[Congressional Record Volume 164, Number 83 (Monday, May 21, 2018)]
[House]
[Pages H4248-H4250]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            MILITARY SEXUAL ASSAULT VICTIMS EMPOWERMENT ACT

  Mr. DUNN. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 3642) to direct the Secretary of Veterans Affairs to carry out a 
pilot program to improve the access to private health care for veterans 
who are survivors of military sexual trauma, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows

                               H.R. 3642

       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 ``Military Sexual Assault 
     Victims Empowerment Act'' or the ``Military SAVE Act''.

     SEC. 2. PILOT PROGRAM FOR PRIVATE HEALTH CARE FOR VETERANS 
                   WHO ARE SURVIVORS OF MILITARY SEXUAL TRAUMA.

       (a) Establishment.--The Secretary of Veterans Affairs shall 
     carry out a pilot program to furnish hospital care and 
     medical services to eligible veterans through non-Department 
     health care providers to treat injuries or illnesses which, 
     in the judgment of a professional employed by the Department, 
     resulted from a physical assault of a sexual nature, battery 
     of a sexual nature, or sexual harassment which occurred while 
     the veteran was serving on active duty, active duty for 
     training, or inactive duty training.
       (b) Duration.--The Secretary shall carry out the pilot 
     program under subsection (a) for a three-year period. If at 
     the completion of the pilot program an eligible veteran is 
     receiving hospital care and medical services from a non-
     Department health care provider under the pilot program, the 
     Secretary may approve, on a case-by-case basis, the 
     continuation of such hospital care and medical services from 
     that non-Department health care provider until the completion 
     of the episode of care.
       (c) Eligible Veterans.--A veteran is eligible to 
     participate in the pilot program under subsection (a) if the 
     veteran--
       (1) is eligible to receive counseling and appropriate care 
     and services under section 1720D of title 38, United States 
     Code; and
       (2) resides in a site selected under subsection (d).

[[Page H4249]]

       (d) Sites.--
       (1) Selection.--The Secretary shall select not more than 
     five sites in which to carry out the pilot program under 
     subsection (a). Each site shall meet each of the following 
     criteria:
       (A) Except as provided by paragraph (2), the site consists 
     of a city with a population between 200,000 and 500,000, as 
     determined by the Bureau of the Census as of the first day of 
     the pilot program.
       (B) The site is in a State in which the National Violence 
     Against Women Prevention Research Center or the Centers for 
     Disease Control and Prevention, or both, has determined the 
     rate of sexual assault to be a substantial problem.
       (C) The site is in a State that, as of the first day of the 
     pilot program, has a weighted percentage of reported rape of 
     not less than 20 percent but not more than 30 percent of 
     sexual assault cases, in accordance with the finding of the 
     Centers for Disease Control and Prevention contained in the 
     `` `Lifetime Prevalence of Sexual Violence by any 
     Perpetrator'' (NISVS 2010).
       (2) Rural site.--Not fewer than one site selected under 
     paragraph (1) shall be rural, as determined by the Secretary.
       (e) Participation.--
       (1) Election.--Subject to paragraph (2), an eligible 
     veteran may elect to participate in the pilot program under 
     subsection (a). Such election shall not affect the ability of 
     the veteran to receive health care furnished by Department 
     providers.
       (2) Number.--Not more than 75 veterans may participate in 
     the pilot program under subsection (a) at each site selected 
     under subsection (d).
       (3) Choice of non-department health care providers.--An 
     eligible veteran who participates in the pilot program under 
     subsection (a) may freely choose from which non-Department 
     health care provider the veteran receives hospital care or 
     medical services under the pilot program, except that the 
     Secretary shall--
       (A) ensure that each such non-Department health care 
     provider maintains at least the same or similar credentials 
     and licenses as those credentials and licenses that are 
     required of health care providers of the Department, as 
     determined by the Secretary for the purposes of this section; 
     and
       (B) make a reasonable effort to ensure that such non-
     Department health care provider is familiar with the 
     conditions and concerns that affect members of the Armed 
     Forces and veterans and is trained in evidence-based 
     psychotherapy
       (4) Provision of information.--The Secretary shall--
       (A) notify eligible veterans of the ability to make an 
     election under paragraph (1); and
       (B) provide to such veterans educational referral 
     materials, including through pamphlets and internet websites, 
     on the non-Department providers in the sites selected under 
     subsection (d).
       (f) Authorization and Monitoring of Care.--In accordance 
     with subsection (e), the Secretary shall ensure that the 
     Department of Veterans Affairs authorizes and monitors the 
     hospital care and medical services furnished under the pilot 
     program for appropriateness and necessity. In authorizing and 
     monitoring such care, the Secretary shall--
       (1) treat a non-Department health care provider that 
     furnishes to such a veteran hospital care or medical services 
     under the pilot program as an authorized recipient of records 
     of such veteran for purposes of section 7332(b) of title 38, 
     United States Code; and
       (2) ensure that such non-Department health care provider 
     transmits to the Department such records as the Secretary 
     determines appropriate.
       (g) Payments.--
       (1) Current providers.--If a non-Department health care 
     provider has entered into a contract, agreement, or other 
     arrangement with the Secretary pursuant to another provision 
     of law to furnish hospital care or medical services to 
     veterans, the Secretary shall pay the health care provider 
     for hospital care or medical services furnished under this 
     section using the same rates and payment schedules as 
     provided for in such contract, agreement, or other 
     arrangement.
       (2) New providers.--If a non-Department health care 
     provider has not entered into a contract, agreement, or other 
     arrangement with the Secretary pursuant to another provision 
     of law to furnish hospital care or medical services to 
     veterans, the Secretary shall pay the health care provider 
     for hospital care or medical services furnished under this 
     section using the same rates and payment schedule as if such 
     care and services was furnished pursuant to section 1703 of 
     title 38, United States Code.
       (3) New contracts and agreements.--The Secretary shall take 
     reasonable efforts to enter into a contract, agreement, or 
     other arrangement with a non-Department health care provider 
     described in subsection (a) to ensure that future care and 
     services authorized by the Secretary and furnished by the 
     provider are subject to such a contract, agreement, or other 
     arrangement
       (h) Surveys.--The Secretary shall conduct a survey of a 
     sample of eligible veterans to assess the hospital care and 
     medical services furnished to such veterans either pursuant 
     to this section or section 1720D of title 38, United States 
     Code, as the case may be.
       (i) Report.--Not later than 60 days before the completion 
     of the pilot program under subsection (a), the Secretary 
     shall submit to the Committees on Veterans' Affairs of the 
     House of Representatives and the Senate a report on the pilot 
     program. The report shall include the following:
       (1) The results of the pilot program, including, to the 
     extent possible, an assessment of the health outcomes of 
     veterans who participated in the pilot program.
       (2) The recommendation of the Secretary with respect to 
     extending or making permanent the pilot program.
       (j) Definitions.--In this section:
       (1) The term ``non-Department health care provider'' means 
     an entity specified in section 101(a)(1)(B) of section 101 of 
     the Veterans Access, Choice, and Accountability Act of 2015 
     (Public Law 113-146; 38 U.S.C. 1701) or any other health care 
     provider that has entered into a contract, agreement, or 
     other arrangement with the Secretary pursuant to another 
     provision of law to furnish hospital care or medical services 
     to veterans.
       (2) The term ``sexual harassment'' has the meaning given 
     that term in section 1720D of title 38, United States Code.
       (3) The term ``State'' has the meaning given that term in 
     section 101(20) of title 38, United States Code.

     SEC. 3. NO ADDITIONAL FUNDS AUTHORIZED.

       No additional funds are authorized to be appropriated to 
     carry out the requirements of this Act. Such requirements 
     shall be carried out using amounts otherwise authorized to be 
     appropriated.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Dunn) and the gentleman from Minnesota (Mr. Walz) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Florida.


                             General Leave

  Mr. DUNN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material into the Record on H.R. 3642, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. DUNN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 3642, as amended, the 
Military Sexual Assault Victims Empowerment Act.
  It is a tragic fact that there are an increasing number of veterans 
who report experiencing sexual harassment or assault while serving on 
Active Duty in our Armed Forces. These veterans deserve the very best 
care and treatment that we can offer them for the psychological trauma 
that they may be feeling as a result of that experience.
  This bill would require the Department of Veterans Affairs to carry 
out a pilot program to furnish care in the community to veterans who 
have experienced military sexual trauma. This would ensure the veterans 
in pilot locations are able to choose a provider that best meets their 
specific needs and that they are most comfortable with.
  This bill is sponsored by Representative  Andy Barr from Kentucky, 
and I thank him for his tireless advocacy to ensure access to care for 
veterans who have experienced this trauma.
  Mr. Speaker, I urge my colleagues to support this bill, and I reserve 
the balance of my time.
  Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of high-quality, accessible treatment 
options for survivors of military sexual trauma. I want to thank the 
gentleman. His concern is exactly in the right place. It is focusing 
our attention on this issue.
  There are some things in the bill, though, that I would like to point 
out, and these concerns have been shared by some of the veterans 
service organizations. I do this in the spirit of the gentleman is 
exactly right on what needs to be done.
  This is about a process of trying to improve upon a piece of 
language. The VA was unable to submit views on this bill because of 
timing on how it was brought up. For this reason, I would like to read 
just a few quotes from a statement the VA submitted on this bill to 
reflect the concerns shared by our staff and the VSO community.
  These are VA quotes:
  ``Aspects of the bill could jeopardize patient safety and well-being 
and create the ethically problematic situation of VA condoning and 
supporting a substandard level of care for program participants.''
  ``It is possible some veterans would even choose to leave VA care 
entirely to avoid the study.''

[[Page H4250]]

  While I certainly appreciate the effort, I am of the belief that this 
study could misallocate VA's limited resources to define a problem to 
which the RAND Corporation and the National Academy of Sciences have 
already offered potential solutions.

                              {time}  1515

  I am supporting today's amendment in the nature of a substitute but 
warning against future efforts to erode the high quality of care that 
VA is providing.
  In order to better reflect VA's position on improving access to 
military sexual trauma, I am excited to work with our VSO partners on 
legislation that would implement some of the recommendations made in 
previous assessments and increase access to high-quality care.
  Mr. Speaker, I urge my colleagues across the aisle to join us in 
drafting legislation that continues to heal military sexual trauma 
victims.
  Mr. Speaker, I reserve the balance of my time.
  Mr. DUNN. Mr. Speaker, I yield 3 minutes to the gentleman from 
Kentucky (Mr. Barr), who is the sponsor of this bill.
  Mr. BARR. Mr. Speaker, I rise today to urge my colleagues to support 
this legislation, H.R. 3642, the Military Sexual Assault Victims 
Empowerment Act, also known as the Military SAVE Act, which would help 
the Department of Veterans Affairs identify deficiencies and 
vulnerabilities in their care for survivors of military sexual trauma 
and take corrective actions to improve those services.
  According to the findings of the Department of Veterans Affairs' 
National Screening Program, 1 in 4 women and 1 in 100 men reported that 
they have been victims of military sexual assault during their time 
serving in the military. This problem was made personal to me by a 
group of women in the Sixth Congressional District of Kentucky, led by 
MST survivor Karen Tufts. Sadly, due in part to this emotional stress, 
two of these women have since committed suicide.
  To the ranking member's concern about quality of care, the problem 
with some of these women was that they were revictimized at the VA. In 
fact, according to an independent nationwide study, research has found 
that female victims of MST are 14 times more likely to commit suicide 
than women who have never been assaulted, so we are all about improving 
the care of these women.
  And while Congress has recently taken several actions to better 
protect survivors of MST within the military justice system, many 
survivors have expressed concern that services available within the VA 
healthcare system are insufficient to address their specific post-MST 
needs. That is exactly why we have been working closely with the House 
Committee on Veterans' Affairs, veteran service organizations, as well, 
and my VA Pilot Program Development Task Force to improve medical care 
for survivors of MST in order to help those survivors get the care that 
best fits their unique physical and psychological needs.
  Specifically, this legislation would allow survivors the ability to 
seek treatment, specifically tailored to their MST injuries, by a 
community care provider of their choice during a 3-year pilot program. 
This pilot program would study the results that direct access care 
provides that the VA does not and would help the VA take the necessary 
corrective actions to improve its care for survivors of MST.
  In fact, our experience is that just the introduction of this 
legislation has focused the mind at the VA to improve the care that the 
VA provides. As I mentioned before, I did not create this legislation 
alone. It has been through the dedicated support and trusted advice of 
MST survivors who are members of our Pilot Program Development Task 
Force, and I thank them for their contributions, including former 
commissioner of the Kentucky Department of Veterans Affairs, Heather 
French Henry.
  In conclusion, I would like to especially thank Chairman Roe and his 
staff for their hard work in support of this legislation and for his 
longstanding leadership on veterans issue. Chairman Roe truly cares 
about improving the lives of veterans, and this legislation is a 
testament to that devotion.
  Mr. WALZ. Mr. Speaker, I thank the gentleman's commitment to this 
issue. I appreciate the work that has been spent to continue to evolve 
to get this right, because I do think there is, obviously, no 
disagreement in the scourge and the horrific crimes committed against 
servicemembers that we must deal with and the treatment of those 
victims afterwards. With that, I encourage my colleagues to support 
this piece of legislation.
  Mr. Speaker, I yield back the balance of my time.
  Mr. DUNN. Mr. Speaker, I thank the ranking member, Mr. Walz. Once 
again, I encourage all Members to support H.R. 3642, as amended, and I 
yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Florida (Mr. Dunn) that the House suspend the rules and 
pass the bill, H.R. 3642, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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