[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 597 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 597

  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.


_______________________________________________________________________


                   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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Women Veterans 
Health Care Improvement Act of 2009''.
    (b) 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.

  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.

    (a) 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.
    (b) Elements.--The report required by subsection (a) shall include 
the following:
            (1) An identification and assessment of the following:
                    (A) Any stigma perceived or associated by women 
                veterans in seeking mental health care services through 
                the Department of Veterans Affairs.
                    (B) 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.
                    (C) The availability of child care.
                    (D) The receipt of health care through women's 
                health clinics, integrated primary care clinics, or 
                both.
                    (E) 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.
                    (F) The quality and nature of the reception of 
                women veterans by Department health care providers and 
                other staff.
                    (G) The perception of personal safety and comfort 
                of women veterans in inpatient, outpatient, and 
                behavioral health facilities of the Department.
                    (H) The sensitivity of Department health care 
                providers and other staff to issues that particularly 
                affect women.
                    (I) The effectiveness of outreach on health care 
                services of the Department that are available to women 
                veterans.
                    (J) Such other matters as the Secretary identifies 
                for purposes of the assessment.
            (2) Such recommendations for administrative and legislative 
        action as the Secretary considers appropriate in light of the 
        report.
    (c) 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.

SEC. 102. INDEPENDENT STUDY ON HEALTH CONSEQUENCES OF WOMEN VETERANS OF 
              MILITARY SERVICE IN OPERATION IRAQI FREEDOM AND OPERATION 
              ENDURING FREEDOM.

    (a) 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.
    (b) Specific Matters Studied.--The study under subsection (a) shall 
include the following:
            (1) 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.
            (2) 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.
    (c) Report.--
            (1) 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.
            (2) 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).

SEC. 103. 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.

 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.

    (a) Plan To Improve Services.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        develop a plan--
                    (A) to improve the provision of health care 
                services to women veterans; and
                    (B) 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.
            (2) Required actions.--In developing the plan required by 
        this subsection, the Secretary shall--
                    (A) identify the types of health care services to 
                be available to women veterans at each Department of 
                Veterans Affairs medical center; and
                    (B) identify the personnel and other resources 
                required to provide such services to women veterans 
                under the plan at each such medical center.
    (b) 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.

SEC. 202. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE PROVIDERS 
              ON CARE FOR VETERANS SUFFERING FROM SEXUAL TRAUMA.

    (a) Program Required.--Section 1720D of title 38, United States 
Code, is amended--
            (1) by redesignating subsection (d) as subsection (f); and
            (2) by inserting after subsection (c) the following new 
        subsections:
    ``(d)(1) 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.
    ``(2) 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.
    ``(e) 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:
            ``(1) 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.
            ``(2) 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).
            ``(3) The number of training, certification, and continuing 
        medical education programs operating under subsection (d).
            ``(4) 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.
            ``(5) Such other information as the Secretary considers 
        appropriate.''.
    (b) 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.

SEC. 203. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR WOMEN 
              VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED 
              FORCES.

    (a) Pilot Program Required.--
            (1) 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.
            (2) Participation at election of veteran.--The 
        participation of a veteran in the pilot program shall be at the 
        election of the veteran.
    (b) Covered Services.--The services provided to a woman veteran 
under the pilot program shall include the following:
            (1) Information on reintegration into the veteran's family, 
        employment, and community.
            (2) Financial counseling.
            (3) Occupational counseling.
            (4) Information and counseling on stress reduction.
            (5) Information and counseling on conflict resolution.
            (6) Such other information and counseling as the Secretary 
        considers appropriate to assist a woman veteran under the pilot 
        program in reintegration into the veteran's family and 
        community.
    (c) 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.
    (d) Duration.--The pilot program shall be carried out during the 
two-year period beginning on the date of the commencement of the pilot 
program.
    (e) 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.
    (f) 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.

SEC. 204. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN RECENTLY 
              SEPARATED FROM SERVICE IN THE ARMED FORCES.

    (a) Advisory Committee on Women Veterans.--Section 542(a)(2)(A) of 
title 38, United States Code, is amended--
            (1) in clause (ii), by striking ``and'' at the end;
            (2) in clause (iii), by striking the period at the end and 
        inserting ``; and''; and
            (3) by inserting after clause (iii) the following new 
        clause:
            ``(iv) women veterans who are recently separated from 
        service in the Armed Forces.''.
    (b) Advisory Committee on Minority Veterans.--Section 544(a)(2)(A) 
of such title is amended--
            (1) in clause (iii), by striking ``and'' at the end;
            (2) in clause (iv), by striking the period at the end and 
        inserting ``; and''; and
            (3) by inserting after clause (iv) the following new 
        clause:
            ``(v) women veterans who are minority group members and are 
        recently separated from service in the Armed Forces.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to appointments made on or after the date of the enactment of 
this Act.

SEC. 205. PILOT PROGRAM ON SUBSIDIES FOR CHILD CARE FOR CERTAIN 
              VETERANS RECEIVING HEALTH CARE.

    (a) 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).
    (b) 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--
            (1) receives the types of health care services described in 
        subsection (c) at a facility of the Department; and
            (2) requires to travel to and return from such facility for 
        the receipt of such health care services.
    (c) 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:
            (1) Regular mental health care services.
            (2) Intensive mental health care services.
            (3) 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.
    (d) 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.
    (e) Duration.--The pilot program shall be carried out during the 
two-year period beginning on the date of the commencement of the pilot 
program.
    (f) 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.
    (g) 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.
    (h) 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.

SEC. 206. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING 
              MATERNITY CARE.

    (a) In General.--Subchapter VIII of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 1786. Care for newborn children of women veterans receiving 
              maternity care
    ``(a) 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--
            ``(1) a facility of the Department; or
            ``(2) another facility pursuant to a Department contract 
        for services relating to such delivery.
    ``(b) 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.''.
    (b) 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:

``1786. Care for newborn children of women veterans receiving maternity 
                            care.''.
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