IB 

Union Calendar No. 226 

116TH CONGRESS 

1ST SESSION H. R. 3224 

[Report No. 116–281] 

To amend title 38, United States Code, to provide for increased access 

to Department of Veterans Affairs medical care for women veterans. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 12, 2019 

Ms. BROWNLEY of California introduced the following bill; which was referred 

to the Committee on Veterans’ Affairs 

NOVEMBER 12, 2019 

Additional sponsors: Mr. AGUILAR, Ms. WILD, Ms. ROYBAL-ALLARD, Ms. 

KUSTER of New Hampshire, Mr. GONZALEZ of Texas, Mrs. HAYES, Mr. 

CISNEROS, Mr. PAPPAS, Mr. ROSE of New York, Ms. MENG, Ms. 

GABBARD, Ms. VELA ́ZQUEZ, Mrs. WATSON COLEMAN, Ms. SPEIER, Mr. 

TAKANO, Ms. MOORE, Mr. CUELLAR, Mr. RUSH, Mr. RYAN, Ms. NORTON, Mr. SABLAN, Mr. RUIZ, Ms. CASTOR of Florida, Mrs. RADEWAGEN, 

Mr. VISCLOSKY, Mr. CORREA, Mrs. LEE of Nevada, Ms. SCANLON, Mr. 

PETERSON, Mr. DELGADO, Mr. LEVIN of California, Mr. CICILLINE, Mr. 

LAMB, Ms. HAALAND, Mr. BEYER, and Ms. HOULAHAN

NOVEMBER 12, 2019 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on June 12, 2019] 


Sspencer on DSKBBXCHB2PROD with BILLS
2 

•HR 3224 RH

A BILL 

To amend title 38, United States Code, to provide for increased access to Department of Veterans Affairs medical care for women veterans. 


Sspencer on DSKBBXCHB2PROD with BILLS
3 

•HR 3224 RH

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Deborah Sampson Act’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—VETERANS HEALTH ADMINISTRATION 

Sec. 101. Office of Women’s Health in the Department of Veterans Affairs. 

Sec. 102. Expansion of capabilities of women veterans call center to include text 

messaging. 

Sec. 103. Requirement for Department of Veterans Affairs internet website to provide information on services available to women veterans. 

Sec. 104. Report on Women Veterans Retrofit Initiative. 

Sec. 105. Establishment of environment of care standards and inspections at Department of Veterans Affairs medical centers. 

Sec. 106. Additional funding for primary care and emergency care clinicians in 

Women Veterans Health Care Mini-Residency Program. 

Sec. 107. Establishment of women veteran training module for non-Department 

of Veterans Affairs health care providers. 

TITLE II—MEDICAL CARE 

Sec. 201. Improved access to Department of Veterans Affairs medical care for 

women veterans. 

Sec. 202. Counseling and treatment for sexual trauma. 

Sec. 203. Counseling in retreat settings for women veterans and other individuals. 

Sec. 204. Improvement of health care services provided to newborn children by 

Department of Veterans Affairs. 

TITLE III—REPORTS AND OTHER MATTERS 

Subtitle A—Reports 

Sec. 301. Assessment of effects of intimate partner violence on women veterans by 

Advisory Committee on Women Veterans. 

Sec. 302. Study on staffing of Women Veteran Program Manager program at 

medical centers of the Department of Veterans Affairs and training of staff. 

Sec. 303. Report on availability of prosthetic items for women veterans from the 

Department of Veterans Affairs. 

Sec. 304. Study of barriers for women veterans to health care from the Department of Veterans Affairs. 

Sec. 305. Report regarding veterans who receive benefits under laws administered 

by the Secretary of Veterans Affairs. 


Sspencer on DSKBBXCHB2PROD with BILLS
4 

•HR 3224 RH

Sec. 306. Study on Women Veteran Coordinator program. 

Subtitle B—Other Matters 

Sec. 321. Anti-harassment and anti-sexual assault policy of the Department of 

Veterans Affairs. 

Sec. 322. Support for organizations that have a focus on providing assistance to 

women veterans and their families. 

Sec. 323. Gap analysis of Department of Veterans Affairs programs that provide 

assistance to women veterans who are homeless. 

Sec. 324. Department of Veterans Affairs public-private partnership on legal services for women veterans. 

Sec. 325. Program to assist veterans who experience intimate partner violence or 

sexual assault. 

Sec. 326. Study and task force on veterans experiencing intimate partner violence 

or sexual assault. 

1 TITLE I—VETERANS HEALTH 

2 ADMINISTRATION 

3 SEC. 101. OFFICE OF WOMEN’S HEALTH IN THE DEPART4 MENT OF VETERANS AFFAIRS. 

5 (a) DIRECTOR OF WOMEN’S HEALTH.—Subsection (a) 

6 of section 7306 of title 38, United States Code, is amend7 ed— 

8 (1) by redesignating paragraph (10) as para9 graph (11); and 

10 (2) by inserting after paragraph (9) the fol11 lowing new paragraph: 

12 ‘‘(10) The Director of Women’s Health.’’. 

13 (b) ORGANIZATION OF OFFICE.— 

14 (1) IN GENERAL.—Subchapter I of chapter 73 of 

15 title 38, United States Code, is amended by adding 

16 at the end of the following new sections: 


Sspencer on DSKBBXCHB2PROD with BILLS
5 

•HR 3224 RH

1 ‘‘§ 7310. Office of Women’s Health 

2 ‘‘(a) ESTABLISHMENT.—(1) The Under Secretary for 

3 Health shall establish and operate in the Veterans Health 

4 Administration the Office of Women’s Health (hereinafter 

5 in this section referred to as the ‘Office’). The Office shall 

6 be located at the Central Office of the Department of Vet7 erans Affairs. 

8 ‘‘(2) The head of the Office is the Director of Women’s 

9 Health (hereinafter in this section referred to as the ‘Direc10 tor’). The Director shall report to the Under Secretary for 

11 Health. 

12 ‘‘(3) The Under Secretary for Health shall provide the 

13 Office with such staff and other support as may be nec14 essary for the Office to carry out effectively its functions 

15 under this section. 

16 ‘‘(4) The Under Secretary for Health may reorganize 

17 existing offices within the Veterans Health Administration 

18 as of the date of the enactment of this section in order to 

19 avoid duplication with the functions of the Office. 

20 ‘‘(b) PURPOSE.—The functions of the Office include the 

21 following: 

22 ‘‘(1) To provide a central office for monitoring 

23 and encouraging the activities of the Veterans Health 

24 Administration with respect to the provision, evalua25 tion, and improvement of women veterans’ health care 

26 services in the Department. 


Sspencer on DSKBBXCHB2PROD with BILLS
6 

•HR 3224 RH

1 ‘‘(2) To develop and implement standards of care 

2 for the provision of health care for women veterans in 

3 the Department. 

4 ‘‘(3) To monitor and identify deficiencies in 

5 standards of care for the provision of health care for 

6 women veterans in the Department, to provide tech7 nical assistance to medical facilities of the Depart8 ment to address and remedy deficiencies, and to per9 form oversight of implementation of standards of care 

10 for women veterans’ health care in the Department. 

11 ‘‘(4) To monitor and identify deficiencies in 

12 standards of care for the provision of health care for 

13 women veterans provided through the community 

14 pursuant to this title, and to provide recommenda15 tions to the appropriate office to address and remedy 

16 any deficiencies. 

17 ‘‘(5) To oversee distribution of resources and in18 formation related to women veterans’ health program19 ming under this title. 

20 ‘‘(6) To promote the expansion and improvement 

21 of clinical, research, and educational activities of the 

22 Veterans Health Administration with respect the 

23 health care of women veterans. 

24 ‘‘(7) To provide, as part of the annual budgeting 

25 process, recommendations with respect to the amount 


Sspencer on DSKBBXCHB2PROD with BILLS
7 

•HR 3224 RH

1 of funds to be requested for furnishing hospital care 

2 and medical services to women veterans pursuant to 

3 chapter 17 of this title, including, at a minimum, 

4 recommendations that ensure that such amount of 

5 funds either reflect or exceed the proportion of vet6 erans enrolled in the patient enrollment system under 

7 section 1705 of this title who are women. 

8 ‘‘(8) To provide recommendations to the Under 

9 Secretary for Health with respect to modifying the 

10 Veterans Equitable Resource Allocation system to en11 sure that resource allocations under such system re12 flect the health care needs of women veterans. 

13 ‘‘(9) To carry out such other duties as the Under 

14 Secretary for Health may require. 

15 ‘‘(c) RECOMMENDATIONS.—If the Under Secretary for 

16 Health determines not to implement any recommendation 

17 made by the Director with respect to the allocation of re18 sources to address the health care needs of women veterans, 

19 the Secretary shall notify the appropriate congressional 

20 committees of such determination by not later than 30 days 

21 after the date on which the Under Secretary for Health re22 ceives the recommendation. Each such notification shall in23 clude the following: 

24 ‘‘(1) The reasoning of the Under Secretary for 

25 Health in making such determination. 


Sspencer on DSKBBXCHB2PROD with BILLS
8 

•HR 3224 RH

1 ‘‘(2) An alternative, if one is selected, to such 

2 recommendation that the Under Secretary for Health 

3 will carry out to fulfill the health care needs of 

4 women veterans. 

5 ‘‘(d) STANDARDS OF CARE.—In this section, the stand6 ards of care for the provision of health care for women vet7 erans in the Department shall include, at a minimum, the 

8 following: 

9 ‘‘(1) Requirement for— 

10 ‘‘(A) at least one designated women’s health 

11 primary care provider at each medical center 

12 whose duties include, to the extent practicable, 

13 providing training to other health care providers 

14 of the Department with respect to the needs of 

15 women veterans; and 

16 ‘‘(B) at least one designated women’s health 

17 primary care provider at each community-based 

18 outpatient clinic of the Department who may 

19 serve female patients as a percentage of the total 

20 duties of the provider. 

21 ‘‘(2) Other requirements as determined by the 

22 Under Secretary for Health. 

23 ‘‘(e) OUTREACH.—The Director shall ensure that— 

24 ‘‘(1) not less frequently than biannually, each 

25 medical facility of the Department holds a public 


Sspencer on DSKBBXCHB2PROD with BILLS
9 

•HR 3224 RH

1 forum for women veterans that occurs outside of reg2 ular business hours; and 

3 ‘‘(2) not less frequently than quarterly, each 

4 medical facility of the Department convenes a focus 

5 group of women veterans that includes a discussion of 

6 harassment occurring at such facility. 

7 ‘‘(f) DEFINITIONS.—In this section: 

8 ‘‘(1) The term ‘appropriate congressional com9 mittees’ has the meaning given that term in section 

10 7310A of this title. 

11 ‘‘(2) The term ‘facility of the Department’ has 

12 the meaning given the term in section 1701(3). 

13 ‘‘(3) The term ‘Veterans Equitable Resource Allo14 cation system’ means the resource allocation system 

15 established pursuant to section 429 of the Depart16 ments of Veterans Affairs and Housing and Urban 

17 Development, and Independent Agencies Appropria18 tions Act, 1997 (Public Law 104–204; 110 Stat. 

19 2929). 

20 ‘‘§ 7310A. Annual reports on women’s health 

21 ‘‘(a) ANNUAL REPORTS.—Not later than December 1 

22 of each year, the Director of Women’s Health shall submit 

23 to the appropriate congressional committees a report con24 taining the matters under subsections (b) through (g). 


Sspencer on DSKBBXCHB2PROD with BILLS
10 

•HR 3224 RH

1 ‘‘(b) OFFICE OF WOMEN’S HEALTH.—Each report 

2 under subsection (a) shall include a description of— 

3 ‘‘(1) actions taken by the Office of Women’s 

4 Health in the preceding fiscal year to improve the De5 partment’s provision of health care to women vet6 erans; 

7 ‘‘(2) any identified deficiencies related to the De8 partment’s provision of health care to women veterans 

9 and the standards of care established in section 7310 

10 of this title, and the Department’s plan to address 

11 such deficiencies; 

12 ‘‘(3) the funding and personnel provided to the 

13 Office and whether additional funding or personnel 

14 are needed to meet the requirements of such section; 

15 and 

16 ‘‘(4) other information that would be of interest 

17 to the appropriate congressional committees with re18 spect to oversight of the Department’s provision of 

19 health care to women veterans. 

20 ‘‘(c) ACCESS TO GENDER-SPECIFIC SERVICES.—Each 

21 report under subsection (a) shall include an analysis of the 

22 access of women veterans to gender-specific services under 

23 contracts, agreements, or other arrangements with non-De24 partment medical providers entered into by the Secretary 

25 for the provision of hospital care or medical services to vetVerDate Sep 11 2014 00:37 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6203 E:\BILLS\H3224.RH H3224

Sspencer on DSKBBXCHB2PROD with BILLS
11 

•HR 3224 RH

1 erans. Such analysis shall include data and performance 

2 measures for the availability of gender specific services, in3 cluding— 

4 ‘‘(1) the average wait time between the veteran’s 

5 preferred appointment date and the date on which the 

6 appointment is completed; 

7 ‘‘(2) the average driving time required for vet8 erans to attend appointments; and 

9 ‘‘(3) reasons why appointments could not be 

10 scheduled with non-Department medical providers. 

11 ‘‘(d) LOCATIONS WHERE WOMEN VETERANS ARE

12 USING HEALTH CARE.—Each report under subsection (a) 

13 shall include an analysis of the use by women veterans of 

14 health care from the Department, including the following 

15 information: 

16 ‘‘(1) The number of women veterans who reside 

17 in each State. 

18 ‘‘(2) The number of women veterans in each 

19 State who are enrolled in the system of patient enroll20 ment of the Department established and operated 

21 under section 1705(a) this title. 

22 ‘‘(3) Of the women veterans who are so enrolled, 

23 the number who have received health care under the 

24 laws administered by the Secretary at least one time 


Sspencer on DSKBBXCHB2PROD with BILLS
12 

•HR 3224 RH

1 during the one-year period preceding the submittal of 

2 the report. 

3 ‘‘(4) The number of women veterans who have 

4 been seen at each medical facility of the Department 

5 during such year. 

6 ‘‘(5) The number of appointments that women 

7 veterans have had at each such facility during such 

8 year. 

9 ‘‘(6) If known, an identification of the medical 

10 facility of the Department in each Veterans Inte11 grated Service Network with the largest rate of in12 crease in patient population of women veterans as 

13 measured by the increase in unique women veteran 

14 patient use. 

15 ‘‘(7) If known, an identification of the medical 

16 facility of the Department in each Veterans Inte17 grated Service Network with the largest rate of de18 crease in patient population of women veterans as 

19 measured by the decrease in unique women veterans 

20 patient use. 

21 ‘‘(e) MODELS OF CARE.—Each report under subsection 

22 (a) shall include an analysis of the use by the Department 

23 of general primary care clinics, separate but shared spaces, 

24 and women’s health centers as models of providing health 


Sspencer on DSKBBXCHB2PROD with BILLS
13 

•HR 3224 RH

1 care to women veterans. Such analysis shall include the fol2 lowing: 

3 ‘‘(1) The number of facilities of the Department 

4 that fall into each such model, disaggregated by Vet5 erans Integrated Service Network and State. 

6 ‘‘(2) A description of the criteria used by the De7 partment to determine which such model is most ap8 propriate for each facility of the Department. 

9 ‘‘(3) An assessment of how the Department de10 cides to make investments to modify facilities to a dif11 ferent model. 

12 ‘‘(4) A description of what, if any, plans the De13 partment has to modify facilities from general pri14 mary care clinics to another model. 

15 ‘‘(5) An assessment of whether any facilities 

16 could be modified to a separate but shared space for 

17 a women’s health center within planned investments 

18 under the strategic capital investment planning proc19 ess of the Department. 

20 ‘‘(6) An assessment of whether any facilities 

21 could be modified to a separate or shared space, or 

22 women’s health center with minor modifications to 

23 existing plans under the strategic capital investment 

24 planning process of the Department. 


Sspencer on DSKBBXCHB2PROD with BILLS
14 

•HR 3224 RH

1 ‘‘(7) An assessment of whether the Department 

2 has a goal for how many facilities should fall into 

3 each such model. 

4 ‘‘(f) STAFFING.—Each report under subsection (a) 

5 shall include an analysis of the staffing of the Department 

6 relating to the treatment of women, including the following, 

7 disaggregated by Veterans Integrated Service Network and 

8 State (except with respect to paragraph (4)): 

9 ‘‘(1) The number of women’s health centers. 

10 ‘‘(2) The number of patient aligned care teams 

11 of the Department relating to women’s health. 

12 ‘‘(3) The number of full- and part-time gyne13 cologists of the Department. 

14 ‘‘(4) The number of designated women’s health 

15 care providers of the Department, disaggregated by 

16 facility of the Department. 

17 ‘‘(5) The number of health care providers of the 

18 Department who have completed a mini-residency for 

19 women’s health care through Women Veterans Health 

20 Care Mini-Residency Program of the Department 

21 during the one-year period preceding the submittal of 

22 the report, and the number that plan to participate 

23 in such a mini-residency during the one-year period 

24 following such date. 


Sspencer on DSKBBXCHB2PROD with BILLS
15 

•HR 3224 RH

1 ‘‘(6) The number of designated women’s health 

2 care providers of the Department who have sufficient 

3 female patients to retain their competencies and pro4 ficiencies. 

5 ‘‘(g) ACCESSIBILITY AND TREATMENT OPTIONS.— 

6 Each report under subsection (a) shall include an analysis 

7 of the accessibility and treatment options for women vet8 erans, including the following: 

9 ‘‘(1) An assessment of wheelchair accessibility of 

10 women’s health centers of the Department, including, 

11 with respect to each such facility, an assessment of 

12 such accessibility for each kind of treatment provided 

13 at the center, including with respect to radiology and 

14 mammography, that addresses all relevant factors, in15 cluding door sizes, hoists, and equipment. 

16 ‘‘(2) The options for women veterans to access fe17 male mental health providers and primary care pro18 viders. 

19 ‘‘(3) The options for women veterans at medical 

20 facilities of the Department with respect to clothing 

21 sizes, including for gowns, drawstring pants, and pa22 jamas. 

23 ‘‘(h) DEFINITIONS.—In this section: 

24 ‘‘(1) The term ‘appropriate congressional com25 mittees’ means— 


Sspencer on DSKBBXCHB2PROD with BILLS
16 

•HR 3224 RH

1 ‘‘(A) the Committees on Veterans’ Affairs of 

2 the House of Representatives and the Senate; and 

3 ‘‘(B) the Committees on Appropriations of 

4 the House of Representatives and the Senate. 

5 ‘‘(2) The term ‘gender-specific services’ means 

6 mammography, obstetric care, gynecological care, and 

7 such other services as the Secretary determines appro8 priate.’’. 

9 (2) CLERICAL AMENDMENT.—The table of sec10 tions for such chapter is amended by inserting after 

11 the item relating to section 7309A the following new 

12 items: 

‘‘7310. Office of Women’s Health. 

‘‘7310A. Annual reports on women’s health.’’. 

13 (c) INITIAL REPORT.—The Secretary of Veterans Af14 fairs shall submit the initial report under section 7310A 

15 of title 38, United States Code, as added by subsection (b), 

16 by not later than 180 days after the date of the enactment 

17 of this Act. 

18 SEC. 102. EXPANSION OF CAPABILITIES OF WOMEN VET19 ERANS CALL CENTER TO INCLUDE TEXT MES20 SAGING. 

21 The Secretary of Veterans Affairs shall expand the ca22 pabilities of the Women Veterans Call Center of the Depart23 ment of Veterans Affairs to include a text messaging capa24 bility. 


Sspencer on DSKBBXCHB2PROD with BILLS
17 

•HR 3224 RH

1 SEC. 103. REQUIREMENT FOR DEPARTMENT OF VETERANS 

2 AFFAIRS INTERNET WEBSITE TO PROVIDE IN3 FORMATION ON SERVICES AVAILABLE TO 

4 WOMEN VETERANS. 

5 (a) IN GENERAL.—The Secretary of Veterans Affairs 

6 shall survey the internet websites and information resources 

7 of the Department of Veterans Affairs in effect on the day 

8 before the date of the enactment of this Act and publish an 

9 internet website that serves as a centralized source for the 

10 provision to women veterans of information about the bene11 fits and services available to them under laws administered 

12 by the Secretary. 

13 (b) ELEMENTS.—The internet website published under 

14 subsection (a) shall provide to women veterans information 

15 regarding all of the services available in the district in 

16 which the veteran is seeking such services, including, with 

17 respect to each medical center and community-based out18 patient clinic in the applicable Veterans Integrated Service 

19 Network— 

20 (1) the name and contact information of each 

21 women veterans program manager; 

22 (2) a list of appropriate staff for other benefits 

23 available from the Veterans Benefits Administration, 

24 the National Cemetery Administration, and such 

25 other entities as the Secretary considers appropriate; 

26 and 


Sspencer on DSKBBXCHB2PROD with BILLS
18 

•HR 3224 RH

1 (3) such other information as the Secretary con2 siders appropriate. 

3 (c) UPDATED INFORMATION.—The Secretary shall en4 sure that the information described in subsection (b) that 

5 is published on the internet website required by subsection 

6 (a) is updated not less frequently than once every 90 days. 

7 (d) OUTREACH.—In carrying out this section, the Sec8 retary shall ensure that the outreach conducted under sec9 tion 1720F(i) of title 38, United States Code, includes infor10 mation regarding the internet website required by sub11 section (a). 

12 (e) DERIVATION OF FUNDS.—Amounts used by the 

13 Secretary to carry out this section shall be derived from 

14 amounts made available to the Secretary to publish internet 

15 websites of the Department. 

16 SEC. 104. REPORT ON WOMEN VETERANS RETROFIT INITIA17 TIVE. 

18 (a) REPORT.—Not later than 180 days after the date 

19 of the enactment of this Act, the Secretary of Veterans Af20 fairs shall submit to the Committees on Veterans’ Affairs 

21 and the Committees on Appropriations of the Senate and 

22 the House of Representatives a report on requirements to 

23 retrofit existing medical facilities of the Department of Vet24 erans Affairs with fixtures, materials, and other outfitting 


Sspencer on DSKBBXCHB2PROD with BILLS
19 

•HR 3224 RH

1 measures to support the provision of care to women veterans 

2 at such facilities. 

3 (b) ELEMENTS.—The report under subsection (a) shall 

4 include the following: 

5 (1) An assessment of how the Secretary 

6 prioritizes retrofitting existing medical facilities to 

7 support provision of care to women veterans in com8 parison to other requirements. 

9 (2) A five-year plan for retrofitting medical fa10 cilities of the Department to support the provision of 

11 care to women veterans. 

12 SEC. 105. ESTABLISHMENT OF ENVIRONMENT OF CARE 

13 STANDARDS AND INSPECTIONS AT DEPART14 MENT OF VETERANS AFFAIRS MEDICAL CEN15 TERS. 

16 (a) IN GENERAL.—The Secretary of Veterans Affairs 

17 shall establish a policy under which the environment of care 

18 standards and inspections at medical centers of the Depart19 ment of Veterans Affairs include— 

20 (1) an alignment of the requirements for such 

21 standards and inspections with the women’s health 

22 handbook of the Veterans Health Administration; 

23 (2) a requirement for the frequency of such in24 spections; 


Sspencer on DSKBBXCHB2PROD with BILLS
20 

•HR 3224 RH

1 (3) delineation of the roles and responsibilities of 

2 staff at the medical center who are responsible for 

3 compliance; 

4 (4) the requirement that each medical center sub5 mit to the Secretary and make publicly available a 

6 report on the compliance of the medical center with 

7 the standards; and 

8 (5) a remediation plan. 

9 (b) REPORT.—Not later than 180 days after the date 

10 of the enactment of this Act, the Secretary shall submit to 

11 the Committees on Veterans’ Affairs of the Senate and 

12 House of Representatives certification in writing that the 

13 policy required by subsection (a) has been finalized and dis14 seminated to Department all medical centers. 

15 SEC. 106. ADDITIONAL FUNDING FOR PRIMARY CARE AND 

16 EMERGENCY CARE CLINICIANS IN WOMEN 

17 VETERANS HEALTH CARE MINI-RESIDENCY 

18 PROGRAM. 

19 (a) IN GENERAL.—There is authorized to be appro20 priated to the Secretary of Veterans Affairs $1,000,000 for 

21 each fiscal year for the Women Veterans Health Care Mini22 Residency Program of the Department of Veterans Affairs 

23 to provide opportunities for participation in such program 

24 for primary care and emergency care clinicians. 


Sspencer on DSKBBXCHB2PROD with BILLS
21 

•HR 3224 RH

1 (b) TREATMENT OF AMOUNTS.—The amounts author2 ized to be appropriated under subsection (a) shall be in ad3 dition to amounts otherwise made available to the Secretary 

4 for the purposes set forth in such subsection. 

5 SEC. 107. ESTABLISHMENT OF WOMEN VETERAN TRAINING 

6 MODULE FOR NON-DEPARTMENT OF VET7 ERANS AFFAIRS HEALTH CARE PROVIDERS. 

8 (a) IN GENERAL.—Not later than one year after the 

9 date of the enactment of this Act, the Secretary of Veterans 

10 Affairs shall establish and make available to community 

11 providers a training module that is specific to women vet12 erans. 

13 (b) COMMUNITY PROVIDER DEFINED.—In this section, 

14 the term ‘‘community provider’’ means a non-Department 

15 of Veterans Affairs health care provider who provides health 

16 care to veterans under the laws administered by the Sec17 retary of Veterans Affairs. 

18 TITLE II—MEDICAL CARE 

19 SEC. 201. IMPROVED ACCESS TO DEPARTMENT OF VET20 ERANS AFFAIRS MEDICAL CARE FOR WOMEN 

21 VETERANS. 

22 (a) IN GENERAL.—Subchapter II of chapter 17 of title 

23 38, United States Code, is amended by adding at the end 

24 the following new section: 


Sspencer on DSKBBXCHB2PROD with BILLS
22 

•HR 3224 RH

1 ‘‘§ 1720J. Medical services for women veterans 

2 ‘‘(a) ACCESS TO CARE.—The Secretary shall ensure 

3 that women’s health primary care services are available 

4 during regular business hours at every medical center and 

5 community based outpatient clinic of the Department. 

6 ‘‘(b) STUDY ON EXTENDED HOURS OF CARE.—The 

7 Secretary shall conduct a study to assess— 

8 ‘‘(1) the use of extended hours as a means of re9 ducing barriers to care; 

10 ‘‘(2) the need for extended hours based on inter11 views with women veterans and employees; and 

12 ‘‘(3) the best practices and resources required to 

13 implement use of extended hours. 

14 ‘‘(c) ANNUAL REPORT TO CONGRESS.—Not later than 

15 September 30 of each year, the Secretary shall submit to 

16 the Committee on Veterans’ Affairs of the Senate and the 

17 Committee on Veterans’ Affairs of the House of Representa18 tives a report on compliance with subsection (a).’’. 

19 (b) CLERICAL AMENDMENT.—The table of sections at 

20 the beginning of such chapter is amended by inserting after 

21 the item relating to section 1720I the following new item: 

‘‘1720J. Medical services for women veterans.’’. 

22 SEC. 202. COUNSELING AND TREATMENT FOR SEXUAL 

23 TRAUMA. 

24 Section 1720D of title 38, United States Code, is 

25 amended— 


Sspencer on DSKBBXCHB2PROD with BILLS
23 

•HR 3224 RH

1 (1) in subsection (a)— 

2 (A) in paragraph (1), by striking ‘‘active 

3 duty, active duty for training, or inactive duty 

4 training’’ and inserting ‘‘duty, regardless of duty 

5 status or line of duty determination (as that 

6 term is used in section 12323 of title 10)’’; and 

7 (B) in paragraph (2)(A), by striking ‘‘ac8 tive duty, active duty for training, or inactive 

9 duty training’’ and inserting ‘‘duty, regardless of 

10 duty status or line of duty determination (as 

11 that term is used in section 12323 of title 10)’’; 

12 (2) by striking ‘‘veteran’’ each place it appears 

13 and inserting ‘‘former member of the Armed Forces’’; 

14 (3) by striking ‘‘veterans’’ each place it appears 

15 and inserting ‘‘former members of the Armed Forces’’; 

16 and 

17 (4) by adding at the end the following new sub18 section: 

19 ‘‘(g) In this section, the term ‘former member of the 

20 Armed Forces’ includes the following: 

21 ‘‘(1) A veteran described in section 101(2) of this 

22 title. 

23 ‘‘(2) An individual not described in paragraph 

24 (1) who was discharged or released from the Armed 


Sspencer on DSKBBXCHB2PROD with BILLS
24 

•HR 3224 RH

1 Forces under a condition that is not honorable but 

2 not— 

3 ‘‘(A) a dishonorable discharge; or 

4 ‘‘(B) a discharge by court-martial.’’. 

5 SEC. 203. COUNSELING IN RETREAT SETTINGS FOR WOMEN 

6 VETERANS AND OTHER INDIVIDUALS. 

7 (a) IN GENERAL.—Chapter 17 of title 38, United 

8 States Code, is amended by inserting after section 1712C 

9 the following new section: 

10 ‘‘§ 1712D. Counseling in retreat settings for women 

11 veterans and other individuals 

12 ‘‘(a) PROGRAM.—(1) Commencing not later than Jan13 uary 1, 2021, the Secretary shall carry out, through the 

14 Readjustment Counseling Service of the Veterans Health 

15 Administration, a program to provide reintegration and re16 adjustment services described in subsection (b) in group re17 treat settings to covered individuals, including cohorts of 

18 women veterans who are eligible for readjustment coun19 seling services under section 1712A of this title. 

20 ‘‘(2) The participation of a covered individual in the 

21 program under paragraph (1) shall be at the election of the 

22 individual. 

23 ‘‘(b) COVERED SERVICES.—The services provided to a 

24 covered individual under the program under subsection 

25 (a)(1) shall include the following: 


Sspencer on DSKBBXCHB2PROD with BILLS
25 

•HR 3224 RH

1 ‘‘(1) Information on reintegration into the fam2 ily, employment, and community of the individual. 

3 ‘‘(2) Financial counseling. 

4 ‘‘(3) Occupational counseling. 

5 ‘‘(4) Information and counseling on stress reduc6 tion. 

7 ‘‘(5) Information and counseling on conflict reso8 lution. 

9 ‘‘(6) Such other information and counseling as 

10 the Secretary considers appropriate to assist the indi11 vidual in reintegration into the family, employment, 

12 and community of the veteran. 

13 ‘‘(c) BIENNIAL REPORTS.—Not later than December 

14 31, 2022, and each even-numbered year thereafter, the Sec15 retary shall submit to the Committees on Veterans’ Affairs 

16 of the House of Representatives and the Senate a report on 

17 the program under subsection (a)(1). 

18 ‘‘(d) COVERED INDIVIDUAL DEFINED.—In this section, 

19 the term ‘covered individual’ means— 

20 ‘‘(1) Any veteran who is enrolled in the system 

21 of annual patient enrollment under section 1705 of 

22 this title. 

23 ‘‘(2) Any survivor or dependent of a veteran who 

24 is eligible for medical care under section 1781 of this 

25 title.’’. 


Sspencer on DSKBBXCHB2PROD with BILLS
26 

•HR 3224 RH

1 (b) CLERICAL AMENDMENT.—The table of sections at 

2 the beginning of such chapter is amended by inserting after 

3 the item relating to section 1712C the following new item: 

‘‘1712D. Counseling in retreat settings for women veterans and other individuals.’’. 

4 SEC. 204. IMPROVEMENT OF HEALTH CARE SERVICES PRO5 VIDED TO NEWBORN CHILDREN BY DEPART6 MENT OF VETERANS AFFAIRS. 

7 (a) EXPANSION.—Section 1786 of title 38, United 

8 States Code, is amended— 

9 (1) in subsection (a), in the matter preceding 

10 paragraph (1), by striking ‘‘seven days’’ and insert11 ing ‘‘14 days’’; and 

12 (2) by adding at the end the following new sub13 section: 

14 ‘‘(f) ANNUAL REPORT.—Not later than 60 days after 

15 the end of each fiscal year, the Secretary shall submit to 

16 the Committee on Veterans’ Affairs of the Senate and the 

17 Committee on Veterans’ Affairs of the House of Representa18 tives a report on the health care services provided under 

19 subsection (a) during such fiscal year, including the number 

20 of newborn children who received such services during such 

21 fiscal year.’’. 

22 (b) AUTHORITY TO FURNISH MEDICALLY NECESSARY

23 TRANSPORTATION FOR NEWBORN CHILDREN OF CERTAIN

24 WOMEN VETERANS.—Such section is further amended— 


Sspencer on DSKBBXCHB2PROD with BILLS
27 

•HR 3224 RH

1 (1) in subsection (a)— 

2 (A) in the matter before paragraph (1)— 

3 (i) by inserting ‘‘and transportation 

4 necessary to receive such services’’ after ‘‘de5 scribed in subsection (b)’’; and 

6 (ii) by inserting ‘‘, except as provided 

7 in subsection (e),’’ after ‘‘14 days’’; 

8 (B) in paragraph (1), by striking ‘‘or’’; 

9 (C) in paragraph (2), by striking the period 

10 at the end and inserting ‘‘; or’’; and 

11 (D) by adding at the end the following new 

12 paragraph: 

13 ‘‘(3) another location, including a health care fa14 cility, if the veteran delivers the child before arriving 

15 at a facility described in paragraph (1) or (2).’’; 

16 (2) in subsection (b), by inserting before the pe17 riod at the end the following: ‘‘, including necessary 

18 health care services provided by a facility other than 

19 the facility where the newborn child was delivered 

20 (including a specialty pediatric hospital) that accepts 

21 transfer of the newborn child and responsibility for 

22 treatment of the newborn child’’; and 

23 (3) by inserting before subsection (f), as added by 

24 subsection (a), the following new subsections: 


Sspencer on DSKBBXCHB2PROD with BILLS
28 

•HR 3224 RH

1 ‘‘(c) TRANSPORTATION.—(1) Transportation furnished 

2 under subsection (a) to, from, or between care settings to 

3 meet the needs of a newborn child includes costs for either 

4 or both the newborn child and parents. 

5 ‘‘(2) Transportation furnished under subsection (a) is 

6 transportation by ambulance, including air ambulance, or 

7 other appropriate medically staffed modes of transpor8 tation— 

9 ‘‘(A) to another health care facility (including a 

10 specialty pediatric hospital) that accepts transfer of 

11 the newborn child or otherwise provides post-delivery 

12 care services when the treating facility is not capable 

13 of furnishing the care or services required; or 

14 ‘‘(B) to a health care facility in a medical emer15 gency of such nature that a prudent layperson reason16 ably expects that delay in seeking immediate medical 

17 attention would be hazardous to life or health. 

18 ‘‘(3) Amounts paid by the Department for transpor19 tation under this section shall be derived from the Medical 

20 Services appropriations account of the Department. 

21 ‘‘(d) REIMBURSEMENT OR PAYMENT FOR HEALTH

22 CARE SERVICES OR TRANSPORTATION.—(1) Pursuant to 

23 regulations the Secretary shall prescribe to establish rates 

24 of reimbursement and any limitations thereto under this 

25 section, the Secretary shall directly reimburse a covered enVerDate Sep 11 2014 00:37 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6203 E:\BILLS\H3224.RH H3224

Sspencer on DSKBBXCHB2PROD with BILLS
29 

•HR 3224 RH

1 tity for health care services or transportation services pro2 vided under this section, unless the cost of the services or 

3 transportation is covered by an established agreement or 

4 contract. If such an agreement or contract exists, its nego5 tiated payment terms shall apply. 

6 ‘‘(2)(A) Reimbursement or payment by the Secretary 

7 under this section on behalf of an individual to a covered 

8 entity shall, unless rejected and refunded by the covered en9 tity within 30 days of receipt, extinguish any liability on 

10 the part of the individual for the health care services or 

11 transportation covered by such payment. 

12 ‘‘(B) Neither the absence of a contract or agreement 

13 between the Secretary and a covered entity nor any provi14 sion of a contract, agreement, or assignment to the contrary 

15 shall operate to modify, limit, or negate the requirements 

16 of subparagraph (A). 

17 ‘‘(3) In this subsection, the term ‘covered entity’ means 

18 any individual, transportation carrier, organization, or 

19 other entity that furnished or paid for health care services 

20 or transportation under this section. 

21 ‘‘(e) EXCEPTION.—Pursuant to such regulations as the 

22 Secretary shall prescribe to carry out this section, the Sec23 retary may furnish more than 14 days of health care serv24 ices described in subsection (b), and transportation nec25 essary to receive such services, to a newborn child based on 


Sspencer on DSKBBXCHB2PROD with BILLS
30 

•HR 3224 RH

1 medical necessity if the child is in need of additional care, 

2 including a case in which the newborn child has been dis3 charged or released from a hospital and requires readmit4 tance to ensure the health and welfare of the newborn 

5 child.’’. 

6 (c) TREATMENT OF CERTAIN EXPENSES ALREADY IN7 CURRED.—Pursuant to such regulations as the Secretary 

8 of Veterans Affairs shall prescribe, the Secretary may pro9 vide reimbursement under section 1786 of title 38, United 

10 States Code, as amended by subsection (a), health care serv11 ices or transportation services furnished to a newborn child 

12 during the period beginning on May 5, 2010, and ending 

13 on the date of the enactment of this Act, if the Secretary 

14 determines that, under the circumstances applicable with 

15 respect to the newborn, such reimbursement appropriate. 

16 TITLE III—REPORTS AND OTHER 

17 MATTERS 

18 Subtitle A—Reports 

19 SEC. 301. ASSESSMENT OF EFFECTS OF INTIMATE PARTNER 

20 VIOLENCE ON WOMEN VETERANS BY ADVI21 SORY COMMITTEE ON WOMEN VETERANS. 

22 Section 542(c)(1) of title 38, United States Code, is 

23 amended— 

24 (1) in subparagraph (B), by striking ‘‘and’’ at 

25 the end; 


Sspencer on DSKBBXCHB2PROD with BILLS
31 

•HR 3224 RH

1 (2) by redesignating subparagraph (C) as sub2 paragraph (D); and 

3 (3) by inserting after subparagraph (B) the fol4 lowing new subparagraph (C): 

5 ‘‘(C) an assessment of the effects of intimate 

6 partner violence on women veterans; and’’. 

7 SEC. 302. STUDY ON STAFFING OF WOMEN VETERAN PRO8 GRAM MANAGER PROGRAM AT MEDICAL CEN9 TERS OF THE DEPARTMENT OF VETERANS AF10 FAIRS AND TRAINING OF STAFF. 

11 (a) STUDY.—The Secretary of Veterans Affairs shall 

12 conduct a study on the use of the Women Veteran Program 

13 Manager program of the Department of Veterans Affairs to 

14 determine— 

15 (1) if the program is appropriately staffed at 

16 each medical center of the Department; 

17 (2) whether each medical center of the Depart18 ment is staffed with a Women Veteran Program Man19 ager; and 

20 (3) whether it would be feasible and advisable to 

21 have a Women Veteran Program Ombudsman at each 

22 medical center of the Department. 

23 (b) REPORT.—Not later than 270 days after the date 

24 of the enactment of this Act, the Secretary shall submit to 

25 the Committee on Veterans’ Affairs of the Senate and the 


Sspencer on DSKBBXCHB2PROD with BILLS
32 

•HR 3224 RH

1 Committee on Veterans’ Affairs of the House of Representa2 tives a report on the study conducted under subsection (a). 

3 (c) TRAINING.—The Secretary shall ensure that all 

4 Women Veteran Program Managers and Women Veteran 

5 Program Ombudsmen receive the proper training to carry 

6 out their duties. 

7 SEC. 303. REPORT ON AVAILABILITY OF PROSTHETIC ITEMS 

8 FOR WOMEN VETERANS FROM THE DEPART9 MENT OF VETERANS AFFAIRS. 

10 Not later than one year after the date of the enactment 

11 of this Act, the Secretary of Veterans Affairs shall submit 

12 to the Committee on Veterans’ Affairs of the Senate and 

13 the Committee on Veterans’ Affairs of the House of Rep14 resentatives a report on the availability from the Depart15 ment of Veterans Affairs of prosthetic items made for 

16 women veterans, including an assessment of the availability 

17 of such prosthetic items at each medical facility of the De18 partment. The report shall— 

19 (1) address efforts on research, development, and 

20 employment of additive manufacture technology (com21 monly referred to as ‘‘3D printing’’) to provide pros22 thetic items for women veterans; and 

23 (2) include a survey with a representative sam24 ple of 50,000 veterans (of which women shall be 

25 overrrepresented) in amputee care program on satisVerDate Sep 11 2014 00:37 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00032 Fmt 6652 Sfmt 6203 E:\BILLS\H3224.RH H3224

Sspencer on DSKBBXCHB2PROD with BILLS
33 

•HR 3224 RH

1 faction with prosthetics furnished or procured by the 

2 Department that replace appendages or their func3 tion. 

4 SEC. 304. STUDY OF BARRIERS FOR WOMEN VETERANS TO 

5 HEALTH CARE FROM THE DEPARTMENT OF 

6 VETERANS AFFAIRS. 

7 (a) STUDY REQUIRED.—The Secretary of Veterans Af8 fairs shall conduct a comprehensive study of the barriers 

9 to the provision of comprehensive health care by the Depart10 ment of Veterans Affairs encountered by women who are 

11 veterans. In conducting the study, the Secretary shall— 

12 (1) survey women veterans who seek or receive 

13 hospital care or medical services provided by the De14 partment of Veterans Affairs as well as women vet15 erans who do not seek or receive such care or services; 

16 (2) administer the survey to a representative 

17 sample of women veterans from each Veterans Inte18 grated Service Network; and 

19 (3) ensure that the sample of women veterans 

20 surveyed is of sufficient size for the study results to 

21 be statistically significant and is a larger sample 

22 than that of the study referred to in subsection (b)(1). 

23 (b) USE OF PREVIOUS STUDIES.—In conducting the 

24 study required by subsection (a), the Secretary shall build 


Sspencer on DSKBBXCHB2PROD with BILLS
34 

•HR 3224 RH

1 on the work of the studies of the Department of Veterans 

2 Affairs titled— 

3 (1) ‘‘National Survey of Women Veterans in Fis4 cal Year 2007–2008’’; and 

5 (2) ‘‘Study of Barriers for Women Veterans to 

6 VA Health Care 2015’’. 

7 (c) ELEMENTS OF STUDY.—In conducting the study 

8 required by subsection (a), the Secretary shall conduct re9 search on the effects of the following on the women veterans 

10 surveyed in the study: 

11 (1) The barriers associated with seeking mental 

12 health care services, including with respect to pro13 vider availability, telehealth access, and family, work, 

14 and school obligations. 

15 (2) The effect of driving distance or availability 

16 of other forms of transportation to the nearest medical 

17 facility on access to care. 

18 (3) The effect of access to care in the community. 

19 (4) The availability of child care. 

20 (5) The acceptability of integrated primary care, 

21 women’s health clinics, or both. 

22 (6) The comprehension of eligibility requirements 

23 for, and the scope of services available under, hospital 

24 care and medical services. 


Sspencer on DSKBBXCHB2PROD with BILLS
35 

•HR 3224 RH

1 (7) The perception of personal safety and com2 fort in inpatient, outpatient, and behavioral health 

3 facilities. 

4 (8) The gender sensitivity of health care pro5 viders and staff to issues that particularly affect 

6 women. 

7 (9) The effectiveness of outreach for health care 

8 services available to women veterans. 

9 (10) The location and operating hours of health 

10 care facilities that provide services to women veterans. 

11 (11) The perception of women veterans regarding 

12 the motto of the Department of Veterans Affairs. 

13 (12) Such other significant barriers as the Sec14 retary considers appropriate. 

15 (d) DISCHARGE BY CONTRACT.—The Secretary shall 

16 enter into a contract with a qualified independent entity 

17 or organization to carry out the study and research re18 quired under this section. 

19 (e) MANDATORY REVIEW OF DATA BY CERTAIN DE20 PARTMENT DIVISIONS.— 

21 (1) IN GENERAL.—The Secretary shall ensure 

22 that the head of each division of the Department of 

23 Veterans Affairs specified in paragraph (2) reviews 

24 the results of the study conducted under this section. 

25 The head of each such division shall submit findings 


Sspencer on DSKBBXCHB2PROD with BILLS
36 

•HR 3224 RH

1 with respect to the study to the Under Secretary for 

2 responsibilities relating to health care services for 

3 women veterans. 

4 (2) SPECIFIED DIVISIONS.—The divisions of the 

5 Department of Veterans Affairs specified in this para6 graph are the following: 

7 (A) The Under Secretary for Health. 

8 (B) The Office of Women’s Health. 

9 (C) The Center for Women Veterans estab10 lished under section 318 of title 38, United 

11 States Code. 

12 (D) The Advisory Committee on Women 

13 Veterans established under section 542 of such 

14 title. 

15 (f) REPORT.—Not later than 30 months after the date 

16 of the enactment of this Act, the Secretary shall submit to 

17 Congress a report on the study required under this section. 

18 The report shall include recommendations for such adminis19 trative and legislative action as the Secretary considers ap20 propriate. The report shall also include the findings of the 

21 head of each division of the Department specified under sub22 section (e)(2) and of the Under Secretary for Health. 


Sspencer on DSKBBXCHB2PROD with BILLS
37 

•HR 3224 RH

1 SEC. 305. REPORT REGARDING VETERANS WHO RECEIVE 

2 BENEFITS UNDER LAWS ADMINISTERED BY 

3 THE SECRETARY OF VETERANS AFFAIRS. 

4 (a) REPORT.—Not later than 180 days after the date 

5 of the enactment of this Act, the Secretary of Veterans Af6 fairs shall publish a report regarding veterans who receive 

7 benefits under laws administered by the Secretary, includ8 ing the Transition Assistance Program under sections 1142 

9 and 1144 of title 10, United States Code. 

10 (b) DATA.—The data regarding veterans published in 

11 the report under subsection (a)— 

12 (1) shall be disaggregated by— 

13 (A) sex; 

14 (B) minority group member status; and 

15 (C) minority group member status listed by 

16 sex. 

17 (2) may not include any personally identifiable 

18 information. 

19 (c) MATTERS INCLUDED.—The report under subsection 

20 (a) shall include— 

21 (1) identification of any disparities in the use of 

22 benefits under laws administered by the Secretary; 

23 and 

24 (2) an analysis of the cause of such disparities 

25 and recommendations to address such disparities. 


Sspencer on DSKBBXCHB2PROD with BILLS
38 

•HR 3224 RH

1 (d) MINORITY GROUP MEMBER DEFINED.—In this 

2 section, the term ‘‘minority group member’’ has the mean3 ing given that term in section 544 of title 38, United States 

4 Code. 

5 SEC. 306. STUDY ON WOMEN VETERAN COORDINATOR PRO6 GRAM. 

7 Not later than 180 days after the date of the enactment 

8 of this Act, the Secretary of Veterans Affairs shall submit 

9 to the Committees on Veterans’ Affairs of the House of Rep10 resentatives and the Senate a report containing a study on 

11 the Women Veteran Coordinator program of the Veterans 

12 Benefits Administration of the Department of Veterans Af13 fairs. Such study shall identify the following: 

14 (1) If the program is appropriately staffed at 

15 each regional benefits office of the Department. 

16 (2) Whether each regional benefits office of the 

17 Department is staffed with a Women Veteran Coordi18 nator. 

19 (3) The position description of the Women Vet20 eran Coordinator. 

21 (4) Whether an individual serving in the Women 

22 Veteran Coordinator position concurrently serves in 

23 any other position, and if so, the allocation of time 

24 the individual spends in each such position. 


Sspencer on DSKBBXCHB2PROD with BILLS
39 

•HR 3224 RH

1 (5) A description of the metrics the Secretary 

2 uses to determine the success and performance of the 

3 Women Veteran Coordinator. 

4 Subtitle B—Other Matters 

5 SEC. 321. ANTI-HARASSMENT AND ANTI-SEXUAL ASSAULT 

6 POLICY OF THE DEPARTMENT OF VETERANS 

7 AFFAIRS. 

8 (a) IN GENERAL.—Subchapter II of chapter 5 of title 

9 38, United States Code, is amended by adding at the end 

10 the following new section: 

11 ‘‘§ 533. Anti-harassment and anti-sexual assault pol12 icy 

13 ‘‘(a) ESTABLISHMENT.—The Secretary of Veterans Af14 fairs shall establish a comprehensive policy to end harass15 ment and sexual assault, including sexual harassment and 

16 gender-based harassment, throughout the Department of 

17 Veterans Affairs. This policy shall include the following: 

18 ‘‘(1) A process for employees and contractors of 

19 the Department to respond to reported incidents of 

20 harassment and sexual assault committed by any 

21 non-Department individual within a facility of the 

22 Department, including with respect to accountability 

23 or disciplinary measures. 

24 ‘‘(2) A process for employees and contractors of 

25 the Department to respond to reported incidents of 


Sspencer on DSKBBXCHB2PROD with BILLS
40 

•HR 3224 RH

1 harassment and sexual assault of any non-Depart2 ment individual within a facility of the Department. 

3 ‘‘(3) A process for any non-Department indi4 vidual to report harassment and sexual assault de5 scribed in paragraph (1), including an option for 

6 confidential reporting, and for the Secretary to re7 spond to and address such reports. 

8 ‘‘(4) Clear mechanisms for non-Department indi9 viduals to readily identify to whom and how to report 

10 incidents of harassment and sexual assault committed 

11 by another non-Department individual. 

12 ‘‘(5) Clear mechanisms for employees and con13 tractors of the Department to readily identify to 

14 whom and how to report incidents of harassment and 

15 sexual assault and how to refer non-Department indi16 viduals with respect to reporting an incident of har17 assment or sexual assault. 

18 ‘‘(6) A process for, and mandatory reporting re19 quirement applicable to, any employee or contractor 

20 of the Department who witnesses harassment or sex21 ual assault described in paragraph (1) or (2) within 

22 a facility of the Department, regardless of whether the 

23 individual affected by such harassment or sexual as24 sault wants to report such harassment or sexual as25 sault. 


Sspencer on DSKBBXCHB2PROD with BILLS
41 

•HR 3224 RH

1 ‘‘(7) The actions possible, including disciplinary 

2 actions, for employees or contractors of the Depart3 ment who fail to report incidents of harassment and 

4 sexual assault described in paragraph (1) or (2) that 

5 the employees or contractors witness. 

6 ‘‘(8) On an annual or more frequent basis, man7 datory training for employees and contractors of the 

8 Department regarding how to report and address har9 assment and sexual assault described in paragraphs 

10 (1) and (2), including bystander intervention train11 ing. 

12 ‘‘(9) On an annual or more frequent basis, the 

13 distribution of the policy under this subsection and 

14 anti-harassment and anti-sexual assault educational 

15 materials by mail or email to each individual receiv16 ing a benefit under a law administered by the Sec17 retary. 

18 ‘‘(10) The prominent display of anti-harassment 

19 and anti-sexual assault messages in each facility of 

20 the Department, including how non-Department indi21 viduals may report harassment and sexual assault de22 scribed in paragraphs (1) and (2) at such facility 

23 and the points of contact under subsection (b). 

24 ‘‘(11) The posting on internet websites of the De25 partment, including the main internet website regardVerDate Sep 11 2014 00:37 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00041 Fmt 6652 Sfmt 6203 E:\BILLS\H3224.RH H3224

Sspencer on DSKBBXCHB2PROD with BILLS
42 

•HR 3224 RH

1 ing benefits of the Department and the main internet 

2 website regarding health care of the Department, of 

3 anti-harassment and anti-sexual assault banners spe4 cifically addressing harassment and sexual assault de5 scribed in paragraphs (1) and (2). 

6 ‘‘(b) POINTS OF CONTACT.—The Secretary shall des7 ignate, as a point of contact to receive reports of harassment 

8 and sexual assault described in paragraphs (1) and (2) of 

9 subsection (a)— 

10 ‘‘(1) at least one individual, in addition to law 

11 enforcement, at each facility of the Department (in12 cluding Vet Centers under section 1712A of this title), 

13 with regard to that facility; 

14 ‘‘(2) at least one individual employed in each 

15 Veterans Integrated Service Network, with regards to 

16 facilities in that Veterans Integrated Service Network; 

17 ‘‘(3) at least one individual employed in each re18 gional benefits office; 

19 ‘‘(4) at least one individual employed at each lo20 cation of the National Cemetery Administration; and 

21 ‘‘(5) at least one individual employed at the Cen22 tral Office of the Department to track reports of such 

23 harassment and sexual assault across the Department, 

24 disaggregated by facility. 


Sspencer on DSKBBXCHB2PROD with BILLS
43 

•HR 3224 RH

1 ‘‘(c) ACCOUNTABILITY.—The Secretary shall establish 

2 a policy to ensure that each facility of the Department and 

3 each director of a Veterans Integrated Service Network is 

4 responsible for addressing harassment and sexual assault 

5 at the facility and the Network. Such policy shall include— 

6 ‘‘(1) a remediation plan for facilities that experi7 ence five or more incidents of sexual harassment, sex8 ual assault, or combination thereof, during any single 

9 fiscal year; and 

10 ‘‘(2) taking appropriate actions under chapter 7 

11 or subchapter V of chapter 74 of this title. 

12 ‘‘(d) DATA.—The Secretary shall ensure that the in13 take process for veterans at medical facilities of the Depart14 ment includes a survey to collect the following information: 

15 ‘‘(1) Whether the veteran feels safe at the facility 

16 and whether any events occurred at the facility that 

17 affect such feeling. 

18 ‘‘(2) Whether the veteran wants to be contacted 

19 later by the Department with respect to such safety 

20 issues. 

21 ‘‘(e) WORKING GROUP.—(1) The Secretary shall estab22 lish a working group to assist the Secretary in imple23 menting policies to carry out this section. 

24 ‘‘(2) The working group established under paragraph 

25 (1) shall consist of representatives from— 


Sspencer on DSKBBXCHB2PROD with BILLS
44 

•HR 3224 RH

1 ‘‘(A) veterans service organizations; 

2 ‘‘(B) State, local, and Tribal veterans agencies; 

3 and 

4 ‘‘(C) other persons the Secretary determines ap5 propriate. 

6 ‘‘(3) The working group established under paragraph 

7 (1) shall develop, and the Secretary shall carry out— 

8 ‘‘(A) an action plan for addressing changes at 

9 the local level to reduce instances of harassment and 

10 sexual assault; 

11 ‘‘(B) standardized media for veterans service or12 ganizations and other persons to use in print and on 

13 the internet with respect to reducing harassment and 

14 sexual assault; and 

15 ‘‘(C) bystander intervention training for vet16 erans. 

17 ‘‘(f) REPORTS.—The Secretary shall submit to the 

18 Committees on Veterans’ Affairs of the Senate and the 

19 House of Representatives an annual report on harassment 

20 and sexual assault described in paragraphs (1) and (2) of 

21 subsection (a) in facilities of the Department. Each such 

22 report shall include the following: 

23 ‘‘(1) Results of harassment and sexual assault 

24 programming, including the End Harassment pro25 gram. 


Sspencer on DSKBBXCHB2PROD with BILLS
45 

•HR 3224 RH

1 ‘‘(2) Results of studies from the Women’s Health 

2 Practice-Based Research Network of the Department 

3 relating to harassment and sexual assault. 

4 ‘‘(3) Data collected on incidents of sexual harass5 ment and sexual assault. 

6 ‘‘(4) A description of any actions taken by the 

7 Secretary during the year preceding the date of the 

8 report to stop harassment and sexual assault at facili9 ties of the Department. 

10 ‘‘(5) An assessment of the implementation of the 

11 training required in subsection (a)(7). 

12 ‘‘(6) A list of resources the Secretary determines 

13 necessary to prevent harassment and sexual assault at 

14 facilities of the Department. 

15 ‘‘(g) DEFINITIONS.—In this section: 

16 ‘‘(1) The term ‘non-Department individual’ 

17 means any individual present at a facility of the De18 partment who is not an employee or contractor of the 

19 Department. 

20 ‘‘(2) The term ‘sexual harassment’ has the mean21 ing given that term in section 1720D of this title.’’. 

22 (b) CLERICAL AMENDMENT.—The table of sections at 

23 the beginning of such chapter is amended by adding after 

24 the item relating to section 532 the following new item: 

‘‘533. Anti-harassment and anti-sexual assault policy.’’. 


Sspencer on DSKBBXCHB2PROD with BILLS
46 

•HR 3224 RH

1 (c) DEFINITION OF SEXUAL HARASSMENT.—Section 

2 1720D(f) of such title is amended by striking ‘‘repeated,’’. 

3 (d) DEADLINE.—The Secretary shall commence car4 rying out section 533 of such title, as added by subsection 

5 (a), not later than 180 days after the date of enactment 

6 of this Act. 

7 SEC. 322. SUPPORT FOR ORGANIZATIONS THAT HAVE A 

8 FOCUS ON PROVIDING ASSISTANCE TO 

9 WOMEN VETERANS AND THEIR FAMILIES. 

10 Section 2044(e) of title 38, United States Code, is 

11 amended by adding at the end the following new paragraph: 

12 ‘‘(4) Not less than $20,000,000 shall be available under 

13 paragraph (1)(H) for the provision of financial assistance 

14 under subsection (a) to organizations that have a focus on 

15 providing assistance to women veterans and their fami16 lies.’’. 

17 SEC. 323. GAP ANALYSIS OF DEPARTMENT OF VETERANS 

18 AFFAIRS PROGRAMS THAT PROVIDE ASSIST19 ANCE TO WOMEN VETERANS WHO ARE HOME20 LESS. 

21 (a) IN GENERAL.—The Secretary of Veterans Affairs 

22 shall complete an analysis of programs of the Department 

23 of Veterans Affairs that provide assistance to women vet24 erans who are homeless or precariously housed to identify 


Sspencer on DSKBBXCHB2PROD with BILLS
47 

•HR 3224 RH

1 the areas in which such programs are failing to meet the 

2 needs of such women. 

3 (b) REPORT.—Not later than 270 days after the date 

4 of the enactment of this Act, the Secretary shall submit to 

5 the Committee on Veterans’ Affairs of the Senate and the 

6 Committee on Veterans’ Affairs of the House of Representa7 tives a report on the analysis completed under subsection 

8 (a). 

9 SEC. 324. DEPARTMENT OF VETERANS AFFAIRS PUBLIC-PRI10 VATE PARTNERSHIP ON LEGAL SERVICES 

11 FOR WOMEN VETERANS. 

12 (a) PARTNERSHIP REQUIRED.—The Secretary of Vet13 erans Affairs shall establish a partnership with at least one 

14 nongovernmental organization to provide legal services to 

15 women veterans. 

16 (b) FOCUS.—The focus of the partnership established 

17 under subsection (a) shall be on the 10 highest unmet needs 

18 of women veterans as set forth in the most recently com19 pleted Community Homelessness Assessment, Local Edu20 cation and Networking Groups for Veterans (CHALENG 

21 for Veterans) survey. 


Sspencer on DSKBBXCHB2PROD with BILLS
48 

•HR 3224 RH

1 SEC. 325. PROGRAM TO ASSIST VETERANS WHO EXPERI2 ENCE INTIMATE PARTNER VIOLENCE OR SEX3 UAL ASSAULT. 

4 (a) PROGRAM REQUIRED.—The Secretary of Veterans 

5 Affairs shall carry out a program to assist former members 

6 of the armed forces who have experienced or are experi7 encing intimate partner violence or sexual assault in access8 ing benefits from the Department of Veterans Affairs, in9 cluding coordinating access to medical treatment centers, 

10 housing assistance, and other benefits from the Department. 

11 (b) COLLABORATION.—The Secretary shall carry out 

12 the program under subsection (a) in collaboration with— 

13 (1) intimate partner violence shelters and pro14 grams; 

15 (2) rape crisis centers; 

16 (3) State intimate partner violence and sexual 

17 assault coalitions; and 

18 (4) such other health care or other service pro19 viders that serve intimate partner violence or sexual 

20 assault victims as determined by the Secretary, par21 ticularly those providing emergency services or hous22 ing assistance. 

23 (c) AUTHORIZED ACTIVITIES.—In carrying out the 

24 program under subsection (a), the Secretary may conduct 

25 the following activities: 


Sspencer on DSKBBXCHB2PROD with BILLS
49 

•HR 3224 RH

1 (1) Training for community-based intimate 

2 partner violence or sexual assault service providers 

3 on— 

4 (A) identifying former members of the 

5 Armed Forces who have been victims of intimate 

6 partner violence or sexual assault; 

7 (B) coordinating with local service pro8 viders of the Department; and 

9 (C) connecting former members of the 

10 Armed Forces with appropriate housing, mental 

11 health, medical, and other financial assistance or 

12 benefits from the Department. 

13 (2) Assistance to service providers to ensure ac14 cess of veterans to intimate partner violence and sex15 ual assault emergency services, particularly in under16 served areas, including services for Native American 

17 veterans (as defined in section 3765 of title 38, 

18 United States Code). 

19 (3) Such other outreach and assistance as the 

20 Secretary determines necessary for the provision of 

21 assistance under subsection (a). 

22 (d) INTIMATE PARTNER VIOLENCE AND SEXUAL AS23 SAULT OUTREACH COORDINATORS.— 

24 (1) IN GENERAL.—In order to effectively assist 

25 veterans who have experienced intimate partner vioVerDate Sep 11 2014 00:37 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6203 E:\BILLS\H3224.RH H3224

Sspencer on DSKBBXCHB2PROD with BILLS
50 

•HR 3224 RH

1 lence or sexual assault, the Secretary may establish 

2 local coordinators to provide outreach under the pro3 gram required by subsection (a). 

4 (2) LOCAL COORDINATOR KNOWLEDGE.—The 

5 Secretary shall ensure that each coordinator estab6 lished under paragraph (1) is knowledgeable about— 

7 (A) the dynamics of intimate partner vio8 lence and sexual assault, including safety con9 cerns, legal protections, and the need for the pro10 vision of confidential services; 

11 (B) the eligibility of veterans for services 

12 and benefits from the Department that are rel13 evant to recovery from intimate partner violence 

14 and sexual assault, particularly emergency hous15 ing assistance, mental health care, other health 

16 care, and disability benefits; and 

17 (C) local community resources addressing 

18 intimate partner violence and sexual assault. 

19 (3) LOCAL COORDINATOR ASSISTANCE.—Each co20 ordinator established under paragraph (1) shall assist 

21 intimate partner violence shelters and rape crisis cen22 ters in providing services to veterans. 


Sspencer on DSKBBXCHB2PROD with BILLS
51 

•HR 3224 RH

1 SEC. 326. STUDY AND TASK FORCE ON VETERANS EXPERI2 ENCING INTIMATE PARTNER VIOLENCE OR 

3 SEXUAL ASSAULT. 

4 (a) NATIONAL BASELINE STUDY.— 

5 (1) IN GENERAL.—Not later than one year after 

6 the date of the enactment of this Act, the Secretary of 

7 Veterans Affairs, in consultation with the Attorney 

8 General, shall conduct a national baseline study to 

9 examine the scope of the problem of intimate partner 

10 violence and sexual assault among veterans and 

11 spouses and intimate partners of veterans. 

12 (2) MATTERS INCLUDED.—The study under 

13 paragraph (1) shall— 

14 (A) include a literature review of all rel15 evant research on intimate partner violence and 

16 sexual assault among veterans and spouses and 

17 intimate partners of veterans; 

18 (B) examine the prevalence of the experience 

19 of intimate partner violence among— 

20 (i) women veterans; 

21 (ii) veterans who are minority group 

22 members (as defined in section 544 of title 

23 38, United States Code, and including other 

24 minority populations as the Secretary de25 termines appropriate); 

26 (iii) urban and rural veterans; 


Sspencer on DSKBBXCHB2PROD with BILLS
52 

•HR 3224 RH

1 (iv) veterans who are enrolled in a 

2 program under section 1720G of title 38, 

3 United States Code; 

4 (v) veterans who are in intimate rela5 tionships with other veterans; and 

6 (vi) veterans who are described in more 

7 than one clause of this subparagraph; 

8 (C) examine the prevalence of the perpetra9 tion of intimate partner violence by veterans; 

10 and 

11 (D) include recommendations to address the 

12 findings of the study. 

13 (3) REPORT.—Not later than 30 days after the 

14 date on which the Secretary completes the study 

15 under paragraph (1), the Secretary shall submit to 

16 the Committees on Veterans’ Affairs of the House of 

17 Representatives and the Senate a report on such 

18 study. 

19 (b) TASK FORCE.—Not later than 90 days after the 

20 date on which the Secretary completes the study under sub21 section (a), the Secretary, in consultation with the Attorney 

22 General and the Secretary of Health and Human Services, 

23 shall establish a national task force (in this section referred 

24 to as the ‘‘Task Force’’) to develop a comprehensive national 

25 program, including by integrating facilities, services, and 


Sspencer on DSKBBXCHB2PROD with BILLS
53 

•HR 3224 RH

1 benefits of the Department of Veterans Affairs into existing 

2 networks of community-based intimate partner violence and 

3 sexual assault services, to address intimate partner violence 

4 and sexual assault among veterans. 

5 (c) CONSULTATION WITH STAKEHOLDERS.—In car6 rying out this section, the Task Force shall consult with— 

7 (1) representatives from veteran service organiza8 tions and military service organizations; 

9 (2) representatives from not fewer than three na10 tional organizations or State coalitions with dem11 onstrated expertise in intimate partner violence pre12 vention, response, or advocacy; and 

13 (3) representatives from not fewer than three na14 tional organizations or State coalitions, particularly 

15 those representing underserved and ethnic minority 

16 communities, with demonstrated expertise in sexual 

17 assault prevention, response, or advocacy. 

18 (d) DUTIES.—The duties of the Task Force shall in19 clude the following: 

20 (1) To review existing services and policies of the 

21 Department and develop a comprehensive national 

22 program to address intimate partner violence and 

23 sexual assault prevention, response, and treatment. 

24 (2) To review the feasibility and advisability of 

25 establishing an expedited process to secure emergency, 


Sspencer on DSKBBXCHB2PROD with BILLS
54 

•HR 3224 RH

1 temporary benefits, including housing or other bene2 fits, for veterans who are experiencing intimate part3 ner violence or sexual assault. 

4 (3) To review and make recommendations re5 garding the feasibility and advisability of establishing 

6 dedicated, temporary housing assistance for veterans 

7 experiencing intimate partner violence or sexual as8 sault. 

9 (4) To identify any requirements regarding inti10 mate partner violence assistance or sexual assault re11 sponse and services that are not being met by the De12 partment and make recommendations on how the De13 partment can meet such requirements. 

14 (5) To review and make recommendations re15 garding the feasibility and advisability of providing 

16 direct services or contracting for community-based 

17 services for veterans in response to a sexual assault, 

18 including through the use of sexual assault nurse ex19 aminers, particularly in underserved or remote areas, 

20 including services for Native American veterans. 

21 (6) To review the availability of counseling serv22 ices provided by the Department and through peer 

23 network support, and to provide recommendations for 

24 the enhancement of such services, to address— 


Sspencer on DSKBBXCHB2PROD with BILLS
55 

•HR 3224 RH

1 (A) the perpetration of intimate partner vi2 olence and sexual assault; and 

3 (B) the recovery of veterans, particularly 

4 women veterans, from intimate partner violence 

5 and sexual assault. 

6 (7) To review and make recommendations to ex7 pand services available for veterans at risk of perpe8 trating intimate partner violence. 

9 (e) REPORT.—Not later than one year after the date 

10 of the enactment of this Act, and not less frequently than 

11 annually thereafter by October 1 of each year, the Task 

12 Force shall submit to the Secretary of Veterans Affairs and 

13 Congress a report on the activities of the Task Force, includ14 ing any recommendations for legislative or administrative 

15 action. 

16 (f) DEFINITIONS.—In this section: 

17 (1) The term ‘‘Native American veteran’’ has the 

18 meaning given that term in section 3765 of title 38, 

19 United States Code. 

20 (2) The term ‘‘State’’ has the meaning given that 

21 term in section 101 of title 38, United States Code. 


Sspencer on DSKBBXCHB2PROD with BILLS
Union Calendar No. 226 

116TH CONGRESS 

1ST SESSION H. R. 3224 

[Report No. 116–281] 

A BILL 

To amend title 38, United States Code, to provide 

Affairs medical care for women veterans. for increased access to Department of Veterans 

NOVEMBER 12, 2019 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


Sspencer on DSKBBXCHB2PROD with BILLS