[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 131 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                 S. 131

  To amend title 38, United States Code, to improve the reproductive 
 assistance provided by the Department of Veterans Affairs to severely 
  wounded, ill, or injured veterans and their spouses, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

             January 24 (legislative day, January 3), 2013

 Mrs. Murray (for herself, Mr. Begich, and Mr. Tester) 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 improve the reproductive 
 assistance provided by the Department of Veterans Affairs to severely 
  wounded, ill, or injured veterans and their spouses, and for other 
                               purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Women Veterans and Other Health Care 
Improvements Act of 2013''.

SEC. 2. CLARIFICATION THAT FERTILITY COUNSELING AND TREATMENT ARE 
              MEDICAL SERVICES WHICH THE SECRETARY MAY FURNISH TO 
              VETERANS LIKE OTHER MEDICAL SERVICES.

    Section 1701(6) of title 38, United States Code, is amended by 
adding at the end the following new subparagraph:
                    ``(H) Fertility counseling and treatment, including 
                treatment using assisted reproductive technology.''.

SEC. 3. REPRODUCTIVE TREATMENT AND CARE FOR SPOUSES AND SURROGATES OF 
              VETERANS.

    (a) In General.--Subchapter VIII of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 1788. Reproductive treatment and care for spouses and surrogates 
              of veterans
    ``(a) In General.--The Secretary shall furnish fertility counseling 
and treatment, including through the use of assisted reproductive 
technology, to a spouse or surrogate of a severely wounded, ill, or 
injured veteran who has an infertility condition incurred or aggravated 
in line of duty in the active military, naval, or air service and who 
is enrolled in the system of annual patient enrollment established 
under section 1705(a) of this title if the spouse or surrogate and the 
veteran apply jointly for such counseling and treatment through a 
process prescribed by the Secretary.
    ``(b) Coordination of Care for Other Spouses and Surrogates.--In 
the case of a spouse or surrogate of a veteran not described in 
subsection (a) who is seeking fertility counseling and treatment, the 
Secretary may coordinate fertility counseling and treatment for such 
spouse or surrogate.
    ``(c) Construction.--Nothing in this section shall be construed to 
require the Secretary--
            ``(1) to find or certify a surrogate for a veteran or to 
        connect a surrogate with a veteran; or
            ``(2) to furnish maternity care to a spouse or surrogate of 
        a veteran.
    ``(d) Assisted Reproductive Technology Defined.--In this section, 
the term `assisted reproductive technology' includes in vitro 
fertilization and other fertility treatments in which both eggs and 
sperm are handled when clinically appropriate.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title is amended by inserting after the item 
relating to section 1787 the following new item:

``1788. Reproductive treatment and care for spouses and surrogates of 
                            veterans.''.

SEC. 4. ADOPTION ASSISTANCE FOR SEVERELY WOUNDED VETERANS.

    (a) In General.--Subchapter VIII of chapter 17 of title 38, United 
States Code, as amended by section 3, is further amended by adding at 
the end the following new section:
``Sec. 1789. Adoption assistance
    ``(a) In General.--The Secretary may pay an amount, not to exceed 
the limitation amount, to assist a covered veteran in the adoption of 
one or more children.
    ``(b) Covered Veteran.--For purposes of this section, a covered 
veteran is any severely wounded, ill, or injured veteran who--
            ``(1) has an infertility condition incurred or aggravated 
        in line of duty in the active military, naval, or air service; 
        and
            ``(2) is enrolled in the system of annual patient 
        enrollment established under section 1705(a) of this title.
    ``(c) Limitation Amount.--For purposes of this section, the 
limitation amount is the amount equal to the lesser of--
            ``(1) the cost the Department would incur if the Secretary 
        were to provide a covered veteran with one cycle of in vitro 
        fertilization, as determined by the Secretary; and
            ``(2) the cost the Department would incur by paying the 
        expenses of three adoptions by covered veterans, as determined 
        by the Secretary.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title, as amended by section 3, is further amended 
by inserting after the item relating to section 1788 the following new 
item:

``1789. Adoption assistance.''.

SEC. 5. ANNUAL REPORT ON PROVISION OF FERTILITY COUNSELING AND 
              TREATMENT FURNISHED BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act and not less frequently than once each year 
thereafter, the Secretary of Veterans Affairs shall submit to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a report on the 
fertility counseling and treatment furnished by the Department of 
Veterans Affairs during the year preceding the submittal of the report.
    (b) Elements.--Each report submitted under subsection (a) shall 
include, for the period covered by the report, the following:
            (1) The number of veterans who received fertility 
        counseling or treatment furnished by the Department of Veterans 
        Affairs, disaggregated by era of military service of such 
        veterans.
            (2) The number of spouses and surrogates of veterans who 
        received fertility counseling or treatment furnished by the 
        Department.
            (3) The cost to the Department of furnishing fertility 
        counseling and treatment, disaggregated by cost of services and 
        administration.
            (4) The average cost to the Department per recipient of 
        such counseling and treatment.
            (5) In cases in which the Department furnished fertility 
        treatment through the use of assisted reproductive technology, 
        the average number of cycles per person furnished.
            (6) A description of how fertility counseling and treatment 
        services of the Department are coordinated with similar 
        services of the Department of Defense.

SEC. 6. REGULATIONS ON FURNISHING OF FERTILITY COUNSELING AND TREATMENT 
              AND ADOPTION ASSISTANCE BY DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) In General.--Not later than 540 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall 
prescribe regulations--
            (1) on the furnishing of fertility treatment to veterans 
        using assisted reproductive technology;
            (2) to carry out section 1788 of title 38, United States 
        Code, as added by section 3; and
            (3) to carry out section 1789 of such title, as added by 
        section 4.
    (b) Limitation.--Notwithstanding any other provision of law, during 
the period beginning on the date of the enactment of this Act and 
ending on the date on which the Secretary prescribes regulations under 
subsection (a), the Secretary may not furnish--
            (1) to a veteran any fertility treatment that uses an 
        assisted reproductive technology that the Secretary has not 
        used in the provision of a fertility treatment to a veteran 
        before the date of the enactment of this Act;
            (2) any fertility counseling or treatment under section 
        1788 of title 38, United States Code, as added by section 3; or
            (3) any assistance under section 1789 of such title, as 
        added by section 4.
    (c) Assisted Reproductive Technology Defined.--In this section, the 
term ``assisted reproductive technology'' has the meaning given the 
term in section 1788 of such title, as added by section 3.

SEC. 7. COORDINATION BETWEEN DEPARTMENT OF VETERANS AFFAIRS AND 
              DEPARTMENT OF DEFENSE ON FURNISHING OF FERTILITY 
              COUNSELING AND TREATMENT.

    The Secretary of Veterans Affairs and the Secretary of Defense 
shall share best practices and facilitate referrals, as they consider 
appropriate, on the furnishing of fertility counseling and treatment.

SEC. 8. FACILITATION OF REPRODUCTION AND INFERTILITY RESEARCH.

    (a) In General.--Subchapter II of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 7330B. Facilitation of reproduction and infertility research
    ``(a) Facilitation of Research Required.--The Secretary shall 
facilitate research conducted collaboratively by the Secretary of 
Defense and the Secretary of Health and Human Services to improve the 
ability of the Department of Veterans Affairs to meet the long-term 
reproductive health care needs of veterans who have a genitourinary 
service-connected disability or a condition that was incurred or 
aggravated in line of duty in the active military, naval, or air 
service, such as spinal cord injury, that affects the veterans' ability 
to reproduce.
    ``(b) Dissemination of Information.--The Secretary shall ensure 
that information produced by the research facilitated under this 
section that may be useful for other activities of the Veterans Health 
Administration is disseminated throughout the Veterans Health 
Administration.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 of such title is amended by inserting after the item 
relating to section 7330A the following new item:

``7330B. Facilitation of reproduction and infertility research.''.
    (c) Report.--Not later than three years after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to Congress a report on the research activities conducted by the 
Secretary under section 7330B of title 38, United States Code, as added 
by subsection (a).

SEC. 9. REQUIREMENT TO IMPROVE DEPARTMENT OF VETERANS AFFAIRS WOMEN 
              VETERANS CONTACT CENTER.

    The Secretary of Veterans Affairs shall enhance the capabilities of 
the Department of Veterans Affairs women veterans contact center--
            (1) to respond to requests by women veterans for assistance 
        with accessing health care and benefits furnished under laws 
        administered by the Secretary; and
            (2) for referral of such veterans to community resources to 
        obtain assistance with services not furnished by the 
        Department.

SEC. 10. MODIFICATION OF PILOT PROGRAM ON COUNSELING IN RETREAT 
              SETTINGS FOR WOMEN VETERANS NEWLY SEPARATED FROM SERVICE 
              IN THE ARMED FORCES.

    (a) Increase in Number of Locations.--Subsection (c) of section 203 
of the Caregivers and Veterans Omnibus Health Services Act of 2010 
(Public Law 111-163; 38 U.S.C. 1712A note) is amended by striking 
``three locations'' and inserting ``14 locations''.
    (b) Extension of Duration.--Subsection (d) of such section is 
amended by striking ``2-year'' and inserting ``four-year''.
    (c) Authorization of Appropriations.--Subsection (f) of such 
section is amended--
            (1) by striking ``Secretary of Veterans Affairs for each'' 
        and inserting the following: ``Secretary of Veterans Affairs--
            ``(1) for each'';
            (2) in paragraph (1), as designated by paragraph (1), by 
        striking the period at the end and inserting ``; and''; and
            (3) by adding at the end the following new paragraph:
            ``(2) for each of fiscal years 2013 and 2014, $400,000 to 
        carry out the pilot program.''.

SEC. 11. PROGRAM ON ASSISTANCE FOR CHILD CARE FOR CERTAIN VETERANS.

    (a) Assistance for Child Care for Certain Veterans Receiving Health 
Care.--
            (1) In general.--Subchapter I of chapter 17 of title 38, 
        United States Code, is amended by adding at the end the 
        following new section:
``Sec. 1709B. Assistance for child care for certain veterans receiving 
              health care
    ``(a) Program Required.--The Secretary shall carry out a program to 
provide, subject to subsection (b), assistance to qualified veterans 
described in subsection (c) to obtain child care so that such veterans 
can receive health care services described in subsection (c).
    ``(b) Limitation on Period of Payments.--Assistance may only be 
provided to a qualified veteran under this section for receipt of child 
care during the period that the qualified veteran--
            ``(1) receives the types of health care services described 
        in subsection (c) at a facility of the Department; and
            ``(2) requires travel to and return from such facility for 
        the receipt of such health care services.
    ``(c) Qualified Veterans.--For purposes of this section, a 
qualified veteran is a veteran who is--
            ``(1) the primary caretaker of a child or children; and
            ``(2)(A) receiving from the Department--
                    ``(i) regular mental health care services;
                    ``(ii) intensive mental health care services; or
                    ``(iii) such other intensive health care services 
                that the Secretary determines that provision of 
                assistance to the veteran to obtain child care would 
                improve access to such health care services by the 
                veteran; or
            ``(B) in need of regular or intensive mental health care 
        services from the Department, and but for lack of child care 
        services, would receive such health care services from the 
        Department.
    ``(d) Locations.--The Secretary shall carry out the program in no 
fewer than three Veterans Integrated Service Networks selected by the 
Secretary for purposes of the program.
    ``(e) Forms of Child Care Assistance.--(1) Child care assistance 
under this section may include the following:
            ``(A) Stipends for the payment of child care offered by 
        licensed child care centers (either directly or through a 
        voucher program) which shall be, to the extent practicable, 
        modeled after the Department of Veterans Affairs Child Care 
        Subsidy Program established pursuant to section 630 of the 
        Treasury and General Government Appropriations Act, 2002 
        (Public Law 107-67; 115 Stat. 552).
            ``(B) Direct provision of child care at an on-site facility 
        of the Department of Veterans Affairs.
            ``(C) Payments to private child care agencies.
            ``(D) Collaboration with facilities or programs of other 
        Federal departments or agencies.
            ``(E) Such other forms of assistance as the Secretary 
        considers appropriate.
    ``(2) In the case that child care assistance under this section is 
provided as a stipend under paragraph (1)(A), such stipend shall cover 
the full cost of such child care.''.
            (2) Conforming amendment.--Section 205(e) of the Caregivers 
        and Veterans Omnibus Health Services Act of 2010 (Public Law 
        111-163; 38 U.S.C. 1710 note) is amended by inserting ``but not 
        after the date of the enactment of the Women Veterans and Other 
        Health Care Improvements Act of 2013'' before the period at the 
        end.
            (3) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by inserting after the 
        item relating to section 1709A the following new item:

``1709B. Assistance for child care for certain veterans receiving 
                            health care.''.
    (b) Assistance for Child Care for Certain Veterans Receiving 
Readjustment Counseling and Related Mental Health Services.--
            (1) In general.--Subchapter I of chapter 17 of such title, 
        as amended by subsection (a)(1), is further amended by adding 
        at the end the following new section:
``Sec. 1709C. Assistance for child care for certain veterans receiving 
              readjustment counseling and related mental health 
              services
    ``(a) Program Required.--The Secretary shall carry out a program to 
provide, subject to subsection (b), assistance to qualified veterans 
described in subsection (c) to obtain child care so that such veterans 
can receive readjustment counseling and related mental health services.
    ``(b) Limitation on Period of Payments.--Assistance may only be 
provided to a qualified veteran under this section for receipt of child 
care during the period that the qualified veteran receives readjustment 
counseling and related health care services at a Vet Center.
    ``(c) Qualified Veterans.--For purposes of this section, a 
qualified veteran is a veteran who is--
            ``(1) the primary caretaker of a child; and
            ``(2)(A) receiving from the Department regular readjustment 
        counseling and related mental health services; or
            ``(B) in need of readjustment counseling and related mental 
        health services from the Department, and but for lack of child 
        care services, would receive such counseling and services from 
        the Department.
    ``(d) Locations.--The Secretary shall carry out the program under 
this section in no fewer than three Readjustment Counseling Service 
Regions selected by the Secretary for purposes of the program.
    ``(e) Forms of Child Care Assistance.--(1) Child care assistance 
under this section may include the following:
            ``(A) Stipends for the payment of child care offered by 
        licensed child care centers (either directly or through a 
        voucher program) which shall be, to the extent practicable, 
        modeled after the Department of Veterans Affairs Child Care 
        Subsidy Program established pursuant to section 630 of the 
        Treasury and General Government Appropriations Act, 2002 
        (Public Law 107-67; 115 Stat. 552).
            ``(B) Payments to private child care agencies.
            ``(C) Collaboration with facilities or programs of other 
        Federal departments or agencies.
            ``(D) Such other forms of assistance as the Secretary 
        considers appropriate.
    ``(2) In the case that child care assistance under this subsection 
is provided as a stipend under paragraph (1)(A), such stipend shall 
cover the full cost of such child care.
    ``(f) Vet Center Defined.--In this section, the term `Vet Center' 
means a center for readjustment counseling and related mental health 
services for veterans under section 1712A of this title.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter, as amended by subsection (a)(3), is 
        further amended by inserting after the item relating to section 
        1709B the following new item:

``1709C. Assistance for child care for certain veterans receiving 
                            readjustment counseling and related mental 
                            health services.''.

SEC. 12. CONTRACTOR USER FEES.

    (a) In General.--Chapter 3 of title 38, United States Code, is 
amended by adding at the end the following new section:
``Sec. 323. Contractor user fees
    ``(a) Fee Requirement.--Except as provided in subsection (c) and 
subject to subsection (d), the Secretary shall impose a fee upon each 
person with whom the Secretary engages in a contract for a good or 
service as a condition of the contract.
    ``(b) Fee Amount.--(1) The amount of a fee imposed upon a person 
under subsection (a) with respect to a contract shall be equal to the 
lesser of--
            ``(A) the amount which is equal to seven percent of the 
        total value of the contract; and
            ``(B) the amount which is equal to the total value of the 
        contract multiplied by the applicable percentage for such 
        fiscal year.
    ``(2) The applicable percentage for a fiscal year shall be equal to 
the percentage by which--
            ``(A) the annual estimate of the total value of contracts 
        for such fiscal year, exceeds
            ``(B) the annual estimate of the total cost of fertility 
        counseling and treatment for such fiscal year.
    ``(3) Before each fiscal year, the Secretary shall establish, for 
purposes of this section, the annual estimate of the total value of 
contracts for the next fiscal year, which shall be the Secretary's 
estimate of what the aggregate value will be of all contracts in which 
the Secretary will engage in the next fiscal year.
    ``(4) Before each fiscal year, the Secretary shall establish, for 
purposes of this section, the annual estimate of the total cost of 
fertility counseling and treatment for the next fiscal year, which 
shall be the Secretary's estimate of what the total cost to the 
Department will be in the next fiscal year of--
            ``(A) furnishing fertility counseling and treatment, 
        including through the use of assisted reproductive technology, 
        to individuals under laws administered by the Secretary in the 
        next fiscal year; and
            ``(B) making payments under section 1789 of this title in 
        the next fiscal year.
    ``(c) Waiver.--The Secretary may waive the fee required by 
subsection (a) for a person as the Secretary considers appropriate if 
the person is an individual or a small business concern.
    ``(d) Limitation on Collection.--No fee may be collected under 
subsection (a) except to the extent that the expenditure of the fee to 
pay the costs of activities and services for which the fee is imposed 
is provided for in advance in an appropriations Act.
    ``(e) Department of Veterans Affairs Fertility Counseling and 
Treatment Fund.--(1) There is in the Treasury a fund to be known as the 
Department of Veterans Affairs Fertility Counseling and Treatment Fund.
    ``(2) All amounts received by the Secretary under subsection (a) 
shall be deposited in the fund.
    ``(3)(A) Subject to the provisions of appropriations Acts, amounts 
in the fund shall be available, without fiscal year limitation, to the 
Secretary for the following purposes:
            ``(i) To furnish fertility counseling and treatment, 
        including through the use of assisted reproductive technology, 
        to individuals under laws administered by the Secretary.
            ``(ii) To make payments under section 1789 of this title.
    ``(B) Amounts available under subparagraph (A) may not be used for 
any purposes other than a purpose set forth in clause (i) or (ii) of 
that subparagraph.
    ``(4) Amounts received by the Secretary under subsection (a) shall 
be treated for the purposes of sections 251 and 252 of the Balanced 
Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901, 902) as 
offsets to discretionary appropriations (rather than as offsets to 
direct spending) to the extent that such amounts are made available for 
expenditure in appropriations Acts for the purposes specified in 
paragraph (3) of this subsection.
    ``(f) Small Business Concern Defined.--In this section, the term 
`small business concern' has the meaning given such term under section 
3 of the Small Business Act (15 U.S.C. 632).''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 3 of such title is amended by adding after the item relating to 
section 322 the following new item:

``323. Contractor user fees.''.
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