[Congressional Record Volume 158, Number 93 (Tuesday, June 19, 2012)]
[Senate]
[Pages S4302-S4304]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. MURRAY (for herself and Mr. Tester):
  S. 3313. A bill to amend title 38, United States Code, to improve the 
assistance provided by the Department of Veterans Affairs to women 
veterans, to improve health care furnished by the Department, and for 
other purposes; to the Committee on Veterans' Affairs.
  Mrs. MURRAY. Mr. President today, as Chairman of the Senate Committee 
on Veterans' Affairs, I introduce the Women Veterans and Other Health 
Care Improvement Act of 2012. I am incredibly proud of the women and 
men who have served or are serving our nation in uniform, and I 
strongly believe we must do all that we can to honor them.
  That is why I introduced legislation, which was signed into law as 
part of the Caregivers and Veterans Omnibus Health Services Act of 
2010, which helped to transform the way that the Department of Veterans 
Affairs, VA, addresses the needs of women veterans. Among other things, 
this law required the VA to provide neonatal care, train mental health 
professionals to provide mental health services for sexual trauma, and 
develop a child care pilot program. VA has an obligation to provide 
veterans with quality care and we have an obligation to make sure that 
VA does so. The legislation I am introducing today builds upon that 
effort to make additional improvements to VA's services for women 
veterans and veterans with families.
  The nature of the current conflict and increasing use of improvised 
explosive devices leaves servicemembers, both male and female, at 
increased risk for blast injuries including spinal cord injury and 
trauma to the reproductive and urinary tracts. Army data shows that 
between 2003 and 2011 more than 600 women and men experienced these 
life-changing battle injuries while serving in Iraq or Afghanistan.
  As they return from the battlefield, the VA system must be equipped 
to help injured veterans step back into their lives as parents, 
spouses, and citizens. These veterans have served honorably and have 
made the ultimate sacrifice for our great nation. They deserve the 
opportunity to pursue their goals and dreams, whether that includes 
pursuing higher education, finding gainful employment, purchasing their 
first house, or starting their own family. VA has many programs that 
help veterans pursue the educational, career, or homeownership dreams 
and goals that they deferred in service to this country, yet it falls 
short when it comes to helping severely wounded veterans who want to 
start a family. These veterans often need far more advanced services in 
order to conceive a child.
  The Department of Defense and the Tricare program are already able to 
provide advanced fertility treatments, including assisted reproductive 
technology, to servicemembers with complex injuries. However; not all 
injured servicemembers are well situated to have a child at the time 
they are eligible for that coverage, and some are no longer eligible 
for Tricare by the time they are ready.
  VA's fertility counseling and treatment options are limited and do 
not meet the complex needs of severely injured veterans. I have heard 
from severely injured veterans whose injuries have made it impossible 
for them to conceive children naturally. While the details of these 
stories vary, the common thread that runs through them all is that 
these veterans were unable to obtain the type of assistance they need. 
Some have spent tens of thousands of dollars in the private sector to 
get the advanced reproductive treatments they need to start a family. 
Others have watched their marriage dissolve because the stress of 
infertility, in combination with the stresses of readjusting to life 
after severe injury, drove their relationship to a breaking point. Any 
servicemember who sustains this type of serious injury deserves so much 
more. It is our responsibility to give VA the tools it needs to serve 
them, and the Women Veterans and Other Health Care Improvement Act is a 
start at doing that.
  This legislation also requires VA to build upon existing research 
framework to gain a better understanding of the long-term reproductive 
health care needs of veterans, from those who experience severe 
reproductive and urinary tract trauma to those who experience gender-
specific infections in the battlefield. A recent Army Task Force Report 
found that women in the battlefield experience high rates of urinary 
tract infections and other women's health conditions. After a decade at 
war, many women servicemembers are still at increased risk for women's 
health difficulties due to deployment conditions and a lack of 
predeployment women's health information, compounded by privacy and 
safety concerns. Little is known about the impact that these issues and 
injuries have on the long-term health care needs of veterans. 
Additional research will provide critical information to help VA 
improve services for veterans.
  VA has come a long way in addressing the unique health needs and 
challenges that women face. Yet for all of its recent progress, VA can 
and must do more to ensure that women veterans are receiving the care 
that they need and deserve. Work remains to make VA a friendly 
environment for women veterans and veterans with families. Many women 
veterans are single mothers, making it difficult for them to take full 
advantage of the services that VA offers. The Women Veterans and Other 
Health Care Improvement Act creates a pilot program that provides child 
care to veterans seeking readjustment counseling at VA's Vet Centers. 
It also helps VA ensure that women veterans can get the information 
that they need in order to access VA health care and benefits.
  This is not a section by section review of all the provisions within 
this legislation. However, I have provided an appropriate overview of 
the major benefits of this legislation and how it would improve the 
lives of our veterans and their families. The promise that we make to 
our veterans is sacred and knows no gender. To honor our veterans, we 
must honor this promise for each and every one of them.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.

[[Page S4303]]

  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3313

       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 and Other Health Care Improvements Act of 2012''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Facilitation of reproduction and infertility research.
Sec. 3. Clarification that fertility counseling and treatment are 
              medical services which the Secretary may furnish to 
              veterans like other medical services.
Sec. 4. Reproductive treatment and care delivery for spouses and 
              surrogates of veterans.
Sec. 5. Requirement to improve Department of Veterans Affairs women 
              veterans call center.
Sec. 6. Modification of pilot program on counseling in retreat settings 
              for women veterans newly separated from service in the 
              Armed Forces.
Sec. 7. Pilot programs on assistance for child care for certain 
              veterans.

     SEC. 2. 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 Director of the National 
     Institutes of Health to improve the ability of the Department 
     of Veterans Affairs to meet the long-term reproductive health 
     care needs of veterans who have a service-connected 
     genitourinary 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 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. 3. CLARIFICATION THAT FERTILITY COUNSELING AND TREATMENT 
                   ARE MEDICAL SERVICES WHICH THE SECRETARY MAY 
                   FURNISH TO VETERANS LIKE OTHER MEDICAL 
                   SERVICES.

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

     SEC. 4. REPRODUCTIVE TREATMENT AND CARE DELIVERY 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.  1787. 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 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 
     health care system established under section 1705(a) of this 
     title if the spouse 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.''.
       (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 1786 the following new 
     section:

``1787. Reproductive treatment and care for spouses and surrogates of 
              veterans.''.

       (c) Regulations.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall prescribe regulations to carry out section 1787 of 
     title 38, United States Code, as added by paragraph (1).

     SEC. 5. REQUIREMENT TO IMPROVE DEPARTMENT OF VETERANS AFFAIRS 
                   WOMEN VETERANS CALL CENTER.

       The Secretary of Veterans Affairs shall enhance the 
     capabilities of the Department of Veterans Affairs women 
     veterans call 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. 6. 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''.

     SEC. 7. PILOT PROGRAMS ON ASSISTANCE FOR CHILD CARE FOR 
                   CERTAIN VETERANS.

       (a) Modification of Duration of Pilot Program on Assistance 
     for Child Care for Certain Veterans Receiving Health Care.--
     Subsection (e) of section 205 of the Caregivers and Veterans 
     Omnibus Health Services Act of 2010 (Public Law 111 163; 38 
     U.S.C. 1710 note) is amended to read as follows:
       ``(e) Duration.--A child care center that is established as 
     part of the pilot program may operate until the date that is 
     two years after the date on which the pilot program is 
     established in the third Veterans Integrated Service Network 
     required by subsection (d).''.
       (b) Requirement for Pilot Program on Assistance for Child 
     Care for Certain Veterans Receiving Readjustment Counseling 
     and Related Mental Health Services.--
       (1) Pilot program required.--The Secretary of Veterans 
     Affairs shall carry out a pilot program to assess the 
     feasibility and advisability of providing, subject to 
     paragraph (2), assistance to qualified veterans described in 
     paragraph (3) to obtain child care so that such veterans can 
     receive readjustment counseling and related mental health 
     services.
       (2) Limitation on period of payments.--Assistance may only 
     be provided to a qualified veteran under the pilot program 
     required by paragraph (1) for receipt of child care during 
     the period that the qualified veteran receives readjustment 
     counseling and related health care services at a Vet Center.
       (3) Qualified veterans.--For purposes of this subsection, a 
     qualified veteran is a veteran who is--
       (A) the primary caretaker of a child or children; and
       (B)(i) receiving from the Department regular readjustment 
     counseling and related mental health services; or
       (ii) 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.
       (4) Locations.--The Secretary shall carry out the pilot 
     program under this subsection in no fewer than three 
     Readjustment Counseling Service Regions selected by the 
     Secretary for purposes of the pilot program.
       (5) Duration.--The pilot program under this subsection 
     shall be carried out until the end of the two-year period 
     beginning on the day on which the Secretary begins carrying 
     out the pilot program at the last Readjustment Counseling 
     Service Region selected under paragraph (4) at which the 
     Secretary begins carrying out the pilot program.
       (6) Forms of child care assistance.--
       (A) In general.--Child care assistance under this 
     subsection may include the following:
       (i) 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).
       (ii) Payments to private child care agencies.
       (iii) Collaboration with facilities or programs of other 
     Federal departments or agencies.
       (iv) Such other forms of assistance as the Secretary 
     considers appropriate.
       (B) Amounts of stipends.--In the case that child care 
     assistance under this subsection is provided as a stipend 
     under subparagraph (A)(i), such stipend shall cover the full 
     cost of such child care.
       (7) Report.--Not later than 180 days after the completion 
     of the pilot program required by paragraph (1), 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.
       (8) Authorization of appropriations.--There is authorized 
     to be appropriated to the Secretary of Veterans Affairs to 
     carry out the pilot program required by paragraph (1)

[[Page S4304]]

     $1,000,000 for each of fiscal years 2014 and 2015.
       (9) 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 title 38, United States Code.
                                 ______