IIB 

116TH CONGRESS 

1ST SESSION H. R. 3224 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 13, 2019 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

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

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


kjohnson on DSK79L0C42 with BILLS
2 

HR 3224 RFS

1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Deborah Sampson Act’’. 

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

5 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. 

Sec. 306. Study on Women Veteran Coordinator program. 

Subtitle B—Other Matters 


kjohnson on DSK79L0C42 with BILLS
3 

HR 3224 RFS

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 

6 (a) of section 7306 of title 38, United States Code, is 

7 amended— 

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 

15 of title 38, United States Code, is amended by add16 ing at the end of the following new sections: 

17 ‘‘§ 7310. Office of Women’s Health 

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

19 Health shall establish and operate in the Veterans Health 

20 Administration the Office of Women’s Health (hereinafter 


kjohnson on DSK79L0C42 with BILLS
4 

HR 3224 RFS

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

2 be located at the Central Office of the Department of Vet3 erans Affairs. 

4 ‘‘(2) The head of the Office is the Director of Wom5 en’s Health (hereinafter in this section referred to as the 

6 ‘Director’). The Director shall report to the Under Sec7 retary for Health. 

8 ‘‘(3) The Under Secretary for Health shall provide 

9 the Office with such staff and other support as may be 

10 necessary for the Office to carry out effectively its func11 tions under this section. 

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

13 existing offices within the Veterans Health Administration 

14 as of the date of the enactment of this section in order 

15 to avoid duplication with the functions of the Office. 

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

17 the following: 

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

19 and encouraging the activities of the Veterans 

20 Health Administration with respect to the provision, 

21 evaluation, and improvement of women veterans’ 

22 health care services in the Department. 

23 ‘‘(2) To develop and implement standards of 

24 care for the provision of health care for women vet25 erans in the Department. 


kjohnson on DSK79L0C42 with BILLS
5 

HR 3224 RFS

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

2 standards of care for the provision of health care for 

3 women veterans in the Department, to provide tech4 nical assistance to medical facilities of the Depart5 ment to address and remedy deficiencies, and to per6 form oversight of implementation of standards of 

7 care for women veterans’ health care in the Depart8 ment. 

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

10 standards of care for the provision of health care for 

11 women veterans provided through the community 

12 pursuant to this title, and to provide recommenda13 tions to the appropriate office to address and rem14 edy any deficiencies. 

15 ‘‘(5) To oversee distribution of resources and 

16 information related to women veterans’ health pro17 gramming under this title. 

18 ‘‘(6) To promote the expansion and improve19 ment of clinical, research, and educational activities 

20 of the Veterans Health Administration with respect 

21 the health care of women veterans. 

22 ‘‘(7) To provide, as part of the annual budg23 eting process, recommendations with respect to the 

24 amount of funds to be requested for furnishing hos25 pital care and medical services to women veterans 


kjohnson on DSK79L0C42 with BILLS
6 

HR 3224 RFS

1 pursuant to chapter 17 of this title, including, at a 

2 minimum, recommendations that ensure that such 

3 amount of funds either reflect or exceed the propor4 tion of veterans enrolled in the patient enrollment 

5 system under section 1705 of this title who are 

6 women. 

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

8 Secretary for Health with respect to modifying the 

9 Veterans Equitable Resource Allocation system to 

10 ensure that resource allocations under such system 

11 reflect the health care needs of women veterans. 

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

13 Under Secretary for Health may require. 

14 ‘‘(c) RECOMMENDATIONS.—If the Under Secretary 

15 for Health determines not to implement any recommenda16 tion made by the Director with respect to the allocation 

17 of resources to address the health care needs of women 

18 veterans, the Secretary shall notify the appropriate con19 gressional committees of such determination by not later 

20 than 30 days after the date on which the Under Secretary 

21 for Health receives the recommendation. Each such notifi22 cation shall include the following: 

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

24 Health in making such determination. 


kjohnson on DSK79L0C42 with BILLS
7 

HR 3224 RFS

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

2 recommendation that the Under Secretary for 

3 Health will carry out to fulfill the health care needs 

4 of women veterans. 

5 ‘‘(d) STANDARDS OF CARE.—In this section, the 

6 standards of care for the provision of health care for 

7 women veterans in the Department shall include, at a min8 imum, the following: 

9 ‘‘(1) Requirement for— 

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

11 health primary care provider at each medical 

12 center whose duties include, to the extent prac13 ticable, providing training to other health care 

14 providers of the Department with respect to the 

15 needs of women veterans; and 

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

17 health primary care provider at each commu18 nity-based outpatient clinic of the Department 

19 who may serve female patients as a percentage 

20 of the total 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 


kjohnson on DSK79L0C42 with BILLS
8 

HR 3224 RFS

1 forum for women veterans that occurs outside of 

2 regular 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 

6 of 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 

14 Allocation system’ means the resource allocation sys15 tem established pursuant to section 429 of the De16 partments of Veterans Affairs and Housing and 

17 Urban Development, and Independent Agencies Ap18 propriations Act, 1997 (Public Law 104–204; 110 

19 Stat. 2929). 

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

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

22 1 of each year, the Director of Women’s Health shall sub23 mit to the appropriate congressional committees a report 

24 containing the matters under subsections (b) through (g). 


kjohnson on DSK79L0C42 with BILLS
9 

HR 3224 RFS

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 

5 Department’s provision of health care to women vet6 erans; 

7 ‘‘(2) any identified deficiencies related to the 

8 Department’s provision of health care to women vet9 erans and the standards of care established in sec10 tion 7310 of this title, and the Department’s plan to 

11 address 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.— 

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

22 of the access of women veterans to gender-specific services 

23 under contracts, agreements, or other arrangements with 

24 non-Department medical providers entered into by the 

25 Secretary for the provision of hospital care or medical 


kjohnson on DSK79L0C42 with BILLS
10 

HR 3224 RFS

1 services to veterans. Such analysis shall include data and 

2 performance measures for the availability of gender spe3 cific services, including— 

4 ‘‘(1) the average wait time between the vet5 eran’s preferred appointment date and the date on 

6 which the 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 

14 of health care from the Department, including the fol15 lowing 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 en20 rollment of the Department established and operated 

21 under section 1705(a) this title. 

22 ‘‘(3) Of the women veterans who are so en23 rolled, the number who have received health care 

24 under the laws administered by the Secretary at 


kjohnson on DSK79L0C42 with BILLS
11 

HR 3224 RFS

1 least one time during the 1-year period preceding 

2 the submittal of 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 sub22 section (a) shall include an analysis of the use by the De23 partment of general primary care clinics, separate but 

24 shared spaces, and women’s health centers as models of 


kjohnson on DSK79L0C42 with BILLS
12 

HR 3224 RFS

1 providing health care to women veterans. Such analysis 

2 shall include the following: 

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 

7 Department to determine which such model is most 

8 appropriate for each facility of the Department. 

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

11 different model. 

12 ‘‘(4) A description of what, if any, plans the 

13 Department has to modify facilities from general 

14 primary 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. 


kjohnson on DSK79L0C42 with BILLS
13 

HR 3224 RFS

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 fol7 lowing, disaggregated by Veterans Integrated Service Net8 work and 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 

19 for women’s health care through Women Veterans 

20 Health Care Mini-Residency Program of the Depart21 ment during the 1-year period preceding the sub22 mittal of the report, and the number that plan to 

23 participate in such a mini-residency during the 1- 

24 year period following such date. 


kjohnson on DSK79L0C42 with BILLS
14 

HR 3224 RFS

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

2 care providers of the Department who have suffi3 cient female patients to retain their competencies 

4 and proficiencies. 

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 

10 of women’s health centers of the Department, in11 cluding, with respect to each such facility, an assess12 ment of such accessibility for each kind of treatment 

13 provided at the center, including with respect to ra14 diology and mammography, that addresses all rel15 evant factors, including door sizes, hoists, and equip16 ment. 

17 ‘‘(2) The options for women veterans to access 

18 female mental health providers and primary care 

19 providers. 

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

21 facilities of the Department with respect to clothing 

22 sizes, including for gowns, drawstring pants, and pa23 jamas. 

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


kjohnson on DSK79L0C42 with BILLS
15 

HR 3224 RFS

1 ‘‘(1) The term ‘appropriate congressional com2 mittees’ means— 

3 ‘‘(A) the Committees on Veterans’ Affairs 

4 of the House of Representatives and the Sen5 ate; and 

6 ‘‘(B) the Committees on Appropriations of 

7 the House of Representatives and the Senate. 

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

9 mammography, obstetric care, gynecological care, 

10 and such other services as the Secretary determines 

11 appropriate.’’. 

12 (2) CLERICAL AMENDMENT.—The table of sec13 tions for such chapter is amended by inserting after 

14 the item relating to section 7309A the following new 

15 items: 

‘‘7310. Office of Women’s Health. 

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

16 (c) INITIAL REPORT.—The Secretary of Veterans Af17 fairs shall submit the initial report under section 7310A 

18 of title 38, United States Code, as added by subsection 

19 (b), by not later than 180 days after the date of the enact20 ment of this Act. 


kjohnson on DSK79L0C42 with BILLS
16 

HR 3224 RFS

1 SEC. 102. EXPANSION OF CAPABILITIES OF WOMEN VET2 ERANS CALL CENTER TO INCLUDE TEXT MES3 SAGING. 

4 The Secretary of Veterans Affairs shall expand the 

5 capabilities of the Women Veterans Call Center of the De6 partment of Veterans Affairs to include a text messaging 

7 capability. 

8 SEC. 103. REQUIREMENT FOR DEPARTMENT OF VETERANS 

9 AFFAIRS INTERNET WEBSITE TO PROVIDE IN10 FORMATION ON SERVICES AVAILABLE TO 

11 WOMEN VETERANS. 

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

13 shall survey the internet websites and information re14 sources of the Department of Veterans Affairs in effect 

15 on the day before the date of the enactment of this Act 

16 and publish an internet website that serves as a central17 ized source for the provision to women veterans of infor18 mation about the benefits and services available to them 

19 under laws administered by the Secretary. 

20 (b) ELEMENTS.—The internet website published 

21 under subsection (a) shall provide to women veterans in22 formation regarding all of the services available in the dis23 trict in which the veteran is seeking such services, includ24 ing, with respect to each medical center and community25 based outpatient clinic in the applicable Veterans Inte26 grated Service Network— 


kjohnson on DSK79L0C42 with BILLS
17 

HR 3224 RFS

1 (1) the name and contact information of each 

2 women veterans program manager; 

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

4 available from the Veterans Benefits Administration, 

5 the National Cemetery Administration, and such 

6 other entities as the Secretary considers appropriate; 

7 and 

8 (3) such other information as the Secretary 

9 considers appropriate. 

10 (c) UPDATED INFORMATION.—The Secretary shall 

11 ensure that the information described in subsection (b) 

12 that is published on the internet website required by sub13 section (a) is updated not less frequently than once every 

14 90 days. 

15 (d) OUTREACH.—In carrying out this section, the 

16 Secretary shall ensure that the outreach conducted under 

17 section 1720F(i) of title 38, United States Code, includes 

18 information regarding the internet website required by 

19 subsection (a). 

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

21 Secretary to carry out this section shall be derived from 

22 amounts made available to the Secretary to publish inter23 net websites of the Department. 


kjohnson on DSK79L0C42 with BILLS
18 

HR 3224 RFS

1 SEC. 104. REPORT ON WOMEN VETERANS RETROFIT INITIA2 TIVE. 

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

4 of the enactment of this Act, the Secretary of Veterans 

5 Affairs shall submit to the Committees on Veterans’ Af6 fairs and the Committees on Appropriations of the Senate 

7 and the House of Representatives a report on require8 ments to retrofit existing medical facilities of the Depart9 ment of Veterans Affairs with fixtures, materials, and 

10 other outfitting measures to support the provision of care 

11 to women veterans at such facilities. 

12 (b) ELEMENTS.—The report under subsection (a) 

13 shall include the following: 

14 (1) An assessment of how the Secretary 

15 prioritizes retrofitting existing medical facilities to 

16 support provision of care to women veterans in com17 parison to other requirements. 

18 (2) A 5-year plan for retrofitting medical facili19 ties of the Department to support the provision of 

20 care to women veterans. 

21 SEC. 105. ESTABLISHMENT OF ENVIRONMENT OF CARE 

22 STANDARDS AND INSPECTIONS AT DEPART23 MENT OF VETERANS AFFAIRS MEDICAL CEN24 TERS. 

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

26 shall establish a policy under which the environment of 


kjohnson on DSK79L0C42 with BILLS
19 

HR 3224 RFS

1 care standards and inspections at medical centers of the 

2 Department of Veterans Affairs include— 

3 (1) an alignment of the requirements for such 

4 standards and inspections with the women’s health 

5 handbook of the Veterans Health Administration; 

6 (2) a requirement for the frequency of such in7 spections; 

8 (3) delineation of the roles and responsibilities 

9 of staff at the medical center who are responsible for 

10 compliance; 

11 (4) the requirement that each medical center 

12 submit to the Secretary and make publicly available 

13 a report on the compliance of the medical center 

14 with the standards; and 

15 (5) a remediation plan. 

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

17 of the enactment of this Act, the Secretary shall submit 

18 to the Committees on Veterans’ Affairs of the Senate and 

19 House of Representatives certification in writing that the 

20 policy required by subsection (a) has been finalized and 

21 disseminated to Department all medical centers. 


kjohnson on DSK79L0C42 with BILLS
20 

HR 3224 RFS

1 SEC. 106. ADDITIONAL FUNDING FOR PRIMARY CARE AND 

2 EMERGENCY CARE CLINICIANS IN WOMEN 

3 VETERANS HEALTH CARE MINI-RESIDENCY 

4 PROGRAM. 

5 (a) IN GENERAL.—There is authorized to be appro6 priated to the Secretary of Veterans Affairs $1,000,000 

7 for each fiscal year for the Women Veterans Health Care 

8 Mini-Residency Program of the Department of Veterans 

9 Affairs to provide opportunities for participation in such 

10 program for primary care and emergency care clinicians. 

11 (b) TREATMENT OF AMOUNTS.—The amounts au12 thorized to be appropriated under subsection (a) shall be 

13 in addition to amounts otherwise made available to the 

14 Secretary for the purposes set forth in such subsection. 

15 SEC. 107. ESTABLISHMENT OF WOMEN VETERAN TRAINING 

16 MODULE FOR NON-DEPARTMENT OF VET17 ERANS AFFAIRS HEALTH CARE PROVIDERS. 

18 (a) IN GENERAL.—Not later than 1 year after the 

19 date of the enactment of this Act, the Secretary of Vet20 erans Affairs shall establish and make available to commu21 nity providers a training module that is specific to women 

22 veterans. 

23 (b) COMMUNITY PROVIDER DEFINED.—In this sec24 tion, the term ‘‘community provider’’ means a non-Depart25 ment of Veterans Affairs health care provider who proVerDate Sep 11 2014 22:50 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H3224.RFS H3224

kjohnson on DSK79L0C42 with BILLS
21 

HR 3224 RFS

1 vides health care to veterans under the laws administered 

2 by the Secretary of Veterans Affairs. 

3 TITLE II—MEDICAL CARE 

4 SEC. 201. IMPROVED ACCESS TO DEPARTMENT OF VET5 ERANS AFFAIRS MEDICAL CARE FOR WOMEN 

6 VETERANS. 

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

8 title 38, United States Code, is amended by adding at the 

9 end the following new section: 

10 ‘‘§ 1720J. Medical services for women veterans 

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

12 that women’s health primary care services are available 

13 during regular business hours at every medical center and 

14 community based outpatient clinic of the Department. 

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

16 Secretary shall conduct a study to assess— 

17 ‘‘(1) the use of extended hours as a means of 

18 reducing barriers to care; 

19 ‘‘(2) the need for extended hours based on 

20 interviews with women veterans and employees; and 

21 ‘‘(3) the best practices and resources required 

22 to implement use of extended hours. 

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

24 than September 30 of each year, the Secretary shall sub25 mit to the Committee on Veterans’ Affairs of the Senate 


kjohnson on DSK79L0C42 with BILLS
22 

HR 3224 RFS

1 and the Committee on Veterans’ Affairs of the House of 

2 Representatives a report on compliance with subsection 

3 (a).’’. 

4 (b) CLERICAL AMENDMENT.—The table of sections 

5 at the beginning of such chapter is amended by inserting 

6 after the item relating to section 1720I the following new 

7 item: 

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

8 SEC. 202. COUNSELING AND TREATMENT FOR SEXUAL 

9 TRAUMA. 

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

11 amended— 

12 (1) in subsection (a)— 

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

14 duty, active duty for training, or inactive duty 

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

16 duty status or line of duty determination (as 

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

18 and 

19 (B) in paragraph (2)(A), by striking ‘‘ac20 tive duty, active duty for training, or inactive 

21 duty training’’ and inserting ‘‘duty, regardless 

22 of duty status or line of duty determination (as 

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


kjohnson on DSK79L0C42 with BILLS
23 

HR 3224 RFS

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

2 and inserting ‘‘former member of the Armed 

3 Forces’’; 

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

5 and inserting ‘‘former members of the Armed 

6 Forces’’; and 

7 (4) by adding at the end the following new sub8 section: 

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

10 Armed Forces’ includes the following: 

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

12 this title. 

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

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

15 Forces under a condition that is not honorable but 

16 not— 

17 ‘‘(A) a dishonorable discharge; or 

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

19 SEC. 203. COUNSELING IN RETREAT SETTINGS FOR WOMEN 

20 VETERANS AND OTHER INDIVIDUALS. 

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

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

23 the following new section: 


kjohnson on DSK79L0C42 with BILLS
24 

HR 3224 RFS

1 ‘‘§ 1712D. Counseling in retreat settings for women 

2 veterans and other individuals 

3 ‘‘(a) PROGRAM.—(1) Commencing not later than 

4 January 1, 2021, the Secretary shall carry out, through 

5 the Readjustment Counseling Service of the Veterans 

6 Health Administration, a program to provide reintegration 

7 and readjustment services described in subsection (b) in 

8 group retreat settings to covered individuals, including co9 horts of women veterans who are eligible for readjustment 

10 counseling services under section 1712A of this title. 

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

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

13 the individual. 

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

15 a covered individual under the program under subsection 

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

17 ‘‘(1) Information on reintegration into the fam18 ily, employment, and community of the individual. 

19 ‘‘(2) Financial counseling. 

20 ‘‘(3) Occupational counseling. 

21 ‘‘(4) Information and counseling on stress re22 duction. 

23 ‘‘(5) Information and counseling on conflict res24 olution. 

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

26 the Secretary considers appropriate to assist the inVerDate Sep 11 2014 22:50 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\H3224.RFS H3224

kjohnson on DSK79L0C42 with BILLS
25 

HR 3224 RFS

1 dividual in reintegration into the family, employ2 ment, and community of the veteran. 

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

4 31, 2022, and each even-numbered year thereafter, the 

5 Secretary shall submit to the Committees on Veterans’ Af6 fairs of the House of Representatives and the Senate a 

7 report on the program under subsection (a)(1). 

8 ‘‘(d) COVERED INDIVIDUAL DEFINED.—In this sec9 tion, the term ‘covered individual’ means— 

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

11 of annual patient enrollment under section 1705 of 

12 this title. 

13 ‘‘(2) Any survivor or dependent of a veteran 

14 who is eligible for medical care under section 1781 

15 of this title.’’. 

16 (b) CLERICAL AMENDMENT.—The table of sections 

17 at the beginning of such chapter is amended by inserting 

18 after the item relating to section 1712C the following new 

19 item: 

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

20 SEC. 204. IMPROVEMENT OF HEALTH CARE SERVICES PRO21 VIDED TO NEWBORN CHILDREN BY DEPART22 MENT OF VETERANS AFFAIRS. 

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

24 States Code, is amended— 


kjohnson on DSK79L0C42 with BILLS
26 

HR 3224 RFS

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

2 paragraph (1), by striking ‘‘seven days’’ and insert3 ing ‘‘14 days’’; and 

4 (2) by adding at the end the following new sub5 section: 

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

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

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

9 Committee on Veterans’ Affairs of the House of Rep10 resentatives a report on the health care services provided 

11 under subsection (a) during such fiscal year, including the 

12 number of newborn children who received such services 

13 during such fiscal year.’’. 

14 (b) AUTHORITY TO FURNISH MEDICALLY NEC15 ESSARY TRANSPORTATION FOR NEWBORN CHILDREN OF

16 CERTAIN WOMEN VETERANS.—Such section is further 

17 amended— 

18 (1) in subsection (a)— 

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

20 (i) by inserting ‘‘and transportation 

21 necessary to receive such services’’ after 

22 ‘‘described in subsection (b)’’; and 

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

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

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


kjohnson on DSK79L0C42 with BILLS
27 

HR 3224 RFS

1 (C) in paragraph (2), by striking the pe2 riod at the end and inserting ‘‘; or’’; and 

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

4 paragraph: 

5 ‘‘(3) another location, including a health care 

6 facility, if the veteran delivers the child before arriv7 ing at a facility described in paragraph (1) or (2).’’; 

8 (2) in subsection (b), by inserting before the pe9 riod at the end the following: ‘‘, including necessary 

10 health care services provided by a facility other than 

11 the facility where the newborn child was delivered 

12 (including a specialty pediatric hospital) that accepts 

13 transfer of the newborn child and responsibility for 

14 treatment of the newborn child’’; and 

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

16 by subsection (a), the following new subsections: 

17 ‘‘(c) TRANSPORTATION.—(1) Transportation fur18 nished under subsection (a) to, from, or between care set19 tings to meet the needs of a newborn child includes costs 

20 for either or both the newborn child and parents. 

21 ‘‘(2) Transportation furnished under subsection (a) 

22 is transportation by ambulance, including air ambulance, 

23 or other appropriate medically staffed modes of transpor24 tation— 


kjohnson on DSK79L0C42 with BILLS
28 

HR 3224 RFS

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

2 specialty pediatric hospital) that accepts transfer of 

3 the newborn child or otherwise provides post-delivery 

4 care services when the treating facility is not capable 

5 of furnishing the care or services required; or 

6 ‘‘(B) to a health care facility in a medical emer7 gency of such nature that a prudent layperson rea8 sonably expects that delay in seeking immediate 

9 medical attention would be hazardous to life or 

10 health. 

11 ‘‘(3) Amounts paid by the Department for transpor12 tation under this section shall be derived from the Medical 

13 Services appropriations account of the Department. 

14 ‘‘(d) REIMBURSEMENT OR PAYMENT FOR HEALTH

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

16 regulations the Secretary shall prescribe to establish rates 

17 of reimbursement and any limitations thereto under this 

18 section, the Secretary shall directly reimburse a covered 

19 entity for health care services or transportation services 

20 provided under this section, unless the cost of the services 

21 or transportation is covered by an established agreement 

22 or contract. If such an agreement or contract exists, its 

23 negotiated payment terms shall apply. 

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

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


kjohnson on DSK79L0C42 with BILLS
29 

HR 3224 RFS

1 entity shall, unless rejected and refunded by the covered 

2 entity within 30 days of receipt, extinguish any liability 

3 on the part of the individual for the health care services 

4 or transportation covered by such payment. 

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

6 between the Secretary and a covered entity nor any provi7 sion of a contract, agreement, or assignment to the con8 trary shall operate to modify, limit, or negate the require9 ments of subparagraph (A). 

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

11 means any individual, transportation carrier, organization, 

12 or other entity that furnished or paid for health care serv13 ices or transportation under this section. 

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

15 the Secretary shall prescribe to carry out this section, the 

16 Secretary may furnish more than 14 days of health care 

17 services described in subsection (b), and transportation 

18 necessary to receive such services, to a newborn child 

19 based on medical necessity if the child is in need of addi20 tional care, including a case in which the newborn child 

21 has been discharged or released from a hospital and re22 quires readmittance to ensure the health and welfare of 

23 the newborn child.’’. 

24 (c) TREATMENT OF CERTAIN EXPENSES ALREADY

25 INCURRED.—Pursuant to such regulations as the SecVerDate Sep 11 2014 22:50 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\H3224.RFS H3224

kjohnson on DSK79L0C42 with BILLS
30 

HR 3224 RFS

1 retary of Veterans Affairs shall prescribe, the Secretary 

2 may provide reimbursement under section 1786 of title 38, 

3 United States Code, as amended by subsection (a), health 

4 care services or transportation services furnished to a new5 born child during the period beginning on May 5, 2010, 

6 and ending on the date of the enactment of this Act, if 

7 the Secretary determines that, under the circumstances 

8 applicable with respect to the newborn, such reimburse9 ment appropriate. 

10 TITLE III—REPORTS AND OTHER 

11 MATTERS 

12 Subtitle A—Reports 

13 SEC. 301. ASSESSMENT OF EFFECTS OF INTIMATE PART14 NER VIOLENCE ON WOMEN VETERANS BY AD15 VISORY COMMITTEE ON WOMEN VETERANS. 

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

17 amended— 

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

19 the end; 

20 (2) by redesignating subparagraph (C) as sub21 paragraph (D); and 

22 (3) by inserting after subparagraph (B) the fol23 lowing new subparagraph (C): 

24 ‘‘(C) an assessment of the effects of inti25 mate partner violence on women veterans; and’’. 


kjohnson on DSK79L0C42 with BILLS
31 

HR 3224 RFS

1 SEC. 302. STUDY ON STAFFING OF WOMEN VETERAN PRO2 GRAM MANAGER PROGRAM AT MEDICAL 

3 CENTERS OF THE DEPARTMENT OF VET4 ERANS AFFAIRS AND TRAINING OF STAFF. 

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

6 conduct a study on the use of the Women Veteran Pro7 gram Manager program of the Department of Veterans 

8 Affairs to determine— 

9 (1) if the program is appropriately staffed at 

10 each medical center of the Department; 

11 (2) whether each medical center of the Depart12 ment is staffed with a Women Veteran Program 

13 Manager; and 

14 (3) whether it would be feasible and advisable 

15 to have a Women Veteran Program Ombudsman at 

16 each medical center of the Department. 

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

18 of the enactment of this Act, the Secretary shall submit 

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

20 the Committee on Veterans’ Affairs of the House of Rep21 resentatives a report on the study conducted under sub22 section (a). 

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

24 Women Veteran Program Managers and Women Veteran 

25 Program Ombudsmen receive the proper training to carry 

26 out their duties. 


kjohnson on DSK79L0C42 with BILLS
32 

HR 3224 RFS

1 SEC. 303. REPORT ON AVAILABILITY OF PROSTHETIC 

2 ITEMS FOR WOMEN VETERANS FROM THE 

3 DEPARTMENT OF VETERANS AFFAIRS. 

4 Not later than 1 year after the date of the enactment 

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

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

7 the Committee on Veterans’ Affairs of the House of Rep8 resentatives a report on the availability from the Depart9 ment of Veterans Affairs of prosthetic items made for 

10 women veterans, including an assessment of the avail11 ability of such prosthetic items at each medical facility of 

12 the Department. The report shall— 

13 (1) address efforts on research, development, 

14 and employment of additive manufacture technology 

15 (commonly referred to as ‘‘3D printing’’) to provide 

16 prosthetic items for women veterans; and 

17 (2) include a survey with a representative sam18 ple of 50,000 veterans (of which women shall be 

19 overrrepresented) in amputee care program on satis20 faction with prosthetics furnished or procured by the 

21 Department that replace appendages or their func22 tion. 


kjohnson on DSK79L0C42 with BILLS
33 

HR 3224 RFS

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

2 HEALTH CARE FROM THE DEPARTMENT OF 

3 VETERANS AFFAIRS. 

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

5 Affairs shall conduct a comprehensive study of the bar6 riers to the provision of comprehensive health care by the 

7 Department of Veterans Affairs encountered by women 

8 who are veterans. In conducting the study, the Secretary 

9 shall— 

10 (1) survey women veterans who seek or receive 

11 hospital care or medical services provided by the De12 partment of Veterans Affairs as well as women vet13 erans who do not seek or receive such care or serv14 ices; 

15 (2) administer the survey to a representative 

16 sample of women veterans from each Veterans Inte17 grated Service Network; and 

18 (3) ensure that the sample of women veterans 

19 surveyed is of sufficient size for the study results to 

20 be statistically significant and is a larger sample 

21 than that of the study referred to in subsection 

22 (b)(1). 

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

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

25 on the work of the studies of the Department of Veterans 

26 Affairs titled— 


kjohnson on DSK79L0C42 with BILLS
34 

HR 3224 RFS

1 (1) ‘‘National Survey of Women Veterans in 

2 Fiscal Year 2007–2008’’; and 

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

4 VA Health Care 2015’’. 

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

6 required by subsection (a), the Secretary shall conduct re7 search on the effects of the following on the women vet8 erans surveyed in the study: 

9 (1) The barriers associated with seeking mental 

10 health care services, including with respect to pro11 vider availability, telehealth access, and family, 

12 work, and school obligations. 

13 (2) The effect of driving distance or availability 

14 of other forms of transportation to the nearest med15 ical facility on access to care. 

16 (3) The effect of access to care in the commu17 nity. 

18 (4) The availability of child care. 

19 (5) The acceptability of integrated primary 

20 care, women’s health clinics, or both. 

21 (6) The comprehension of eligibility require22 ments for, and the scope of services available under, 

23 hospital care and medical services. 


kjohnson on DSK79L0C42 with BILLS
35 

HR 3224 RFS

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 vet11 erans. 

12 (11) The perception of women veterans regard13 ing the motto of the Department of Veterans Af14 fairs. 

15 (12) Such other significant barriers as the Sec16 retary considers appropriate. 

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

18 enter into a contract with a qualified independent entity 

19 or organization to carry out the study and research re20 quired under this section. 

21 (e) MANDATORY REVIEW OF DATA BY CERTAIN DE22 PARTMENT DIVISIONS.— 

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

24 that the head of each division of the Department of 

25 Veterans Affairs specified in paragraph (2) reviews 


kjohnson on DSK79L0C42 with BILLS
36 

HR 3224 RFS

1 the results of the study conducted under this sec2 tion. The head of each such division shall submit 

3 findings with respect to the study to the Under Sec4 retary for responsibilities relating to health care 

5 services for women veterans. 

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

7 Department of Veterans Affairs specified in this 

8 paragraph are the following: 

9 (A) The Under Secretary for Health. 

10 (B) The Office of Women’s Health. 

11 (C) The Center for Women Veterans estab12 lished under section 318 of title 38, United 

13 States Code. 

14 (D) The Advisory Committee on Women 

15 Veterans established under section 542 of such 

16 title. 

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

18 date of the enactment of this Act, the Secretary shall sub19 mit to Congress a report on the study required under this 

20 section. The report shall include recommendations for 

21 such administrative and legislative action as the Secretary 

22 considers appropriate. The report shall also include the 

23 findings of the head of each division of the Department 

24 specified under subsection (e)(2) and of the Under Sec25 retary for Health. 


kjohnson on DSK79L0C42 with BILLS
37 

HR 3224 RFS

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 

6 Affairs shall publish a report regarding veterans who re7 ceive benefits under laws administered by the Secretary, 

8 including the Transition Assistance Program under sec9 tions 1142 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 

16 by sex. 

17 (2) may not include any personally identifiable 

18 information. 

19 (c) MATTERS INCLUDED.—The report under sub20 section (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. 


kjohnson on DSK79L0C42 with BILLS
38 

HR 3224 RFS

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 

4 States Code. 

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

7 Not later than 180 days after the date of the enact8 ment of this Act, the Secretary of Veterans Affairs shall 

9 submit to the Committees on Veterans’ Affairs of the 

10 House of Representatives and the Senate a report con11 taining a study on the Women Veteran Coordinator pro12 gram of the Veterans Benefits Administration of the De13 partment of Veterans Affairs. Such study shall identify 

14 the following: 

15 (1) If the program is appropriately staffed at 

16 each regional benefits office of the Department. 

17 (2) Whether each regional benefits office of the 

18 Department is staffed with a Women Veteran Coor19 dinator. 

20 (3) The position description of the Women Vet21 eran Coordinator. 

22 (4) Whether an individual serving in the 

23 Women Veteran Coordinator position concurrently 

24 serves in any other position, and if so, the allocation 

25 of time the individual spends in each such position. 


kjohnson on DSK79L0C42 with BILLS
39 

HR 3224 RFS

1 (5) A description of the metrics the Secretary 

2 uses to determine the success and performance of 

3 the 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 

14 Affairs shall establish a comprehensive policy to end har15 assment and sexual assault, including sexual harassment 

16 and gender-based harassment, throughout the Depart17 ment of Veterans Affairs. This policy shall include the fol18 lowing: 

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

20 the Department to respond to reported incidents of 

21 harassment and sexual assault committed by any 

22 non-Department individual within a facility of the 

23 Department, including with respect to accountability 

24 or disciplinary measures. 


kjohnson on DSK79L0C42 with BILLS
40 

HR 3224 RFS

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

2 the Department to respond to reported incidents of 

3 harassment and sexual assault of any non-Depart4 ment individual within a facility of the Department. 

5 ‘‘(3) A process for any non-Department indi6 vidual to report harassment and sexual assault de7 scribed in paragraph (1), including an option for 

8 confidential reporting, and for the Secretary to re9 spond to and address such reports. 

10 ‘‘(4) Clear mechanisms for non-Department in11 dividuals to readily identify to whom and how to re12 port incidents of harassment and sexual assault 

13 committed by another non-Department individual. 

14 ‘‘(5) Clear mechanisms for employees and con15 tractors of the Department to readily identify to 

16 whom and how to report incidents of harassment 

17 and sexual assault and how to refer non-Department 

18 individuals with respect to reporting an incident of 

19 harassment or sexual assault. 

20 ‘‘(6) A process for, and mandatory reporting re21 quirement applicable to, any employee or contractor 

22 of the Department who witnesses harassment or sex23 ual assault described in paragraph (1) or (2) within 

24 a facility of the Department, regardless of whether 

25 the individual affected by such harassment or sexual 


kjohnson on DSK79L0C42 with BILLS
41 

HR 3224 RFS

1 assault wants to report such harassment or sexual 

2 assault. 

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

4 actions, for employees or contractors of the Depart5 ment who fail to report incidents of harassment and 

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

7 the employees or contractors witness. 

8 ‘‘(8) On an annual or more frequent basis, 

9 mandatory training for employees and contractors of 

10 the Department regarding how to report and ad11 dress harassment and sexual assault described in 

12 paragraphs (1) and (2), including bystander inter13 vention training. 

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

15 distribution of the policy under this subsection and 

16 anti-harassment and anti-sexual assault educational 

17 materials by mail or email to each individual receiv18 ing a benefit under a law administered by the Sec19 retary. 

20 ‘‘(10) The prominent display of anti-harass21 ment and anti-sexual assault messages in each facil22 ity of the Department, including how non-Depart23 ment individuals may report harassment and sexual 

24 assault described in paragraphs (1) and (2) at such 


kjohnson on DSK79L0C42 with BILLS
42 

HR 3224 RFS

1 facility and the points of contact under subsection 

2 (b). 

3 ‘‘(11) The posting on internet websites of the 

4 Department, including the main internet website re5 garding benefits of the Department and the main 

6 internet website regarding health care of the Depart7 ment, of anti-harassment and anti-sexual assault 

8 banners specifically addressing harassment and sex9 ual assault described in paragraphs (1) and (2). 

10 ‘‘(b) POINTS OF CONTACT.—The Secretary shall des11 ignate, as a point of contact to receive reports of harass12 ment and sexual assault described in paragraphs (1) and 

13 (2) of subsection (a)— 

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

15 enforcement, at each facility of the Department (in16 cluding Vet Centers under section 1712A of this 

17 title), with regard to that facility; 

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

19 Veterans Integrated Service Network, with regards 

20 to facilities in that Veterans Integrated Service Net21 work; 

22 ‘‘(3) at least one individual employed in each 

23 regional benefits office; 

24 ‘‘(4) at least one individual employed at each lo25 cation of the National Cemetery Administration; and 


kjohnson on DSK79L0C42 with BILLS
43 

HR 3224 RFS

1 ‘‘(5) at least one individual employed at the 

2 Central Office of the Department to track reports of 

3 such harassment and sexual assault across the De4 partment, disaggregated by facility. 

5 ‘‘(c) ACCOUNTABILITY.—The Secretary shall estab6 lish a policy to ensure that each facility of the Department 

7 and each director of a Veterans Integrated Service Net8 work is responsible for addressing harassment and sexual 

9 assault at the facility and the Network. Such policy shall 

10 include— 

11 ‘‘(1) a remediation plan for facilities that expe12 rience five or more incidents of sexual harassment, 

13 sexual assault, or combination thereof, during any 

14 single fiscal year; and 

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

16 or subchapter V of chapter 74 of this title. 

17 ‘‘(d) DATA.—The Secretary shall ensure that the in18 take process for veterans at medical facilities of the De19 partment includes a survey to collect the following infor20 mation: 

21 ‘‘(1) Whether the veteran feels safe at the facil22 ity and whether any events occurred at the facility 

23 that affect such feeling. 


kjohnson on DSK79L0C42 with BILLS
44 

HR 3224 RFS

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

2 later by the Department with respect to such safety 

3 issues. 

4 ‘‘(e) WORKING GROUP.—(1) The Secretary shall es5 tablish a working group to assist the Secretary in imple6 menting policies to carry out this section. 

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

8 (1) shall consist of representatives from— 

9 ‘‘(A) veterans service organizations; 

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

11 and 

12 ‘‘(C) other persons the Secretary determines 

13 appropriate. 

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

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

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

17 the local level to reduce instances of harassment and 

18 sexual assault; 

19 ‘‘(B) standardized media for veterans service 

20 organizations and other persons to use in print and 

21 on the internet with respect to reducing harassment 

22 and sexual assault; and 

23 ‘‘(C) bystander intervention training for vet24 erans. 


kjohnson on DSK79L0C42 with BILLS
45 

HR 3224 RFS

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

2 Committees on Veterans’ Affairs of the Senate and the 

3 House of Representatives an annual report on harassment 

4 and sexual assault described in paragraphs (1) and (2) 

5 of subsection (a) in facilities of the Department. Each 

6 such report shall include the following: 

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

8 programming, including the End Harassment pro9 gram. 

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

11 Health Practice-Based Research Network of the De12 partment relating to harassment and sexual assault. 

13 ‘‘(3) Data collected on incidents of sexual har14 assment and sexual assault. 

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

16 Secretary during the year preceding the date of the 

17 report to stop harassment and sexual assault at fa18 cilities of the Department. 

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

20 the training required in subsection (a)(7). 

21 ‘‘(6) A list of resources the Secretary deter22 mines necessary to prevent harassment and sexual 

23 assault at facilities of the Department. 

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


kjohnson on DSK79L0C42 with BILLS
46 

HR 3224 RFS

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

2 means any individual present at a facility of the De3 partment who is not an employee or contractor of 

4 the Department. 

5 ‘‘(2) The term ‘sexual harassment’ has the 

6 meaning given that term in section 1720D of this 

7 title.’’. 

8 (b) CLERICAL AMENDMENT.—The table of sections 

9 at the beginning of such chapter is amended by adding 

10 after the item relating to section 532 the following new 

11 item: 

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

12 (c) DEFINITION OF SEXUAL HARASSMENT.—Section 

13 1720D(f) of such title is amended by striking ‘‘repeated,’’. 

14 (d) DEADLINE.—The Secretary shall commence car15 rying out section 533 of such title, as added by subsection 

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

17 of this Act. 

18 SEC. 322. SUPPORT FOR ORGANIZATIONS THAT HAVE A 

19 FOCUS ON PROVIDING ASSISTANCE TO 

20 WOMEN VETERANS AND THEIR FAMILIES. 

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

22 amended by adding at the end the following new para23 graph: 

24 ‘‘(4) There is authorized to be appropriated 

25 $20,000,000 for fiscal year 2020 to provide, under 


kjohnson on DSK79L0C42 with BILLS
47 

HR 3224 RFS

1 subsection (a), financial assistance to organizations 

2 that have a focus on providing assistance to women 

3 veterans and their families.’’. 

4 SEC. 323. GAP ANALYSIS OF DEPARTMENT OF VETERANS 

5 AFFAIRS PROGRAMS THAT PROVIDE ASSIST6 ANCE TO WOMEN VETERANS WHO ARE HOME7 LESS. 

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

9 shall complete an analysis of programs of the Department 

10 of Veterans Affairs that provide assistance to women vet11 erans who are homeless or precariously housed to identify 

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

13 needs of such women. 

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

15 of the enactment of this Act, the Secretary shall submit 

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

17 the Committee on Veterans’ Affairs of the House of Rep18 resentatives a report on the analysis completed under sub19 section (a). 

20 SEC. 324. DEPARTMENT OF VETERANS AFFAIRS PUBLIC21 PRIVATE PARTNERSHIP ON LEGAL SERVICES 

22 FOR WOMEN VETERANS. 

23 (a) PARTNERSHIP REQUIRED.—The Secretary of 

24 Veterans Affairs shall establish a partnership with at least 


kjohnson on DSK79L0C42 with BILLS
48 

HR 3224 RFS

1 one nongovernmental organization to provide legal services 

2 to women veterans. 

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

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

5 needs of women veterans as set forth in the most recently 

6 completed Community Homelessness Assessment, Local 

7 Education and Networking Groups for Veterans 

8 (CHALENG for Veterans) survey. 

9 SEC. 325. PROGRAM TO ASSIST VETERANS WHO EXPERI10 ENCE INTIMATE PARTNER VIOLENCE OR SEX11 UAL ASSAULT. 

12 (a) PROGRAM REQUIRED.—The Secretary of Vet13 erans Affairs shall carry out a program to assist former 

14 members of the armed forces who have experienced or are 

15 experiencing intimate partner violence or sexual assault in 

16 accessing benefits from the Department of Veterans Af17 fairs, including coordinating access to medical treatment 

18 centers, housing assistance, and other benefits from the 

19 Department. 

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

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

22 (1) intimate partner violence shelters and pro23 grams; 

24 (2) rape crisis centers; 


kjohnson on DSK79L0C42 with BILLS
49 

HR 3224 RFS

1 (3) State intimate partner violence and sexual 

2 assault coalitions; and 

3 (4) such other health care or other service pro4 viders that serve intimate partner violence or sexual 

5 assault victims as determined by the Secretary, par6 ticularly those providing emergency services or hous7 ing assistance. 

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

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

10 the following activities: 

11 (1) Training for community-based intimate 

12 partner violence or sexual assault service providers 

13 on— 

14 (A) identifying former members of the 

15 Armed Forces who have been victims of inti16 mate partner violence or sexual assault; 

17 (B) coordinating with local service pro18 viders of the Department; and 

19 (C) connecting former members of the 

20 Armed Forces with appropriate housing, mental 

21 health, medical, and other financial assistance 

22 or benefits from the Department. 

23 (2) Assistance to service providers to ensure ac24 cess of veterans to intimate partner violence and 

25 sexual assault emergency services, particularly in unVerDate Sep 11 2014 22:50 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6201 E:\BILLS\H3224.RFS H3224

kjohnson on DSK79L0C42 with BILLS
50 

HR 3224 RFS

1 derserved areas, including services for Native Amer2 ican veterans (as defined in section 3765 of title 38, 

3 United States Code). 

4 (3) Such other outreach and assistance as the 

5 Secretary determines necessary for the provision of 

6 assistance under subsection (a). 

7 (d) INTIMATE PARTNER VIOLENCE AND SEXUAL AS8 SAULT OUTREACH COORDINATORS.— 

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

10 veterans who have experienced intimate partner vio11 lence or sexual assault, the Secretary may establish 

12 local coordinators to provide outreach under the pro13 gram required by subsection (a). 

14 (2) LOCAL COORDINATOR KNOWLEDGE.—The 

15 Secretary shall ensure that each coordinator estab16 lished under paragraph (1) is knowledgeable about— 

17 (A) the dynamics of intimate partner vio18 lence and sexual assault, including safety con19 cerns, legal protections, and the need for the 

20 provision of confidential services; 

21 (B) the eligibility of veterans for services 

22 and benefits from the Department that are rel23 evant to recovery from intimate partner violence 

24 and sexual assault, particularly emergency 


kjohnson on DSK79L0C42 with BILLS
51 

HR 3224 RFS

1 housing assistance, mental health care, other 

2 health care, and disability benefits; and 

3 (C) local community resources addressing 

4 intimate partner violence and sexual assault. 

5 (3) LOCAL COORDINATOR ASSISTANCE.—Each 

6 coordinator established under paragraph (1) shall 

7 assist intimate partner violence shelters and rape 

8 crisis centers in providing services to veterans. 

9 SEC. 326. STUDY AND TASK FORCE ON VETERANS EXPERI10 ENCING INTIMATE PARTNER VIOLENCE OR 

11 SEXUAL ASSAULT. 

12 (a) NATIONAL BASELINE STUDY.— 

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

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

15 of Veterans Affairs, in consultation with the Attor16 ney General, shall conduct a national baseline study 

17 to examine the scope of the problem of intimate 

18 partner violence and sexual assault among veterans 

19 and spouses and intimate partners of veterans. 

20 (2) MATTERS INCLUDED.—The study under 

21 paragraph (1) shall— 

22 (A) include a literature review of all rel23 evant research on intimate partner violence and 

24 sexual assault among veterans and spouses and 

25 intimate partners of veterans; 


kjohnson on DSK79L0C42 with BILLS
52 

HR 3224 RFS

1 (B) examine the prevalence of the experi2 ence of intimate partner violence among— 

3 (i) women veterans; 

4 (ii) veterans who are minority group 

5 members (as defined in section 544 of title 

6 38, United States Code, and including 

7 other minority populations as the Sec8 retary determines appropriate); 

9 (iii) urban and rural veterans; 

10 (iv) veterans who are enrolled in a 

11 program under section 1720G of title 38, 

12 United States Code; 

13 (v) veterans who are in intimate rela14 tionships with other veterans; and 

15 (vi) veterans who are described in 

16 more than one clause of this subparagraph; 

17 (C) examine the prevalence of the per18 petration of intimate partner violence by vet19 erans; and 

20 (D) include recommendations to address 

21 the findings of the study. 

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

23 date on which the Secretary completes the study 

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

25 the Committees on Veterans’ Affairs of the House of 


kjohnson on DSK79L0C42 with BILLS
53 

HR 3224 RFS

1 Representatives and the Senate a report on such 

2 study. 

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

4 date on which the Secretary completes the study under 

5 subsection (a), the Secretary, in consultation with the At6 torney General and the Secretary of Health and Human 

7 Services, shall establish a national task force (in this sec8 tion referred to as the ‘‘Task Force’’) to develop a com9 prehensive national program, including by integrating fa10 cilities, services, and benefits of the Department of Vet11 erans Affairs into existing networks of community-based 

12 intimate partner violence and sexual assault services, to 

13 address intimate partner violence and sexual assault 

14 among veterans. 

15 (c) CONSULTATION WITH STAKEHOLDERS.—In car16 rying out this section, the Task Force shall consult with— 

17 (1) representatives from veteran service organi18 zations and military service organizations; 

19 (2) representatives from not fewer than three 

20 national organizations or State coalitions with dem21 onstrated expertise in intimate partner violence pre22 vention, response, or advocacy; and 

23 (3) representatives from not fewer than three 

24 national organizations or State coalitions, particu25 larly those representing underserved and ethnic miVerDate Sep 11 2014 22:50 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00053 Fmt 6652 Sfmt 6201 E:\BILLS\H3224.RFS H3224

kjohnson on DSK79L0C42 with BILLS
54 

HR 3224 RFS

1 nority communities, with demonstrated expertise in 

2 sexual assault prevention, response, or advocacy. 

3 (d) DUTIES.—The duties of the Task Force shall in4 clude the following: 

5 (1) To review existing services and policies of 

6 the Department and develop a comprehensive na7 tional program to address intimate partner violence 

8 and sexual assault prevention, response, and treat9 ment. 

10 (2) To review the feasibility and advisability of 

11 establishing an expedited process to secure emer12 gency, temporary benefits, including housing or 

13 other benefits, for veterans who are experiencing in14 timate partner violence or sexual assault. 

15 (3) To review and make recommendations re16 garding the feasibility and advisability of estab17 lishing dedicated, temporary housing assistance for 

18 veterans experiencing intimate partner violence or 

19 sexual assault. 

20 (4) To identify any requirements regarding inti21 mate partner violence assistance or sexual assault 

22 response and services that are not being met by the 

23 Department and make recommendations on how the 

24 Department can meet such requirements. 


kjohnson on DSK79L0C42 with BILLS
55 

HR 3224 RFS

1 (5) To review and make recommendations re2 garding the feasibility and advisability of providing 

3 direct services or contracting for community-based 

4 services for veterans in response to a sexual assault, 

5 including through the use of sexual assault nurse ex6 aminers, particularly in underserved or remote 

7 areas, including services for Native American vet8 erans. 

9 (6) To review the availability of counseling serv10 ices provided by the Department and through peer 

11 network support, and to provide recommendations 

12 for the enhancement of such services, to address— 

13 (A) the perpetration of intimate partner vi14 olence and sexual assault; and 

15 (B) the recovery of veterans, particularly 

16 women veterans, from intimate partner violence 

17 and sexual assault. 

18 (7) To review and make recommendations to 

19 expand services available for veterans at risk of per20 petrating intimate partner violence. 

21 (e) REPORT.—Not later than 1 year after the date 

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

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

24 Force shall submit to the Secretary of Veterans Affairs 

25 and Congress a report on the activities of the Task Force, 


kjohnson on DSK79L0C42 with BILLS
56 

HR 3224 RFS

1 including any recommendations for legislative or adminis2 trative action. 

3 (f) DEFINITIONS.—In this section: 

4 (1) The term ‘‘Native American veteran’’ has 

5 the meaning given that term in section 3765 of title 

6 38, United States Code. 

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

8 that term in section 101 of title 38, United States 

9 Code. 

Passed the House of Representatives November 12, 

2019. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


kjohnson on DSK79L0C42 with BILLS