[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3025 Reported in Senate (RS)]
<DOC>
Calendar No. 289
117th CONGRESS
2d Session
S. 3025
To amend title 38, United States Code, to expand health care and
benefits from the Department of Veterans Affairs for military sexual
trauma, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
October 20, 2021
Mr. Tester (for himself and Ms. Murkowski) introduced the following
bill; which was read twice and referred to the Committee on Veterans'
Affairs
March 1, 2022
Reported by Mr. Tester, 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 expand health care and
benefits from the Department of Veterans Affairs for military sexual
trauma, 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
``Servicemembers and Veterans Empowerment and Support Act of
2021''.</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--DEFINING MILITARY SEXUAL TRAUMA
<DELETED>Sec. 101. Military sexual trauma defined for the digital age.
<DELETED>TITLE II--DISABILITY COMPENSATION AND CLAIMS PROCESSING
<DELETED>Sec. 201. Definition of military sexual trauma.
<DELETED>Sec. 202. Conforming changes relating to specialized teams to
evaluate claims involving military sexual
trauma.
<DELETED>Sec. 203. Standard of proof for service-connection of mental
health conditions relating to military
sexual trauma.
<DELETED>Sec. 204. Choice of location of Department of Veterans Affairs
medical examination for assessment of
claims for compensation relating to
disability resulting from military sexual
trauma.
<DELETED>Sec. 205. Communications from the Department of Veterans
Affairs to military sexual trauma
survivors.
<DELETED>Sec. 206. Study on training and processing relating to claims
for disability compensation relating to
military sexual trauma.
<DELETED>Sec. 207. Annual special focus review of claims for disability
compensation for disabilities relating to
military sexual trauma.
<DELETED>TITLE III--ACCESS TO HEALTH CARE
<DELETED>Sec. 301. Expansion of eligibility for counseling and
treatment for military sexual trauma to
include all former members of the reserve
components of the Armed Forces.
<DELETED>Sec. 302. Connection to Veterans Health Administration when a
disability claim related to military sexual
trauma is submitted to Veterans Benefits
Administration.
<DELETED>Sec. 303. Study on access to inpatient mental health care for
survivors of military sexual trauma.
<DELETED>Sec. 304. Pilot program for interim access to mental health
care for survivors of military sexual
trauma.
<DELETED>Sec. 305. Comptroller General study on access to care for
survivors of military sexual trauma at the
Department of Veterans Affairs.
<DELETED>TITLE I--DEFINING MILITARY SEXUAL TRAUMA</DELETED>
<DELETED>SEC. 101. MILITARY SEXUAL TRAUMA DEFINED FOR THE DIGITAL
AGE.</DELETED>
<DELETED> (a) Revision to Regulations Required.--The Secretary of
Veterans Affairs shall, in accordance with subsection (b), revise
regulations for the definition of ``military sexual trauma'' for the
purposes of access to health care under chapter 17 of title 38, United
States Code, and compensation under chapter 11 of such title.</DELETED>
<DELETED> (b) Requirements.--</DELETED>
<DELETED> (1) Technological abuse.--</DELETED>
<DELETED> (A) In general.--The Secretary shall
ensure that all regulations revised under subsection
(a) include matters relating to technological abuse to
reflect sexual harassment in the digital age.</DELETED>
<DELETED> (B) Inclusion of certain behavior and
activities.--For purposes of subparagraph (A), the term
``technological abuse'' may include--</DELETED>
<DELETED> (i) behavior intended to harm,
threaten, intimidate, control, stalk, harass,
impersonate, or monitor another person, except
as otherwise permitted by law, that occurs via
the internet, social networking sites,
computers, mobile devices, mobile telephones,
apps, location tracking devices, instant
messages, text messages, or other forms of
technology; and</DELETED>
<DELETED> (ii) specific activities,
including--</DELETED>
<DELETED> (I) unwanted, repeated
telephone calls, text messages, instant
messages, or social media
posts;</DELETED>
<DELETED> (II) nonconsensual access
of email accounts, texts or instant
messaging accounts, social networking
accounts, or mobile telephone
logs;</DELETED>
<DELETED> (III) attempting to
control or restrict a person's ability
to access technology with the intent to
isolate the person from support and
social connection;</DELETED>
<DELETED> (IV) using tracking
devices or location tracking software
for the purpose of monitoring or
stalking another person's
location;</DELETED>
<DELETED> (V) impersonation of a
person with the intent to deceive or
cause harm through the use of spoofing
technology or the creation of fake
email or social media accounts;
or</DELETED>
<DELETED> (VI) pressuring for or
sharing of another person's private
information, photographs, or videos
without the person's consent.</DELETED>
<DELETED> (2) Collaboration.--In carrying out subsection
(a), the Secretary of Veterans Affairs shall collaborate with
the Secretary of Defense.</DELETED>
<DELETED> (3) Consultation.--In carrying out subsection (a),
the Secretary of Veterans Affairs shall consult with veterans
service organizations, military service organizations, and
other stakeholders.</DELETED>
<DELETED> (c) Commencement of Efforts.--Not later than one year
after the date of the enactment of this Act, the Secretary shall
commence efforts to carry out subsection (a).</DELETED>
<DELETED> (d) Progress Report.--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 progress of the Secretary in carrying out subsection
(a).</DELETED>
<DELETED> (e) Final Regulations.--Not later than two years after the
date of the enactment of this Act, the Secretary shall--</DELETED>
<DELETED> (1) issue the revised regulations required by
subsection (a); and</DELETED>
<DELETED> (2) update training aids, manuals, and
informational materials for staff, veterans, members of the
Armed Forces, and stakeholders to reflect the revised
regulations.</DELETED>
<DELETED>TITLE II--DISABILITY COMPENSATION AND CLAIMS
PROCESSING</DELETED>
<DELETED>SEC. 201. DEFINITION OF MILITARY SEXUAL TRAUMA.</DELETED>
<DELETED> In this title, the term ``military sexual trauma'' has the
meaning given such term in section 1167(j) of title 38, United States
Code, as added by section 203(a).</DELETED>
<DELETED>SEC. 202. CONFORMING CHANGES RELATING TO SPECIALIZED TEAMS TO
EVALUATE CLAIMS INVOLVING MILITARY SEXUAL
TRAUMA.</DELETED>
<DELETED> Section 1166(c) of title 38, United States Code, as
redesignated by section 7(a) of the Training in High-demand Roles to
Improve Veteran Employment Act (Public Law 117-16), is amended by
striking ``In this section'' and all that follows and inserting the
following: ``In this section, the terms `covered mental health
condition' and `military sexual trauma' have the meanings given those
terms in section 1167(j) of this title.''.</DELETED>
<DELETED>SEC. 203. STANDARD OF PROOF FOR SERVICE-CONNECTION OF MENTAL
HEALTH CONDITIONS RELATING TO MILITARY SEXUAL
TRAUMA.</DELETED>
<DELETED> (a) In General.--Subchapter VI of chapter 11 of such title
is amended by adding at the end the following new section:</DELETED>
<DELETED>``Sec. 1167. Evaluation of claims involving military sexual
trauma</DELETED>
<DELETED> ``(a) Standard of Proof.--(1) In the case of any veteran
who claims that a covered mental health condition based on military
sexual trauma was incurred in or aggravated by 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, in accordance with subsections (b) and (c), of such trauma
and an opinion by the mental health professional that such covered
mental health condition is related to such military sexual trauma, as
specified in subsection (f), 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.</DELETED>
<DELETED> ``(2) Service-connection of such covered mental health
condition may be rebutted by clear and convincing evidence to the
contrary.</DELETED>
<DELETED> ``(3) The reasons for granting or denying service-
connection in each case shall be recorded in full.</DELETED>
<DELETED> ``(b) Nonmilitary Sources of Evidence.--(1) In carrying
out subsection (a), the Secretary shall ensure that if a claim for
compensation under this chapter is received by the Secretary for a
covered mental health condition based on military sexual trauma,
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 trauma.</DELETED>
<DELETED> ``(2) Examples of evidence described in paragraph (1)
include the following:</DELETED>
<DELETED> ``(A) Records from law enforcement authorities,
rape crisis centers, mental health counseling centers,
hospitals, and physicians.</DELETED>
<DELETED> ``(B) Pregnancy tests and tests for sexually
transmitted diseases.</DELETED>
<DELETED> ``(C) Statements from family members, roommates,
other members of the Armed Forces or veterans, and
clergy.</DELETED>
<DELETED> ``(c) Evidence of Behavior Changes.--(1) In carrying out
subsection (a), 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.</DELETED>
<DELETED> ``(2) Examples of behavior changes that may be relevant
evidence of military sexual trauma include the following:</DELETED>
<DELETED> ``(A) A request for a transfer to another military
duty assignment.</DELETED>
<DELETED> ``(B) Deterioration in work performance.</DELETED>
<DELETED> ``(C) Substance abuse or substance use
disorder.</DELETED>
<DELETED> ``(D) Episodes of depression, panic attacks, or
anxiety without an identifiable cause.</DELETED>
<DELETED> ``(E) Unexplained economic or social behavior
changes.</DELETED>
<DELETED> ``(d) 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--</DELETED>
<DELETED> ``(1) advising the veteran that evidence described
in subsections (b) and (c) may constitute credible
corroborating evidence of the military sexual trauma;
and</DELETED>
<DELETED> ``(2) allowing the veteran an opportunity to
furnish such corroborating evidence or advise the Secretary of
potential sources of such evidence.</DELETED>
<DELETED> ``(e) Role of Lay Statements.--In a case where evidence
described in subsection (b) or (c) is unavailable, and the only
evidence of the occurrence of the military sexual trauma is the
veteran's own lay statement, the Secretary shall accept such lay
statement as credible evidence the event occurred, unless such
statement is inconsistent with the places, types, and circumstances of
the service of the veteran, including evidence of the veteran's unit
assignments, military specialty, or dates and locations of service, or
unless there is clear and convincing evidence to the
contrary.</DELETED>
<DELETED> ``(f) Review of Evidence.--(1) In reviewing a claim for
compensation described in subsection (a)(1), for any evidence
identified as part of such claim that is described in subsection (b) or
(c), or if subsection (e) applies, the Secretary shall 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 an opinion as to whether it is at
least as likely as not that there is a nexus between the military
sexual trauma and any diagnosed covered mental health
condition.</DELETED>
<DELETED> ``(2) In the case of any veteran who submits with the
claim for a covered mental health condition a lay statement describing
the military sexual trauma, such veteran shall be provided with a
medical examination and opinion as described in paragraph (1) without
delay for request of records specified in subsections (b) and (c) from
the veteran.</DELETED>
<DELETED> ``(3) For any veteran described in paragraph (2), if the
medical examination and opinion do not result in a diagnosis of a
covered mental health condition and a positive opinion that the
military sexual trauma is related to such diagnosis, the Secretary
shall request the records specified in subsections (b) and (c) and, if
such evidence is received, paragraph (1) shall again apply and a
subsequent medical examination and opinion shall be
requested.</DELETED>
<DELETED> ``(g) Point of Contact.--The Secretary shall ensure that
each document provided to a veteran relating to a claim for
compensation described in subsection (a) includes contact information
for an appropriate point of contact with the Department.</DELETED>
<DELETED> ``(h) Specialized Teams.--The Secretary shall ensure that
all claims for compensation described in subsection (a) are reviewed
and processed by a specialized team established under section 1166 of
this title.</DELETED>
<DELETED> ``(i) Rule of Construction Regarding Application to
Nonsexual Personal Assault.--The Secretary shall not construe this
section as supplanting the standard of proof or evidence required for
claims for posttraumatic stress disorder based on non-sexual personal
assault, which the Secretary shall continue to define in
regulation.</DELETED>
<DELETED> ``(j) Definitions.--In this section:</DELETED>
<DELETED> ``(1) 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
and which may be service-connected.</DELETED>
<DELETED> ``(2) The term `military sexual trauma' means,
with respect to a veteran, a physical assault of a sexual
nature, battery of a sexual nature, or sexual harassment that
occurred while the veteran was serving in the active military,
naval, or air service.''.</DELETED>
<DELETED> (b) Outreach.--Not later than 180 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
implement, with input from the veteran community, an informative
outreach program for veterans regarding the standard of proof for
evaluation of claims related to military sexual trauma, including
consideration of lay statements and requirements for a medical
examination and opinion.</DELETED>
<DELETED> (c) Clerical Amendment.--The table of sections at the
beginning of such chapter is amended by adding at the end the following
new item:</DELETED>
<DELETED>``1167. Evaluation of claims involving military sexual
trauma.''.
<DELETED>SEC. 204. CHOICE OF LOCATION OF DEPARTMENT OF VETERANS AFFAIRS
MEDICAL EXAMINATION FOR ASSESSMENT OF CLAIMS FOR
COMPENSATION RELATING TO DISABILITY RESULTING FROM
MILITARY SEXUAL TRAUMA.</DELETED>
<DELETED> (a) In General.--Section 1165 of title 38, United States
Code, is amended--</DELETED>
<DELETED> (1) in the section heading, by inserting ``and
location of medical examination'' after ``examiner'';</DELETED>
<DELETED> (2) in subsection (a), by striking ``a physical
assault of a sexual nature, battery of a sexual nature, or
sexual harassment'' and inserting ``military sexual trauma (as
defined in section 1167(j) of this title)'';</DELETED>
<DELETED> (3) by redesignating subsection (c) as subsection
(d); and</DELETED>
<DELETED> (4) by inserting after subsection (b) the
following new subsection (c):</DELETED>
<DELETED> ``(c) Choice of Examination Location.--(1) The Secretary
shall ensure that a veteran who requires a medical examination in
support of a claim described in subsection (a) may request that the
medical examination take place at a facility of the Department by a
qualified employee of the Department.</DELETED>
<DELETED> ``(2) The Secretary--</DELETED>
<DELETED> ``(A) shall grant any request under paragraph (1);
and</DELETED>
<DELETED> ``(B) may not issue a decision on a claim
described in such paragraph before the requested examination is
completed.''.</DELETED>
<DELETED> (b) Clerical Amendment.--The table of sections at the
beginning of chapter 11 of such title is amended by striking the item
relating to section 1165 and inserting the following new
item:</DELETED>
<DELETED>``1165. Choice of sex of medical examiner and location of
medical examination for certain
disabilities.''.
<DELETED>SEC. 205. COMMUNICATIONS FROM THE DEPARTMENT OF VETERANS
AFFAIRS TO MILITARY SEXUAL TRAUMA SURVIVORS.</DELETED>
<DELETED> (a) Review Board.--</DELETED>
<DELETED> (1) In general.--The Secretary of Veterans Affairs
shall establish a board to review correspondence relating to
military sexual trauma.</DELETED>
<DELETED> (2) Membership.--The Secretary shall appoint
members of the board from among experts in military sexual
trauma and mental health, including--</DELETED>
<DELETED> (A) mental health providers of the
Department;</DELETED>
<DELETED> (B) experts on sexual assault and sexual
harassment; and</DELETED>
<DELETED> (C) members from both the Veterans Health
Administration and Veterans Benefits
Administration.</DELETED>
<DELETED> (3) Duties.--The board established under paragraph
(1) shall--</DELETED>
<DELETED> (A) review all standard correspondence and
other materials, which may include templates for
notices under sections 5103 and 5104B of title 38,
United States Code, as well as outreach materials and
veteran-facing website content, from the Department of
Veterans Affairs to survivors of military sexual trauma
for sensitivity; and</DELETED>
<DELETED> (B) ensure that the communications--
</DELETED>
<DELETED> (i) treat survivors with dignity
and respect; and</DELETED>
<DELETED> (ii) do not re-traumatize
survivors.</DELETED>
<DELETED> (b) Contents of Written Communications to Military Sexual
Trauma Survivors.--The Secretary shall ensure that any written
communication from the Department of Veterans Affairs to a military
sexual trauma survivor shall include contact information for the
following:</DELETED>
<DELETED> (1) The military sexual trauma coordinator of the
Veterans Benefits Administration.</DELETED>
<DELETED> (2) The military sexual trauma coordinator for the
Veterans Health Administration.</DELETED>
<DELETED> (3) The Veterans Crisis Line.</DELETED>
<DELETED> (4) The facility of the Veterans Health
Administration closest to where the survivor resides.</DELETED>
<DELETED> (c) Definitions.--In this section:</DELETED>
<DELETED> (1) Military sexual trauma survivor.--The term
``military sexual trauma survivor'' means--</DELETED>
<DELETED> (A) a veteran who has filed a claim for
compensation under chapter 11 of title 38, United
States Code, relating to military sexual
trauma;</DELETED>
<DELETED> (B) a veteran who has been awarded
compensation under such chapter relating to military
sexual trauma; or</DELETED>
<DELETED> (C) a former member of the Armed Forces or
a veteran who is receiving care from the Department of
Veterans Affairs relating to military sexual
trauma.</DELETED>
<DELETED> (2) Veterans crisis line.--The term ``Veterans
Crisis Line'' means the toll-free hotline for veterans
established under section 1720F(h) of title 38, United States
Code.</DELETED>
<DELETED>SEC. 206. STUDY ON TRAINING AND PROCESSING RELATING TO CLAIMS
FOR DISABILITY COMPENSATION RELATING TO MILITARY SEXUAL
TRAUMA.</DELETED>
<DELETED> (a) Study Required.--The Secretary of Veterans Affairs
shall conduct a study on--</DELETED>
<DELETED> (1) the quality of training provided to personnel
of the Department of Veterans Affairs who review claims for
disability compensation under chapter 11 of title 38, United
States Code, for disabilities relating to military sexual
trauma; and</DELETED>
<DELETED> (2) the quality of the procedures of the
Department for reviewing the accuracy of the processing of such
claims.</DELETED>
<DELETED> (b) Elements.--The study required by subsection (a) shall
include the following:</DELETED>
<DELETED> (1) With respect to the quality of training
described in paragraph (1) of such subsection:</DELETED>
<DELETED> (A) Whether the Department ensures
personnel complete such training on time.</DELETED>
<DELETED> (B) Whether the training has resulted in
improvements to the processing of claims described in
such subsection and issue-based accuracy.</DELETED>
<DELETED> (C) Such recommendations as the Secretary
of Veterans Affairs may have for improving the
training.</DELETED>
<DELETED> (2) With respect to the quality of procedures
described in paragraph (2) of such subsection:</DELETED>
<DELETED> (A) Whether the procedures of the
Department for reviewing the accuracy of the processing
of claims described in such subsection comport with
generally accepted statistical methodologies to ensure
reasonable accuracy of such reviews.</DELETED>
<DELETED> (B) Whether such procedures adequately
include mechanisms to correct errors found in such
reviews.</DELETED>
<DELETED> (C) Such recommendations as the Secretary
may have for improving such procedures.</DELETED>
<DELETED> (c) Report Required.--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
the findings of the Secretary with respect to the study conducted under
subsection (a).</DELETED>
<DELETED>SEC. 207. ANNUAL SPECIAL FOCUS REVIEW OF CLAIMS FOR DISABILITY
COMPENSATION FOR DISABILITIES RELATING TO MILITARY SEXUAL
TRAUMA.</DELETED>
<DELETED> (a) Annual Special Focus Review.--</DELETED>
<DELETED> (1) In general.--Each year, the Under Secretary
for Benefits of the Department of Veterans Affairs shall
conduct a special focus review on the accuracy of the
processing of claims for disability compensation under chapter
11 of title 38, United States Code, for disabilities relating
to military sexual trauma.</DELETED>
<DELETED> (2) Elements.--Each review conducted under
paragraph (1) shall include a review of the
following:</DELETED>
<DELETED> (A) A statistically significant,
nationally representative sample of all claims for
benefits under the laws administered by the Secretary
of Veterans Affairs relating to military sexual trauma
filed during the fiscal year preceding the fiscal year
in which the report is submitted.</DELETED>
<DELETED> (B) The accuracy of each decision made
with respect to each claim described in subparagraph
(A).</DELETED>
<DELETED> (C) The types of benefit entitlement
errors found, disaggregated by category.</DELETED>
<DELETED> (D) Trends from year to year.</DELETED>
<DELETED> (E) Training completion rates for
personnel of the Department who process claims
described in paragraph (1).</DELETED>
<DELETED> (b) Reprocessing of Claims.--If the Under Secretary finds,
pursuant to a special focus review conducted under subsection (a)(1),
that an error was made with respect to the entitlement of a veteran to
a benefit under the laws administered by the Secretary, the Secretary
shall return the relevant claim of the veteran to the appropriate
regional office of the Department for reprocessing to ensure that the
veteran receives an accurate decision with respect to the
claim.</DELETED>
<DELETED> (c) Re-Reviewing of Claims.--If the Under Secretary finds,
pursuant to a special focus review conducted under paragraph (1) of
subsection (a), that the accuracy rate, under paragraph (2)(B) of such
subsection, is less than 90 percent, the Secretary shall conduct a
review of each claim for benefits under the laws administered by the
Secretary of Veterans Affairs relating to military sexual trauma filed
during the fiscal year preceding the fiscal year in which the report is
submitted.</DELETED>
<DELETED> (d) Report.--Section 5501(b)(2) of the Johnny Isakson and
David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of
2020 (Public Law 116-315; 134 Stat. 5048) is amended by adding at the
end the following new subparagraph:</DELETED>
<DELETED> ``(I) The findings of the most recent
special focus review conducted under subsection (a)(1)
of section 207 of the Servicemembers and Veterans
Empowerment and Support Act of 2021, including--
</DELETED>
<DELETED> ``(i) the elements under
subsection (a)(2) of such section;</DELETED>
<DELETED> ``(ii) the number of claims
returned for reprocessing under subsection (b)
of such section; and</DELETED>
<DELETED> ``(iii) the number of claims
described in clause (ii) for which the decision
relating to service-connection or entitlement
to compensation changed as a result of
reprocessing the claim.''.</DELETED>
<DELETED>TITLE III--ACCESS TO HEALTH CARE</DELETED>
<DELETED>SEC. 301. EXPANSION OF ELIGIBILITY FOR COUNSELING AND
TREATMENT FOR MILITARY SEXUAL TRAUMA TO INCLUDE ALL
FORMER MEMBERS OF THE RESERVE COMPONENTS OF THE ARMED
FORCES.</DELETED>
<DELETED> Section 1720D of title 38, United States Code, is amended
by striking subsections (f) and (g) and inserting the following new
subsection (f):</DELETED>
<DELETED> ``(f) In this section:</DELETED>
<DELETED> ``(1) The term `former member of the Armed Forces'
means a person who served on active duty, active duty for
training, or inactive duty training, and who was discharged or
released therefrom under any condition that is not--</DELETED>
<DELETED> ``(A) a discharge by court-martial;
or</DELETED>
<DELETED> ``(B) a discharge subject to a bar to
benefits under section 5303 of this title.</DELETED>
<DELETED> ``(2) The term `military sexual trauma' means,
with respect to a former member of the Armed Forces, a physical
assault of a sexual nature, battery of a sexual nature, or
sexual harassment which occurred while the former member of the
Armed Forces was serving on duty, regardless of duty status or
line of duty determination (as that term is used in section
12323 of title 10).</DELETED>
<DELETED> ``(3) The term `sexual harassment' means
unsolicited verbal or physical contact of a sexual nature which
is threatening in character.''.</DELETED>
<DELETED>SEC. 302. CONNECTION TO VETERANS HEALTH ADMINISTRATION WHEN A
DISABILITY CLAIM RELATED TO MILITARY SEXUAL TRAUMA IS
SUBMITTED TO VETERANS BENEFITS ADMINISTRATION.</DELETED>
<DELETED> (a) In General.--Not later than 14 days after the date on
which a veteran submits a claim for disability compensation to the
Veterans Benefits Administration for a disability related to military
sexual trauma, the Secretary of Veterans Affairs shall send a
communication to the veteran with the following information:</DELETED>
<DELETED> (1) The contact information for the nearest
military sexual trauma coordinator for the veteran at the
Veterans Benefits Administration and a description of the
assistance such coordinator can provide.</DELETED>
<DELETED> (2) The contact information for the nearest
military sexual trauma coordinator for the veteran at the
Veterans Health Administration and a description of the
assistance such coordinator can provide.</DELETED>
<DELETED> (3) The types of services that survivors of
military sexual trauma are eligible to receive from the
Department of Veterans Affairs, including the nearest locations
and the contact information for such services.</DELETED>
<DELETED> (4) The contact information for the Veterans
Crisis Line established under section 1720F(h) of title 38,
United States Code.</DELETED>
<DELETED> (5) Such other information on services, care, or
resources for military sexual trauma as the Secretary
determines appropriate.</DELETED>
<DELETED> (b) Definition of Military Sexual Trauma.--In this
section, the term ``military sexual trauma'' has the meaning given such
term in section 1167(j) of title 38, United States Code, as added by
section 203(a).</DELETED>
<DELETED>SEC. 303. STUDY ON ACCESS TO INPATIENT MENTAL HEALTH CARE FOR
SURVIVORS OF MILITARY SEXUAL TRAUMA.</DELETED>
<DELETED> (a) In General.--The Secretary of Veterans Affairs shall
conduct a study on access to inpatient mental health care for current
and former members of the Armed Forces who are survivors of military
sexual trauma.</DELETED>
<DELETED> (b) Elements.--The study required by subsection (a) shall
include the following:</DELETED>
<DELETED> (1) An assessment of the availability of bed
spaces in the mental health residential rehabilitation
treatment programs of the Department of Veterans Affairs for
survivors of military sexual trauma, including the suitability
of those programs for such survivors and the wait times for
services under those programs.</DELETED>
<DELETED> (2) An assessment of geographic disparities in
access to those programs for survivors of military sexual
trauma, including by region and by rural and urban
areas.</DELETED>
<DELETED> (3) An assessment of alternative care options
provided when a survivor of military sexual trauma is waiting
for inpatient care, the efficacy of those alternatives, and the
satisfaction of patients with those alternatives.</DELETED>
<DELETED> (4) Recommendations for reducing the average wait
time for services under those programs to 14 days or less,
including by increasing bed space or addressing staffing
needs.</DELETED>
<DELETED> (5) An assessment of the satisfaction of patients
with the tracks of those programs specific to military sexual
trauma, the wait times for services under those tracks, and
recommendations for increasing or changing the number of
locations for services under those tracks to better meet the
needs of survivors of military sexual trauma.</DELETED>
<DELETED> (c) 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 the findings of the
study required by subsection (a).</DELETED>
<DELETED> (d) Definition of Military Sexual Trauma.--In this
section, the term ``military sexual trauma'' has the meaning given such
term in section 1720D(f) of title 38, United States Code, as added by
section 301.</DELETED>
<DELETED>SEC. 304. PILOT PROGRAM FOR INTERIM ACCESS TO MENTAL HEALTH
CARE FOR SURVIVORS OF MILITARY SEXUAL TRAUMA.</DELETED>
<DELETED> (a) In General.--Commencing not later than one year after
the date of the enactment of this Act, the Secretary of Veterans
Affairs shall carry out a pilot program to provide intensive outpatient
mental health care to current and former members of the Armed Forces
who are survivors of military sexual trauma when the wait times for
inpatient mental health care from the Department of Veterans Affairs
for the survivor is more than 14 days.</DELETED>
<DELETED> (b) Duration.--The Secretary shall carry out the pilot
program under subsection (a) for a three-year period beginning on the
commencement of the pilot program.</DELETED>
<DELETED> (c) Locations.--</DELETED>
<DELETED> (1) In general.--The Secretary shall carry out the
pilot program under subsection (a) at not fewer than four
Veterans Integrated Service Networks of the
Department.</DELETED>
<DELETED> (2) Selection of locations.--In selecting
locations for the pilot program under subsection (a), the
Secretary shall select locations that have the longest wait
times for inpatient mental health care, particularly for
survivors of military sexual trauma.</DELETED>
<DELETED> (3) Notification.--Before commencing the pilot
program under subsection (a), the Secretary shall notify the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives of the
locations selected for the pilot program.</DELETED>
<DELETED> (d) Types of Services.--Subject to the preference of the
survivor participating in the pilot program under subsection (a) and
the capacity of facilities of the Department, the Secretary may provide
services under the pilot program via telehealth or at community-based
outpatient clinics of the Department.</DELETED>
<DELETED> (e) Participation.--</DELETED>
<DELETED> (1) Clarification on participation.--Participation
by a survivor in the pilot program under subsection (a) shall
be during the period in which the survivor is waiting for an
inpatient bed opening and shall not disqualify the survivor
from receiving inpatient mental health care following their
participation in the pilot program.</DELETED>
<DELETED> (2) Decisions on participation.--Decisions about
the participation of a survivor in the pilot program and the
transition of the survivor to inpatient mental health care
shall be made by the survivor and their health care
provider.</DELETED>
<DELETED> (f) Report.--Not later than 180 days after the conclusion
of the pilot program under subsection (a), the Secretary shall submit
to Congress a report on--</DELETED>
<DELETED> (1) participation in the pilot program;</DELETED>
<DELETED> (2) clinical outcomes under the pilot program;
and</DELETED>
<DELETED> (3) such recommendations for continuation or
termination of the program as the Secretary may have, including
recommendations for legislative or administrative
action.</DELETED>
<DELETED> (g) Definition of Military Sexual Trauma.--In this
section, the term ``military sexual trauma'' has the meaning given such
term in section 1720D(f) of title 38, United States Code, as added by
section 301.</DELETED>
<DELETED>SEC. 305. COMPTROLLER GENERAL STUDY ON ACCESS TO CARE FOR
SURVIVORS OF MILITARY SEXUAL TRAUMA AT THE DEPARTMENT OF
VETERANS AFFAIRS.</DELETED>
<DELETED> (a) In General.--The Comptroller General of the United
States shall conduct a study on access to mental health care for
survivors of military sexual trauma at facilities of the Department of
Veterans Affairs.</DELETED>
<DELETED> (b) Elements.--The study conducted under subsection (a)
shall include an assessment of the following:</DELETED>
<DELETED> (1) The availability of inpatient and outpatient
services, including wait times and geographic disparities for
such services.</DELETED>
<DELETED> (2) The availability of other types of training
and support services for survivors of military sexual trauma,
such as the Parenting STAIR program of the
Department.</DELETED>
<DELETED> (3) The communication and advertisement by the
Department of the care, services, and resources available for
such survivors.</DELETED>
<DELETED> (4) The barriers to accessing mental health care
at a facility of the Department for such survivors, including
transportation, child care, lack of telehealth, and
more.</DELETED>
<DELETED> (5) The barriers to mental health care at
facilities of the Department for such survivors of each gender,
including the unique considerations for male survivors versus
female survivors.</DELETED>
<DELETED> (6) The extent to which the Secretary has assessed
the quality of the training provided to providers of the
Department on military sexual trauma and made any adjustments
in response to such assessment.</DELETED>
<DELETED> (7) The role of Vet Centers in providing care to
such survivors, including current and former members of the
Armed Forces.</DELETED>
<DELETED> (8) The role of military sexual trauma
coordinators of the Veterans Health Administration in
coordinating and providing care for such survivors at
facilities of the Department.</DELETED>
<DELETED> (9) Any current actions by the Secretary to
strengthen access to high-quality care for such survivors and
such recommendations for improving access to care for such
survivors as the Comptroller General considers
appropriate.</DELETED>
<DELETED> (c) Report.--Not later than two years after the date of
the enactment of this Act, the Comptroller General shall submit to
Congress a report on the findings of the study conducted under
subsection (a).</DELETED>
<DELETED> (d) Definitions.--In this section:</DELETED>
<DELETED> (1) Military sexual trauma.--In this section, the
term ``military sexual trauma'' has the meaning given such term
in section 1720D(f) of title 38, United States Code, as added
by section 301.</DELETED>
<DELETED> (2) Vet center.--The term ``Vet Center'' has the
meaning given that term in section 1712A(h) of title 38, United
States Code.</DELETED>
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Servicemembers and
Veterans Empowerment and Support Act of 2021''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--DEFINING MILITARY SEXUAL TRAUMA
Sec. 101. Report on military sexual trauma in the digital age.
TITLE II--DISABILITY COMPENSATION AND CLAIMS PROCESSING
Sec. 201. Definition of military sexual trauma.
Sec. 202. Conforming changes relating to specialized teams to evaluate
claims involving military sexual trauma.
Sec. 203. Standard of proof for service-connection of mental health
conditions relating to military sexual
trauma.
Sec. 204. Choice of location of Department of Veterans Affairs medical
examination for assessment of claims for
compensation relating to disability
resulting from military sexual trauma.
Sec. 205. Communications from the Department of Veterans Affairs to
individuals who have experienced military
sexual trauma.
Sec. 206. Study on training and processing relating to claims for
disability compensation relating to
military sexual trauma.
Sec. 207. Annual special focus review of claims for disability
compensation for disabilities relating to
military sexual trauma.
TITLE III--ACCESS TO HEALTH CARE
Sec. 301. Expansion of eligibility for counseling and treatment for
military sexual trauma to include all
former members of the reserve components of
the Armed Forces.
Sec. 302. Connection to Veterans Health Administration when a
disability claim related to military sexual
trauma is submitted to Veterans Benefits
Administration.
Sec. 303. Pilot program for interim access to mental health care for
individuals who have experienced military
sexual trauma.
Sec. 304. Comptroller General study on access to care from Department
of Veterans Affairs for individuals who
have experienced military sexual trauma.
TITLE I--DEFINING MILITARY SEXUAL TRAUMA
SEC. 101. REPORT ON MILITARY SEXUAL TRAUMA IN THE DIGITAL AGE.
(a) Report Required.--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
military sexual trauma in the digital age.
(b) Requirements.--The report required under subsection (a) shall
include the following:
(1) A comprehensive evaluation and assessment of current
Department of Veterans Affairs statutes, regulations, and
agency guidance relating to military sexual trauma for the
purposes of access to health care under chapter 17 of title 38,
United States Code, and compensation under chapter 11 of such
title to identify--
(A) gaps in coverage for health care and
compensation eligibility relating to technological
abuse that is sexual in nature, including gaps induced
by the military status (or lack thereof) of a veteran
at the time of such abuse; and
(B) the feasibility and advisability of expanding
eligibility for health care and compensation relating
to technological abuse that is nonsexual in nature
consistent with current policies relating to military
sexual trauma.
(2) Recommendations for revising statutes, regulations, and
agency guidance in response to the evaluation and assessment
under paragraph (1).
(c) Consultation.--In carrying out subsection (a), the Secretary of
Veterans Affairs shall consult veterans service organizations and such
other stakeholders as the Secretary considers relevant and appropriate.
(d) Definitions.--In this section:
(1) Military sexual trauma.--The term ``military sexual
trauma''--
(A) with respect to eligibility for health care,
has the meaning given such term in section 1720D(f) of
title 38, United States Code, as added by section 301;
and
(B) with respect to eligibility for compensation,
has the meaning given such term in section 1167(i) of
title 38, United States Code, as added by section
203(a).
(2) Technological abuse.--The term ``technological abuse''
may include--
(A) behavior which harms, threatens, intimidates,
controls, stalks, harasses, impersonates, or monitors
another person, except as otherwise permitted by law,
that occurs via the internet, social networking sites,
computers, mobile devices, mobile telephones,
applications, location tracking devices, instant
messages, text messages, or other forms of technology;
and
(B) specific activities, including--
(i) unwanted, repeated telephone calls,
text messages, instant messages, or social
media posts;
(ii) nonconsensual access of email
accounts, texts or instant messaging accounts,
social networking accounts, or mobile telephone
logs;
(iii) attempting to control or restrict a
person's ability to access technology with the
intent to isolate the person from support and
social connection;
(iv) using tracking devices or location
tracking software for the purpose of monitoring
or stalking another person's location;
(v) impersonation of a person with the
intent to deceive or cause harm through the use
of spoofing technology or the creation of fake
email or social media accounts; or
(vi) pressuring for or sharing of another
person's private information, photographs, or
videos without the person's consent.
TITLE II--DISABILITY COMPENSATION AND CLAIMS PROCESSING
SEC. 201. DEFINITION OF MILITARY SEXUAL TRAUMA.
In this title, the term ``military sexual trauma'' has the meaning
given such term in section 1167(i) of title 38, United States Code, as
added by section 203(a).
SEC. 202. CONFORMING CHANGES RELATING TO SPECIALIZED TEAMS TO EVALUATE
CLAIMS INVOLVING MILITARY SEXUAL TRAUMA.
Section 1166(c) of title 38, United States Code, as redesignated by
section 7(a) of the Training in High-demand Roles to Improve Veteran
Employment Act (Public Law 117-16), is amended by striking ``In this
section'' and all that follows and inserting the following: ``In this
section, the terms `covered mental health condition' and `military
sexual trauma' have the meanings given those terms in section 1167(i)
of this title.''.
SEC. 203. STANDARD OF PROOF FOR SERVICE-CONNECTION OF MENTAL HEALTH
CONDITIONS RELATING TO MILITARY SEXUAL TRAUMA.
(a) In General.--Subchapter VI of chapter 11 of such title is
amended by adding at the end the following new section:
``Sec. 1167. Evaluation of claims involving military sexual trauma
``(a) Standard of Proof.--(1) In the case of any veteran who claims
that a covered mental health condition based on military sexual trauma
was incurred in or aggravated by active military, naval, air, or space
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,
in accordance with subsections (b) and (c), of such trauma and an
opinion by the mental health professional that the evidence indicates
such trauma occurred and such covered mental health condition is at
least as likely as not related to such military sexual trauma, as
specified in subsection (e), 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.
``(2) Service-connection of such covered mental health condition
may be rebutted by clear and convincing evidence to the contrary.
``(3) The reasons for granting or denying service-connection in
each case shall be recorded in full.
``(b) Nonmilitary Sources of Evidence.--(1) In carrying out
subsection (a), the Secretary shall ensure that if a claim for
compensation under this chapter is received by the Secretary for a
covered mental health condition based on military sexual trauma,
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 trauma.
``(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.
``(c) Evidence of Behavior Changes.--(1) In carrying out subsection
(a), 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 or substance use disorder.
``(D) Episodes of depression, panic attacks, or anxiety
without an identifiable cause.
``(E) Unexplained economic or social behavior changes.
``(d) 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 (b) and (c) 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.
``(e) Review of Evidence.--In reviewing a claim for compensation
described in subsection (a)(1), for any evidence identified as part of
such claim that is described in subsection (b) or (c), the Secretary
shall 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 an opinion
as to whether--
``(1) the evidence indicates that a military sexual trauma
occurred; and
``(2) it is at least as likely as not that there is a nexus
between the military sexual trauma and any diagnosed covered
mental health condition.
``(f) 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.
``(g) Specialized Teams.--The Secretary shall ensure that all
claims for compensation described in subsection (a)(1) are reviewed and
processed by a specialized team established under section 1166 of this
title.
``(h) Rule of Construction Regarding Application to Nonsexual
Personal Assault.-- The Secretary shall not construe this section as
supplanting the standard of proof or evidence required for claims for
posttraumatic stress disorder based on nonsexual personal assault,
which the Secretary shall continue to define in regulation.
``(i) Definitions.--In this section:
``(1) The term `covered mental health condition' means
post-traumatic stress disorder, anxiety, depression, or other
mental health diagnosis that the Secretary determines to be
related to military sexual trauma and which may be service-
connected under section 1110 of this title.
``(2) The term `military sexual trauma' means, with respect
to a veteran, a physical assault of a sexual nature, battery of
a sexual nature, or sexual harassment that occurred while the
veteran was serving in the active military, naval, air, or
space service.''.
(b) Outreach.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall
implement, with input from the veteran community, an informative
outreach program for veterans regarding the standard of proof for
evaluation of claims relating to military sexual trauma, including
requirements for a medical examination and opinion.
(c) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by adding at the end the following new item:
``1167. Evaluation of claims involving military sexual trauma.''.
SEC. 204. CHOICE OF LOCATION OF DEPARTMENT OF VETERANS AFFAIRS MEDICAL
EXAMINATION FOR ASSESSMENT OF CLAIMS FOR COMPENSATION
RELATING TO DISABILITY RESULTING FROM MILITARY SEXUAL
TRAUMA.
(a) In General.--Section 1165 of title 38, United States Code, is
amended--
(1) in the section heading, by inserting ``and location of
medical examination'' after ``examiner'';
(2) in subsection (a), by striking ``a physical assault of
a sexual nature, battery of a sexual nature, or sexual
harassment'' and inserting ``military sexual trauma (as defined
in section 1167(i) of this title)'';
(3) by redesignating subsection (c) as subsection (d); and
(4) by inserting after subsection (b) the following new
subsection (c):
``(c) Choice of Examination Location.--(1) The Secretary shall
ensure that a veteran who requires a medical examination in support of
a claim described in subsection (a) may request that the medical
examination take place at a medical facility of the Department by a
qualified employee of the Department rather than at a location
designated by a Department contractor that performs such examinations
on behalf of the Department.
``(2) The Secretary--
``(A) shall grant any request under paragraph (1) if a
medical facility of the Department is available not further
than 100 miles from the veteran's home; and
``(B) may not issue a decision on a claim described in such
paragraph before the requested examination is completed, or
notice is provided per paragraph (c)(3).
``(3) If a medical facility of the Department is not available
within 100 miles of the veteran's home, the Secretary shall notify the
veteran and provide the veteran the opportunity--
``(A) to have the examination completed by a contractor of
the Department; or
``(B) to complete the examination at a medical facility
further than 100 miles from the veteran's home.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 11 of such title is amended by striking the item relating to
section 1165 and inserting the following new item:
``1165. Choice of sex of medical examiner and location of medical
examination for certain disabilities.''.
SEC. 205. COMMUNICATIONS FROM THE DEPARTMENT OF VETERANS AFFAIRS TO
INDIVIDUALS WHO HAVE EXPERIENCED MILITARY SEXUAL TRAUMA.
(a) Review Board.--
(1) In general.--The Secretary of Veterans Affairs shall
establish a board to review correspondence relating to military
sexual trauma.
(2) Membership.--The board established under paragraph (1)
shall be composed of members who shall be appointed by the
Secretary from among employees of the Department of Veterans
Affairs who are experts in military sexual trauma and mental
health, of whom--
(A) one or more shall be appointed from among
mental health providers of the Veterans Health
Administration;
(B) one or more shall be appointed from among
experts on sexual assault and sexual harassment of the
Veterans Benefits Administration; and
(C) one or more shall be appointed from among
experts on sexual assault and sexual harassment of the
Board of Veterans' Appeals.
(3) Duties.--The board established under paragraph (1)
shall--
(A) review standard correspondence, which may
include templates for notices under sections 5103,
5104, 5104B, and 7104 of title 38, United States Code,
from the Department to individuals who have experienced
military sexual trauma for sensitivity; and
(B) ensure that the correspondence--
(i) treats such individuals with dignity
and respect; and
(ii) does not re-traumatize such
individuals.
(4) Individual who has experienced military sexual trauma
defined.--In this subsection, the term ``individual who has
experienced military sexual trauma'' means--
(A) a veteran who has filed a claim for
compensation under chapter 11 of title 38, United
States Code, relating to military sexual trauma;
(B) a veteran who has been awarded compensation
under such chapter relating to military sexual trauma;
or
(C) a former member of the Armed Forces or a
veteran who is receiving care from the Department
relating to military sexual trauma.
(b) Contents of Certain Written Communications to Individuals Who
Have Experienced Military Sexual Trauma.--
(1) Notice to claimants of required information and
evidence.--Section 5103 of title 38, United States Code, is
amended by adding at the end the following new subsection:
``(c) Written Communications to Individuals Who Have Experienced
Military Sexual Trauma.--(1) The Secretary shall ensure that any
written communication under this section from the Department to an
individual who has experienced military sexual trauma includes contact
information for each of the following:
``(A) The military sexual trauma coordinator of the
Veterans Benefits Administration.
``(B) The military sexual trauma coordinator of the
Veterans Health Administration.
``(C) The Veterans Crisis Line.
``(D) The facility of the Veterans Health Administration
closest to where the individual resides.
``(2) In this subsection:
``(A) The term `individual who has experienced military
sexual trauma' means--
``(i) a veteran who has filed a claim for
compensation under chapter 11 of this title relating to
military sexual trauma;
``(ii) a veteran who has been awarded compensation
under such chapter relating to military sexual trauma;
or
``(iii) a former member of the Armed Forces or a
veteran who is receiving care from the Department
relating to military sexual trauma.
``(B) The term `military sexual trauma' has the meaning
given that term in section 1167(i) of this title.
``(C) The term `Veterans Crisis Line' means the toll-free
hotline for veterans established under section 1720F(h) of this
title.''.
(2) Decisions and notices of decisions.--Section 5104 of
title 38, United States Code, is amended by adding at the end
the following new subsection:
``(c)(1) The Secretary shall ensure that any written communication
under this section from the Department to an individual who has
experienced military sexual trauma includes contact information for
each of the following:
``(A) The military sexual trauma coordinator of the
Veterans Health Administration.
``(B) The Veterans Crisis Line.
``(C) The facility of the Veterans Health Administration
closest to where the individual resides.
``(2) The Secretary shall ensure that any written communication
under this section from the Department to an individual who has
experienced military sexual trauma that includes notification of an
award of compensation under chapter 11 of this title relating to
military sexual trauma includes--
``(A) the contact information described in paragraph (1);
and
``(B) the contact information for the military sexual
trauma coordinator of the Veterans Benefits Administration.
``(3) In this subsection:
``(A) The term `individual who has experienced military
sexual trauma' means--
``(i) a veteran who has filed a claim for
compensation under chapter 11 of this title relating to
military sexual trauma;
``(ii) a veteran who has been awarded compensation
under such chapter relating to military sexual trauma;
or
``(iii) a former member of the Armed Forces or a
veteran who is receiving care from the Department
relating to military sexual trauma.
``(B) The term `military sexual trauma' has the meaning
given that term in section 1167(i) of this title.
``(C) The term `Veterans Crisis Line' means the toll-free
hotline for veterans established under section 1720F(h) of this
title.''.
(3) Higher-level review by the agency of original
jurisdiction.--Section 5104B of title 38, United States Code,
is amended by adding at the end the following new subsection:
``(f) Written Communications to Individuals Who Have Experienced
Military Sexual Trauma.--(1) The Secretary shall ensure that any
written communication under this section from the Department to an
individual who has experienced military sexual trauma includes contact
information for each of the following:
``(A) The military sexual trauma coordinator of the
Veterans Health Administration.
``(B) The Veterans Crisis Line.
``(C) The facility of the Veterans Health Administration
closest to where the individual resides.
``(2) The Secretary shall ensure that any written communication
under this section from the Department to an individual who has
experienced military sexual trauma that includes notification of an
award of compensation under chapter 11 of this title relating to
military sexual trauma includes--
``(A) the contact information described in paragraph (1);
and
``(B) the contact information for the military sexual
trauma coordinator of the Veterans Benefits Administration.
``(3) In this subsection:
``(A) The term `individual who has experienced military
sexual trauma' means--
``(i) a veteran who has filed a claim for
compensation under chapter 11 of this title relating to
military sexual trauma;
``(ii) a veteran who has been awarded compensation
under such chapter relating to military sexual trauma;
or
``(iii) a former member of the Armed Forces or a
veteran who is receiving care from the Department
relating to military sexual trauma.
``(B) The term `military sexual trauma' has the meaning
given that term in section 1167(i) of this title.
``(C) The term `Veterans Crisis Line' means the toll-free
hotline for veterans established under section 1720F(h) of this
title.''.
(4) Board of veterans' appeals.--Section 7104 of title 38,
United States Code, is amended by adding at the end the
following new subsection:
``(f)(1) The Secretary shall ensure that any written communication
under this section from the Department to an individual who has
experienced military sexual trauma includes contact information for
each of the following:
``(A) The military sexual trauma coordinator of the
Veterans Health Administration.
``(B) The Veterans Crisis Line.
``(C) The facility of the Veterans Health Administration
closest to where the individual resides.
``(2) The Secretary shall ensure that any written communication
under this section from the Department to an individual who has
experienced military sexual trauma that includes notification of an
award of compensation under chapter 11 of this title relating to
military sexual trauma includes--
``(A) the contact information described in paragraph (1);
and
``(B) the contact information for the military sexual
trauma coordinator of the Veterans Benefits Administration.
``(3) In this subsection:
``(A) The term `individual who has experienced military
sexual trauma' means--
``(i) a veteran who has filed a claim for
compensation under chapter 11 of this title relating to
military sexual trauma;
``(ii) a veteran who has been awarded compensation
under such chapter relating to military sexual trauma;
or
``(iii) a former member of the Armed Forces or a
veteran who is receiving care from the Department
relating to military sexual trauma.
``(B) The term `military sexual trauma' has the meaning
given that term in section 1167(i) of this title.
``(C) The term `Veterans Crisis Line' means the toll-free
hotline for veterans established under section 1720F(h) of this
title.''.
SEC. 206. STUDY ON TRAINING AND PROCESSING RELATING TO CLAIMS FOR
DISABILITY COMPENSATION RELATING TO MILITARY SEXUAL
TRAUMA.
(a) Study Required.--The Secretary of Veterans Affairs shall
conduct a study on--
(1) the quality of training provided to personnel of the
Department of Veterans Affairs who review claims for disability
compensation under chapter 11 of title 38, United States Code,
for disabilities relating to military sexual trauma; and
(2) the quality of the procedures of the Department for
reviewing the accuracy of the processing of such claims.
(b) Elements.--The study required by subsection (a) shall include
the following:
(1) With respect to the quality of training described in
paragraph (1) of such subsection:
(A) Whether the Department ensures personnel
complete such training on time.
(B) Whether the training has resulted in
improvements to the processing of claims described in
such subsection and issue-based accuracy.
(C) Such recommendations as the Secretary of
Veterans Affairs may have for improving the training.
(2) With respect to the quality of procedures described in
paragraph (2) of such subsection:
(A) Whether the procedures of the Department for
reviewing the accuracy of the processing of claims
described in such subsection comport with generally
accepted statistical methodologies to ensure reasonable
accuracy of such reviews.
(B) Whether such procedures adequately include
mechanisms to correct errors found in such reviews.
(C) Such recommendations as the Secretary may have
for improving such procedures.
(c) Report Required.--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 the findings of the
Secretary with respect to the study conducted under subsection (a).
SEC. 207. ANNUAL SPECIAL FOCUS REVIEW OF CLAIMS FOR DISABILITY
COMPENSATION FOR DISABILITIES RELATING TO MILITARY SEXUAL
TRAUMA.
(a) Annual Special Focus Review.--
(1) In general.--Each year, the Under Secretary for
Benefits of the Department of Veterans Affairs shall conduct a
special focus review on the accuracy of the processing of
claims for disability compensation under chapter 11 of title
38, United States Code, for disabilities relating to military
sexual trauma.
(2) Elements.--Each review conducted under paragraph (1)
shall include a review of the following:
(A) A statistically significant, nationally
representative sample of all claims for benefits under
the laws administered by the Secretary of Veterans
Affairs relating to military sexual trauma filed during
the fiscal year preceding the fiscal year in which the
report is submitted.
(B) The accuracy of each decision made with respect
to each claim described in subparagraph (A).
(C) The types of benefit entitlement errors found,
disaggregated by category.
(D) Trends from year to year.
(E) Training completion rates for personnel of the
Department who process claims described in paragraph
(1).
(b) Reprocessing of Claims.--If the Under Secretary finds, pursuant
to a special focus review conducted under subsection (a)(1), that an
error was made with respect to the entitlement of a veteran to a
benefit under the laws administered by the Secretary, the Secretary
shall return the relevant claim of the veteran to the appropriate
regional office of the Department for reprocessing to ensure that the
veteran receives an accurate decision with respect to the claim.
(c) Re-reviewing of Claims.--If the Under Secretary finds, pursuant
to a special focus review conducted under paragraph (1) of subsection
(a), that the accuracy rate, under paragraph (2)(B) of such subsection,
is less than 90 percent, the Secretary shall conduct a review of each
claim for benefits under the laws administered by the Secretary of
Veterans Affairs relating to military sexual trauma filed during the
fiscal year preceding the fiscal year in which the report is submitted.
(d) Report.--Section 5501(b)(2) of the Johnny Isakson and David P.
Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020
(Public Law 116-315; 134 Stat. 5048) is amended by adding at the end
the following new subparagraph:
``(I) The findings of the most recent special focus
review conducted under subsection (a)(1) of section 207
of the Servicemembers and Veterans Empowerment and
Support Act of 2021, including--
``(i) the elements under subsection (a)(2)
of such section;
``(ii) the number of claims returned for
reprocessing under subsection (b) of such
section; and
``(iii) the number of claims described in
clause (ii) for which the decision relating to
service-connection or entitlement to
compensation changed as a result of
reprocessing the claim.''.
(e) Sunset.--On the date that the Under Secretary determines,
pursuant to special focus reviews conducted under paragraph (1) of
subsection (a), that the accuracy rates under paragraph (2)(B) of such
subsection have been 95 percent or greater for five consecutive years--
(1) subsection (a)(1) shall cease to be in effect; and
(2) subparagraph (I) of section 5501(b)(2) of the Johnny
Isakson and David P. Roe, M.D. Veterans Health Care and
Benefits Improvement Act of 2020 (Public Law 116-315; 134 Stat.
5048), as added by subsection (d), is repealed.
TITLE III--ACCESS TO HEALTH CARE
SEC. 301. EXPANSION OF ELIGIBILITY FOR COUNSELING AND TREATMENT FOR
MILITARY SEXUAL TRAUMA TO INCLUDE ALL FORMER MEMBERS OF
THE RESERVE COMPONENTS OF THE ARMED FORCES.
Section 1720D of title 38, United States Code, is amended--
(1) in subsection (a)--
(A) in paragraph (1), by striking ``a physical
assault'' and all that follows through the period at
the end and inserting ``military sexual trauma.''; and
(B) in paragraph (2), by striking ``was suffered''
and all that follows through the period at the end and
inserting ``resulted from military sexual trauma.'';
and
(2) by striking subsections (f) and (g) and inserting the
following new subsection (f):
``(f) In this section:
``(1) The term `former member of the Armed Forces' means a
person who served on active duty, active duty for training, or
inactive duty training, and who was discharged or released
therefrom under any condition that is not--
``(A) a discharge by court-martial; or
``(B) a discharge subject to a bar to benefits
under section 5303 of this title.
``(2) The term `military sexual trauma' means, with respect
to a member of the Armed Forces or former member of the Armed
Forces, a physical assault of a sexual nature, battery of a
sexual nature, or sexual harassment which occurred while the
member or former member was serving on duty, regardless of duty
status or line of duty determination (as that term is used in
section 12323 of title 10).
``(3) The term `sexual harassment' means unsolicited verbal
or physical contact of a sexual nature which is threatening in
character.''.
SEC. 302. CONNECTION TO VETERANS HEALTH ADMINISTRATION WHEN A
DISABILITY CLAIM RELATED TO MILITARY SEXUAL TRAUMA IS
SUBMITTED TO VETERANS BENEFITS ADMINISTRATION.
(a) In General.--Not later than 14 days after the date on which a
veteran submits a claim for disability compensation to the Veterans
Benefits Administration for a disability related to military sexual
trauma, the Secretary of Veterans Affairs shall send a communication to
the veteran with the following information:
(1) The contact information for the nearest military sexual
trauma coordinator for the veteran at the Veterans Benefits
Administration and a description of the assistance such
coordinator can provide.
(2) The contact information for the nearest military sexual
trauma coordinator for the veteran at the Veterans Health
Administration and a description of the assistance such
coordinator can provide.
(3) The types of services that individuals who have
experienced military sexual trauma are eligible to receive from
the Department of Veterans Affairs, including the nearest
locations and the contact information for such services.
(4) The contact information for the Veterans Crisis Line
established under section 1720F(h) of title 38, United States
Code.
(5) Such other information on services, care, or resources
for military sexual trauma as the Secretary determines
appropriate.
(b) Definition of Military Sexual Trauma.--In this section, the
term ``military sexual trauma'' has the meaning given that term in
section 1167(i) of title 38, United States Code, as added by section
203(a).
SEC. 303. PILOT PROGRAM FOR INTERIM ACCESS TO MENTAL HEALTH CARE FOR
INDIVIDUALS WHO HAVE EXPERIENCED MILITARY SEXUAL TRAUMA.
(a) In General.--Commencing not later than one year after the date
of the enactment of this Act, the Secretary of Veterans Affairs shall
carry out a pilot program to provide intensive outpatient mental health
care to current and former members of the Armed Forces who have
experienced military sexual trauma when the wait times for residential
mental health care from the Department of Veterans Affairs for the
individual is more than 14 days.
(b) Duration.--The Secretary shall carry out the pilot program
under subsection (a) for a three-year period beginning on the
commencement of the pilot program.
(c) Locations.--
(1) In general.--The Secretary shall carry out the pilot
program under subsection (a) at not fewer than four Veterans
Integrated Service Networks of the Department.
(2) Selection of locations.--In selecting locations for the
pilot program under subsection (a), the Secretary shall select
locations that have the longest wait times for residential
mental health care, particularly for individuals who have
experienced military sexual trauma.
(3) Notification.--Before commencing the pilot program
under subsection (a), the Secretary shall notify the Committee
on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives of the
locations selected for the pilot program.
(d) Types of Services.--Subject to the preference of the individual
participating in the pilot program under subsection (a) and the
capacity of facilities of the Department, the Secretary may provide
services under the pilot program via telehealth or in person at a
facility of the Department.
(e) Participation.--
(1) Clarification on participation.--Participation by an
individual in the pilot program under subsection (a) shall be
during the period in which the individual is waiting for a
residential mental health bed opening and shall not disqualify
the individual from receiving residential mental health care
following their participation in the pilot program.
(2) Decisions on participation.--Decisions about the
participation of an individual in the pilot program and the
transition of the individual to residential mental health care
shall be made by the individual and their health care provider.
(f) Report.--Not later than 180 days after the conclusion of the
pilot program under subsection (a), the Secretary shall submit to
Congress a report on--
(1) participation in the pilot program;
(2) clinical outcomes under the pilot program; and
(3) such recommendations for continuation or termination of
the program as the Secretary may have, including
recommendations for legislative or administrative action.
(g) Definition of Military Sexual Trauma.--In this section, the
term ``military sexual trauma'' has the meaning given that term in
section 1720D(f) of title 38, United States Code, as added by section
301.
SEC. 304. COMPTROLLER GENERAL STUDY ON ACCESS TO CARE FROM DEPARTMENT
OF VETERANS AFFAIRS FOR INDIVIDUALS WHO HAVE EXPERIENCED
MILITARY SEXUAL TRAUMA.
(a) In General.--The Comptroller General of the United States shall
conduct a study on access to mental health care at facilities of the
Department of Veterans Affairs for individuals who have experienced
military sexual trauma.
(b) Elements.--The study conducted under subsection (a) shall
include an assessment of the following:
(1) The availability of residential and outpatient
services, including wait times and geographic disparities for
such services, to include--
(A) an assessment of the availability of bed spaces
in the mental health residential rehabilitation
treatment programs of the Department of Veterans
Affairs for individuals who have experienced military
sexual trauma, including an assessment of the
suitability of those programs for such individuals and
the wait times for services under those programs;
(B) an assessment of geographic disparities in
access to those programs for individuals who have
experienced military sexual trauma, including by region
and by rural and urban areas;
(C) an assessment of alternative care options
provided when an individual who has experienced
military sexual trauma is waiting for residential care,
the efficacy of those alternatives, and the
satisfaction of patients with those alternatives;
(D) recommendations for reducing the average wait
time for services under those programs to 14 days or
less, including by increasing bed space or addressing
staffing needs; and
(E) an assessment of the satisfaction of patients
with the tracks of those programs specific to military
sexual trauma, an assessment of the wait times for
services under those tracks, and recommendations for
increasing or changing the number of locations for
services under those tracks to better meet the needs of
individuals who have experienced military sexual
trauma.
(2) The communication and advertisement by the Department
of the care, services, and resources available for individuals
who have experienced military sexual trauma.
(3) The barriers to accessing health care related to
military sexual trauma at a facility of the Department for
individuals who have experienced military sexual trauma,
including transportation, child care, lack of telehealth,
gender-specific barriers, and more.
(4) The extent to which the Secretary has assessed the
quality of the training provided to providers of the Department
on military sexual trauma and made any adjustments in response
to such assessment.
(5) The role of Vet Centers in providing care to
individuals who have experienced military sexual trauma,
including current and former members of the Armed Forces.
(6) Any current actions by the Secretary to strengthen
access to high-quality care for individuals who have
experienced military sexual trauma and such recommendations for
improving access to care for such individuals as the
Comptroller General considers appropriate.
(c) Report.--Not later than two years after the date of the
enactment of this Act, the Comptroller General shall submit to Congress
a report on the findings of the study conducted under subsection (a).
(d) Definitions.--In this section:
(1) Military sexual trauma.--The term ``military sexual
trauma'' has the meaning given that term in section 1720D(f) of
title 38, United States Code, as added by section 301.
(2) Vet center.--The term ``Vet Center'' has the meaning
given that term in section 1712A(h) of title 38, United States
Code.
Calendar No. 289
117th CONGRESS
2d Session
S. 3025
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to expand health care and
benefits from the Department of Veterans Affairs for military sexual
trauma, and for other purposes.
_______________________________________________________________________
March 1, 2022
Reported with an amendment