II
111th CONGRESS
1st Session
S. 597
IN THE SENATE OF THE UNITED STATES
March 16, 2009
Mrs. Murray (for herself, Mrs. Hutchison, Mr. Rockefeller, Ms. Mikulski, Mrs. Boxer, Ms. Snowe, Mr. Wyden, Mr. Johnson, Mrs. Lincoln, Ms. Stabenow, Ms. Murkowski, Mr. Brown, Ms. Collins, and Mr. Lautenberg) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs
A BILL
To amend title 38, United States Code, to expand and improve health care services available to women veterans, especially those serving in Operation Iraqi Freedom and Operation Enduring Freedom, from the Department of Veterans Affairs, and for other purposes.
Short title; table of contents
Short title
This Act may be cited
as the Women Veterans Health Care
Improvement Act of 2009
.
Table of contents
The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—Studies and assessments of Department of Veterans Affairs health services for women veterans
Sec. 101. Report on barriers to receipt of health care for women veterans.
Sec. 102. Independent study on health consequences of women veterans of military service in Operation Iraqi Freedom and Operation Enduring Freedom.
Sec. 103. Report on full-time program managers for women veterans programs at medical centers.
TITLE II—Improvement and expansion of Department of Veterans Affairs health care programs for women veterans
Sec. 201. Plan to improve provision of health care services to women veterans.
Sec. 202. Training and certification for mental health care providers on care for veterans suffering from sexual trauma.
Sec. 203. Pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces.
Sec. 204. Service on certain advisory committees of women recently separated from service in the Armed Forces.
Sec. 205. Pilot program on subsidies for child care for certain veterans receiving health care.
Sec. 206. Care for newborn children of women veterans receiving maternity care.
Studies and assessments of Department of Veterans Affairs health services for women veterans
Report on barriers to receipt of health care for women veterans
Report
Not later than June 1, 2010, 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 barriers to the receipt of comprehensive health care through the Department of Veterans Affairs that are encountered by women veterans, especially veterans of Operation Iraqi Freedom and Operation Enduring Freedom.
Elements
The report required by subsection (a) shall include the following:
An identification and assessment of the following:
Any stigma perceived or associated by women veterans in seeking mental health care services through the Department of Veterans Affairs.
The effect on access by women veterans to care through the Department of driving distance or availability of other forms of transportation to the nearest appropriate facility of the Department.
The availability of child care.
The receipt of health care through women's health clinics, integrated primary care clinics, or both.
The extent of comprehension by women veterans of eligibility requirements for health care through the Department, and the scope of health care services available through the Department.
The quality and nature of the reception of women veterans by Department health care providers and other staff.
The perception of personal safety and comfort of women veterans in inpatient, outpatient, and behavioral health facilities of the Department.
The sensitivity of Department health care providers and other staff to issues that particularly affect women.
The effectiveness of outreach on health care services of the Department that are available to women veterans.
Such other matters as the Secretary identifies for purposes of the assessment.
Such recommendations for administrative and legislative action as the Secretary considers appropriate in light of the report.
Facility of the Department defined
In this section, the term facility of the Department has the meaning given that term in section 1701 of title 38, United States Code.
Independent study on health consequences of women veterans of military service in Operation Iraqi Freedom and Operation Enduring Freedom
Study required
The Secretary of Veterans Affairs shall enter into an agreement with a non-Department of Veterans Affairs entity for the purpose of conducting a study on health consequences for women veterans of service on active duty in the Armed Forces in deployment in Operation Iraqi Freedom and Operation Enduring Freedom.
Specific matters studied
The study under subsection (a) shall include the following:
A determination of any association of environmental and occupational exposures and combat in Operation Iraqi Freedom or Operation Enduring Freedom with the general health, mental health, or reproductive health of women who served on active duty in the Armed Forces in Operation Iraqi Freedom or Operation Enduring Freedom.
A review and analysis of published literature on environmental and occupational exposures of women while serving in the Armed Forces, including combat trauma, military sexual trauma, and exposure to potential teratogens associated with reproductive problems and birth defects.
Report
In general
Not later than 18 months after entering into the agreement for the study under subsection (a), the entity described in subsection (a) shall submit to the Secretary of Veterans Affairs and to Congress a report on the study containing such findings and determinations as the entity considers appropriate.
Responsive report
Not later than 90 days after the receipt of the report under paragraph (1), the Secretary shall submit to Congress a report setting forth the response of the Secretary to the findings and determinations of the entity described in subsection (a) in the report under paragraph (1).
Report on full-time program managers for women veterans programs at medical centers
The Secretary of Veterans Affairs shall, acting through the Under Secretary for Health, submit to Congress a report on employment of full-time managers for women veterans programs at Department of Veterans Affairs medical centers to ensure that health care needs of women veterans at such medical centers are met. The report shall include an assessment of whether there is at least one full-time employee at each Department medical center who is a full-time women veterans programs manager.
Improvement and expansion of Department of Veterans Affairs health care programs for women veterans
Plan to improve provision of health care services to women veterans
Plan To improve services
In general
The Secretary of Veterans Affairs shall develop a plan—
to improve the provision of health care services to women veterans; and
to plan appropriately for the future health care needs, including mental health care needs, of women serving on active duty in the Armed Forces in the combat theaters of Operation Iraqi Freedom and Operation Enduring Freedom.
Required actions
In developing the plan required by this subsection, the Secretary shall—
identify the types of health care services to be available to women veterans at each Department of Veterans Affairs medical center; and
identify the personnel and other resources required to provide such services to women veterans under the plan at each such medical center.
Submittal of plan to Congress
Not later than 18 months 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 the plan required by this section, together with such recommendations for administrative and legislative action as the Secretary considers appropriate in light of the plan.
Training and certification for mental health care providers on care for veterans suffering from sexual trauma
Program required
Section 1720D of title 38, United States Code, is amended—
by redesignating subsection (d) as subsection (f); and
by inserting after subsection (c) the following new subsections:
The Secretary shall carry out a program of education, training, certification, and continuing medical education for mental health professionals to specialize in the provision of counseling and care to veterans eligible for services under subsection (a). In carrying out the program, the Secretary shall ensure that all such mental health professionals have been trained in a consistent manner and that such training includes principles of evidence-based treatment and care for sexual trauma.
The Secretary shall determine the minimum qualifications necessary for mental health professionals certified by the program under paragraph (1) to provide evidence-based treatment and care to veterans eligible for services under subsection (a) in facilities of the Department.
The Secretary shall submit to Congress each year a report on the counseling, care, and services provided to veterans under this section. Each report shall include data for the preceding year with respect to the following:
The number of mental health professionals and primary care providers who have been certified under the program under subsection (d), and the amount and nature of continuing medical education provided under such program to professionals and providers who have been so certified.
The number of women veterans who received counseling, care, and services under subsection (a) from professionals and providers who have been trained or certified under the program under subsection (d).
The number of training, certification, and continuing medical education programs operating under subsection (d).
The number of trained full-time equivalent employees required in each facility of the Department to meet the needs of veterans requiring treatment and care for sexual trauma.
Such other information as the Secretary considers appropriate.
.
Standards for personnel providing treatment for sexual trauma
The Secretary of Veterans Affairs shall establish standards on education, training, certification, and staffing for Department of Veterans Affairs health care facilities for full-time equivalent employees who are trained to provide treatment and care to veterans for sexual trauma.
Pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces
Pilot program required
In general
Commencing not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out, through the Readjustment Counseling Service of the Veterans Health Administration, a pilot program to evaluate the feasibility and advisability of providing reintegration and readjustment services described in subsection (b) in group retreat settings to women veterans who are recently separated from service in the Armed Forces after a prolonged deployment.
Participation at election of veteran
The participation of a veteran in the pilot program shall be at the election of the veteran.
Covered services
The services provided to a woman veteran under the pilot program shall include the following:
Information on reintegration into the veteran's family, employment, and community.
Financial counseling.
Occupational counseling.
Information and counseling on stress reduction.
Information and counseling on conflict resolution.
Such other information and counseling as the Secretary considers appropriate to assist a woman veteran under the pilot program in reintegration into the veteran's family and community.
Locations
The Secretary shall carry out the pilot program at not fewer than five locations selected by the Secretary for purposes of the pilot program.
Duration
The pilot program shall be carried out during the two-year period beginning on the date of the commencement of the pilot program.
Report
Not later than 180 days after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program. The report shall contain the findings and conclusions of the Secretary as a result of the pilot program and shall include such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate.
Authorization of appropriations
There are authorized to be appropriated to the Secretary of Veterans Affairs for each of fiscal years 2010 and 2011, $2,000,000 to carry out the pilot program.
Service on certain advisory committees of women recently separated from service in the Armed Forces
Advisory committee on women veterans
Section 542(a)(2)(A) of title 38, United States Code, is amended—
in clause (ii),
by striking and
at the end;
in clause (iii),
by striking the period at the end and inserting ; and
;
and
by inserting after clause (iii) the following new clause:
women veterans who are recently separated from service in the Armed Forces.
.
Advisory committee on minority veterans
Section 544(a)(2)(A) of such title is amended—
in clause (iii),
by striking and
at the end;
in clause (iv),
by striking the period at the end and inserting ; and
;
and
by inserting after clause (iv) the following new clause:
women veterans who are minority group members and are recently separated from service in the Armed Forces.
.
Effective date
The amendments made by this section shall apply to appointments made on or after the date of the enactment of this Act.
Pilot program on subsidies for child care for certain veterans receiving health care
Pilot program required
The Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing, subject to subsection (b), subsidies to qualified veterans described in subsection (c) to obtain child care so that such veterans can receive health care services described in subsection (c).
Limitation on period of payments
A subsidy may only be provided to a qualified veteran under the pilot program for receipt of child care during the period that the qualified veteran—
receives the types of health care services described in subsection (c) at a facility of the Department; and
requires to travel to and return from such facility for the receipt of such health care services.
Qualified veterans
In this section, the term qualified veteran means a veteran who is the primary caretaker of a child or children and who is receiving from the Department one or more of the following health care services:
Regular mental health care services.
Intensive mental health care services.
Such other intensive health care services that the Secretary determines that payment to the veteran for the provision of child care would improve access to those health care services by the veteran.
Locations
The Secretary shall carry out the pilot program in not fewer than three Veterans Integrated Service Networks (VISNs) selected by the Secretary for purposes of the pilot program.
Duration
The pilot program shall be carried out during the two-year period beginning on the date of the commencement of the pilot program.
Existing model
To the extent practicable, the Secretary shall model the pilot program 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), using the same income eligibility standards and payment structure.
Report
Not later than six months after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program. The report shall include the findings and conclusions of the Secretary as a result of the pilot program and shall include such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate.
Authorization of appropriations
There are authorized to be appropriated to the Secretary of Veterans Affairs for each of fiscal years 2010 and 2011, $1,500,000 to carry out the pilot program.
Care for newborn children of women veterans receiving maternity care
In general
Subchapter VIII of chapter 17 of title 38, United States Code, is amended by adding at the end the following new section:
Care for newborn children of women veterans receiving maternity care
In general
The Secretary may furnish health care services described in subsection (b) to a newborn child of a woman veteran who is receiving maternity care furnished by the Department for not more than seven days after the birth of the child if the veteran delivered the child in—
a facility of the Department; or
another facility pursuant to a Department contract for services relating to such delivery.
Covered health care services
Health care services described in this subsection are all post-delivery care services, including routine care services, that a newborn requires.
.
Clerical amendment
The table of sections at the beginning of such chapter 17 is amended by inserting after the item relating to section 1785 the following new item:
.