and
(bb);</DELETED>
<DELETED> (B) by redesignating clauses (i) and (ii)
as subclauses (I) and (II);</DELETED>
<DELETED> (C) in the matter preceding subclause (I),
as redesignated by subparagraph (B), by striking
``Counseling'' and inserting ``(i) Counseling'';
and</DELETED>
<DELETED> (D) by adding at the end the following new
clause:</DELETED>
<DELETED> ``(ii)(I) Except as provided in subclause (IV), counseling
furnished to an individual under subparagraph (A) may include
reintegration and readjustment services described in subclause (II)
furnished in group retreat settings.</DELETED>
<DELETED> ``(II) Reintegration and readjustment services described
in this subclause are the following:</DELETED>
<DELETED> ``(aa) Information on reintegration of the
individual into family, employment, and community.</DELETED>
<DELETED> ``(bb) Financial counseling.</DELETED>
<DELETED> ``(cc) Occupational counseling.</DELETED>
<DELETED> ``(dd) Information and counseling on stress
reduction.</DELETED>
<DELETED> ``(ee) Information and counseling on conflict
resolution.</DELETED>
<DELETED> ``(ff) Such other information and counseling as
the Secretary considers appropriate to assist the individual in
reintegration into family, employment, and community.</DELETED>
<DELETED> ``(III) In furnishing reintegration and readjustment
services under subclause (I), the Secretary shall offer women the
opportunity to receive such services in group retreat settings in which
the only participants are women.</DELETED>
<DELETED> ``(IV) An individual referred to in subparagraph (C)(v)
may receive reintegration and readjustment services under subclause (I)
only if the individual receives such services with a family member
described in subclause (I) or (II) of such subparagraph.''.</DELETED>
<DELETED> (b) Request for Services.--Subsection (a)(2) of such
section is amended--</DELETED>
<DELETED> (1) by striking ``Upon'' and inserting ``(A)
Upon'';</DELETED>
<DELETED> (2) by striking ``paragraph (1)(B)'' and inserting
``paragraph (1)(B)(i)''; and</DELETED>
<DELETED> (3) by adding at the end the following new
subparagraph:</DELETED>
<DELETED> ``(B) Upon the request of an individual described in
paragraph (1)(C), the Secretary shall furnish the individual
reintegration and readjustment services in group retreat settings under
paragraph (1)(B)(ii).''.</DELETED>
<DELETED>SEC. 102. EXPANSION OF CAPABILITIES OF WOMEN VETERANS CALL
CENTER TO INCLUDE TEXT MESSAGING.</DELETED>
<DELETED> The Secretary of Veterans Affairs shall expand the
capabilities of the Women Veterans Call Center of the Department of
Veterans Affairs to include a text messaging capability.</DELETED>
<DELETED>TITLE II--LEGAL AND SUPPORTIVE SERVICES</DELETED>
<DELETED>SEC. 201. DEPARTMENT OF VETERANS AFFAIRS PUBLIC-PRIVATE
PARTNERSHIP ON LEGAL SERVICES FOR WOMEN
VETERANS.</DELETED>
<DELETED> (a) Partnership Required.--The Secretary of Veterans
Affairs shall establish a partnership with at least one nongovernmental
organization to provide legal services to women veterans.</DELETED>
<DELETED> (b) Focus.--The focus of the partnership established under
subsection (a) shall be on the 10 highest unmet needs of women veterans
as set forth in the most recently completed Community Homelessness
Assessment, Local Education and Networking Groups for Veterans (CHALENG
for Veterans) survey.</DELETED>
<DELETED>SEC. 202. ADDITIONAL AMOUNT FOR SUPPORTIVE SERVICES FOR
VETERAN FAMILIES GRANT PROGRAM TO SUPPORT ORGANIZATIONS
THAT HAVE A FOCUS ON PROVIDING ASSISTANCE TO WOMEN
VETERANS AND THEIR FAMILIES.</DELETED>
<DELETED> Section 2044(e) of title 38, United States Code, is
amended--</DELETED>
<DELETED> (1) in paragraph (1), by adding at the end the
following new subparagraph:</DELETED>
<DELETED> ``(F) $400,000,000 for each of fiscal years 2020
through 2022.''; and</DELETED>
<DELETED> (2) by adding at the end the following new
paragraph:</DELETED>
<DELETED> ``(4) Not less than $20,000,000 shall be available under
paragraph (1)(H) for the provision of financial assistance under
subsection (a) to organizations that have a focus on providing
assistance to women veterans and their families.''.</DELETED>
<DELETED>SEC. 203. GAP ANALYSIS OF DEPARTMENT OF VETERANS AFFAIRS
PROGRAMS THAT PROVIDE ASSISTANCE TO WOMEN VETERANS WHO
ARE HOMELESS.</DELETED>
<DELETED> (a) In General.--The Secretary of Veterans Affairs shall
complete an analysis of programs of the Department of Veterans Affairs
that provide assistance to women veterans who are homeless or
precariously housed to identify the areas in which such programs are
failing to meet the needs of such women.</DELETED>
<DELETED> (b) Report.--Not later than 270 days after the date of the
enactment of this Act, the Secretary 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 analysis completed
under subsection (a).</DELETED>
<DELETED>TITLE III--NEWBORN CARE</DELETED>
<DELETED>SEC. 301. EXTENSION OF PERIOD OF ELIGIBILITY FOR CARE FOR
NEWBORN CHILDREN FROM THE DEPARTMENT OF VETERANS
AFFAIRS.</DELETED>
<DELETED> Section 1786(a) of title 38, United States Code, is
amended, in the matter preceding paragraph (1), by striking ``seven
days'' and inserting ``14 days''.</DELETED>
<DELETED>TITLE IV--ELIMINATING BARRIERS TO ACCESS</DELETED>
<DELETED>SEC. 401. WOMEN VETERANS RETROFIT INITIATIVE.</DELETED>
<DELETED> (a) In General.--The Secretary of Veterans Affairs shall
retrofit existing medical facilities of the Department of Veterans
Affairs with fixtures, materials, and other outfitting measures to
support the provision of care to women veterans at such
facilities.</DELETED>
<DELETED> (b) Plan.--Not later than 180 days after the date of the
enactment of this Act, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a plan to address deficiencies in
environment of care for women veterans at medical facilities of the
Department.</DELETED>
<DELETED> (c) Authorization of Appropriations.--There is authorized
to be appropriated to the Secretary $20,000,000 to carry out subsection
(a) in addition to amounts otherwise made available to the Secretary
for the purposes set forth in such subsection.</DELETED>
<DELETED>SEC. 402. STAFFING OF WOMEN'S HEALTH PRIMARY CARE PROVIDERS AT
MEDICAL FACILITIES OF THE DEPARTMENT OF VETERANS
AFFAIRS.</DELETED>
<DELETED> The Secretary of Veterans Affairs shall ensure that each
medical facility of the Department of Veterans Affairs has not fewer
than one full-time or part-time women's health primary care provider
whose duties include, to the extent possible, providing training to
other health care providers of the Department on the needs of women
veterans.</DELETED>
<DELETED>SEC. 403. ADDITIONAL FUNDING FOR PRIMARY CARE AND EMERGENCY
CARE CLINICIANS IN WOMEN VETERANS HEALTH CARE MINI-
RESIDENCY PROGRAM.</DELETED>
<DELETED> (a) In General.--There is authorized to be appropriated to
the Secretary of Veterans Affairs $1,000,000 for each fiscal year for
the Women Veterans Health Care Mini-Residency Program of the Department
of Veterans Affairs to provide opportunities for participation in such
program for primary care and emergency care clinicians.</DELETED>
<DELETED> (b) Treatment of Amounts.--The amounts authorized to be
appropriated under subsection (a) shall be in addition to amounts
otherwise made available to the Secretary for the purposes set forth in
such subsection.</DELETED>
<DELETED>SEC. 404. ESTABLISHMENT OF WOMEN VETERAN TRAINING MODULE FOR
NON-DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE
PROVIDERS.</DELETED>
<DELETED> (a) In General.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
establish and make available to community providers a training module
that is specific to women veterans.</DELETED>
<DELETED> (b) Community Provider Defined.--In this section, the term
``community provider'' means a non-Department of Veterans Affairs
health care provider who provides health care to veterans under the
laws administered by the Secretary of Veterans Affairs.</DELETED>
<DELETED>SEC. 405. STUDY ON STAFFING OF WOMEN VETERAN PROGRAM MANAGER
PROGRAM AT MEDICAL CENTERS OF THE DEPARTMENT OF VETERANS
AFFAIRS AND TRAINING OF STAFF.</DELETED>
<DELETED> (a) Study.--The Secretary of Veterans Affairs shall
conduct a study on the use of the Women Veteran Program Manager program
of the Department of Veterans Affairs to determine--</DELETED>
<DELETED> (1) if the program is appropriately staffed at
each medical center of the Department;</DELETED>
<DELETED> (2) whether each medical center of the Department
is staffed with a Women Veteran Program Manager; and</DELETED>
<DELETED> (3) whether it would be feasible and advisable to
have a Women Veteran Program Ombudsman at each medical center
of the Department.</DELETED>
<DELETED> (b) Report.--Not later than 270 days after the date of the
enactment of this Act, the Secretary 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 study conducted under
subsection (a).</DELETED>
<DELETED> (c) Training.--The Secretary shall ensure that all Women
Veteran Program Managers and Women Veteran Program Ombudsmen receive
the proper training to carry out their duties.</DELETED>
<DELETED>TITLE V--DATA COLLECTION AND REPORTING</DELETED>
<DELETED>SEC. 501. REQUIREMENT FOR COLLECTION AND ANALYSIS OF DATA ON
DEPARTMENT OF VETERANS AFFAIRS BENEFITS AND SERVICES AND
DISAGGREGATION OF SUCH DATA BY SEX AND MINORITY
STATUS.</DELETED>
<DELETED> The Secretary of Veterans Affairs shall--</DELETED>
<DELETED> (1) collect and analyze data on each program of
the Department of Veterans Affairs that provides a service or
benefit to a veteran, including the program carried out under
section 1144 of title 10, United States Code;</DELETED>
<DELETED> (2) disaggregate such data by sex and minority
status, when the data lends itself to such disaggregation;
and</DELETED>
<DELETED> (3) publish the data collected and analyzed under
paragraph (1), except for such cases in which the Secretary
determines that some portions of the data would undermine the
anonymity of a veteran.</DELETED>
<DELETED>SEC. 502. REPORT ON AVAILABILITY OF PROSTHETICS FOR WOMEN
VETERANS FROM THE DEPARTMENT OF VETERANS
AFFAIRS.</DELETED>
<DELETED> Not later than one year after the date of the enactment of
this Act, 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
availability from the Department of Veterans Affairs of prosthetics
made for women veterans, including an assessment of the availability of
such prosthetics at each medical facility of the Department.</DELETED>
<DELETED>SEC. 503. REQUIREMENT FOR DEPARTMENT OF VETERANS AFFAIRS
INTERNET WEBSITE TO PROVIDE INFORMATION ON SERVICES
AVAILABLE TO WOMEN VETERANS.</DELETED>
<DELETED> (a) In General.--The Secretary of Veterans Affairs shall
survey the internet websites and information resources of the
Department of Veterans Affairs in effect on the day before the date of
the enactment of this Act and publish an internet website that serves
as a centralized source for the provision to women veterans of
information about the benefits and services available to them under
laws administered by the Secretary.</DELETED>
<DELETED> (b) Elements.--The internet website published under
subsection (a) shall provide to women veterans information regarding
all of the services available in the district in which that the veteran
is seeking such services, including, with respect to each medical
center and community-based outpatient clinic in the applicable Veterans
Integrated Service Network--</DELETED>
<DELETED> (1) the name and contact information of each
women's health coordinator;</DELETED>
<DELETED> (2) a list of appropriate staff for other benefits
available from the Veterans Benefits Administration, the
National Cemetery Administration, and such other entities as
the Secretary considers appropriate; and</DELETED>
<DELETED> (3) such other information as the Secretary
considers appropriate.</DELETED>
<DELETED> (c) Updated Information.--The Secretary shall ensure that
the information described in subsection (b) that is published on the
internet website required by subsection (a) is updated not less
frequently than once every 90 days.</DELETED>
<DELETED> (d) Outreach.--In carrying out this section, the Secretary
shall ensure that the outreach conducted under section 1720F(i) of
title 38, United States Code, includes information regarding the
internet website required by subsection (a).</DELETED>
<DELETED> (e) Derivation of Funds.--Amounts used by the Secretary to
carry out this section shall be derived from amounts made available to
the Secretary to publish internet websites of the Department.</DELETED>
<DELETED>SEC. 504. REPORT ON LOCATIONS WHERE WOMEN VETERANS ARE USING
HEALTH CARE FROM DEPARTMENT OF VETERANS
AFFAIRS.</DELETED>
<DELETED> (a) In General.--Not later than 90 days after the date of
the enactment of this Act, and 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 use by women veterans of health care
from the Department of Veterans Affairs.</DELETED>
<DELETED> (b) Elements.--Each report required by subsection (a)
shall include the following information:</DELETED>
<DELETED> (1) The number of women veterans who reside in
each State.</DELETED>
<DELETED> (2) The number of women veterans in each State who
are enrolled in the system of patient enrollment of the
Department established and operated under section 1705(a) of
title 38, United States Code.</DELETED>
<DELETED> (3) Of the women veterans who are so enrolled, the
number who have received health care under the laws
administered by the Secretary at least one time during the one-
year period preceding the submittal of the report.</DELETED>
<DELETED> (4) The number of women veterans who have been
seen at each medical facility of the Department during such
year.</DELETED>
<DELETED> (5) The number of appointments that women veterans
have had at each such facility during such year.</DELETED>
<DELETED> (6) If known, an identification of the medical
facility of the Department in each Veterans Integrated Service
Network with the largest rate of increase in patient population
of women veterans as measured by the increase in unique women
veteran patient use.</DELETED>
<DELETED> (7) If known, an identification of the medical
facility of the Department in each Veterans Integrated Service
Network with the largest rate of decrease in patient population
of women veterans as measured by the decrease in unique women
veterans patient use.</DELETED>
<DELETED>SEC. 505. REPORT ON MODELS OF MEDICAL FACILITIES OF DEPARTMENT
OF VETERANS AFFAIRS FOR THE TREATMENT OF WOMEN.</DELETED>
<DELETED> (a) In General.--Not later than 90 days after the date of
the enactment of this Act, and 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 use by the Department of Veterans
Affairs of general primary care clinics, separate but shared spaces,
and women's health centers as models of providing health care to women
veterans.</DELETED>
<DELETED> (b) Elements.--Each report required by subsection (a)
shall include the following:</DELETED>
<DELETED> (1) The number of facilities of the Department
that fall into each model described in subsection (a),
disaggregated by Veterans Integrated Service Network and
State.</DELETED>
<DELETED> (2) A description of the criteria used by the
Department to determine which such model is most appropriate
for each facility of the Department.</DELETED>
<DELETED> (3) An assessment of how the Department decides to
make investments to upgrade facilities to the next higher-level
model.</DELETED>
<DELETED> (4) A description of what, if any, plans the
Department has to upgrade facilities from the lowest-level
model, general primary care clinics, to another
model.</DELETED>
<DELETED> (5) An assessment of whether any facilities could
be upgraded to the next higher-level model within planned
investments under the strategic capital investment planning
process of the Department.</DELETED>
<DELETED> (6) An assessment of whether any facilities could
be upgraded to the next higher-level model with minor
modifications to existing plans under the strategic capital
investment planning process of the Department.</DELETED>
<DELETED> (7) An assessment of whether the Department has a
goal for how many facilities should fall into each such
model.</DELETED>
<DELETED>SEC. 506. REPORT ON STAFFING OF DEPARTMENT OF VETERANS
RELATING TO THE TREATMENT OF WOMEN.</DELETED>
<DELETED> (a) In General.--Not later than 90 days after the date of
the enactment of this Act, and 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 staffing of the Department of Veterans
Affairs relating to the treatment of women.</DELETED>
<DELETED> (b) Elements.--Each report required by subsection (a)
shall include the following, disaggregated by Veterans Integrated
Service Network and State (except with respect to paragraph
(4)):</DELETED>
<DELETED> (1) The number of women's health
centers.</DELETED>
<DELETED> (2) The number of patient aligned care teams of
the Department relating to women's health.</DELETED>
<DELETED> (3) The number of full- and part-time
gynecologists of the Department.</DELETED>
<DELETED> (4) The number of designated women's health care
providers of the Department, disaggregated by facility of the
Department.</DELETED>
<DELETED> (5) The number of health care providers of the
Department who have completed a mini-residency for women's
health care through Women Veterans Health Care Mini-Residency
Program of the Department during the one-year period preceding
the submittal of the report, and the number that plan to
participate in such a mini-residency during the one-year period
following such date.</DELETED>
<DELETED> (6) The number of designated women's health care
providers of the Department who have sufficient female patients
to retain their competencies and proficiencies.</DELETED>
SECTION 1. SHORT TITLE.
(a) Short Title.--This Act may be cited as the ``Deborah Sampson
Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title.
TITLE I--IMPROVING ACCESS FOR WOMEN VETERANS TO THE DEPARTMENT OF
VETERANS AFFAIRS
Sec. 101. Office of Women's Health in Department of Veterans Affairs.
Sec. 102. Women veterans retrofit initiative.
Sec. 103. Establishment of environment of care standards and
inspections at Department of Veterans
Affairs medical centers.
Sec. 104. Provision of reintegration and readjustment services to
veterans and family members in group
retreat settings.
Sec. 105. Provision of legal services for women veterans.
Sec. 106. Comptroller General surveys and report on supportive services
provided for very low-income women
veterans.
Sec. 107. Programs on assistance for child care for certain veterans.
Sec. 108. Availability of prosthetics for women veterans from
Department of Veterans Affairs.
Sec. 109. Requirement to improve Department of Veterans Affairs women
veterans call center.
Sec. 110. Facilitation of reproduction and infertility research.
Sec. 111. Information for members of the Armed Forces regarding
availability of services provided by
Department of Veterans Affairs.
Sec. 112. Sense of Congress on access to facilities of Department of
Veterans Affairs by reservists for
counseling and treatment relating to
military sexual trauma.
TITLE II--INCREASING STAFF CULTURAL COMPETENCY
Sec. 201. Staffing of women's health primary care providers at medical
facilities of Department of Veterans
Affairs.
Sec. 202. Additional funding for primary care and emergency care
clinicians in Women Veterans Health Care
Mini-Residency Program.
Sec. 203. Establishment of women veteran training module for non-
Department of Veterans Affairs health care
providers.
Sec. 204. Study on staffing of women veteran program manager program at
medical centers of Department of Veterans
Affairs and training of staff.
Sec. 205. Study on Women Veteran Coordinator program.
Sec. 206. Staffing improvement plan for peer specialists of Department
of Veterans Affairs who are women.
TITLE III--ELIMINATING HARASSMENT AND ASSAULT
Sec. 301. Expansion of coverage by Department of Veterans Affairs of
counseling and treatment for sexual trauma.
Sec. 302. Assessment of effects of intimate partner violence on women
veterans by Advisory Committee on Women
Veterans.
Sec. 303. Anti-harassment and anti-sexual assault policy of Department
of Veterans Affairs.
Sec. 304. Pilot program on assisting veterans who experience intimate
partner violence or sexual assault.
Sec. 305. Study and task force on veterans experiencing intimate
partner violence or sexual assault.
TITLE IV--DATA COLLECTION AND REPORTING
Sec. 401. Requirement for collection and analysis of data on Department
of Veterans Affairs benefits and services
and disaggregation of such data by gender,
race, and ethnicity.
Sec. 402. Study on barriers for women veterans to receipt of health
care from Department of Veterans Affairs.
Sec. 403. Study on feasibility and advisability of offering Parenting
STAIR program at all medical centers of
Department of Veterans Affairs.
Sec. 404. Gap analysis of Department of Veterans Affairs programs that
provide assistance to women veterans who
are homeless.
TITLE V--BENEFITS MATTERS
Sec. 501. Standard of proof for service-connection of mental health
conditions related to military sexual
trauma.
Sec. 502. Choice of sex of Department of Veterans Affairs medical
examiner for assessment of claims for
compensation relating to disability
resulting from physical assault of a sexual
nature, battery of a sexual nature, or
sexual harassment.
Sec. 503. Secretary of Veterans Affairs report on implementing
recommendations of Inspector General of
Department of Veterans Affairs in certain
report on denied posttraumatic stress
disorder claims related to military sexual
trauma.
TITLE I--IMPROVING ACCESS FOR WOMEN VETERANS TO THE DEPARTMENT OF
VETERANS AFFAIRS
SEC. 101. OFFICE OF WOMEN'S HEALTH IN DEPARTMENT OF VETERANS AFFAIRS.
(a) Chief Officer of Women's Health.--Subsection (a) of section
7306 of title 38, United States Code, is amended--
(1) by redesignating paragraph (10) as paragraph (11); and
(2) by inserting after paragraph (9) the following new
paragraph (10):
``(10) The Chief Officer of Women's Health.''.
(b) Organization of Office and Annual Reports.--
(1) In general.--Subchapter I of chapter 73 of title 38,
United States Code, is amended by adding at the end of the
following new sections:
``Sec. 7310. Office of Women's Health
``(a) Establishment.--(1) The Under Secretary for Health shall
establish and operate in the Veterans Health Administration the Office
of Women's Health (in this section referred to as the `Office').
``(2) The Office shall be located at the Central Office of the
Department of Veterans Affairs.
``(3)(A) The head of the Office is the Chief Officer of Women's
Health (in this section referred to as the `Chief Officer').
``(B) The Chief Officer shall report to the Under Secretary for
Health.
``(4) The Under Secretary for Health shall provide the Office with
such staff and other support as may be necessary for the Office to
carry out effectively the functions of the Office under this section.
``(5) The Under Secretary for Health may reorganize existing
offices within the Veterans Health Administration as of the date of the
enactment of this section in order to avoid duplication with the
functions of the Office.
``(b) Functions.--The functions of the Office include the
following:
``(1) To provide a central office for monitoring and
encouraging the activities of the Veterans Health
Administration with respect to the provision, evaluation, and
improvement of health care services provided to women veterans
by the Department.
``(2) To develop and implement standards of care for the
provision of health care for women veterans by the Department.
``(3) To monitor and identify deficiencies in standards of
care for the provision of health care for women veterans by the
Department, to provide technical assistance to medical
facilities of the Department to address and remedy
deficiencies, and to perform oversight of implementation of
such standards of care.
``(4) To monitor and identify deficiencies in standards of
care for the provision of health care for women veterans
provided through the community pursuant to this title and to
provide recommendations to the appropriate office to address
and remedy any deficiencies.
``(5) To oversee distribution of resources and information
related to health programming for women veterans under this
title.
``(6) To promote the expansion and improvement of clinical,
research, and educational activities of the Veterans Health
Administration with respect to the health care of women
veterans.
``(7) To provide, as part of the annual budgeting process,
recommendations with respect to the amounts to be requested for
furnishing hospital care and medical services to women veterans
pursuant to chapter 17 of this title, including, at a minimum,
recommendations that ensure that such amounts either reflect or
exceed the proportion of veterans enrolled in the system of
patient enrollment of the Department established and operated
under section 1705(a) of this title who are women.
``(8) To provide recommendations to the Under Secretary for
Health with respect to modifying the Veterans Equitable
Resource Allocation system, or successor system, to ensure that
resource allocations under such system, or successor system,
reflect the health care needs of women veterans.
``(9) To carry out such other duties as the Under Secretary
for Health may require.
``(c) Recommendations.--(1) If the Under Secretary for Health
determines not to implement any recommendation made by the Chief
Officer with respect to the allocation of resources to address the
health care needs of women veterans, the Secretary shall notify the
appropriate congressional committees of such determination by not later
than 30 days after the date on which the Under Secretary for Health
receives the recommendation.
``(2) Each notification under paragraph (1) relating to a
determination with respect to a recommendation shall include the
following:
``(A) The reasoning of the Under Secretary for Health in
making the determination.
``(B) An alternative, if one is selected, to the
recommendation that the Under Secretary for Health will carry
out to fulfill the health care needs of women veterans.
``(d) Standards of Care.--For purposes of carrying out the
functions of the Office under this section, the standards of care for
the provision of health care for women veterans from the Department
shall include, at a minimum, the following:
``(1) A requirement for--
``(A) at least one designated women's health
primary care provider at each medical center of the
Department whose duties include, to the extent
practicable, providing training to other health care
providers of the Department with respect to the needs
of women veterans; and
``(B) at least one designated women's health
primary care provider at each community-based
outpatient clinic of the Department who may serve women
patients as a percentage of the total duties of the
provider.
``(2) Other requirements as determined by the Under
Secretary for Health.
``(e) Outreach.--The Chief Officer shall ensure that--
``(1) not less frequently than biannually, each medical
facility of the Department holds a public forum for women
veterans that occurs outside of regular business hours; and
``(2) not less frequently than quarterly, each medical
facility of the Department convenes a focus group of women
veterans that includes a discussion of harassment occurring at
such facility.
``(f) Definitions.--In this section:
``(1) The term `appropriate congressional committees' has
the meaning given that term in section 7310A(h) of this title.
``(2) The term `facility of the Department' has the meaning
given the term `facilities of the Department' in section
1701(3) of this title.
``(3) The term `Veterans Equitable Resource Allocation
system' means the resource allocation system established
pursuant to section 429 of the Departments of Veterans Affairs
and Housing and Urban Development, and Independent Agencies
Appropriations Act, 1997 (Public Law 104-204; 110 Stat. 2929).
``Sec. 7310A. Annual reports on women's health
``(a) Annual Reports.--Not later than December 1 of each year, the
Chief Officer of Women's Health shall submit to the appropriate
congressional committees a report containing the matters under
subsections (b) through (g).
``(b) Office of Women's Health.--Each report under subsection (a)
shall include a description of--
``(1) actions taken by the Office of Women's Health
established under section 7310 of this title in the preceding
fiscal year to improve the provision of health care by the
Department to women veterans;
``(2) any identified deficiencies related to the provision
of health care by the Department to women veterans and the
standards of care established in such section and the plan of
the Department to address such deficiencies;
``(3) the funding and personnel provided to the Office and
whether additional funding or personnel are needed to meet the
requirements of such section; and
``(4) other information that would be of interest to the
appropriate congressional committees with respect to oversight
of the provision of health care by the Department to women
veterans.
``(c) Access to Gender-specific Services.--(1) Each report under
subsection (a) shall include an analysis of the access of women
veterans to gender-specific services under contracts, agreements, or
other arrangements with non-Department medical providers entered into
by the Secretary for the provision of hospital care or medical services
to veterans.
``(2) The analysis under paragraph (1) shall include data and
performance measures for the availability of gender-specific services
described in such paragraph, including--
``(A) the average wait time between the preferred
appointment date of the veteran and the date on which the
appointment is completed;
``(B) the average driving time required for veterans to
attend appointments; and
``(C) reasons why appointments could not be scheduled with
non-Department medical providers.
``(d) Locations Where Women Veterans Are Using Health Care.--Each
report under subsection (a) shall include an analysis of the use by
women veterans of health care from the Department, including the
following information:
``(1) The number of women veterans who reside in each
State.
``(2) The number of women veterans in each State who are
enrolled in the system of patient enrollment of the Department
established and operated under section 1705(a) of this title.
``(3) Of the women veterans who are so enrolled, the number
who have received health care under the laws administered by
the Secretary at least one time during the one-year period
preceding the submittal of the report.
``(4) The number of women veterans who have been seen at a
medical facility of the Department during such year,
disaggregated by facility.
``(5) The number of appointments that women veterans have
had at a medical facility of the Department during such year,
disaggregated by--
``(A) facility; and
``(B) appointments for--
``(i) primary care;
``(ii) specialty care; and
``(iii) mental health care.
``(6) For each appointment type specified in paragraph
(5)(B), the number of appointments completed face-to-face and
the number completed via telehealth.
``(7) If known, an identification of the medical facility
of the Department in each Veterans Integrated Service Network
with the largest rate of increase in patient population of
women veterans as measured by the increase in unique women
veteran patient use.
``(8) If known, an identification of the medical facility
of the Department in each Veterans Integrated Service Network
with the largest rate of decrease in patient population of
women veterans as measured by the decrease in unique women
veteran patient use.
``(e) Models of Care.--(1) Each report under subsection (a) shall
include an analysis of the use by the Department of general primary
care clinics, separate but shared spaces, and women's health centers as
delivery of care models for women veterans.
``(2) The analysis under paragraph (1) shall include the following:
``(A) The number of facilities of the Department that fall
into each delivery of care model described in such paragraph,
disaggregated by Veterans Integrated Service Network and State.
``(B) A description of the criteria used by the Department
to determine which such model is most appropriate for each
facility of the Department.
``(C) An assessment of how the Department decides to make
investments to modify facilities to a different model.
``(D) A description of what, if any, plans the Department
has to modify facilities from general primary care clinics to
another model.
``(E) An assessment of whether any facilities could be
modified to a separate but shared space for a women's health
center within planned investments under the strategic capital
investment planning process of the Department.
``(F) An assessment of whether any facilities could be
modified to a separate or shared space or a women's health
center with minor modifications to existing plans under the
strategic capital investment planning process of the
Department.
``(G) An assessment of whether the Department has a goal
for how many facilities should fall into each such model.
``(f) Staffing.--Each report under subsection (a) shall include an
analysis of the staffing of the Department relating to the treatment of
women, including the following, disaggregated by Veterans Integrated
Service Network and State (except with respect to paragraph (4)):
``(1) The number of women's health centers.
``(2) The number of patient aligned care teams of the
Department relating to women's health.
``(3) The number of full- and part-time gynecologists of
the Department.
``(4) The number of designated women's health care
providers of the Department, disaggregated by facility of the
Department.
``(5) The number of health care providers of the Department
who have completed a mini-residency for women's health care
through the Women Veterans Health Care Mini-Residency Program
of the Department during the one-year period preceding the
submittal of the report and the number of mini-residency
training slots for such program that are available during the
one-year period following such date.
``(6) The number of designated women's health care
providers of the Department who have sufficient women patient
loads or case complexities to retain their competencies and
proficiencies.
``(g) Accessibility and Treatment Options.--Each report under
subsection (a) shall include an analysis of the accessibility and
treatment options for women veterans, including the following:
``(1) An assessment of wheelchair accessibility of women's
health centers of the Department, including, with respect to
each such center, an assessment of accessibility for each kind
of treatment provided at the center, including with respect to
radiology and mammography, that addresses all relevant factors,
including door sizes, hoists, and equipment.
``(2) The options for women veterans to access mental
health providers and primary care providers who are women.
``(3) The options for women veterans at medical facilities
of the Department with respect to clothing sizes, including for
gowns, drawstring pants, and pajamas.
``(h) Definitions.--In this section:
``(1) The term `appropriate congressional committees'
means--
``(A) the Committee on Appropriations and the
Committee on Veterans' Affairs of the Senate; and
``(B) the Committee on Appropriations and the
Committee on Veterans' Affairs of the House of
Representatives.
``(2) The term `gender-specific services' means
mammography, obstetric care, gynecological care, and such other
services as the Secretary determines appropriate.''.
(2) Clerical amendment.--The table of sections for such
chapter is amended by inserting after the item relating to
section 7309A the following new items:
``7310. Office of Women's Health.
``7310A. Annual reports on women's health.''.
(c) Initial Report.--The Chief Officer of Women's Health of the
Department of Veterans Affairs shall submit the initial report under
section 7310A of title 38, United States Code, as added by subsection
(b), by not later than one year after the date of the enactment of this
Act.
SEC. 102. WOMEN VETERANS RETROFIT INITIATIVE.
(a) In General.--The Secretary of Veterans Affairs shall prioritize
the retrofitting of existing medical facilities of the Department of
Veterans Affairs with fixtures, materials, and other outfitting
measures to support the provision of care to women veterans at such
facilities.
(b) Plan.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a plan to
address deficiencies in environment of care for women veterans
at medical facilities of the Department.
(2) Elements.--The plan required by paragraph (1) shall
include the following:
(A) An assessment of how the Secretary prioritizes
retrofitting existing medical facilities to support
provision of care to women veterans in comparison to
other requirements.
(B) A five-year strategic plan for retrofitting
medical facilities of the Department to support the
provision of care to women veterans as required under
subsection (a).
(c) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary $20,000,000 to carry out subsection (a)
in addition to amounts otherwise made available to the Secretary for
the purposes set forth in such subsection.
SEC. 103. ESTABLISHMENT OF ENVIRONMENT OF CARE STANDARDS AND
INSPECTIONS AT DEPARTMENT OF VETERANS AFFAIRS MEDICAL
CENTERS.
(a) In General.--The Secretary of Veterans Affairs shall establish
a policy under which the environment of care standards and inspections
at medical centers of the Department of Veterans Affairs include--
(1) an alignment of the requirements for such standards and
inspections with the women's health handbook of the Veterans
Health Administration;
(2) a requirement for the frequency of such inspections;
(3) delineation of the roles and responsibilities of staff
at each medical center who are responsible for compliance;
(4) the requirement that each medical center submit to the
Secretary and make publicly available a report on the
compliance of the medical center with the standards; and
(5) a remediation plan.
(b) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a report certifying in writing that the
policy required by subsection (a) has been finalized and disseminated
to all medical centers of the Department.
SEC. 104. PROVISION OF REINTEGRATION AND READJUSTMENT SERVICES TO
VETERANS AND FAMILY MEMBERS IN GROUP RETREAT SETTINGS.
(a) In General.--Section 1712A of title 38, United States Code, is
amended--
(1) in subsection (a)(1)(B)--
(A) in clause (ii), by redesignating subclauses (I)
and (II) as items (aa) and (bb);
(B) by redesignating clauses (i) and (ii) as
subclauses (I) and (II);
(C) in the matter preceding subclause (I), as
redesignated by subparagraph (B), by striking
``Counseling'' and inserting ``(i) Counseling''; and
(D) by adding at the end the following new clause:
``(ii)(I) Except as provided in subclause (IV), counseling
furnished to an individual under subparagraph (A) may include
reintegration and readjustment services described in subclause (II)
furnished in group retreat settings.
``(II) Reintegration and readjustment services described in this
subclause are the following:
``(aa) Information on reintegration of the individual into
family, employment, and community.
``(bb) Financial counseling.
``(cc) Occupational counseling.
``(dd) Information and counseling on stress reduction.
``(ee) Information and counseling on conflict resolution.
``(ff) Such other information and counseling as the
Secretary considers appropriate to assist the individual in
reintegration into family, employment, and community.
``(III) In furnishing reintegration and readjustment services under
subclause (I), the Secretary shall offer women the opportunity to
receive such services in group retreat settings in which the only
participants are women.
``(IV) An individual described in subparagraph (C)(v) may receive
reintegration and readjustment services under subclause (I) only if the
individual receives such services with a family member described in
subclause (I) or (II) of such subparagraph.''.
(b) Request for Services.--Subsection (a)(2) of such section is
amended--
(1) by striking ``Upon'' and inserting ``(A) Upon'';
(2) by striking ``paragraph (1)(B)'' and inserting
``paragraph (1)(B)(i)''; and
(3) by adding at the end the following new subparagraph:
``(B) Upon the request of an individual described in paragraph
(1)(C), the Secretary shall furnish the individual reintegration and
readjustment services in group retreat settings under paragraph
(1)(B)(ii) if the Secretary determines the experience will be
therapeutically appropriate.''.
SEC. 105. PROVISION OF LEGAL SERVICES FOR WOMEN VETERANS.
(a) Agreement Required.--The Secretary of Veterans Affairs shall
enter into one or more agreements with public or private entities to
provide legal services to women veterans.
(b) Focus.--The focus of an agreement entered into under subsection
(a) shall be to address the following unmet needs of women veterans as
set forth in the most recently completed Community Homelessness
Assessment, Local Education and Networking Groups for Veterans (CHALENG
for Veterans) survey:
(1) Child support.
(2) Prevention of eviction and foreclosure.
(3) Discharge upgrades.
(4) Financial guardianship.
(5) Credit counseling.
(6) Family reconciliation assistance.
SEC. 106. COMPTROLLER GENERAL SURVEYS AND REPORT ON SUPPORTIVE SERVICES
PROVIDED FOR VERY LOW-INCOME WOMEN VETERANS.
(a) Surveys.--
(1) Survey of women veterans.--The Comptroller General of
the United States shall survey women veterans who have received
or are receiving supportive services provided under section
2044 of title 38, United States Code, to determine satisfaction
with the ability of such services to meet the specific needs of
such veterans.
(2) Survey of eligible entities.--The Comptroller General
shall survey eligible entities receiving financial assistance
under such section and other partners of the Department of
Veterans Affairs, including veterans service organizations and
the National Coalition of Homeless Veterans, on the view of
such entities and partners regarding--
(A) whether the Department is meeting the needs of
women veterans through the provision of supportive
services under such section; and
(B) any additional supportive services that may be
required to meet such needs.
(b) Report.--
(1) In general.--Not later than 18 months after the date of
the enactment of this Act, the Comptroller General of the
United States 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 efforts of the
Department of Veterans Affairs to provide supportive services
to women veterans under section 2044 of title 38, United
States.
(2) Elements.--The report required by paragraph (1) shall
include the following:
(A) A review of how the Department determines which
categories of supportive services would be beneficial
to women veterans who receive services under such
section.
(B) A description of the challenges women veterans
who have children face in accessing supportive services
under such section, including with respect to
accessing--
(i) homeless shelters with their children;
(ii) homeless shelters that have
restrictions on male children; and
(iii) affordable child care.
(C) A description of how the Department identifies
eligible entities under such section that can provide
supportive services to meet the needs of women
veterans, including eligible entities with experience
in--
(i) intimate partner violence;
(ii) legal matters pertaining especially to
women veterans, including temporary restraining
orders and child care orders;
(iii) supportive services for children; and
(iv) the evaluation of which categories of
services would be beneficial to women veterans
who receive such services under such section.
(D) A description of how much the Department
spends, from funds appropriated to carry out such
section and funds provided under the Coronavirus Aid,
Relief, and Economic Security Act (Public Law 116-136),
on supportive services specifically for women veterans,
and in particular, on the services described in
subparagraph (A).
(E) The results of the surveys conducted under
subsection (a).
(F) A review of the resources and programming
offered to woman veterans under such section.
(G) An assessment of such other areas as the
Comptroller General considers appropriate.
SEC. 107. PROGRAMS 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 of title 38,
United States Code, is amended by adding at the end the
following new section:
``Sec. 1709C. 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)(2).
``(b) Limitation on Period of Payments.--Assistance may be provided
to a qualified veteran under this section for receipt of child care
only during the period that the qualified veteran--
``(1) receives the types of health care services described
in subsection (c)(2) at a facility of the Department; and
``(2) requires travel to and return 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--
``(1) is the primary caretaker of a child or children; and
``(2)(A) receives 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) is 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.--Not later than five years after the date of the
enactment of the Deborah Sampson Act, the Secretary shall carry out the
program at each medical center of the Department.
``(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 a
licensed child care center (either directly or through a
voucher program) that 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 agencies.
``(E) Such other forms of assistance as the Secretary
considers appropriate.
``(2) In providing child care assistance under this section, the
child care needs of the local area shall be considered and the head of
each medical center may select the type of care that is most
appropriate or feasible for such medical center.
``(3) 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) 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 striking
``September 30, 2020'' and inserting ``the date of the
enactment of the Deborah Sampson Act''.
(3) 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 1709B the following new
item:
``1709C. Assistance for child care for certain veterans receiving
health care,''.
(b) Pilot Program on Assistance for Child Care for Certain Veterans
Receiving Readjustment Counseling and Related Mental Health Services.--
(1) In general.--The Secretary of Veterans Affairs shall
carry out a pilot program to assess the feasibility and
advisability of providing, subject to paragraph (2), assistance
to qualified veterans described in paragraph (3) to obtain
child care so that such veterans can receive readjustment
counseling and related mental health services.
(2) Limitation on period of payments.--Assistance may be
provided to a qualified veteran under the pilot program for
receipt of child care only during the period that the qualified
veteran receives readjustment counseling and related health
care services at a Vet Center.
(3) Qualified veterans.--For purposes of this subsection, a
qualified veteran is a veteran who--
(A) is the primary caretaker of a child or
children; and
(B)(i) receives from the Department regular
readjustment counseling and related mental health
services; or
(ii) is in need of regular 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.
(4) Locations.--The Secretary shall carry out the pilot
program in not fewer than three Readjustment Counseling Service
Regions selected by the Secretary for purposes of the pilot
program.
(5) Forms of child care assistance.--
(A) In general.--Child care assistance under the
pilot program may include the following:
(i) Stipends for the payment of child care
offered by a licensed child care center (either
directly or through a voucher program) that
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).
(ii) Payments to private child care
agencies.
(iii) Collaboration with facilities or
programs of other Federal agencies.
(iv) Such other forms of assistance as the
Secretary considers appropriate.
(B) Local area.--In providing child care assistance
under the pilot program, the child care needs of the
local area shall be considered and the head of each Vet
Center may select the type of care that is most
appropriate or feasible for such Vet Center.
(C) Use of stipend.--In the case that child care
assistance under the pilot program is provided as a
stipend under subparagraph (A)(i), such stipend shall
cover the full cost of such child care.
(6) Duration.--The pilot program shall be carried out
during the two-year period beginning on the date of the
commencement of the pilot program.
(7) Report.--
(A) In general.--Not later than 180 days after the
completion of the pilot program, the Secretary shall
submit to Congress a report on the pilot program.
(B) Elements.--The report required by subparagraph
(A) shall include the findings and conclusions of the
Secretary regarding the pilot program, and shall
include such recommendations for the continuation or
expansion of the pilot program as the Secretary
considers appropriate.
(8) Vet center defined.--In this subsection, the term ``Vet
Center'' has the meaning given that term in section 1712A(h) of
title 38, United States Code.
SEC. 108. AVAILABILITY OF PROSTHETICS FOR WOMEN VETERANS FROM
DEPARTMENT OF VETERANS AFFAIRS.
(a) Access at Each Medical Facility.--Section 1714(a) of title 38,
United States Code, is amended--
(1) by striking ``(a) Any veteran'' and inserting ``(a)(1)
Any veteran''; and
(2) by adding at the end the following new paragraph:
``(2) In furnishing prosthetic appliances under paragraph (1), the
Secretary shall ensure women veterans are able to access clinically
appropriate prosthetic appliances through each medical facility of the
Department.''.
(b) Report.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, 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 availability from the
Department of Veterans Affairs of prosthetics made for women
veterans, including an assessment of the availability of such
prosthetics at medical facilities of the Department.
(2) Elements.--The report required by paragraph (1) shall
include--
(A) a list of all devices classified by the
Department as prosthetic devices, including a breakdown
of whether a device is considered gender-neutral or
gender-specific;
(B) for gender-neutral devices, a breakdown of
sizing;
(C) the average time it takes for a woman veteran
to receive a prosthetic device after it is prescribed,
disaggregated by Veterans Integrated Service Network
and medical center of the Department;
(D) the total number of women veterans utilizing
the Department for prosthetic services, disaggregated
by facility of the Department;
(E) an assessment of efforts by the Department on
research, development, and employment of additive
manufacture technology (commonly referred to as 3D
printing) to provide prosthetic items for women
veterans;
(F) the results of a survey with a representative
sample of not fewer than 50,000 veterans (of which
women shall be overrepresented) in an amputee care
program on satisfaction with prosthetics furnished or
procured by the Department that replace appendages or
their function; and
(G) such other information as the Secretary
considers appropriate.
SEC. 109. REQUIREMENT TO IMPROVE DEPARTMENT OF VETERANS AFFAIRS WOMEN
VETERANS CALL CENTER.
The Secretary of Veterans Affairs shall enhance the capabilities of
the women veterans call center of the Department of Veterans Affairs--
(1) to respond to requests by women veterans for assistance
with accessing health care and benefits furnished under the
laws administered by the Secretary; and
(2) to refer such veterans to resources provided by the
Federal Government and the community to obtain assistance with
services not furnished by the Department.
SEC. 110. FACILITATION OF REPRODUCTION AND INFERTILITY RESEARCH.
(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:
``Sec. 7330D. 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 ability of the
veteran 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 of such title is amended by inserting after the item
relating to section 7330C the following new item:
``7330D. 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 7330D of title 38, United States Code, as added
by subsection (a).
SEC. 111. INFORMATION FOR MEMBERS OF THE ARMED FORCES REGARDING
AVAILABILITY OF SERVICES PROVIDED BY DEPARTMENT OF
VETERANS AFFAIRS.
(a) In General.--The Secretary of Defense shall inform members of
the Armed Forces, using mechanisms available to the Secretary, of the
eligibility of such members for services provided by the Department of
Veterans Affairs.
(b) Information From Sexual Assault Response Coordinators.--The
Secretary of Defense shall ensure that Sexual Assault Response
Coordinators of the Department of Defense advise members of the Armed
Forces who have experienced physical assault of a sexual nature,
battery of a sexual nature, or sexual harassment regarding the
eligibility of such members for services provided by the Department of
Veterans Affairs.
SEC. 112. SENSE OF CONGRESS ON ACCESS TO FACILITIES OF DEPARTMENT OF
VETERANS AFFAIRS BY RESERVISTS FOR COUNSELING AND
TREATMENT RELATING TO MILITARY SEXUAL TRAUMA.
(a) In General.--It is the sense of Congress that members of the
reserve components of the Armed Forces, including members of the
National Guard, should be able to access all health care facilities of
the Department of Veterans Affairs, not just Vet Centers, to receive
counseling and treatment relating to military sexual trauma.
(b) Definitions.--In this section:
(1) Military sexual trauma.--The term ``military sexual
trauma'' means a condition described in section 1720D(a)(1) of
title 38, United States Code.
(2) Vet center.--The term ``Vet Center'' has the meaning
given that term in section 1712A(h) of such title.
TITLE II--INCREASING STAFF CULTURAL COMPETENCY
SEC. 201. STAFFING OF WOMEN'S HEALTH PRIMARY CARE PROVIDERS AT MEDICAL
FACILITIES OF DEPARTMENT OF VETERANS AFFAIRS.
The Secretary of Veterans Affairs shall ensure that each medical
facility of the Department of Veterans Affairs has not fewer than one
full-time or part-time women's health primary care provider whose
duties include, to the extent possible, providing training to other
health care providers of the Department on the needs of women veterans.
SEC. 202. ADDITIONAL FUNDING FOR PRIMARY CARE AND EMERGENCY CARE
CLINICIANS IN WOMEN VETERANS HEALTH CARE MINI-RESIDENCY
PROGRAM.
(a) In General.--There is authorized to be appropriated to the
Secretary of Veterans Affairs $1,000,000 for each fiscal year for the
Women Veterans Health Care Mini-Residency Program of the Department of
Veterans Affairs to provide opportunities for participation in such
program for primary care and emergency care clinicians.
(b) Treatment of Amounts.--The amounts authorized to be
appropriated under subsection (a) shall be in addition to amounts
otherwise made available to the Secretary for the purposes set forth in
such subsection.
SEC. 203. ESTABLISHMENT OF WOMEN VETERAN TRAINING MODULE FOR NON-
DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE PROVIDERS.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall
establish and make available to community providers a training module
that is specific to women veterans.
(b) Training Materials Provided.--Under the training module
established and made available to community providers under subsection
(a), the Secretary shall provide to community providers the same
training materials relating to treatment of women veterans that is
provided to health care providers of the Department of Veterans Affairs
to ensure that all health care providers treating women veterans have
access to the same materials to support competency throughout the
community.
(c) Administration of Training Module.--The Secretary shall
administer the training module established under subsection (a) to
community providers through an internet website of the Department.
(d) Annual Report.--Not later than one year after the establishment
of the training module under subsection (a), and annually thereafter,
the Secretary shall submit to Congress a report on--
(1) the utilization by community providers of the training
module; and
(2) the effectiveness of the training module.
(e) Definitions.--In this section:
(1) Community provider.--The term ``community provider''
means a non-Department of Veterans Affairs health care provider
who provides preauthorized health care to veterans under the
laws administered by the Secretary of Veterans Affairs.
(2) Preauthorized health care.--The term ``preauthorized
health care'' means health care provided to a veteran that is
authorized by the Secretary before being provided.
SEC. 204. STUDY ON STAFFING OF WOMEN VETERAN PROGRAM MANAGER PROGRAM AT
MEDICAL CENTERS OF DEPARTMENT OF VETERANS AFFAIRS AND
TRAINING OF STAFF.
(a) Study.--The Secretary of Veterans Affairs shall conduct a study
on the use of the Women Veteran Program Manager program of the
Department of Veterans Affairs to determine--
(1) if the program is appropriately staffed at each medical
center of the Department;
(2) whether each medical center of the Department is
staffed with a Women Veteran Program Manager; and
(3) whether it would be feasible and advisable to have a
Women Veteran Program Ombudsman at each medical center of the
Department.
(b) Report.--Not later than 270 days after the date of the
enactment of this Act, the Secretary 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 study conducted under
subsection (a).
(c) Training.--The Secretary shall ensure that all Women Veteran
Program Managers and Women Veteran Program Ombudsmen receive the proper
training to carry out their duties.
SEC. 205. STUDY ON WOMEN VETERAN COORDINATOR PROGRAM.
(a) Study and Report Required.--Not later than 180 days after the
date of the enactment of this Act, the Secretary of Veterans Affairs
shall--
(1) complete a study on the Women Veteran Coordinator
program of the Veterans Benefits Administration of the
Department of Veterans Affairs; and
(2) 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 findings of the Secretary with
respect to the study completed under paragraph (1).
(b) Elements.--The study required by subsection (a)(1) shall
identify the following:
(1) If the program described in such subsection is
appropriately staffed at each regional benefits office of the
Department.
(2) Whether each regional benefits office of the Department
is staffed with a Women Veteran Coordinator.
(3) The position description of the Women Veteran
Coordinator.
(4) Whether an individual serving in the Women Veteran
Coordinator position concurrently serves in any other position,
and if so, the allocation of time the individual spends in each
such position.
(5) A description of the metrics the Secretary uses to
determine the job performance and effectiveness of the Women
Veteran Coordinator.
SEC. 206. STAFFING IMPROVEMENT PLAN FOR PEER SPECIALISTS OF DEPARTMENT
OF VETERANS AFFAIRS WHO ARE WOMEN.
(a) Assessment of Capacity.--
(1) In general.--Not later than 90 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs,
in consultation with the Inspector General of the Department of
Veterans Affairs, shall commence an assessment of the capacity
of peer specialists of the Department of Veterans Affairs who
are women.
(2) Elements.--The assessment required by paragraph (1)
shall include an assessment of the following:
(A) The geographical distribution of peer
specialists of the Department who are women.
(B) The geographical distribution of women
veterans.
(C) The number and proportion of women peer
specialists who specialize in peer counseling on mental
health or suicide prevention.
(D) The number and proportion of women peer
specialists who specialize in peer counseling on non-
mental health related matters.
(b) Report.--Not later than one year after the assessment required
by subsection (a) has commenced, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a report detailing
the findings of the assessment.
(c) Staffing Improvement Plan.--
(1) In general.--Not later than 180 days after submitting
the report under subsection (b), the Secretary, in consultation
with the Inspector General, shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives a plan, based on the
results of the assessment required by subsection (a), to hire
additional qualified peer specialists who are women, with
special consideration for areas that lack peer specialists who
are women.
(2) Elements.--The peer specialist positions included in
the plan required by paragraph (1)--
(A) shall be non-volunteer, paid positions; and
(B) may be part-time positions.
TITLE III--ELIMINATING HARASSMENT AND ASSAULT
SEC. 301. EXPANSION OF COVERAGE BY DEPARTMENT OF VETERANS AFFAIRS OF
COUNSELING AND TREATMENT FOR SEXUAL TRAUMA.
(a) Expansion of Eligibility for Counseling and Treatment.--Section
1720D of title 38, United States Code, is amended--
(1) in subsection (a)--
(A) in paragraph (1), by striking ``active duty,
active duty for training, or inactive duty training''
and inserting ``duty, regardless of duty status or line
of duty determination (as that term is used in section
12323 of title 10)''; and
(B) in paragraph (2)(A), by striking ``active duty,
active duty for training, or inactive duty training''
and inserting ``duty, regardless of duty status or line
of duty determination (as that term is used in section
12323 of title 10)'';
(2) by striking ``veteran'' each place it appears and
inserting ``former member of the Armed Forces'';
(3) by striking ``veterans'' each place it appears and
inserting ``former members of the Armed Forces''; and
(4) by adding at the end the following new subsection:
``(g) In this section, the term `former member of the Armed Forces'
includes the following:
``(1) A veteran.
``(2) An individual described in section 1720I(b) of this
title.''.
(b) Inclusion of Treatment for Physical Health Conditions.--Such
section is further amended--
(1) in subsection (a)--
(A) in paragraph (1)--
(i) by inserting ``, to include care for
physical health conditions, as appropriate,''
after ``counseling and appropriate care and
services'';
(ii) by striking ``overcome psychological
trauma'' and inserting ``treat a condition'';
and
(iii) by striking ``mental health
professional'' and inserting ``health care
professional''; and
(B) in paragraph (2)(A), by striking ``overcome
psychological trauma'' and inserting ``treat a
condition''; and
(2) in subsection (d)--
(A) in paragraph (1), by inserting ``and other
health care professionals'' after ``mental health
professionals''; and
(B) in paragraph (2)(A), by inserting ``and other
health care professionals'' after ``mental health
professionals''.
SEC. 302. ASSESSMENT OF EFFECTS OF INTIMATE PARTNER VIOLENCE ON WOMEN
VETERANS BY ADVISORY COMMITTEE ON WOMEN VETERANS.
Section 542(c)(1) of title 38, United States Code, is amended--
(1) in subparagraph (B), by striking ``and'' at the end;
(2) by redesignating subparagraph (C) as subparagraph (D);
and
(3) by inserting after subparagraph (B) the following new
subparagraph (C):
``(C) an assessment of the effects of intimate partner
violence on women veterans; and''.
SEC. 303. ANTI-HARASSMENT AND ANTI-SEXUAL ASSAULT POLICY OF DEPARTMENT
OF VETERANS AFFAIRS.
(a) In General.--Subchapter II of chapter 5 of title 38, United
States Code, is amended by adding at the end the following new section:
``Sec. 533. Anti-harassment and anti-sexual assault policy
``(a) Establishment.--(1) The Secretary, acting through the Office
of Assault and Prevention of the Veterans Health Administration, shall
establish a comprehensive policy to end harassment and sexual assault,
including sexual harassment and gender-based harassment, throughout the
Department.
``(2) The policy required by paragraph (1) shall include the
following:
``(A) A process for employees and contractors of the
Department to respond to reported incidents of harassment and
sexual assault committed by any non-Department individual
within a facility of the Department, including with respect to
accountability or disciplinary measures.
``(B) A process for employees and contractors of the
Department to respond to reported incidents of harassment and
sexual assault of any non-Department individual within a
facility of the Department.
``(C) A process for any non-Department individual to report
harassment and sexual assault described in subparagraph (A),
including an option for confidential reporting, and for the
Secretary to respond to and address such reports.
``(D) Clear mechanisms for non-Department individuals to
readily identify to whom and how to report incidents of
harassment and sexual assault committed by another non-
Department individual.
``(E) Clear mechanisms for employees and contractors of the
Department to readily identify to whom and how to report
incidents of harassment and sexual assault and how to refer
non-Department individuals with respect to reporting an
incident of harassment or sexual assault.
``(F) A process for, and mandatory reporting requirement
applicable to, any employee or contractor of the Department who
witnesses harassment or sexual assault described in
subparagraph (A) or (B) within a facility of the Department,
regardless of whether the individual affected by such
harassment or sexual assault wants to report such harassment or
sexual assault.
``(G) The actions possible, including disciplinary actions,
for employees or contractors of the Department who fail to
report incidents of harassment and sexual assault described in
subparagraph (A) or (B) that the employees or contractors
witness.
``(H) On an annual or more frequent basis, mandatory
training for employees and contractors of the Department
regarding how to report and address harassment and sexual
assault described in subparagraphs (A) and (B), including
bystander intervention training.
``(I) On an annual or more frequent basis, the distribution
of the policy under this subsection and anti-harassment and
anti-sexual assault educational materials by mail or email to
each individual receiving a benefit under a law administered by
the Secretary.
``(J) The prominent display of anti-harassment and anti-
sexual assault messages in each facility of the Department,
including how non-Department individuals may report harassment
and sexual assault described in subparagraphs (A) and (B) at
such facility and the points of contact under subsection (b).
``(K) The posting on internet websites of the Department,
including the main internet website regarding benefits of the
Department and the main internet website regarding health care
of the Department, of anti-harassment and anti-sexual assault
banners specifically addressing harassment and sexual assault
described in subparagraphs (A) and (B).
``(b) Points of Contact.--The Secretary shall designate, as a point
of contact to receive reports of harassment and sexual assault
described in subparagraphs (A) and (B) of subsection (a)(2)--
``(1) at least one individual, in addition to law
enforcement, at each facility of the Department (including Vet
Centers under section 1712A of this title), with regard to that
facility;
``(2) at least one individual employed in each Veterans
Integrated Service Network, with regard to facilities in that
Veterans Integrated Service Network;
``(3) at least one individual employed in each regional
benefits office;
``(4) at least one individual employed at each location of
the National Cemetery Administration; and
``(5) at least one individual employed at the Central
Office of the Department to track reports of such harassment
and sexual assault across the Department, disaggregated by
facility.
``(c) Accountability.--(1) The Secretary shall establish a policy
to ensure that each facility of the Department and each director of a
Veterans Integrated Service Network is responsible for addressing
harassment and sexual assault at the facility and the Network.
``(2) The policy required by paragraph (1) shall include--
``(A) a remediation plan for facilities that experience
five or more incidents of sexual harassment, sexual assault, or
combination thereof, during any single fiscal year; and
``(B) taking appropriate actions under chapter 7 or
subchapter V of chapter 74 of this title.
``(d) Data.--The Secretary shall ensure that the in-take process
for veterans at medical facilities of the Department includes a survey
to collect the following information:
``(1) Whether the veteran feels safe at the facility and
whether any events occurred at the facility that affect such
feeling.
``(2) Whether the veteran wants to be contacted later by
the Department with respect to such safety issues.
``(e) Working Group.--(1) The Secretary shall establish a working
group to assist the Secretary in implementing policies to carry out
this section.
``(2) The working group established under paragraph (1) shall
consist of representatives from--
``(A) veterans service organizations;
``(B) State, local, and Tribal veterans agencies; and
``(C) other persons the Secretary determines appropriate.
``(3) The working group established under paragraph (1) shall
develop, and the Secretary shall carry out--
``(A) an action plan for addressing changes at the local
level to reduce instances of harassment and sexual assault;
``(B) standardized media for veterans service organizations
and other persons to use in print and on the internet with
respect to reducing harassment and sexual assault; and
``(C) bystander intervention training for veterans.
``(4) The working group established under paragraph (1) shall not
be subject to the requirements of the Federal Advisory Committee Act (5
U.S.C. App.).
``(f) Annual Reports.--(1) The Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives an annual report on
harassment and sexual assault described in subparagraphs (A) and (B) of
subsection (a)(2) in facilities of the Department.
``(2) Each report submitted under paragraph (1) shall include the
following:
``(A) Results of harassment and sexual assault programming,
including the End Harassment program.
``(B) Results of studies from the Women's Health Practice-
Based Research Network of the Department relating to harassment
and sexual assault.
``(C) Data collected on incidents of sexual harassment and
sexual assault.
``(D) A description of any actions taken by the Secretary
during the year preceding the date of the report to stop
harassment and sexual assault at facilities of the Department.
``(E) An assessment of the implementation of the training
required in subsection (a)(2)(H).
``(F) A list of resources the Secretary determines
necessary to prevent harassment and sexual assault at
facilities of the Department.
``(g) Definitions.--In this section:
``(1) The term `non-Department individual' means any
individual present at a facility of the Department who is not
an employee or contractor of the Department.
``(2) The term `sexual harassment' means unsolicited verbal
or physical contact of a sexual nature which is threatening in
character.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by adding after the item relating to section
532 the following new item:
``533. Anti-harassment and anti-sexual assault policy.''.
(c) Definition of Sexual Harassment.--Section 1720D(f) of such
title is amended by striking ``repeated,''.
(d) Deadline.--The Secretary shall commence carrying out section
533 of such title, as added by subsection (a), not later than 180 days
after the date of enactment of this Act.
SEC. 304. PILOT PROGRAM ON ASSISTING VETERANS WHO EXPERIENCE INTIMATE
PARTNER VIOLENCE OR SEXUAL ASSAULT.
(a) Pilot Program Required.--The Secretary of Veterans Affairs
shall carry out a pilot program to assess the feasibility and
advisability of assisting former members of the Armed Forces who have
experienced or are experiencing intimate partner violence or sexual
assault in accessing benefits from the Department of Veterans Affairs,
including coordinating access to medical treatment centers, housing
assistance, and other benefits from the Department.
(b) Duration.--The Secretary shall carry out the pilot program
under subsection (a) during the two-year period beginning on the date
of the commencement of the pilot program.
(c) Collaboration.--The Secretary shall carry out the pilot program
under subsection (a) in collaboration with--
(1) intimate partner violence shelters and programs;
(2) rape crisis centers;
(3) State intimate partner violence and sexual assault
coalitions; and
(4) such other health care or other service providers that
serve intimate partner violence or sexual assault victims as
determined by the Secretary, particularly those providing
emergency services or housing assistance.
(d) Authorized Activities.--In carrying out the pilot program under
subsection (a), the Secretary may conduct the following activities:
(1) Training for community-based intimate partner violence
or sexual assault service providers on--
(A) identifying former members of the Armed Forces
who have been victims of, or are currently
experiencing, intimate partner violence or sexual
assault;
(B) coordinating with local service providers of
the Department; and
(C) connecting former members of the Armed Forces
with appropriate housing, mental health, medical, and
other financial assistance or benefits from the
Department.
(2) Assistance to service providers to ensure access of
veterans to intimate partner violence and sexual assault
emergency services, particularly in underserved areas,
including services for Native American veterans (as defined in
section 3765 of title 38, United States Code).
(3) Such other outreach and assistance as the Secretary
determines necessary for the provision of assistance under
subsection (a).
(e) Intimate Partner Violence and Sexual Assault Outreach
Coordinators.--
(1) In general.--In order to effectively assist veterans
who have experienced intimate partner violence or sexual
assault, the Secretary may establish local coordinators to
provide outreach under the pilot program required by subsection
(a).
(2) Local coordinator knowledge.--The Secretary shall
ensure that each coordinator established under paragraph (1) is
knowledgeable about--
(A) the dynamics of intimate partner violence and
sexual assault, including safety concerns, legal
protections, and the need for the provision of
confidential services;
(B) the eligibility of veterans for services and
benefits from the Department that are relevant to
recovery from intimate partner violence and sexual
assault, particularly emergency housing assistance,
mental health care, other health care, and disability
benefits; and
(C) local community resources addressing intimate
partner violence and sexual assault.
(3) Local coordinator assistance.--Each coordinator
established under paragraph (1) shall assist intimate partner
violence shelters and rape crisis centers in providing services
to veterans.
(f) Report.--
(1) In general.--Not later than 180 days after the
completion of the pilot program under subsection (a), the
Secretary shall submit to Congress a report on the pilot
program.
(2) Contents.--The report required by paragraph (1) shall
include the following:
(A) The findings and conclusions of the Secretary
with respect to the pilot program.
(B) Such recommendations for continuing or
expanding the pilot program as the Secretary considers
appropriate.
(g) Definitions.--In this section:
(1) Intimate partner.--
(A) In general.--The term ``intimate partner''
means a person with whom one has a close personal
relationship that may be characterized by the partners'
emotional connectedness, regular contact, ongoing
physical contact and sexual behavior, identity as a
couple, and familiarity and knowledge about each
other's lives.
(B) Close personal relationships.--In this
paragraph, the term ``close personal relationships''
includes the following:
(i) A relationship between married spouses.
(ii) A relationship between common-law
spouses.
(iii) A relationship between civil union
spouses.
(iv) A relationship between domestic
partners.
(v) A relationship between dating partners.
(vi) A relationship between ongoing sexual
partners.
(2) Intimate partner violence.--The term ``intimate partner
violence'' includes physical violence, sexual violence,
stalking, and psychological aggression, including coercive
tactics by a current or former intimate partner.
SEC. 305. STUDY AND TASK FORCE ON VETERANS EXPERIENCING INTIMATE
PARTNER VIOLENCE OR SEXUAL ASSAULT.
(a) National Baseline Study.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs,
in consultation with the Attorney General, shall conduct a
national baseline study to examine the scope of the problem of
intimate partner violence and sexual assault among veterans and
spouses and intimate partners of veterans.
(2) Matters included.--The study under paragraph (1)
shall--
(A) include a literature review of all relevant
research on intimate partner violence and sexual
assault among veterans and spouses and intimate
partners of veterans;
(B) examine the prevalence of the experience of
intimate partner violence among--
(i) women veterans;
(ii) veterans who are minority group
members (as defined in section 544 of title 38,
United States Code, and including other
minority populations as the Secretary
determines appropriate);
(iii) urban and rural veterans;
(iv) veterans who are enrolled in a program
under section 1720G of title 38, United States
Code;
(v) veterans who are in intimate
relationships with other veterans; and
(vi) veterans who are described in more
than one clause of this subparagraph;
(C) examine the prevalence of the perpetration of
intimate partner violence by veterans; and
(D) include recommendations to address the findings
of the study.
(3) Report.--Not later than 30 days after the date on which
the Secretary completes the study under paragraph (1), the
Secretary 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 such study.
(b) Task Force.--
(1) In general.--Not later than 90 days after the date on
which the Secretary completes the study under subsection (a),
the Secretary, in consultation with the Attorney General and
the Secretary of Health and Human Services, shall establish a
national task force (in this section referred to as the ``Task
Force'') to develop a comprehensive national program, including
by integrating facilities, services, and benefits of the
Department of Veterans Affairs into existing networks of
community-based intimate partner violence and sexual assault
services, to address intimate partner violence and sexual
assault among veterans.
(2) Leadership.--The Secretary of Veterans Affairs shall
lead the Task Force in collaboration with the Attorney General
and the Secretary of Health and Human Services.
(c) Consultation With Stakeholders.--In carrying out this section,
the Task Force shall consult with--
(1) representatives from veteran service organizations and
military service organizations;
(2) representatives from not fewer than three national
organizations or State coalitions with demonstrated expertise
in intimate partner violence prevention, response, or advocacy;
and
(3) representatives from not fewer than three national
organizations or State coalitions, particularly those
representing underserved and ethnic minority communities, with
demonstrated expertise in sexual assault prevention, response,
or advocacy.
(d) Duties.--The duties of the Task Force shall include the
following:
(1) To review existing services and policies of the
Department and develop a comprehensive national program to be
carried out by the Secretary of Veterans Affairs, in
collaboration with the heads of relevant Federal agencies, to
address intimate partner violence and sexual assault
prevention, response, and treatment.
(2) To review the feasibility and advisability of
establishing an expedited process to secure emergency,
temporary benefits, including housing or other benefits, for
veterans who are experiencing intimate partner violence or
sexual assault.
(3) To review and make recommendations regarding the
feasibility and advisability of establishing dedicated,
temporary housing assistance for veterans experiencing intimate
partner violence or sexual assault.
(4) To identify any requirements regarding intimate partner
violence assistance or sexual assault response and services
that are not being met by the Department and make
recommendations on how the Department can meet such
requirements.
(5) To review and make recommendations regarding the
feasibility and advisability of providing direct services or
contracting for community-based services for veterans in
response to a sexual assault, including through the use of
sexual assault nurse examiners, particularly in underserved or
remote areas, including services for Native American veterans.
(6) To review the availability of counseling services
provided by the Department and through peer network support,
and to provide recommendations for the enhancement of such
services, to address--
(A) the perpetration of intimate partner violence
and sexual assault; and
(B) the recovery of veterans, particularly women
veterans, from intimate partner violence and sexual
assault.
(7) To review and make recommendations to expand services
available for veterans at risk of perpetrating intimate partner
violence.
(e) Report.--Not later than one year after the date of the
enactment of this Act, and not less frequently than annually thereafter
by October 1 of each year, the Task Force shall submit to the Secretary
of Veterans Affairs and Congress a report on the activities of the Task
Force, including any recommendations for legislative or administrative
action.
(f) Nonapplicability of FACA.--The Task Force shall not be subject
to the requirements of the Federal Advisory Committee Act (5 U.S.C.
App.).
(g) Definitions.--In this section:
(1) Native american veteran.--The term ``Native American
veteran'' has the meaning given that term in section 3765 of
title 38, United States Code.
(2) State.--The term ``State'' has the meaning given that
term in section 101 of title 38, United States Code.
TITLE IV--DATA COLLECTION AND REPORTING
SEC. 401. REQUIREMENT FOR COLLECTION AND ANALYSIS OF DATA ON DEPARTMENT
OF VETERANS AFFAIRS BENEFITS AND SERVICES AND
DISAGGREGATION OF SUCH DATA BY GENDER, RACE, AND
ETHNICITY.
The Secretary of Veterans Affairs shall--
(1) collect and analyze data on each program of the
Department of Veterans Affairs that provides a service or
benefit to a veteran, including the program carried out under
section 1144 of title 10, United States Code;
(2) disaggregate such data by gender, race, and ethnicity,
when the data lends itself to such disaggregation; and
(3) publish the data collected and analyzed under paragraph
(1), except for such cases in which the Secretary determines
that some portions of the data would undermine the anonymity of
a veteran.
SEC. 402. STUDY ON BARRIERS FOR WOMEN VETERANS TO RECEIPT OF HEALTH
CARE FROM DEPARTMENT OF VETERANS AFFAIRS.
(a) Study Required.--The Secretary of Veterans Affairs shall
conduct a comprehensive study of the barriers to the provision of
comprehensive health care by the Department of Veterans Affairs
encountered by women who are veterans.
(b) Survey.--In conducting the study required by subsection (a),
the Secretary shall--
(1) survey women veterans who seek or receive hospital care
or medical services provided by the Department as well as women
veterans who do not seek or receive such care or services;
(2) administer the survey to a representative sample of
women veterans from each Veterans Integrated Service Network;
and
(3) ensure that the sample of women veterans surveyed is of
sufficient size for the study results to be statistically
significant and is a larger sample than that of the study
specified in subsection (c)(1).
(c) Use of Previous Studies.--In conducting the study required by
subsection (a), the Secretary shall build on the work of the studies of
the Department titled--
(1) ``National Survey of Women Veterans in Fiscal Year
2007-2008''; and
(2) ``Study of Barriers for Women Veterans to VA Health
Care 2015''.
(d) Elements of Study.--In conducting the study required by
subsection (a), the Secretary shall conduct research on the effects of
the following on the women veterans surveyed in the study:
(1) The barriers associated with seeking mental health care
services, including with respect to provider availability,
telehealth access, and family, work, and school obligations.
(2) The effect of driving distance or availability of other
forms of transportation to the nearest medical facility on
access to care.
(3) The effect of access to care from non-Department
providers.
(4) The availability of child care.
(5) The satisfaction of such veterans with the provision by
the Department of integrated primary care, women's health
clinics, or both, including perceptions of quality of care,
safety, and comfort.
(6) The understanding and perceived accessibility among
such veterans of eligibility requirements for, and the scope of
services available under, hospital care and medical services.
(7) The perception of such veterans of personal safety and
comfort in inpatient, outpatient, and behavioral health
facilities.
(8) The gender sensitivity of health care providers and
staff to issues that particularly affect women.
(9) The effectiveness of outreach for health care services
available to women veterans.
(10) The location and operating hours of health care
facilities that provide services to women veterans.
(11) The perception of such veterans of the motto of the
Department.
(12) Such other significant barriers as the Secretary
considers appropriate.
(e) Discharge by Contract.--The Secretary shall enter into a
contract with a qualified independent entity or organization to carry
out the study and research required under this section.
(f) Mandatory Review of Data by Certain Department Divisions.--
(1) Review.--
(A) In general.--The Secretary shall ensure that
the head of each division of the Department of Veterans
Affairs specified in paragraph (2) reviews the results
of the study conducted under this section.
(B) Submittal of findings.--The head of each
division specified in paragraph (2) shall submit
findings with respect to the study under this section
to the Under Secretary of the Department with
responsibilities relating to health care services for
women veterans.
(2) Specified divisions.--The divisions of the Department
of Veterans Affairs specified in this paragraph are the
following:
(A) The Office of the Under Secretary for Health.
(B) The Office of Women's Health established under
section 7310 of title 38, United States Code.
(C) The Center for Women Veterans under section 318
of such title.
(D) The Advisory Committee on Women Veterans
established under section 542 of such title.
(g) Report.--
(1) In general.--Not later than 30 months after the date of
the enactment of this Act, the Secretary shall submit to
Congress a report on the study required under this section.
(2) Elements.--The report under paragraph (1) shall
include--
(A) the findings of the head of each division of
the Department specified under subsection (f)(2); and
(B) recommendations for such administrative and
legislative action as the Secretary considers
appropriate.
SEC. 403. STUDY ON FEASIBILITY AND ADVISABILITY OF OFFERING PARENTING
STAIR PROGRAM AT ALL MEDICAL CENTERS OF DEPARTMENT OF
VETERANS AFFAIRS.
(a) In General.--The Secretary of Veterans Affairs shall conduct a
study on the feasibility and advisability of expanding the Parenting
STAIR program to all medical centers of the Department of Veterans
Affairs and including such program as part of care for military sexual
trauma for affected members and former members of the Armed Forces.
(b) Elements.--In conducting the study under subsection (a), the
Secretary shall assess--
(1) staffing needed to offer the Parenting STAIR program at
all medical centers of the Department;
(2) any additional infrastructure or resources (such as
child care during the program) needed for the expansion of the
program; and
(3) such other factors relevant to the expansion of the
program as the Secretary considers appropriate.
(c) Reports to Congress.--
(1) Interim report.--Not later than one year after the date
of the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a report
detailing--
(A) the current number and locations of all
facilities of the Department offering the Parenting
STAIR program; and
(B) the number of veterans served by such program
in the most recent fiscal year or calendar year for
which data is available.
(2) Final report.--Not later than three years after the
date of the enactment of this Act, the Secretary shall submit
to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of Representatives
a report detailing--
(A) the results of the study conducted under
subsection (a);
(B) an update on how many veterans have used the
Parenting STAIR program since its development in fiscal
year 2017, disaggregated by year, including the
locations in which veterans have used such program; and
(C) a determination on the feasibility and
advisability of expanding the Parenting STAIR program
to all medical facilities of the Department offering
care for military sexual trauma.
(d) Definitions.--In this section:
(1) Affected members and former members of the armed
forces.--The term ``affected members and former members of the
Armed Forces'' means members and former members of the Armed
Forces who are parents and have experienced military sexual
trauma.
(2) Military sexual trauma.--The term ``military sexual
trauma'' means a condition described in section 1720D(a)(1) of
title 38, United States Code.
(3) Parenting stair program.--The term ``Parenting STAIR
program'' means the program of the Department of Veterans
Affairs that consists of a five-session, parenting-specific
treatment protocol based on skills training in affective and
interpersonal regulation (commonly referred to as ``STAIR''),
which is a cognitive behavioral therapy that has been
identified as a promising practice for treating post-traumatic
stress disorder, including chronic and complicated forms, among
individuals with co-occurring disorders.
SEC. 404. GAP ANALYSIS OF DEPARTMENT OF VETERANS AFFAIRS PROGRAMS THAT
PROVIDE ASSISTANCE TO WOMEN VETERANS WHO ARE HOMELESS.
(a) In General.--The Secretary of Veterans Affairs shall complete
an analysis of programs of the Department of Veterans Affairs that
provide assistance to women veterans who are homeless or precariously
housed to identify the areas in which such programs are failing to meet
the needs of such women.
(b) Report.--Not later than 270 days after the date of the
enactment of this Act, the Secretary 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 analysis completed
under subsection (a).
TITLE V--BENEFITS MATTERS
SEC. 501. STANDARD OF PROOF FOR SERVICE-CONNECTION OF MENTAL HEALTH
CONDITIONS RELATED TO MILITARY SEXUAL TRAUMA.
(a) Standard of Proof.--Section 1154 of title 38, United States
Code, is amended by adding at the end the following new subsection:
``(c)(1)(A) In the case of any veteran who claims that a covered
mental health condition was incurred or aggravated by military sexual
trauma during active military, naval, or air service, the Secretary
shall accept as sufficient proof of service-connection a diagnosis of
such mental health condition by a mental health professional together
with satisfactory lay or other evidence of such trauma and an opinion
by the mental health professional that such covered mental health
condition is related to such military sexual trauma, if consistent with
the circumstances, conditions, or hardships of such service,
notwithstanding the fact that there is no official record of such
incurrence or aggravation in such service, and, to that end, shall
resolve every reasonable doubt in favor of the veteran.
``(B) Service-connection of a covered mental health condition
described in subparagraph (A) may be rebutted by clear and convincing
evidence to the contrary.
``(C) The reasons for granting or denying service-connection in
each case shall be recorded in full.
``(2) In this subsection:
``(A) The term `covered mental health condition' means
post-traumatic stress disorder, anxiety, depression, or other
mental health diagnosis described in the current version of the
Diagnostic and Statistical Manual of Mental Disorders published
by the American Psychiatric Association that the Secretary
determines to be related to military sexual trauma.
``(B) The term `military sexual trauma' means, with respect
to a veteran, a physical assault of a sexual nature, battery of
a sexual nature, technological abuse of a sexual nature, or
sexual harassment during active military, naval, or air
service.''.
(b) Use of Evidence in Evaluating Disability Claims Involving
Military Sexual Trauma.--
(1) In general.--Subchapter VI of chapter 11 of such title
is amended by adding at the end the following new section:
``Sec. 1164. Evaluation of claims involving military sexual trauma
``(a) Nonmilitary Sources of Evidence.--(1) In carrying out section
1154(c) of this title, the Secretary shall ensure that if a claim for
compensation under this chapter is received by the Secretary for a
covered mental health condition (as defined in such section) based on
military sexual trauma experienced by a veteran during active military,
naval, or air service, evidence from sources other than official
records of the Department of Defense regarding the veteran's service
may corroborate the veteran's account of the assault, battery, or
harassment.
``(2) Examples of evidence described in paragraph (1) include the
following:
``(A) Records from law enforcement authorities, rape crisis
centers, mental health counseling centers, hospitals, and
physicians.
``(B) Pregnancy tests and tests for sexually transmitted
diseases.
``(C) Statements from family members, roommates, other
members of the Armed Forces or veterans, and clergy.
``(b) Behavior Changes Corroborating Evidence.--(1) In carrying out
section 1154(c) of this title, the Secretary shall ensure that evidence
of a behavior change following military sexual trauma is one type of
relevant evidence that may be found in sources described in such
subsection.
``(2) Examples of behavior changes that may be relevant evidence of
military sexual trauma include the following:
``(A) A request for a transfer to another military duty
assignment.
``(B) Deterioration in work performance.
``(C) Substance abuse.
``(D) Episodes of depression, panic attacks, or anxiety
without an identifiable cause.
``(E) Unexplained economic or social behavior changes.
``(c) Notice and Opportunity to Supply Evidence.--The Secretary may
not deny a claim of a veteran for compensation under this chapter for a
covered mental health condition that is based on military sexual trauma
without first--
``(1) advising the veteran that evidence described in
subsections (a) and (b) may constitute credible corroborating
evidence of the military sexual trauma; and
``(2) allowing the veteran an opportunity to furnish such
corroborating evidence or advise the Secretary of potential
sources of such evidence.
``(d) Review of Evidence.--In reviewing a claim for compensation
described in subsection (a)(1), for any evidence received with such
claim that is described in subsection (a) or (b), the Secretary may
submit such evidence to such medical or mental health professional as
the Secretary considers appropriate, including clinical and counseling
experts employed by the Department, to obtain a credible opinion as to
whether the evidence indicates that military sexual trauma occurred.
``(e) Point of Contact.--The Secretary shall ensure that each
document provided to a veteran relating to a claim for compensation
described in subsection (a)(1) includes contact information for an
appropriate point of contact with the Department.
``(f) Specialized Teams.--(1) The Secretary shall establish
specialized teams to process claims for compensation described in
subsection (a)(1).
``(2) The Secretary shall ensure that members of teams established
under paragraph (1) are trained to identify markers indicating military
sexual trauma.
``(3) In any case in which the Secretary obtains conflicting
evidence relating to the substantiation of a claim for compensation
described in subsection (a)(1), the Secretary shall give more credence
to the evidence that is more beneficial to the claimant.
``(g) Definitions.--In this section, the terms `covered mental
health condition' and `military sexual trauma' have the meanings given
such terms in section 1154(c) of this title.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by adding at the end the
following new item:
``1164. Evaluation of claims involving military sexual trauma.''.
(c) Annual Reports.--
(1) In general.--Subchapter VI of chapter 11 of title 38,
United States Code, as amended by subsection (b), is further
amended by adding at the end the following new section:
``Sec. 1166. Annual reports on claims for disabilities incurred or
aggravated by military sexual trauma
``(a) Reports.--Not later than March 1, 2021, and not less
frequently than once each year thereafter through 2027, the Secretary
shall submit to Congress a report on covered claims submitted during
the previous fiscal year to identify and track the consistency of
decisions across regional offices.
``(b) Elements.--Each report under subsection (a) shall include the
following:
``(1) The number of covered claims submitted to or
considered by the Secretary during the fiscal year covered by
the report.
``(2) Of the covered claims listed under paragraph (1), the
number and percentage of such claims--
``(A) submitted by each sex;
``(B) that were approved, including the number and
percentage of such approved claims submitted by each
sex; and
``(C) that were denied, including the number and
percentage of such denied claims submitted by each sex.
``(3) Of the covered claims listed under paragraph (1) that
were approved, the number and percentage, disaggregated by sex,
of claims assigned to each rating percentage.
``(4) Of the covered claims listed under paragraph (1) that
were denied--
``(A) the three most common reasons given by the
Secretary under section 5104(b)(1) of this title for
such denials; and
``(B) the number of denials that were based on the
failure of a veteran to report for a medical
examination.
``(5) The number of covered claims that, as of the end of
the fiscal year covered by the report, are pending and,
separately, the number of such claims on appeal.
``(6) For the fiscal year covered by the report, the
average number of days that covered claims take to complete,
beginning on the date on which the claim is submitted.
``(7) A description of the training that the Secretary
provides to employees of the Veterans Benefits Administration,
or such contractors or other individuals as the Secretary
considers appropriate, specifically with respect to covered
claims, including the frequency, length, and content of such
training.
``(c) Definitions.--In this section:
``(1) The term `covered claims' means claims for disability
compensation submitted to the Secretary based on a covered
mental health condition alleged to have been incurred or
aggravated by military sexual trauma.
``(2) The terms `covered mental health condition' and
`military sexual trauma' have the meanings given such terms in
section 1154(c) of this title.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter, as amended by subsection (b), is
further amended by adding at the end the following new item:
``1166. Annual reports on claims for disabilities incurred or
aggravated by military sexual trauma.''.
(d) Effective Date.--Subsection (c) of section 1154 of title 38,
United States Code, as added by subsection (a), shall apply with
respect to any claim for disability compensation under laws
administered by the Secretary of Veterans Affairs for which no final
decision has been made before the date of the enactment of this Act.
SEC. 502. CHOICE OF SEX OF DEPARTMENT OF VETERANS AFFAIRS MEDICAL
EXAMINER FOR ASSESSMENT OF CLAIMS FOR COMPENSATION
RELATING TO DISABILITY RESULTING FROM PHYSICAL ASSAULT OF
A SEXUAL NATURE, BATTERY OF A SEXUAL NATURE, OR SEXUAL
HARASSMENT.
(a) In General.--Subchapter VI of chapter 11 of title 38, United
States Code, as amended by section 501, is further amended by inserting
after section 1164, as added by section 501, the following new section:
``Sec. 1165. Choice of sex of medical examiner for certain disabilities
``(a) In General.--The Secretary shall ensure that a veteran who
requires a medical examination from a covered medical provider in
support of a claim for compensation under this chapter for a mental or
physical health condition that resulted from a physical assault of a
sexual nature, battery of a sexual nature, or sexual harassment may
designate the sex of the medical provider who provides such medical
examination.
``(b) Covered Medical Providers.--For purposes of this section, a
covered medical provider is any medical provider who is employed by the
Department or is under any contract with the Department to provide
medical examinations for the purpose of assessing a claim for
compensation under this chapter.
``(c) Notice.--Before providing any medical examination for a
veteran in support for a claim described in subsection (a), the
Secretary shall notify the veteran of the veteran's rights under
subsection (a).''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 11 of such title, as amended by section 501, is further amended
by inserting after the item relating to section 1164 the following new
item:
``1165. Choice of sex of medical examiner for certain disabilities.''.
SEC. 503. SECRETARY OF VETERANS AFFAIRS REPORT ON IMPLEMENTING
RECOMMENDATIONS OF INSPECTOR GENERAL OF DEPARTMENT OF
VETERANS AFFAIRS IN CERTAIN REPORT ON DENIED
POSTTRAUMATIC STRESS DISORDER CLAIMS RELATED TO MILITARY
SEXUAL TRAUMA.
Not later than 90 days after the date of the enactment of this Act,
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 a report on the progress of the Secretary in implementing
the recommendations from the report of the Inspector General of the
Department of Veterans Affairs entitled ``Denied Posttraumatic Stress
Disorder Claims Related to Military Sexual Trauma'' (17-05248-241).
Calendar No. 536
116th CONGRESS
2d Session
S. 514
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to improve the benefits and
services provided by the Department of Veterans Affairs to women
veterans, and for other purposes.
_______________________________________________________________________
September 15, 2020
Reported with an amendment