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

                                                       Calendar No. 185
113th CONGRESS
  1st Session
                                 S. 131

                          [Report No. 113-106]

  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, Mr. Tester, and Mr. Blumenthal) 
introduced the following bill; which was read twice and referred to the 
                     Committee on Veterans' Affairs

                           September 17, 2013

               Reported by Mr. Sanders, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 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,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

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

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

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

<DELETED>SEC. 3. REPRODUCTIVE TREATMENT AND CARE FOR SPOUSES AND 
              SURROGATES OF VETERANS.</DELETED>

<DELETED>    (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:</DELETED>
<DELETED>``Sec. 1788. Reproductive treatment and care for spouses and 
              surrogates of veterans</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(c) Construction.--Nothing in this section shall be 
construed to require the Secretary--</DELETED>
        <DELETED>    ``(1) to find or certify a surrogate for a veteran 
        or to connect a surrogate with a veteran; or</DELETED>
        <DELETED>    ``(2) to furnish maternity care to a spouse or 
        surrogate of a veteran.</DELETED>
<DELETED>    ``(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.''.</DELETED>
<DELETED>    (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:</DELETED>

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

<DELETED>SEC. 4. ADOPTION ASSISTANCE FOR SEVERELY WOUNDED 
              VETERANS.</DELETED>

<DELETED>    (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:</DELETED>
<DELETED>``Sec. 1789. Adoption assistance</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Covered Veteran.--For purposes of this section, a 
covered veteran is any severely wounded, ill, or injured veteran who--
</DELETED>
        <DELETED>    ``(1) has an infertility condition incurred or 
        aggravated in line of duty in the active military, naval, or 
        air service; and</DELETED>
        <DELETED>    ``(2) is enrolled in the system of annual patient 
        enrollment established under section 1705(a) of this 
        title.</DELETED>
<DELETED>    ``(c) Limitation Amount.--For purposes of this section, 
the limitation amount is the amount equal to the lesser of--</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(2) the cost the Department would incur by 
        paying the expenses of three adoptions by covered veterans, as 
        determined by the Secretary.''.</DELETED>
<DELETED>    (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:</DELETED>

<DELETED>``1789. Adoption assistance.''.

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

<DELETED>    (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.</DELETED>
<DELETED>    (b) Elements.--Each report submitted under subsection (a) 
shall include, for the period covered by the report, the 
following:</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (2) The number of spouses and surrogates of 
        veterans who received fertility counseling or treatment 
        furnished by the Department.</DELETED>
        <DELETED>    (3) The cost to the Department of furnishing 
        fertility counseling and treatment, disaggregated by cost of 
        services and administration.</DELETED>
        <DELETED>    (4) The average cost to the Department per 
        recipient of such counseling and treatment.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (6) A description of how fertility counseling and 
        treatment services of the Department are coordinated with 
        similar services of the Department of Defense.</DELETED>

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

<DELETED>    (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--</DELETED>
        <DELETED>    (1) on the furnishing of fertility treatment to 
        veterans using assisted reproductive technology;</DELETED>
        <DELETED>    (2) to carry out section 1788 of title 38, United 
        States Code, as added by section 3; and</DELETED>
        <DELETED>    (3) to carry out section 1789 of such title, as 
        added by section 4.</DELETED>
<DELETED>    (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--
</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (2) any fertility counseling or treatment under 
        section 1788 of title 38, United States Code, as added by 
        section 3; or</DELETED>
        <DELETED>    (3) any assistance under section 1789 of such 
        title, as added by section 4.</DELETED>
<DELETED>    (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.</DELETED>

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

<DELETED>    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.</DELETED>

<DELETED>SEC. 8. FACILITATION OF REPRODUCTION AND INFERTILITY 
              RESEARCH.</DELETED>

<DELETED>    (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:</DELETED>
<DELETED>``Sec. 7330B. Facilitation of reproduction and infertility 
              research</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>
<DELETED>    (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:</DELETED>

<DELETED>``7330B. Facilitation of reproduction and infertility 
                            research.''.
<DELETED>    (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).</DELETED>

<DELETED>SEC. 9. REQUIREMENT TO IMPROVE DEPARTMENT OF VETERANS AFFAIRS 
              WOMEN VETERANS CONTACT CENTER.</DELETED>

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

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

<DELETED>    (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''.</DELETED>
<DELETED>    (b) Extension of Duration.--Subsection (d) of such section 
is amended by striking ``2-year'' and inserting ``four-
year''.</DELETED>
<DELETED>    (c) Authorization of Appropriations.--Subsection (f) of 
such section is amended--</DELETED>
        <DELETED>    (1) by striking ``Secretary of Veterans Affairs 
        for each'' and inserting the following: ``Secretary of Veterans 
        Affairs--</DELETED>
        <DELETED>    ``(1) for each'';</DELETED>
        <DELETED>    (2) in paragraph (1), as designated by paragraph 
        (1), by striking the period at the end and inserting ``; and''; 
        and</DELETED>
        <DELETED>    (3) by adding at the end the following new 
        paragraph:</DELETED>
        <DELETED>    ``(2) for each of fiscal years 2013 and 2014, 
        $400,000 to carry out the pilot program.''.</DELETED>

<DELETED>SEC. 11. PROGRAM ON ASSISTANCE FOR CHILD CARE FOR CERTAIN 
              VETERANS.</DELETED>

<DELETED>    (a) Assistance for Child Care for Certain Veterans 
Receiving Health Care.--</DELETED>
        <DELETED>    (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:</DELETED>
<DELETED>``Sec. 1709B. Assistance for child care for certain veterans 
              receiving health care</DELETED>
<DELETED>    ``(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).</DELETED>
<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(1) receives the types of health care services 
        described in subsection (c) at a facility of the Department; 
        and</DELETED>
        <DELETED>    ``(2) requires travel to and return from such 
        facility for the receipt of such health care 
        services.</DELETED>
<DELETED>    ``(c) Qualified Veterans.--For purposes of this section, a 
qualified veteran is a veteran who is--</DELETED>
        <DELETED>    ``(1) the primary caretaker of a child or 
        children; and</DELETED>
        <DELETED>    ``(2)(A) receiving from the Department--</DELETED>
                <DELETED>    ``(i) regular mental health care 
                services;</DELETED>
                <DELETED>    ``(ii) intensive mental health care 
                services; or</DELETED>
                <DELETED>    ``(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</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(e) Forms of Child Care Assistance.--(1) Child care 
assistance under this section may include the following:</DELETED>
        <DELETED>    ``(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).</DELETED>
        <DELETED>    ``(B) Direct provision of child care at an on-site 
        facility of the Department of Veterans Affairs.</DELETED>
        <DELETED>    ``(C) Payments to private child care 
        agencies.</DELETED>
        <DELETED>    ``(D) Collaboration with facilities or programs of 
        other Federal departments or agencies.</DELETED>
        <DELETED>    ``(E) Such other forms of assistance as the 
        Secretary considers appropriate.</DELETED>
<DELETED>    ``(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.''.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (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:</DELETED>

<DELETED>``1709B. Assistance for child care for certain veterans 
                            receiving health care.''.
<DELETED>    (b) Assistance for Child Care for Certain Veterans 
Receiving Readjustment Counseling and Related Mental Health Services.--
</DELETED>
        <DELETED>    (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:</DELETED>
<DELETED>``Sec. 1709C. Assistance for child care for certain veterans 
              receiving readjustment counseling and related mental 
              health services</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(c) Qualified Veterans.--For purposes of this section, a 
qualified veteran is a veteran who is--</DELETED>
        <DELETED>    ``(1) the primary caretaker of a child; 
        and</DELETED>
        <DELETED>    ``(2)(A) receiving from the Department regular 
        readjustment counseling and related mental health services; 
        or</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(e) Forms of Child Care Assistance.--(1) Child care 
assistance under this section may include the following:</DELETED>
        <DELETED>    ``(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).</DELETED>
        <DELETED>    ``(B) Payments to private child care 
        agencies.</DELETED>
        <DELETED>    ``(C) Collaboration with facilities or programs of 
        other Federal departments or agencies.</DELETED>
        <DELETED>    ``(D) Such other forms of assistance as the 
        Secretary considers appropriate.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>
        <DELETED>    (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:</DELETED>

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

<DELETED>SEC. 12. CONTRACTOR USER FEES.</DELETED>

<DELETED>    (a) In General.--Chapter 3 of title 38, United States 
Code, is amended by adding at the end the following new 
section:</DELETED>
<DELETED>``Sec. 323. Contractor user fees</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(A) the amount which is equal to seven percent 
        of the total value of the contract; and</DELETED>
        <DELETED>    ``(B) the amount which is equal to the total value 
        of the contract multiplied by the applicable percentage for 
        such fiscal year.</DELETED>
<DELETED>    ``(2) The applicable percentage for a fiscal year shall be 
equal to the percentage by which--</DELETED>
        <DELETED>    ``(A) the annual estimate of the total value of 
        contracts for such fiscal year, exceeds</DELETED>
        <DELETED>    ``(B) the annual estimate of the total cost of 
        fertility counseling and treatment for such fiscal 
        year.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(B) making payments under section 1789 of this 
        title in the next fiscal year.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(2) All amounts received by the Secretary under 
subsection (a) shall be deposited in the fund.</DELETED>
<DELETED>    ``(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:</DELETED>
        <DELETED>    ``(i) To furnish fertility counseling and 
        treatment, including through the use of assisted reproductive 
        technology, to individuals under laws administered by the 
        Secretary.</DELETED>
        <DELETED>    ``(ii) To make payments under section 1789 of this 
        title.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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).''.</DELETED>
<DELETED>    (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:</DELETED>

<DELETED>``323. Contractor user fees.''.

</DELETED>SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES 
              CODE.

    (a) Short Title.--This Act may be cited as the ``Women Veterans and 
Other Health Care Improvements Act of 2013''.
    (b) References to Title 38, United States Code.--Except as 
otherwise expressly provided, whenever in this Act an amendment or 
repeal is expressed in terms of an amendment to, or repeal of, a 
section or other provision, the reference shall be considered to be 
made to a section or other provision of title 38, United States Code.

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) 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 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 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, as amended by 
section 3 of this Act, 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 fertility 
        treatment through the use of assisted reproductive technology 
        under section 1788 of this title, as determined by the 
        Secretary; or
            ``(2) the cost the Department would incur by paying the 
        expenses of three adoptions by covered veterans, as determined 
        by the Secretary.
    ``(d) Assisted Reproductive Technology Defined.--In this section, 
the term `assisted reproductive technology' has the meaning given that 
term in section 1788 of this title.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17, as amended by section 3(b) of this Act, is further amended 
by inserting after the item relating to section 1788 the following new 
item:

``1789. Adoption assistance.''.

SEC. 5. 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 of this Act; and
            (3) to carry out section 1789 of such title, as added by 
        section 4 of this Act.
    (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 such title, as added by section 3 of this Act; or
            (3) any assistance under section 1789 of such title, as 
        added by section 4 of this Act.
    (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 of this Act.

SEC. 6. 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. 7. FACILITATION OF REPRODUCTION AND INFERTILITY RESEARCH.

    (a) In General.--Subchapter II of chapter 73 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 a 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. 8. 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 annually 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. 9. 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 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 health care services described in subsection 
        (c) at a facility of the Department; and
            ``(2) requires travel to and 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.
            ``(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) Clerical amendment.--The table of sections at the 
        beginning of chapter 17 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.''.
            (3) 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.
    (b) Assistance for Child Care for Individuals Receiving 
Readjustment Counseling and Related Mental Health Services.--
            (1) In general.--Subchapter I of chapter 17, as amended by 
        subsection (a)(1) of this section, is further amended by adding 
        at the end the following new section:
``Sec. 1709C. Assistance for child care for individuals 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 individuals 
described in subsection (c) to obtain child care so that such 
individuals can receive readjustment counseling and related mental 
health services.
    ``(b) Limitation on Period of Payments.--Assistance may only be 
provided to a qualified individual under this section for receipt of 
child care during the period that the qualified individual receives 
readjustment counseling and related health care services at a Vet 
Center.
    ``(c) Qualified Individuals.--For purposes of this section, a 
qualified individual is an individual who is--
            ``(1) the primary caretaker of a child or children; 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 individuals under section 1712A of this title.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 17, as amended by subsection (a)(2) of 
        this section, is further amended by inserting after the item 
        relating to section 1709B the following new item:

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

SEC. 10. COUNSELING IN RETREAT SETTINGS FOR WOMEN VETERANS NEWLY 
              SEPARATED FROM SERVICE IN THE ARMED FORCES.

    (a) Counseling in Retreat Settings.--
            (1) In general.--Subchapter II of chapter 17 is amended by 
        adding at the end the following new section:
``Sec. 1720H. Counseling in retreat settings for women veterans newly 
              separated from service in the Armed Forces
    ``(a) In General.--The Secretary shall provide, through the 
Readjustment Counseling Service of the Veterans Health Administration, 
reintegration and readjustment services described in subsection (c) in 
group retreat settings to women veterans who are recently separated 
from service in the Armed Forces after a prolonged deployment.
    ``(b) Election of Veteran.--The receipt of services under this 
section by a woman veteran shall be at the election of the veteran.
    ``(c) Covered Services.--The services provided to a woman veteran 
under this section 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 the veteran in 
        reintegration into the veteran's family, employment, and 
        community.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 17 is amended by inserting after the item 
        relating to section 1720G the following new item:

``1720H. Counseling in retreat settings for women veterans newly 
                            separated from service in the Armed 
                            Forces.''.
    (b) Repeal of Superseded Pilot Program Authority.--Section 203 of 
the Caregivers and Veterans Omnibus Health Services Act of 2010 (Public 
Law 111-163; 38 U.S.C. 1712A note) is hereby repealed.
                                                       Calendar No. 185

113th CONGRESS

  1st Session

                                 S. 131

                          [Report No. 113-106]

_______________________________________________________________________

                                 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.

_______________________________________________________________________

                           September 17, 2013

                       Reported with an amendment
```