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[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3025 Reported in Senate (RS)]

<DOC>

                                                       Calendar No. 289
117th CONGRESS
  2d Session
                                S. 3025

   To amend title 38, United States Code, to expand health care and 
 benefits from the Department of Veterans Affairs for military sexual 
                    trauma, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            October 20, 2021

  Mr. Tester (for himself and Ms. Murkowski) introduced the following 
 bill; which was read twice and referred to the Committee on Veterans' 
                                Affairs

                             March 1, 2022

               Reported by Mr. Tester, 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 expand health care and 
 benefits from the Department of Veterans Affairs for military sexual 
                    trauma, 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; TABLE OF CONTENTS.</DELETED>

<DELETED>    (a) Short Title.--This Act may be cited as the 
``Servicemembers and Veterans Empowerment and Support Act of 
2021''.</DELETED>
<DELETED>    (b) Table of Contents.--The table of contents for this Act 
is as follows:</DELETED>

<DELETED>Sec. 1. Short title; table of contents.
           <DELETED>TITLE I--DEFINING MILITARY SEXUAL TRAUMA

<DELETED>Sec. 101. Military sexual trauma defined for the digital age.
    <DELETED>TITLE II--DISABILITY COMPENSATION AND CLAIMS PROCESSING

<DELETED>Sec. 201. Definition of military sexual trauma.
<DELETED>Sec. 202. Conforming changes relating to specialized teams to 
                            evaluate claims involving military sexual 
                            trauma.
<DELETED>Sec. 203. Standard of proof for service-connection of mental 
                            health conditions relating to military 
                            sexual trauma.
<DELETED>Sec. 204. Choice of location of Department of Veterans Affairs 
                            medical examination for assessment of 
                            claims for compensation relating to 
                            disability resulting from military sexual 
                            trauma.
<DELETED>Sec. 205. Communications from the Department of Veterans 
                            Affairs to military sexual trauma 
                            survivors.
<DELETED>Sec. 206. Study on training and processing relating to claims 
                            for disability compensation relating to 
                            military sexual trauma.
<DELETED>Sec. 207. Annual special focus review of claims for disability 
                            compensation for disabilities relating to 
                            military sexual trauma.
               <DELETED>TITLE III--ACCESS TO HEALTH CARE

<DELETED>Sec. 301. Expansion of eligibility for counseling and 
                            treatment for military sexual trauma to 
                            include all former members of the reserve 
                            components of the Armed Forces.
<DELETED>Sec. 302. Connection to Veterans Health Administration when a 
                            disability claim related to military sexual 
                            trauma is submitted to Veterans Benefits 
                            Administration.
<DELETED>Sec. 303. Study on access to inpatient mental health care for 
                            survivors of military sexual trauma.
<DELETED>Sec. 304. Pilot program for interim access to mental health 
                            care for survivors of military sexual 
                            trauma.
<DELETED>Sec. 305. Comptroller General study on access to care for 
                            survivors of military sexual trauma at the 
                            Department of Veterans Affairs.

      <DELETED>TITLE I--DEFINING MILITARY SEXUAL TRAUMA</DELETED>

<DELETED>SEC. 101. MILITARY SEXUAL TRAUMA DEFINED FOR THE DIGITAL 
              AGE.</DELETED>

<DELETED>    (a) Revision to Regulations Required.--The Secretary of 
Veterans Affairs shall, in accordance with subsection (b), revise 
regulations for the definition of ``military sexual trauma'' for the 
purposes of access to health care under chapter 17 of title 38, United 
States Code, and compensation under chapter 11 of such title.</DELETED>
<DELETED>    (b) Requirements.--</DELETED>
        <DELETED>    (1) Technological abuse.--</DELETED>
                <DELETED>    (A) In general.--The Secretary shall 
                ensure that all regulations revised under subsection 
                (a) include matters relating to technological abuse to 
                reflect sexual harassment in the digital age.</DELETED>
                <DELETED>    (B) Inclusion of certain behavior and 
                activities.--For purposes of subparagraph (A), the term 
                ``technological abuse'' may include--</DELETED>
                        <DELETED>    (i) behavior intended to harm, 
                        threaten, intimidate, control, stalk, harass, 
                        impersonate, or monitor another person, except 
                        as otherwise permitted by law, that occurs via 
                        the internet, social networking sites, 
                        computers, mobile devices, mobile telephones, 
                        apps, location tracking devices, instant 
                        messages, text messages, or other forms of 
                        technology; and</DELETED>
                        <DELETED>    (ii) specific activities, 
                        including--</DELETED>
                                <DELETED>    (I) unwanted, repeated 
                                telephone calls, text messages, instant 
                                messages, or social media 
                                posts;</DELETED>
                                <DELETED>    (II) nonconsensual access 
                                of email accounts, texts or instant 
                                messaging accounts, social networking 
                                accounts, or mobile telephone 
                                logs;</DELETED>
                                <DELETED>    (III) attempting to 
                                control or restrict a person's ability 
                                to access technology with the intent to 
                                isolate the person from support and 
                                social connection;</DELETED>
                                <DELETED>    (IV) using tracking 
                                devices or location tracking software 
                                for the purpose of monitoring or 
                                stalking another person's 
                                location;</DELETED>
                                <DELETED>    (V) impersonation of a 
                                person with the intent to deceive or 
                                cause harm through the use of spoofing 
                                technology or the creation of fake 
                                email or social media accounts; 
                                or</DELETED>
                                <DELETED>    (VI) pressuring for or 
                                sharing of another person's private 
                                information, photographs, or videos 
                                without the person's consent.</DELETED>
        <DELETED>    (2) Collaboration.--In carrying out subsection 
        (a), the Secretary of Veterans Affairs shall collaborate with 
        the Secretary of Defense.</DELETED>
        <DELETED>    (3) Consultation.--In carrying out subsection (a), 
        the Secretary of Veterans Affairs shall consult with veterans 
        service organizations, military service organizations, and 
        other stakeholders.</DELETED>
<DELETED>    (c) Commencement of Efforts.--Not later than one year 
after the date of the enactment of this Act, the Secretary shall 
commence efforts to carry out subsection (a).</DELETED>
<DELETED>    (d) Progress Report.--Not later than one year after the 
date of the enactment of this Act, 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 progress of the Secretary in carrying out subsection 
(a).</DELETED>
<DELETED>    (e) Final Regulations.--Not later than two years after the 
date of the enactment of this Act, the Secretary shall--</DELETED>
        <DELETED>    (1) issue the revised regulations required by 
        subsection (a); and</DELETED>
        <DELETED>    (2) update training aids, manuals, and 
        informational materials for staff, veterans, members of the 
        Armed Forces, and stakeholders to reflect the revised 
        regulations.</DELETED>

         <DELETED>TITLE II--DISABILITY COMPENSATION AND CLAIMS 
                          PROCESSING</DELETED>

<DELETED>SEC. 201. DEFINITION OF MILITARY SEXUAL TRAUMA.</DELETED>

<DELETED>    In this title, the term ``military sexual trauma'' has the 
meaning given such term in section 1167(j) of title 38, United States 
Code, as added by section 203(a).</DELETED>

<DELETED>SEC. 202. CONFORMING CHANGES RELATING TO SPECIALIZED TEAMS TO 
              EVALUATE CLAIMS INVOLVING MILITARY SEXUAL 
              TRAUMA.</DELETED>

<DELETED>    Section 1166(c) of title 38, United States Code, as 
redesignated by section 7(a) of the Training in High-demand Roles to 
Improve Veteran Employment Act (Public Law 117-16), is amended by 
striking ``In this section'' and all that follows and inserting the 
following: ``In this section, the terms `covered mental health 
condition' and `military sexual trauma' have the meanings given those 
terms in section 1167(j) of this title.''.</DELETED>

<DELETED>SEC. 203. STANDARD OF PROOF FOR SERVICE-CONNECTION OF MENTAL 
              HEALTH CONDITIONS RELATING TO MILITARY SEXUAL 
              TRAUMA.</DELETED>

<DELETED>    (a) In General.--Subchapter VI of chapter 11 of such title 
is amended by adding at the end the following new section:</DELETED>
<DELETED>``Sec. 1167. Evaluation of claims involving military sexual 
              trauma</DELETED>
<DELETED>    ``(a) Standard of Proof.--(1) In the case of any veteran 
who claims that a covered mental health condition based on military 
sexual trauma was incurred in or aggravated by active military, naval, 
or air service, the Secretary shall accept as sufficient proof of 
service-connection a diagnosis of such mental health condition by a 
mental health professional together with satisfactory lay or other 
evidence, in accordance with subsections (b) and (c), of such trauma 
and an opinion by the mental health professional that such covered 
mental health condition is related to such military sexual trauma, as 
specified in subsection (f), notwithstanding the fact that there is no 
official record of such incurrence or aggravation in such service, and, 
to that end, shall resolve every reasonable doubt in favor of the 
veteran.</DELETED>
<DELETED>    ``(2) Service-connection of such covered mental health 
condition may be rebutted by clear and convincing evidence to the 
contrary.</DELETED>
<DELETED>    ``(3) The reasons for granting or denying service-
connection in each case shall be recorded in full.</DELETED>
<DELETED>    ``(b) Nonmilitary Sources of Evidence.--(1) In carrying 
out subsection (a), the Secretary shall ensure that if a claim for 
compensation under this chapter is received by the Secretary for a 
covered mental health condition based on military sexual trauma, 
evidence from sources other than official records of the Department of 
Defense regarding the veteran's service may corroborate the veteran's 
account of the trauma.</DELETED>
<DELETED>    ``(2) Examples of evidence described in paragraph (1) 
include the following:</DELETED>
        <DELETED>    ``(A) Records from law enforcement authorities, 
        rape crisis centers, mental health counseling centers, 
        hospitals, and physicians.</DELETED>
        <DELETED>    ``(B) Pregnancy tests and tests for sexually 
        transmitted diseases.</DELETED>
        <DELETED>    ``(C) Statements from family members, roommates, 
        other members of the Armed Forces or veterans, and 
        clergy.</DELETED>
<DELETED>    ``(c) Evidence of Behavior Changes.--(1) In carrying out 
subsection (a), the Secretary shall ensure that evidence of a behavior 
change following military sexual trauma is one type of relevant 
evidence that may be found in sources described in such 
subsection.</DELETED>
<DELETED>    ``(2) Examples of behavior changes that may be relevant 
evidence of military sexual trauma include the following:</DELETED>
        <DELETED>    ``(A) A request for a transfer to another military 
        duty assignment.</DELETED>
        <DELETED>    ``(B) Deterioration in work performance.</DELETED>
        <DELETED>    ``(C) Substance abuse or substance use 
        disorder.</DELETED>
        <DELETED>    ``(D) Episodes of depression, panic attacks, or 
        anxiety without an identifiable cause.</DELETED>
        <DELETED>    ``(E) Unexplained economic or social behavior 
        changes.</DELETED>
<DELETED>    ``(d) Notice and Opportunity To Supply Evidence.--The 
Secretary may not deny a claim of a veteran for compensation under this 
chapter for a covered mental health condition that is based on military 
sexual trauma without first--</DELETED>
        <DELETED>    ``(1) advising the veteran that evidence described 
        in subsections (b) and (c) may constitute credible 
        corroborating evidence of the military sexual trauma; 
        and</DELETED>
        <DELETED>    ``(2) allowing the veteran an opportunity to 
        furnish such corroborating evidence or advise the Secretary of 
        potential sources of such evidence.</DELETED>
<DELETED>    ``(e) Role of Lay Statements.--In a case where evidence 
described in subsection (b) or (c) is unavailable, and the only 
evidence of the occurrence of the military sexual trauma is the 
veteran's own lay statement, the Secretary shall accept such lay 
statement as credible evidence the event occurred, unless such 
statement is inconsistent with the places, types, and circumstances of 
the service of the veteran, including evidence of the veteran's unit 
assignments, military specialty, or dates and locations of service, or 
unless there is clear and convincing evidence to the 
contrary.</DELETED>
<DELETED>    ``(f) Review of Evidence.--(1) In reviewing a claim for 
compensation described in subsection (a)(1), for any evidence 
identified as part of such claim that is described in subsection (b) or 
(c), or if subsection (e) applies, the Secretary shall submit such 
evidence to such medical or mental health professional as the Secretary 
considers appropriate, including clinical and counseling experts 
employed by the Department, to obtain an opinion as to whether it is at 
least as likely as not that there is a nexus between the military 
sexual trauma and any diagnosed covered mental health 
condition.</DELETED>
<DELETED>    ``(2) In the case of any veteran who submits with the 
claim for a covered mental health condition a lay statement describing 
the military sexual trauma, such veteran shall be provided with a 
medical examination and opinion as described in paragraph (1) without 
delay for request of records specified in subsections (b) and (c) from 
the veteran.</DELETED>
<DELETED>    ``(3) For any veteran described in paragraph (2), if the 
medical examination and opinion do not result in a diagnosis of a 
covered mental health condition and a positive opinion that the 
military sexual trauma is related to such diagnosis, the Secretary 
shall request the records specified in subsections (b) and (c) and, if 
such evidence is received, paragraph (1) shall again apply and a 
subsequent medical examination and opinion shall be 
requested.</DELETED>
<DELETED>    ``(g) Point of Contact.--The Secretary shall ensure that 
each document provided to a veteran relating to a claim for 
compensation described in subsection (a) includes contact information 
for an appropriate point of contact with the Department.</DELETED>
<DELETED>    ``(h) Specialized Teams.--The Secretary shall ensure that 
all claims for compensation described in subsection (a) are reviewed 
and processed by a specialized team established under section 1166 of 
this title.</DELETED>
<DELETED>    ``(i) Rule of Construction Regarding Application to 
Nonsexual Personal Assault.--The Secretary shall not construe this 
section as supplanting the standard of proof or evidence required for 
claims for posttraumatic stress disorder based on non-sexual personal 
assault, which the Secretary shall continue to define in 
regulation.</DELETED>
<DELETED>    ``(j) Definitions.--In this section:</DELETED>
        <DELETED>    ``(1) The term `covered mental health condition' 
        means post-traumatic stress disorder, anxiety, depression, or 
        other mental health diagnosis described in the current version 
        of the Diagnostic and Statistical Manual of Mental Disorders 
        published by the American Psychiatric Association that the 
        Secretary determines to be related to military sexual trauma 
        and which may be service-connected.</DELETED>
        <DELETED>    ``(2) The term `military sexual trauma' means, 
        with respect to a veteran, a physical assault of a sexual 
        nature, battery of a sexual nature, or sexual harassment that 
        occurred while the veteran was serving in the active military, 
        naval, or air service.''.</DELETED>
<DELETED>    (b) Outreach.--Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall 
implement, with input from the veteran community, an informative 
outreach program for veterans regarding the standard of proof for 
evaluation of claims related to military sexual trauma, including 
consideration of lay statements and requirements for a medical 
examination and opinion.</DELETED>
<DELETED>    (c) Clerical Amendment.--The table of sections at the 
beginning of such chapter is amended by adding at the end the following 
new item:</DELETED>

<DELETED>``1167. Evaluation of claims involving military sexual 
                            trauma.''.

<DELETED>SEC. 204. CHOICE OF LOCATION OF DEPARTMENT OF VETERANS AFFAIRS 
              MEDICAL EXAMINATION FOR ASSESSMENT OF CLAIMS FOR 
              COMPENSATION RELATING TO DISABILITY RESULTING FROM 
              MILITARY SEXUAL TRAUMA.</DELETED>

<DELETED>    (a) In General.--Section 1165 of title 38, United States 
Code, is amended--</DELETED>
        <DELETED>    (1) in the section heading, by inserting ``and 
        location of medical examination'' after ``examiner'';</DELETED>
        <DELETED>    (2) in subsection (a), by striking ``a physical 
        assault of a sexual nature, battery of a sexual nature, or 
        sexual harassment'' and inserting ``military sexual trauma (as 
        defined in section 1167(j) of this title)'';</DELETED>
        <DELETED>    (3) by redesignating subsection (c) as subsection 
        (d); and</DELETED>
        <DELETED>    (4) by inserting after subsection (b) the 
        following new subsection (c):</DELETED>
<DELETED>    ``(c) Choice of Examination Location.--(1) The Secretary 
shall ensure that a veteran who requires a medical examination in 
support of a claim described in subsection (a) may request that the 
medical examination take place at a facility of the Department by a 
qualified employee of the Department.</DELETED>
<DELETED>    ``(2) The Secretary--</DELETED>
        <DELETED>    ``(A) shall grant any request under paragraph (1); 
        and</DELETED>
        <DELETED>    ``(B) may not issue a decision on a claim 
        described in such paragraph before the requested examination is 
        completed.''.</DELETED>
<DELETED>    (b) Clerical Amendment.--The table of sections at the 
beginning of chapter 11 of such title is amended by striking the item 
relating to section 1165 and inserting the following new 
item:</DELETED>

<DELETED>``1165. Choice of sex of medical examiner and location of 
                            medical examination for certain 
                            disabilities.''.

<DELETED>SEC. 205. COMMUNICATIONS FROM THE DEPARTMENT OF VETERANS 
              AFFAIRS TO MILITARY SEXUAL TRAUMA SURVIVORS.</DELETED>

<DELETED>    (a) Review Board.--</DELETED>
        <DELETED>    (1) In general.--The Secretary of Veterans Affairs 
        shall establish a board to review correspondence relating to 
        military sexual trauma.</DELETED>
        <DELETED>    (2) Membership.--The Secretary shall appoint 
        members of the board from among experts in military sexual 
        trauma and mental health, including--</DELETED>
                <DELETED>    (A) mental health providers of the 
                Department;</DELETED>
                <DELETED>    (B) experts on sexual assault and sexual 
                harassment; and</DELETED>
                <DELETED>    (C) members from both the Veterans Health 
                Administration and Veterans Benefits 
                Administration.</DELETED>
        <DELETED>    (3) Duties.--The board established under paragraph 
        (1) shall--</DELETED>
                <DELETED>    (A) review all standard correspondence and 
                other materials, which may include templates for 
                notices under sections 5103 and 5104B of title 38, 
                United States Code, as well as outreach materials and 
                veteran-facing website content, from the Department of 
                Veterans Affairs to survivors of military sexual trauma 
                for sensitivity; and</DELETED>
                <DELETED>    (B) ensure that the communications--
                </DELETED>
                        <DELETED>    (i) treat survivors with dignity 
                        and respect; and</DELETED>
                        <DELETED>    (ii) do not re-traumatize 
                        survivors.</DELETED>
<DELETED>    (b) Contents of Written Communications to Military Sexual 
Trauma Survivors.--The Secretary shall ensure that any written 
communication from the Department of Veterans Affairs to a military 
sexual trauma survivor shall include contact information for the 
following:</DELETED>
        <DELETED>    (1) The military sexual trauma coordinator of the 
        Veterans Benefits Administration.</DELETED>
        <DELETED>    (2) The military sexual trauma coordinator for the 
        Veterans Health Administration.</DELETED>
        <DELETED>    (3) The Veterans Crisis Line.</DELETED>
        <DELETED>    (4) The facility of the Veterans Health 
        Administration closest to where the survivor resides.</DELETED>
<DELETED>    (c) Definitions.--In this section:</DELETED>
        <DELETED>    (1) Military sexual trauma survivor.--The term 
        ``military sexual trauma survivor'' means--</DELETED>
                <DELETED>    (A) a veteran who has filed a claim for 
                compensation under chapter 11 of title 38, United 
                States Code, relating to military sexual 
                trauma;</DELETED>
                <DELETED>    (B) a veteran who has been awarded 
                compensation under such chapter relating to military 
                sexual trauma; or</DELETED>
                <DELETED>    (C) a former member of the Armed Forces or 
                a veteran who is receiving care from the Department of 
                Veterans Affairs relating to military sexual 
                trauma.</DELETED>
        <DELETED>    (2) Veterans crisis line.--The term ``Veterans 
        Crisis Line'' means the toll-free hotline for veterans 
        established under section 1720F(h) of title 38, United States 
        Code.</DELETED>

<DELETED>SEC. 206. STUDY ON TRAINING AND PROCESSING RELATING TO CLAIMS 
              FOR DISABILITY COMPENSATION RELATING TO MILITARY SEXUAL 
              TRAUMA.</DELETED>

<DELETED>    (a) Study Required.--The Secretary of Veterans Affairs 
shall conduct a study on--</DELETED>
        <DELETED>    (1) the quality of training provided to personnel 
        of the Department of Veterans Affairs who review claims for 
        disability compensation under chapter 11 of title 38, United 
        States Code, for disabilities relating to military sexual 
        trauma; and</DELETED>
        <DELETED>    (2) the quality of the procedures of the 
        Department for reviewing the accuracy of the processing of such 
        claims.</DELETED>
<DELETED>    (b) Elements.--The study required by subsection (a) shall 
include the following:</DELETED>
        <DELETED>    (1) With respect to the quality of training 
        described in paragraph (1) of such subsection:</DELETED>
                <DELETED>    (A) Whether the Department ensures 
                personnel complete such training on time.</DELETED>
                <DELETED>    (B) Whether the training has resulted in 
                improvements to the processing of claims described in 
                such subsection and issue-based accuracy.</DELETED>
                <DELETED>    (C) Such recommendations as the Secretary 
                of Veterans Affairs may have for improving the 
                training.</DELETED>
        <DELETED>    (2) With respect to the quality of procedures 
        described in paragraph (2) of such subsection:</DELETED>
                <DELETED>    (A) Whether the procedures of the 
                Department for reviewing the accuracy of the processing 
                of claims described in such subsection comport with 
                generally accepted statistical methodologies to ensure 
                reasonable accuracy of such reviews.</DELETED>
                <DELETED>    (B) Whether such procedures adequately 
                include mechanisms to correct errors found in such 
                reviews.</DELETED>
                <DELETED>    (C) Such recommendations as the Secretary 
                may have for improving such procedures.</DELETED>
<DELETED>    (c) Report Required.--Not later than one year after the 
date of the enactment of this Act, the Secretary shall submit to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a report detailing 
the findings of the Secretary with respect to the study conducted under 
subsection (a).</DELETED>

<DELETED>SEC. 207. ANNUAL SPECIAL FOCUS REVIEW OF CLAIMS FOR DISABILITY 
              COMPENSATION FOR DISABILITIES RELATING TO MILITARY SEXUAL 
              TRAUMA.</DELETED>

<DELETED>    (a) Annual Special Focus Review.--</DELETED>
        <DELETED>    (1) In general.--Each year, the Under Secretary 
        for Benefits of the Department of Veterans Affairs shall 
        conduct a special focus review on the accuracy of the 
        processing of claims for disability compensation under chapter 
        11 of title 38, United States Code, for disabilities relating 
        to military sexual trauma.</DELETED>
        <DELETED>    (2) Elements.--Each review conducted under 
        paragraph (1) shall include a review of the 
        following:</DELETED>
                <DELETED>    (A) A statistically significant, 
                nationally representative sample of all claims for 
                benefits under the laws administered by the Secretary 
                of Veterans Affairs relating to military sexual trauma 
                filed during the fiscal year preceding the fiscal year 
                in which the report is submitted.</DELETED>
                <DELETED>    (B) The accuracy of each decision made 
                with respect to each claim described in subparagraph 
                (A).</DELETED>
                <DELETED>    (C) The types of benefit entitlement 
                errors found, disaggregated by category.</DELETED>
                <DELETED>    (D) Trends from year to year.</DELETED>
                <DELETED>    (E) Training completion rates for 
                personnel of the Department who process claims 
                described in paragraph (1).</DELETED>
<DELETED>    (b) Reprocessing of Claims.--If the Under Secretary finds, 
pursuant to a special focus review conducted under subsection (a)(1), 
that an error was made with respect to the entitlement of a veteran to 
a benefit under the laws administered by the Secretary, the Secretary 
shall return the relevant claim of the veteran to the appropriate 
regional office of the Department for reprocessing to ensure that the 
veteran receives an accurate decision with respect to the 
claim.</DELETED>
<DELETED>    (c) Re-Reviewing of Claims.--If the Under Secretary finds, 
pursuant to a special focus review conducted under paragraph (1) of 
subsection (a), that the accuracy rate, under paragraph (2)(B) of such 
subsection, is less than 90 percent, the Secretary shall conduct a 
review of each claim for benefits under the laws administered by the 
Secretary of Veterans Affairs relating to military sexual trauma filed 
during the fiscal year preceding the fiscal year in which the report is 
submitted.</DELETED>
<DELETED>    (d) Report.--Section 5501(b)(2) of the Johnny Isakson and 
David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 
2020 (Public Law 116-315; 134 Stat. 5048) is amended by adding at the 
end the following new subparagraph:</DELETED>
                <DELETED>    ``(I) The findings of the most recent 
                special focus review conducted under subsection (a)(1) 
                of section 207 of the Servicemembers and Veterans 
                Empowerment and Support Act of 2021, including--
                </DELETED>
                        <DELETED>    ``(i) the elements under 
                        subsection (a)(2) of such section;</DELETED>
                        <DELETED>    ``(ii) the number of claims 
                        returned for reprocessing under subsection (b) 
                        of such section; and</DELETED>
                        <DELETED>    ``(iii) the number of claims 
                        described in clause (ii) for which the decision 
                        relating to service-connection or entitlement 
                        to compensation changed as a result of 
                        reprocessing the claim.''.</DELETED>

          <DELETED>TITLE III--ACCESS TO HEALTH CARE</DELETED>

<DELETED>SEC. 301. EXPANSION OF ELIGIBILITY FOR COUNSELING AND 
              TREATMENT FOR MILITARY SEXUAL TRAUMA TO INCLUDE ALL 
              FORMER MEMBERS OF THE RESERVE COMPONENTS OF THE ARMED 
              FORCES.</DELETED>

<DELETED>    Section 1720D of title 38, United States Code, is amended 
by striking subsections (f) and (g) and inserting the following new 
subsection (f):</DELETED>
<DELETED>    ``(f) In this section:</DELETED>
        <DELETED>    ``(1) The term `former member of the Armed Forces' 
        means a person who served on active duty, active duty for 
        training, or inactive duty training, and who was discharged or 
        released therefrom under any condition that is not--</DELETED>
                <DELETED>    ``(A) a discharge by court-martial; 
                or</DELETED>
                <DELETED>    ``(B) a discharge subject to a bar to 
                benefits under section 5303 of this title.</DELETED>
        <DELETED>    ``(2) The term `military sexual trauma' means, 
        with respect to a former member of the Armed Forces, a physical 
        assault of a sexual nature, battery of a sexual nature, or 
        sexual harassment which occurred while the former member of the 
        Armed Forces was serving on duty, regardless of duty status or 
        line of duty determination (as that term is used in section 
        12323 of title 10).</DELETED>
        <DELETED>    ``(3) The term `sexual harassment' means 
        unsolicited verbal or physical contact of a sexual nature which 
        is threatening in character.''.</DELETED>

<DELETED>SEC. 302. CONNECTION TO VETERANS HEALTH ADMINISTRATION WHEN A 
              DISABILITY CLAIM RELATED TO MILITARY SEXUAL TRAUMA IS 
              SUBMITTED TO VETERANS BENEFITS ADMINISTRATION.</DELETED>

<DELETED>    (a) In General.--Not later than 14 days after the date on 
which a veteran submits a claim for disability compensation to the 
Veterans Benefits Administration for a disability related to military 
sexual trauma, the Secretary of Veterans Affairs shall send a 
communication to the veteran with the following information:</DELETED>
        <DELETED>    (1) The contact information for the nearest 
        military sexual trauma coordinator for the veteran at the 
        Veterans Benefits Administration and a description of the 
        assistance such coordinator can provide.</DELETED>
        <DELETED>    (2) The contact information for the nearest 
        military sexual trauma coordinator for the veteran at the 
        Veterans Health Administration and a description of the 
        assistance such coordinator can provide.</DELETED>
        <DELETED>    (3) The types of services that survivors of 
        military sexual trauma are eligible to receive from the 
        Department of Veterans Affairs, including the nearest locations 
        and the contact information for such services.</DELETED>
        <DELETED>    (4) The contact information for the Veterans 
        Crisis Line established under section 1720F(h) of title 38, 
        United States Code.</DELETED>
        <DELETED>    (5) Such other information on services, care, or 
        resources for military sexual trauma as the Secretary 
        determines appropriate.</DELETED>
<DELETED>    (b) Definition of Military Sexual Trauma.--In this 
section, the term ``military sexual trauma'' has the meaning given such 
term in section 1167(j) of title 38, United States Code, as added by 
section 203(a).</DELETED>

<DELETED>SEC. 303. STUDY ON ACCESS TO INPATIENT MENTAL HEALTH CARE FOR 
              SURVIVORS OF MILITARY SEXUAL TRAUMA.</DELETED>

<DELETED>    (a) In General.--The Secretary of Veterans Affairs shall 
conduct a study on access to inpatient mental health care for current 
and former members of the Armed Forces who are survivors of military 
sexual trauma.</DELETED>
<DELETED>    (b) Elements.--The study required by subsection (a) shall 
include the following:</DELETED>
        <DELETED>    (1) An assessment of the availability of bed 
        spaces in the mental health residential rehabilitation 
        treatment programs of the Department of Veterans Affairs for 
        survivors of military sexual trauma, including the suitability 
        of those programs for such survivors and the wait times for 
        services under those programs.</DELETED>
        <DELETED>    (2) An assessment of geographic disparities in 
        access to those programs for survivors of military sexual 
        trauma, including by region and by rural and urban 
        areas.</DELETED>
        <DELETED>    (3) An assessment of alternative care options 
        provided when a survivor of military sexual trauma is waiting 
        for inpatient care, the efficacy of those alternatives, and the 
        satisfaction of patients with those alternatives.</DELETED>
        <DELETED>    (4) Recommendations for reducing the average wait 
        time for services under those programs to 14 days or less, 
        including by increasing bed space or addressing staffing 
        needs.</DELETED>
        <DELETED>    (5) An assessment of the satisfaction of patients 
        with the tracks of those programs specific to military sexual 
        trauma, the wait times for services under those tracks, and 
        recommendations for increasing or changing the number of 
        locations for services under those tracks to better meet the 
        needs of survivors of military sexual trauma.</DELETED>
<DELETED>    (c) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report detailing the findings of the 
study required by subsection (a).</DELETED>
<DELETED>    (d) Definition of Military Sexual Trauma.--In this 
section, the term ``military sexual trauma'' has the meaning given such 
term in section 1720D(f) of title 38, United States Code, as added by 
section 301.</DELETED>

<DELETED>SEC. 304. PILOT PROGRAM FOR INTERIM ACCESS TO MENTAL HEALTH 
              CARE FOR SURVIVORS OF MILITARY SEXUAL TRAUMA.</DELETED>

<DELETED>    (a) In General.--Commencing not later than one year after 
the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall carry out a pilot program to provide intensive outpatient 
mental health care to current and former members of the Armed Forces 
who are survivors of military sexual trauma when the wait times for 
inpatient mental health care from the Department of Veterans Affairs 
for the survivor is more than 14 days.</DELETED>
<DELETED>    (b) Duration.--The Secretary shall carry out the pilot 
program under subsection (a) for a three-year period beginning on the 
commencement of the pilot program.</DELETED>
<DELETED>    (c) Locations.--</DELETED>
        <DELETED>    (1) In general.--The Secretary shall carry out the 
        pilot program under subsection (a) at not fewer than four 
        Veterans Integrated Service Networks of the 
        Department.</DELETED>
        <DELETED>    (2) Selection of locations.--In selecting 
        locations for the pilot program under subsection (a), the 
        Secretary shall select locations that have the longest wait 
        times for inpatient mental health care, particularly for 
        survivors of military sexual trauma.</DELETED>
        <DELETED>    (3) Notification.--Before commencing the pilot 
        program under subsection (a), the Secretary shall notify the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives of the 
        locations selected for the pilot program.</DELETED>
<DELETED>    (d) Types of Services.--Subject to the preference of the 
survivor participating in the pilot program under subsection (a) and 
the capacity of facilities of the Department, the Secretary may provide 
services under the pilot program via telehealth or at community-based 
outpatient clinics of the Department.</DELETED>
<DELETED>    (e) Participation.--</DELETED>
        <DELETED>    (1) Clarification on participation.--Participation 
        by a survivor in the pilot program under subsection (a) shall 
        be during the period in which the survivor is waiting for an 
        inpatient bed opening and shall not disqualify the survivor 
        from receiving inpatient mental health care following their 
        participation in the pilot program.</DELETED>
        <DELETED>    (2) Decisions on participation.--Decisions about 
        the participation of a survivor in the pilot program and the 
        transition of the survivor to inpatient mental health care 
        shall be made by the survivor and their health care 
        provider.</DELETED>
<DELETED>    (f) Report.--Not later than 180 days after the conclusion 
of the pilot program under subsection (a), the Secretary shall submit 
to Congress a report on--</DELETED>
        <DELETED>    (1) participation in the pilot program;</DELETED>
        <DELETED>    (2) clinical outcomes under the pilot program; 
        and</DELETED>
        <DELETED>    (3) such recommendations for continuation or 
        termination of the program as the Secretary may have, including 
        recommendations for legislative or administrative 
        action.</DELETED>
<DELETED>    (g) Definition of Military Sexual Trauma.--In this 
section, the term ``military sexual trauma'' has the meaning given such 
term in section 1720D(f) of title 38, United States Code, as added by 
section 301.</DELETED>

<DELETED>SEC. 305. COMPTROLLER GENERAL STUDY ON ACCESS TO CARE FOR 
              SURVIVORS OF MILITARY SEXUAL TRAUMA AT THE DEPARTMENT OF 
              VETERANS AFFAIRS.</DELETED>

<DELETED>    (a) In General.--The Comptroller General of the United 
States shall conduct a study on access to mental health care for 
survivors of military sexual trauma at facilities of the Department of 
Veterans Affairs.</DELETED>
<DELETED>    (b) Elements.--The study conducted under subsection (a) 
shall include an assessment of the following:</DELETED>
        <DELETED>    (1) The availability of inpatient and outpatient 
        services, including wait times and geographic disparities for 
        such services.</DELETED>
        <DELETED>    (2) The availability of other types of training 
        and support services for survivors of military sexual trauma, 
        such as the Parenting STAIR program of the 
        Department.</DELETED>
        <DELETED>    (3) The communication and advertisement by the 
        Department of the care, services, and resources available for 
        such survivors.</DELETED>
        <DELETED>    (4) The barriers to accessing mental health care 
        at a facility of the Department for such survivors, including 
        transportation, child care, lack of telehealth, and 
        more.</DELETED>
        <DELETED>    (5) The barriers to mental health care at 
        facilities of the Department for such survivors of each gender, 
        including the unique considerations for male survivors versus 
        female survivors.</DELETED>
        <DELETED>    (6) The extent to which the Secretary has assessed 
        the quality of the training provided to providers of the 
        Department on military sexual trauma and made any adjustments 
        in response to such assessment.</DELETED>
        <DELETED>    (7) The role of Vet Centers in providing care to 
        such survivors, including current and former members of the 
        Armed Forces.</DELETED>
        <DELETED>    (8) The role of military sexual trauma 
        coordinators of the Veterans Health Administration in 
        coordinating and providing care for such survivors at 
        facilities of the Department.</DELETED>
        <DELETED>    (9) Any current actions by the Secretary to 
        strengthen access to high-quality care for such survivors and 
        such recommendations for improving access to care for such 
        survivors as the Comptroller General considers 
        appropriate.</DELETED>
<DELETED>    (c) Report.--Not later than two years after the date of 
the enactment of this Act, the Comptroller General shall submit to 
Congress a report on the findings of the study conducted under 
subsection (a).</DELETED>
<DELETED>    (d) Definitions.--In this section:</DELETED>
        <DELETED>    (1) Military sexual trauma.--In this section, the 
        term ``military sexual trauma'' has the meaning given such term 
        in section 1720D(f) of title 38, United States Code, as added 
        by section 301.</DELETED>
        <DELETED>    (2) Vet center.--The term ``Vet Center'' has the 
        meaning given that term in section 1712A(h) of title 38, United 
        States Code.</DELETED>

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Servicemembers and 
Veterans Empowerment and Support Act of 2021''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.

                TITLE I--DEFINING MILITARY SEXUAL TRAUMA

Sec. 101. Report on military sexual trauma in the digital age.

        TITLE II--DISABILITY COMPENSATION AND CLAIMS PROCESSING

Sec. 201. Definition of military sexual trauma.
Sec. 202. Conforming changes relating to specialized teams to evaluate 
                            claims involving military sexual trauma.
Sec. 203. Standard of proof for service-connection of mental health 
                            conditions relating to military sexual 
                            trauma.
Sec. 204. Choice of location of Department of Veterans Affairs medical 
                            examination for assessment of claims for 
                            compensation relating to disability 
                            resulting from military sexual trauma.
Sec. 205. Communications from the Department of Veterans Affairs to 
                            individuals who have experienced military 
                            sexual trauma.
Sec. 206. Study on training and processing relating to claims for 
                            disability compensation relating to 
                            military sexual trauma.
Sec. 207. Annual special focus review of claims for disability 
                            compensation for disabilities relating to 
                            military sexual trauma.

                    TITLE III--ACCESS TO HEALTH CARE

Sec. 301. Expansion of eligibility for counseling and treatment for 
                            military sexual trauma to include all 
                            former members of the reserve components of 
                            the Armed Forces.
Sec. 302. Connection to Veterans Health Administration when a 
                            disability claim related to military sexual 
                            trauma is submitted to Veterans Benefits 
                            Administration.
Sec. 303. Pilot program for interim access to mental health care for 
                            individuals who have experienced military 
                            sexual trauma.
Sec. 304. Comptroller General study on access to care from Department 
                            of Veterans Affairs for individuals who 
                            have experienced military sexual trauma.

                TITLE I--DEFINING MILITARY SEXUAL TRAUMA

SEC. 101. REPORT ON MILITARY SEXUAL TRAUMA IN THE DIGITAL AGE.

    (a) Report Required.--Not later than one year after the date of the 
enactment of this Act, 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 
military sexual trauma in the digital age.
    (b) Requirements.--The report required under subsection (a) shall 
include the following:
            (1) A comprehensive evaluation and assessment of current 
        Department of Veterans Affairs statutes, regulations, and 
        agency guidance relating to military sexual trauma for the 
        purposes of access to health care under chapter 17 of title 38, 
        United States Code, and compensation under chapter 11 of such 
        title to identify--
                    (A) gaps in coverage for health care and 
                compensation eligibility relating to technological 
                abuse that is sexual in nature, including gaps induced 
                by the military status (or lack thereof) of a veteran 
                at the time of such abuse; and
                    (B) the feasibility and advisability of expanding 
                eligibility for health care and compensation relating 
                to technological abuse that is nonsexual in nature 
                consistent with current policies relating to military 
                sexual trauma.
            (2) Recommendations for revising statutes, regulations, and 
        agency guidance in response to the evaluation and assessment 
        under paragraph (1).
    (c) Consultation.--In carrying out subsection (a), the Secretary of 
Veterans Affairs shall consult veterans service organizations and such 
other stakeholders as the Secretary considers relevant and appropriate.
    (d) Definitions.--In this section:
            (1) Military sexual trauma.--The term ``military sexual 
        trauma''--
                    (A) with respect to eligibility for health care, 
                has the meaning given such term in section 1720D(f) of 
                title 38, United States Code, as added by section 301; 
                and
                    (B) with respect to eligibility for compensation, 
                has the meaning given such term in section 1167(i) of 
                title 38, United States Code, as added by section 
                203(a).
            (2) Technological abuse.--The term ``technological abuse'' 
        may include--
                    (A) behavior which harms, threatens, intimidates, 
                controls, stalks, harasses, impersonates, or monitors 
                another person, except as otherwise permitted by law, 
                that occurs via the internet, social networking sites, 
                computers, mobile devices, mobile telephones, 
                applications, location tracking devices, instant 
                messages, text messages, or other forms of technology; 
                and
                    (B) specific activities, including--
                            (i) unwanted, repeated telephone calls, 
                        text messages, instant messages, or social 
                        media posts;
                            (ii) nonconsensual access of email 
                        accounts, texts or instant messaging accounts, 
                        social networking accounts, or mobile telephone 
                        logs;
                            (iii) attempting to control or restrict a 
                        person's ability to access technology with the 
                        intent to isolate the person from support and 
                        social connection;
                            (iv) using tracking devices or location 
                        tracking software for the purpose of monitoring 
                        or stalking another person's location;
                            (v) impersonation of a person with the 
                        intent to deceive or cause harm through the use 
                        of spoofing technology or the creation of fake 
                        email or social media accounts; or
                            (vi) pressuring for or sharing of another 
                        person's private information, photographs, or 
                        videos without the person's consent.

        TITLE II--DISABILITY COMPENSATION AND CLAIMS PROCESSING

SEC. 201. DEFINITION OF MILITARY SEXUAL TRAUMA.

    In this title, the term ``military sexual trauma'' has the meaning 
given such term in section 1167(i) of title 38, United States Code, as 
added by section 203(a).

SEC. 202. CONFORMING CHANGES RELATING TO SPECIALIZED TEAMS TO EVALUATE 
              CLAIMS INVOLVING MILITARY SEXUAL TRAUMA.

    Section 1166(c) of title 38, United States Code, as redesignated by 
section 7(a) of the Training in High-demand Roles to Improve Veteran 
Employment Act (Public Law 117-16), is amended by striking ``In this 
section'' and all that follows and inserting the following: ``In this 
section, the terms `covered mental health condition' and `military 
sexual trauma' have the meanings given those terms in section 1167(i) 
of this title.''.

SEC. 203. STANDARD OF PROOF FOR SERVICE-CONNECTION OF MENTAL HEALTH 
              CONDITIONS RELATING TO MILITARY SEXUAL TRAUMA.

    (a) In General.--Subchapter VI of chapter 11 of such title is 
amended by adding at the end the following new section:
``Sec. 1167. Evaluation of claims involving military sexual trauma
    ``(a) Standard of Proof.--(1) In the case of any veteran who claims 
that a covered mental health condition based on military sexual trauma 
was incurred in or aggravated by active military, naval, air, or space 
service, the Secretary shall accept as sufficient proof of service-
connection a diagnosis of such mental health condition by a mental 
health professional together with satisfactory lay or other evidence, 
in accordance with subsections (b) and (c), of such trauma and an 
opinion by the mental health professional that the evidence indicates 
such trauma occurred and such covered mental health condition is at 
least as likely as not related to such military sexual trauma, as 
specified in subsection (e), notwithstanding the fact that there is no 
official record of such incurrence or aggravation in such service, and, 
to that end, shall resolve every reasonable doubt in favor of the 
veteran.
    ``(2) Service-connection of such covered mental health condition 
may be rebutted by clear and convincing evidence to the contrary.
    ``(3) The reasons for granting or denying service-connection in 
each case shall be recorded in full.
    ``(b) Nonmilitary Sources of Evidence.--(1) In carrying out 
subsection (a), the Secretary shall ensure that if a claim for 
compensation under this chapter is received by the Secretary for a 
covered mental health condition based on military sexual trauma, 
evidence from sources other than official records of the Department of 
Defense regarding the veteran's service may corroborate the veteran's 
account of the trauma.
    ``(2) Examples of evidence described in paragraph (1) include the 
following:
            ``(A) Records from law enforcement authorities, rape crisis 
        centers, mental health counseling centers, hospitals, and 
        physicians.
            ``(B) Pregnancy tests and tests for sexually transmitted 
        diseases.
            ``(C) Statements from family members, roommates, other 
        members of the Armed Forces or veterans, and clergy.
    ``(c) Evidence of Behavior Changes.--(1) In carrying out subsection 
(a), the Secretary shall ensure that evidence of a behavior change 
following military sexual trauma is one type of relevant evidence that 
may be found in sources described in such subsection.
    ``(2) Examples of behavior changes that may be relevant evidence of 
military sexual trauma include the following:
            ``(A) A request for a transfer to another military duty 
        assignment.
            ``(B) Deterioration in work performance.
            ``(C) Substance abuse or substance use disorder.
            ``(D) Episodes of depression, panic attacks, or anxiety 
        without an identifiable cause.
            ``(E) Unexplained economic or social behavior changes.
    ``(d) Notice and Opportunity to Supply Evidence.--The Secretary may 
not deny a claim of a veteran for compensation under this chapter for a 
covered mental health condition that is based on military sexual trauma 
without first--
            ``(1) advising the veteran that evidence described in 
        subsections (b) and (c) may constitute credible corroborating 
        evidence of the military sexual trauma; and
            ``(2) allowing the veteran an opportunity to furnish such 
        corroborating evidence or advise the Secretary of potential 
        sources of such evidence.
    ``(e) Review of Evidence.--In reviewing a claim for compensation 
described in subsection (a)(1), for any evidence identified as part of 
such claim that is described in subsection (b) or (c), the Secretary 
shall submit such evidence to such medical or mental health 
professional as the Secretary considers appropriate, including clinical 
and counseling experts employed by the Department, to obtain an opinion 
as to whether--
            ``(1) the evidence indicates that a military sexual trauma 
        occurred; and
            ``(2) it is at least as likely as not that there is a nexus 
        between the military sexual trauma and any diagnosed covered 
        mental health condition.
    ``(f) Point of Contact.--The Secretary shall ensure that each 
document provided to a veteran relating to a claim for compensation 
described in subsection (a)(1) includes contact information for an 
appropriate point of contact with the Department.
    ``(g) Specialized Teams.--The Secretary shall ensure that all 
claims for compensation described in subsection (a)(1) are reviewed and 
processed by a specialized team established under section 1166 of this 
title.
    ``(h) Rule of Construction Regarding Application to Nonsexual 
Personal Assault.-- The Secretary shall not construe this section as 
supplanting the standard of proof or evidence required for claims for 
posttraumatic stress disorder based on nonsexual personal assault, 
which the Secretary shall continue to define in regulation.
    ``(i) Definitions.--In this section:
            ``(1) The term `covered mental health condition' means 
        post-traumatic stress disorder, anxiety, depression, or other 
        mental health diagnosis that the Secretary determines to be 
        related to military sexual trauma and which may be service-
        connected under section 1110 of this title.
            ``(2) The term `military sexual trauma' means, with respect 
        to a veteran, a physical assault of a sexual nature, battery of 
        a sexual nature, or sexual harassment that occurred while the 
        veteran was serving in the active military, naval, air, or 
        space service.''.
    (b) Outreach.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall 
implement, with input from the veteran community, an informative 
outreach program for veterans regarding the standard of proof for 
evaluation of claims relating to military sexual trauma, including 
requirements for a medical examination and opinion.
    (c) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following new item:

``1167. Evaluation of claims involving military sexual trauma.''.

SEC. 204. CHOICE OF LOCATION OF DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
              EXAMINATION FOR ASSESSMENT OF CLAIMS FOR COMPENSATION 
              RELATING TO DISABILITY RESULTING FROM MILITARY SEXUAL 
              TRAUMA.

    (a) In General.--Section 1165 of title 38, United States Code, is 
amended--
            (1) in the section heading, by inserting ``and location of 
        medical examination'' after ``examiner'';
            (2) in subsection (a), by striking ``a physical assault of 
        a sexual nature, battery of a sexual nature, or sexual 
        harassment'' and inserting ``military sexual trauma (as defined 
        in section 1167(i) of this title)'';
            (3) by redesignating subsection (c) as subsection (d); and
            (4) by inserting after subsection (b) the following new 
        subsection (c):
    ``(c) Choice of Examination Location.--(1) The Secretary shall 
ensure that a veteran who requires a medical examination in support of 
a claim described in subsection (a) may request that the medical 
examination take place at a medical facility of the Department by a 
qualified employee of the Department rather than at a location 
designated by a Department contractor that performs such examinations 
on behalf of the Department.
    ``(2) The Secretary--
            ``(A) shall grant any request under paragraph (1) if a 
        medical facility of the Department is available not further 
        than 100 miles from the veteran's home; and
            ``(B) may not issue a decision on a claim described in such 
        paragraph before the requested examination is completed, or 
        notice is provided per paragraph (c)(3).
    ``(3) If a medical facility of the Department is not available 
within 100 miles of the veteran's home, the Secretary shall notify the 
veteran and provide the veteran the opportunity--
            ``(A) to have the examination completed by a contractor of 
        the Department; or
            ``(B) to complete the examination at a medical facility 
        further than 100 miles from the veteran's home.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 11 of such title is amended by striking the item relating to 
section 1165 and inserting the following new item:

``1165. Choice of sex of medical examiner and location of medical 
                            examination for certain disabilities.''.

SEC. 205. COMMUNICATIONS FROM THE DEPARTMENT OF VETERANS AFFAIRS TO 
              INDIVIDUALS WHO HAVE EXPERIENCED MILITARY SEXUAL TRAUMA.

    (a) Review Board.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        establish a board to review correspondence relating to military 
        sexual trauma.
            (2) Membership.--The board established under paragraph (1) 
        shall be composed of members who shall be appointed by the 
        Secretary from among employees of the Department of Veterans 
        Affairs who are experts in military sexual trauma and mental 
        health, of whom--
                    (A) one or more shall be appointed from among 
                mental health providers of the Veterans Health 
                Administration;
                    (B) one or more shall be appointed from among 
                experts on sexual assault and sexual harassment of the 
                Veterans Benefits Administration; and
                    (C) one or more shall be appointed from among 
                experts on sexual assault and sexual harassment of the 
                Board of Veterans' Appeals.
            (3) Duties.--The board established under paragraph (1) 
        shall--
                    (A) review standard correspondence, which may 
                include templates for notices under sections 5103, 
                5104, 5104B, and 7104 of title 38, United States Code, 
                from the Department to individuals who have experienced 
                military sexual trauma for sensitivity; and
                    (B) ensure that the correspondence--
                            (i) treats such individuals with dignity 
                        and respect; and
                            (ii) does not re-traumatize such 
                        individuals.
            (4) Individual who has experienced military sexual trauma 
        defined.--In this subsection, the term ``individual who has 
        experienced military sexual trauma'' means--
                    (A) a veteran who has filed a claim for 
                compensation under chapter 11 of title 38, United 
                States Code, relating to military sexual trauma;
                    (B) a veteran who has been awarded compensation 
                under such chapter relating to military sexual trauma; 
                or
                    (C) a former member of the Armed Forces or a 
                veteran who is receiving care from the Department 
                relating to military sexual trauma.
    (b) Contents of Certain Written Communications to Individuals Who 
Have Experienced Military Sexual Trauma.--
            (1) Notice to claimants of required information and 
        evidence.--Section 5103 of title 38, United States Code, is 
        amended by adding at the end the following new subsection:
    ``(c) Written Communications to Individuals Who Have Experienced 
Military Sexual Trauma.--(1) The Secretary shall ensure that any 
written communication under this section from the Department to an 
individual who has experienced military sexual trauma includes contact 
information for each of the following:
            ``(A) The military sexual trauma coordinator of the 
        Veterans Benefits Administration.
            ``(B) The military sexual trauma coordinator of the 
        Veterans Health Administration.
            ``(C) The Veterans Crisis Line.
            ``(D) The facility of the Veterans Health Administration 
        closest to where the individual resides.
    ``(2) In this subsection:
            ``(A) The term `individual who has experienced military 
        sexual trauma' means--
                    ``(i) a veteran who has filed a claim for 
                compensation under chapter 11 of this title relating to 
                military sexual trauma;
                    ``(ii) a veteran who has been awarded compensation 
                under such chapter relating to military sexual trauma; 
                or
                    ``(iii) a former member of the Armed Forces or a 
                veteran who is receiving care from the Department 
                relating to military sexual trauma.
            ``(B) The term `military sexual trauma' has the meaning 
        given that term in section 1167(i) of this title.
            ``(C) The term `Veterans Crisis Line' means the toll-free 
        hotline for veterans established under section 1720F(h) of this 
        title.''.
            (2) Decisions and notices of decisions.--Section 5104 of 
        title 38, United States Code, is amended by adding at the end 
        the following new subsection:
    ``(c)(1) The Secretary shall ensure that any written communication 
under this section from the Department to an individual who has 
experienced military sexual trauma includes contact information for 
each of the following:
            ``(A) The military sexual trauma coordinator of the 
        Veterans Health Administration.
            ``(B) The Veterans Crisis Line.
            ``(C) The facility of the Veterans Health Administration 
        closest to where the individual resides.
    ``(2) The Secretary shall ensure that any written communication 
under this section from the Department to an individual who has 
experienced military sexual trauma that includes notification of an 
award of compensation under chapter 11 of this title relating to 
military sexual trauma includes--
            ``(A) the contact information described in paragraph (1); 
        and
            ``(B) the contact information for the military sexual 
        trauma coordinator of the Veterans Benefits Administration.
    ``(3) In this subsection:
            ``(A) The term `individual who has experienced military 
        sexual trauma' means--
                    ``(i) a veteran who has filed a claim for 
                compensation under chapter 11 of this title relating to 
                military sexual trauma;
                    ``(ii) a veteran who has been awarded compensation 
                under such chapter relating to military sexual trauma; 
                or
                    ``(iii) a former member of the Armed Forces or a 
                veteran who is receiving care from the Department 
                relating to military sexual trauma.
            ``(B) The term `military sexual trauma' has the meaning 
        given that term in section 1167(i) of this title.
            ``(C) The term `Veterans Crisis Line' means the toll-free 
        hotline for veterans established under section 1720F(h) of this 
        title.''.
            (3) Higher-level review by the agency of original 
        jurisdiction.--Section 5104B of title 38, United States Code, 
        is amended by adding at the end the following new subsection:
    ``(f) Written Communications to Individuals Who Have Experienced 
Military Sexual Trauma.--(1) The Secretary shall ensure that any 
written communication under this section from the Department to an 
individual who has experienced military sexual trauma includes contact 
information for each of the following:
            ``(A) The military sexual trauma coordinator of the 
        Veterans Health Administration.
            ``(B) The Veterans Crisis Line.
            ``(C) The facility of the Veterans Health Administration 
        closest to where the individual resides.
    ``(2) The Secretary shall ensure that any written communication 
under this section from the Department to an individual who has 
experienced military sexual trauma that includes notification of an 
award of compensation under chapter 11 of this title relating to 
military sexual trauma includes--
            ``(A) the contact information described in paragraph (1); 
        and
            ``(B) the contact information for the military sexual 
        trauma coordinator of the Veterans Benefits Administration.
    ``(3) In this subsection:
            ``(A) The term `individual who has experienced military 
        sexual trauma' means--
                    ``(i) a veteran who has filed a claim for 
                compensation under chapter 11 of this title relating to 
                military sexual trauma;
                    ``(ii) a veteran who has been awarded compensation 
                under such chapter relating to military sexual trauma; 
                or
                    ``(iii) a former member of the Armed Forces or a 
                veteran who is receiving care from the Department 
                relating to military sexual trauma.
            ``(B) The term `military sexual trauma' has the meaning 
        given that term in section 1167(i) of this title.
            ``(C) The term `Veterans Crisis Line' means the toll-free 
        hotline for veterans established under section 1720F(h) of this 
        title.''.
            (4) Board of veterans' appeals.--Section 7104 of title 38, 
        United States Code, is amended by adding at the end the 
        following new subsection:
    ``(f)(1) The Secretary shall ensure that any written communication 
under this section from the Department to an individual who has 
experienced military sexual trauma includes contact information for 
each of the following:
            ``(A) The military sexual trauma coordinator of the 
        Veterans Health Administration.
            ``(B) The Veterans Crisis Line.
            ``(C) The facility of the Veterans Health Administration 
        closest to where the individual resides.
    ``(2) The Secretary shall ensure that any written communication 
under this section from the Department to an individual who has 
experienced military sexual trauma that includes notification of an 
award of compensation under chapter 11 of this title relating to 
military sexual trauma includes--
            ``(A) the contact information described in paragraph (1); 
        and
            ``(B) the contact information for the military sexual 
        trauma coordinator of the Veterans Benefits Administration.
    ``(3) In this subsection:
            ``(A) The term `individual who has experienced military 
        sexual trauma' means--
                    ``(i) a veteran who has filed a claim for 
                compensation under chapter 11 of this title relating to 
                military sexual trauma;
                    ``(ii) a veteran who has been awarded compensation 
                under such chapter relating to military sexual trauma; 
                or
                    ``(iii) a former member of the Armed Forces or a 
                veteran who is receiving care from the Department 
                relating to military sexual trauma.
            ``(B) The term `military sexual trauma' has the meaning 
        given that term in section 1167(i) of this title.
            ``(C) The term `Veterans Crisis Line' means the toll-free 
        hotline for veterans established under section 1720F(h) of this 
        title.''.

SEC. 206. STUDY ON TRAINING AND PROCESSING RELATING TO CLAIMS FOR 
              DISABILITY COMPENSATION RELATING TO MILITARY SEXUAL 
              TRAUMA.

    (a) Study Required.--The Secretary of Veterans Affairs shall 
conduct a study on--
            (1) the quality of training provided to personnel of the 
        Department of Veterans Affairs who review claims for disability 
        compensation under chapter 11 of title 38, United States Code, 
        for disabilities relating to military sexual trauma; and
            (2) the quality of the procedures of the Department for 
        reviewing the accuracy of the processing of such claims.
    (b) Elements.--The study required by subsection (a) shall include 
the following:
            (1) With respect to the quality of training described in 
        paragraph (1) of such subsection:
                    (A) Whether the Department ensures personnel 
                complete such training on time.
                    (B) Whether the training has resulted in 
                improvements to the processing of claims described in 
                such subsection and issue-based accuracy.
                    (C) Such recommendations as the Secretary of 
                Veterans Affairs may have for improving the training.
            (2) With respect to the quality of procedures described in 
        paragraph (2) of such subsection:
                    (A) Whether the procedures of the Department for 
                reviewing the accuracy of the processing of claims 
                described in such subsection comport with generally 
                accepted statistical methodologies to ensure reasonable 
                accuracy of such reviews.
                    (B) Whether such procedures adequately include 
                mechanisms to correct errors found in such reviews.
                    (C) Such recommendations as the Secretary may have 
                for improving such procedures.
    (c) Report Required.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report detailing the findings of the 
Secretary with respect to the study conducted under subsection (a).

SEC. 207. ANNUAL SPECIAL FOCUS REVIEW OF CLAIMS FOR DISABILITY 
              COMPENSATION FOR DISABILITIES RELATING TO MILITARY SEXUAL 
              TRAUMA.

    (a) Annual Special Focus Review.--
            (1) In general.--Each year, the Under Secretary for 
        Benefits of the Department of Veterans Affairs shall conduct a 
        special focus review on the accuracy of the processing of 
        claims for disability compensation under chapter 11 of title 
        38, United States Code, for disabilities relating to military 
        sexual trauma.
            (2) Elements.--Each review conducted under paragraph (1) 
        shall include a review of the following:
                    (A) A statistically significant, nationally 
                representative sample of all claims for benefits under 
                the laws administered by the Secretary of Veterans 
                Affairs relating to military sexual trauma filed during 
                the fiscal year preceding the fiscal year in which the 
                report is submitted.
                    (B) The accuracy of each decision made with respect 
                to each claim described in subparagraph (A).
                    (C) The types of benefit entitlement errors found, 
                disaggregated by category.
                    (D) Trends from year to year.
                    (E) Training completion rates for personnel of the 
                Department who process claims described in paragraph 
                (1).
    (b) Reprocessing of Claims.--If the Under Secretary finds, pursuant 
to a special focus review conducted under subsection (a)(1), that an 
error was made with respect to the entitlement of a veteran to a 
benefit under the laws administered by the Secretary, the Secretary 
shall return the relevant claim of the veteran to the appropriate 
regional office of the Department for reprocessing to ensure that the 
veteran receives an accurate decision with respect to the claim.
    (c) Re-reviewing of Claims.--If the Under Secretary finds, pursuant 
to a special focus review conducted under paragraph (1) of subsection 
(a), that the accuracy rate, under paragraph (2)(B) of such subsection, 
is less than 90 percent, the Secretary shall conduct a review of each 
claim for benefits under the laws administered by the Secretary of 
Veterans Affairs relating to military sexual trauma filed during the 
fiscal year preceding the fiscal year in which the report is submitted.
    (d) Report.--Section 5501(b)(2) of the Johnny Isakson and David P. 
Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 
(Public Law 116-315; 134 Stat. 5048) is amended by adding at the end 
the following new subparagraph:
                    ``(I) The findings of the most recent special focus 
                review conducted under subsection (a)(1) of section 207 
                of the Servicemembers and Veterans Empowerment and 
                Support Act of 2021, including--
                            ``(i) the elements under subsection (a)(2) 
                        of such section;
                            ``(ii) the number of claims returned for 
                        reprocessing under subsection (b) of such 
                        section; and
                            ``(iii) the number of claims described in 
                        clause (ii) for which the decision relating to 
                        service-connection or entitlement to 
                        compensation changed as a result of 
                        reprocessing the claim.''.
    (e) Sunset.--On the date that the Under Secretary determines, 
pursuant to special focus reviews conducted under paragraph (1) of 
subsection (a), that the accuracy rates under paragraph (2)(B) of such 
subsection have been 95 percent or greater for five consecutive years--
            (1) subsection (a)(1) shall cease to be in effect; and
            (2) subparagraph (I) of section 5501(b)(2) of the Johnny 
        Isakson and David P. Roe, M.D. Veterans Health Care and 
        Benefits Improvement Act of 2020 (Public Law 116-315; 134 Stat. 
        5048), as added by subsection (d), is repealed.

                    TITLE III--ACCESS TO HEALTH CARE

SEC. 301. EXPANSION OF ELIGIBILITY FOR COUNSELING AND TREATMENT FOR 
              MILITARY SEXUAL TRAUMA TO INCLUDE ALL FORMER MEMBERS OF 
              THE RESERVE COMPONENTS OF THE ARMED FORCES.

    Section 1720D of title 38, United States Code, is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``a physical 
                assault'' and all that follows through the period at 
                the end and inserting ``military sexual trauma.''; and
                    (B) in paragraph (2), by striking ``was suffered'' 
                and all that follows through the period at the end and 
                inserting ``resulted from military sexual trauma.''; 
                and
            (2) by striking subsections (f) and (g) and inserting the 
        following new subsection (f):
    ``(f) In this section:
            ``(1) The term `former member of the Armed Forces' means a 
        person who served on active duty, active duty for training, or 
        inactive duty training, and who was discharged or released 
        therefrom under any condition that is not--
                    ``(A) a discharge by court-martial; or
                    ``(B) a discharge subject to a bar to benefits 
                under section 5303 of this title.
            ``(2) The term `military sexual trauma' means, with respect 
        to a member of the Armed Forces or former member of the Armed 
        Forces, a physical assault of a sexual nature, battery of a 
        sexual nature, or sexual harassment which occurred while the 
        member or former member was serving on duty, regardless of duty 
        status or line of duty determination (as that term is used in 
        section 12323 of title 10).
            ``(3) The term `sexual harassment' means unsolicited verbal 
        or physical contact of a sexual nature which is threatening in 
        character.''.

SEC. 302. CONNECTION TO VETERANS HEALTH ADMINISTRATION WHEN A 
              DISABILITY CLAIM RELATED TO MILITARY SEXUAL TRAUMA IS 
              SUBMITTED TO VETERANS BENEFITS ADMINISTRATION.

    (a) In General.--Not later than 14 days after the date on which a 
veteran submits a claim for disability compensation to the Veterans 
Benefits Administration for a disability related to military sexual 
trauma, the Secretary of Veterans Affairs shall send a communication to 
the veteran with the following information:
            (1) The contact information for the nearest military sexual 
        trauma coordinator for the veteran at the Veterans Benefits 
        Administration and a description of the assistance such 
        coordinator can provide.
            (2) The contact information for the nearest military sexual 
        trauma coordinator for the veteran at the Veterans Health 
        Administration and a description of the assistance such 
        coordinator can provide.
            (3) The types of services that individuals who have 
        experienced military sexual trauma are eligible to receive from 
        the Department of Veterans Affairs, including the nearest 
        locations and the contact information for such services.
            (4) The contact information for the Veterans Crisis Line 
        established under section 1720F(h) of title 38, United States 
        Code.
            (5) Such other information on services, care, or resources 
        for military sexual trauma as the Secretary determines 
        appropriate.
    (b) Definition of Military Sexual Trauma.--In this section, the 
term ``military sexual trauma'' has the meaning given that term in 
section 1167(i) of title 38, United States Code, as added by section 
203(a).

SEC. 303. PILOT PROGRAM FOR INTERIM ACCESS TO MENTAL HEALTH CARE FOR 
              INDIVIDUALS WHO HAVE EXPERIENCED MILITARY SEXUAL TRAUMA.

    (a) In General.--Commencing not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
carry out a pilot program to provide intensive outpatient mental health 
care to current and former members of the Armed Forces who have 
experienced military sexual trauma when the wait times for residential 
mental health care from the Department of Veterans Affairs for the 
individual is more than 14 days.
    (b) Duration.--The Secretary shall carry out the pilot program 
under subsection (a) for a three-year period beginning on the 
commencement of the pilot program.
    (c) Locations.--
            (1) In general.--The Secretary shall carry out the pilot 
        program under subsection (a) at not fewer than four Veterans 
        Integrated Service Networks of the Department.
            (2) Selection of locations.--In selecting locations for the 
        pilot program under subsection (a), the Secretary shall select 
        locations that have the longest wait times for residential 
        mental health care, particularly for individuals who have 
        experienced military sexual trauma.
            (3) Notification.--Before commencing the pilot program 
        under subsection (a), the Secretary shall notify the Committee 
        on Veterans' Affairs of the Senate and the Committee on 
        Veterans' Affairs of the House of Representatives of the 
        locations selected for the pilot program.
    (d) Types of Services.--Subject to the preference of the individual 
participating in the pilot program under subsection (a) and the 
capacity of facilities of the Department, the Secretary may provide 
services under the pilot program via telehealth or in person at a 
facility of the Department.
    (e) Participation.--
            (1) Clarification on participation.--Participation by an 
        individual in the pilot program under subsection (a) shall be 
        during the period in which the individual is waiting for a 
        residential mental health bed opening and shall not disqualify 
        the individual from receiving residential mental health care 
        following their participation in the pilot program.
            (2) Decisions on participation.--Decisions about the 
        participation of an individual in the pilot program and the 
        transition of the individual to residential mental health care 
        shall be made by the individual and their health care provider.
    (f) Report.--Not later than 180 days after the conclusion of the 
pilot program under subsection (a), the Secretary shall submit to 
Congress a report on--
            (1) participation in the pilot program;
            (2) clinical outcomes under the pilot program; and
            (3) such recommendations for continuation or termination of 
        the program as the Secretary may have, including 
        recommendations for legislative or administrative action.
    (g) Definition of Military Sexual Trauma.--In this section, the 
term ``military sexual trauma'' has the meaning given that term in 
section 1720D(f) of title 38, United States Code, as added by section 
301.

SEC. 304. COMPTROLLER GENERAL STUDY ON ACCESS TO CARE FROM DEPARTMENT 
              OF VETERANS AFFAIRS FOR INDIVIDUALS WHO HAVE EXPERIENCED 
              MILITARY SEXUAL TRAUMA.

    (a) In General.--The Comptroller General of the United States shall 
conduct a study on access to mental health care at facilities of the 
Department of Veterans Affairs for individuals who have experienced 
military sexual trauma.
    (b) Elements.--The study conducted under subsection (a) shall 
include an assessment of the following:
            (1) The availability of residential and outpatient 
        services, including wait times and geographic disparities for 
        such services, to include--
                    (A) an assessment of the availability of bed spaces 
                in the mental health residential rehabilitation 
                treatment programs of the Department of Veterans 
                Affairs for individuals who have experienced military 
                sexual trauma, including an assessment of the 
                suitability of those programs for such individuals and 
                the wait times for services under those programs;
                    (B) an assessment of geographic disparities in 
                access to those programs for individuals who have 
                experienced military sexual trauma, including by region 
                and by rural and urban areas;
                    (C) an assessment of alternative care options 
                provided when an individual who has experienced 
                military sexual trauma is waiting for residential care, 
                the efficacy of those alternatives, and the 
                satisfaction of patients with those alternatives;
                    (D) recommendations for reducing the average wait 
                time for services under those programs to 14 days or 
                less, including by increasing bed space or addressing 
                staffing needs; and
                    (E) an assessment of the satisfaction of patients 
                with the tracks of those programs specific to military 
                sexual trauma, an assessment of the wait times for 
                services under those tracks, and recommendations for 
                increasing or changing the number of locations for 
                services under those tracks to better meet the needs of 
                individuals who have experienced military sexual 
                trauma.
            (2) The communication and advertisement by the Department 
        of the care, services, and resources available for individuals 
        who have experienced military sexual trauma.
            (3) The barriers to accessing health care related to 
        military sexual trauma at a facility of the Department for 
        individuals who have experienced military sexual trauma, 
        including transportation, child care, lack of telehealth, 
        gender-specific barriers, and more.
            (4) The extent to which the Secretary has assessed the 
        quality of the training provided to providers of the Department 
        on military sexual trauma and made any adjustments in response 
        to such assessment.
            (5) The role of Vet Centers in providing care to 
        individuals who have experienced military sexual trauma, 
        including current and former members of the Armed Forces.
            (6) Any current actions by the Secretary to strengthen 
        access to high-quality care for individuals who have 
        experienced military sexual trauma and such recommendations for 
        improving access to care for such individuals as the 
        Comptroller General considers appropriate.
    (c) Report.--Not later than two years after the date of the 
enactment of this Act, the Comptroller General shall submit to Congress 
a report on the findings of the study conducted under subsection (a).
    (d) Definitions.--In this section:
            (1) Military sexual trauma.--The term ``military sexual 
        trauma'' has the meaning given that term in section 1720D(f) of 
        title 38, United States Code, as added by section 301.
            (2) Vet center.--The term ``Vet Center'' has the meaning 
        given that term in section 1712A(h) of title 38, United States 
        Code.
                                                       Calendar No. 289

117th CONGRESS

  2d Session

                                S. 3025

_______________________________________________________________________

                                 A BILL

   To amend title 38, United States Code, to expand health care and 
 benefits from the Department of Veterans Affairs for military sexual 
                    trauma, and for other purposes.

_______________________________________________________________________

                             March 1, 2022

                       Reported with an amendment
```