I 

113TH CONGRESS 

1ST SESSION H. R. 958 

To amend title 38, United States Code, to improve the reproductive assistance 

provided by the Department of Veterans Affairs to severely wounded, 

ill, or injured veterans and their spouses, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 5, 2013 

Mr. LARSEN of Washington (for himself, Ms. BONAMICI, Mr. BRADY of Pennsylvania, Ms. BROWNLEY of California, Ms. CHU, Mr. CONYERS, Mrs. 

DAVIS of California, Ms. DELBENE, Ms. HANABUSA, Mr. HECK of Washington, Ms. MCCOLLUM, Mrs. NAPOLITANO, Ms. NORTON, Ms. SLAUGHTER, Mr. STIVERS, and Ms. WASSERMAN SCHULTZ) introduced the following bill; which was referred to the Committee on Veterans’ Affairs, 

and in addition to the Committees on the Budget and Armed Services, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To amend title 38, United States Code, to improve the 

reproductive assistance provided by the Department of 

Veterans Affairs to severely wounded, ill, or injured veterans and their spouses, and for other purposes. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Women Veterans and 

3 Other Health Care Improvements Act of 2013’’. 

4 SEC. 2. CLARIFICATION THAT FERTILITY COUNSELING AND 

5 TREATMENT ARE MEDICAL SERVICES WHICH 

6 THE SECRETARY MAY FURNISH TO VET7 ERANS LIKE OTHER MEDICAL SERVICES. 

8 Section 1701(6) of title 38, United States Code, is 

9 amended by adding at the end the following new subpara10 graph: 

11 ‘‘(H) Fertility counseling and treatment, includ12 ing treatment using assisted reproductive technology 

13 such as in vitro fertilization and other fertility treat14 ments in which both eggs and sperm are handled 

15 when clinically appropriate.’’. 

16 SEC. 3. REPRODUCTIVE TREATMENT AND CARE FOR 

17 SPOUSES AND SURROGATES OF VETERANS. 

18 (a) IN GENERAL.—Subchapter VIII of chapter 17 of 

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

20 end the following new section: 

21 ‘‘§ 1788. Reproductive treatment and care for spouses 

22 and surrogates of veterans 

23 ‘‘(a) IN GENERAL.—The Secretary shall furnish fer24 tility counseling and treatment, including through the use 

25 of assisted reproductive technology, to a spouse or surro26 gate of a severely wounded, ill, or injured veteran who has 


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1 an infertility condition incurred or aggravated in line of 

2 duty in the active military, naval, or air service and who 

3 is enrolled in the system of annual patient enrollment es4 tablished under section 1705(a) of this title if the spouse 

5 or surrogate and the veteran apply jointly for such coun6 seling and treatment through a process prescribed by the 

7 Secretary. 

8 ‘‘(b) COORDINATION OF CARE FOR OTHER SPOUSES

9 AND SURROGATES.—In the case of a spouse or surrogate 

10 of a veteran not described in subsection (a) who is seeking 

11 fertility counseling and treatment, the Secretary may co12 ordinate fertility counseling and treatment for such spouse 

13 or surrogate. 

14 ‘‘(c) CONSTRUCTION.—Nothing in this section shall 

15 be construed to require the Secretary— 

16 ‘‘(1) to find or certify a surrogate for a veteran 

17 or to connect a surrogate with a veteran; or 

18 ‘‘(2) to furnish maternity care to a spouse or 

19 surrogate of a veteran. 

20 ‘‘(d) ASSISTED REPRODUCTIVE TECHNOLOGY DE21 FINED.—In this section, the term ‘assisted reproductive 

22 technology’ includes in vitro fertilization and other fertility 

23 treatments in which both eggs and sperm are handled 

24 when clinically appropriate.’’. 


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

2 at the beginning of chapter 17 of such title is amended 

3 by inserting after the item relating to section 1787 the 

4 following new item: 

‘‘1788. Reproductive treatment and care for spouses and surrogates of veterans.’’. 

5 SEC. 4. ADOPTION ASSISTANCE FOR SEVERELY WOUNDED 

6 VETERANS. 

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

8 title 38, United States Code, as amended by section 3, 

9 is further amended by adding at the end the following new 

10 section: 

11 ‘‘§ 1789. Adoption assistance 

12 ‘‘(a) IN GENERAL.—The Secretary may pay an 

13 amount, not to exceed the limitation amount, to assist a 

14 covered veteran in the adoption of one or more children. 

15 ‘‘(b) COVERED VETERAN.—For purposes of this sec16 tion, a covered veteran is any severely wounded, ill, or in17 jured veteran who— 

18 ‘‘(1) has an infertility condition incurred or ag19 gravated in line of duty in the active military, naval, 

20 or air service; and 

21 ‘‘(2) is enrolled in the system of annual patient 

22 enrollment established under section 1705(a) of this 

23 title. 


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1 ‘‘(c) LIMITATION AMOUNT.—For purposes of this 

2 section, the limitation amount is the amount equal to the 

3 lesser of— 

4 ‘‘(1) the cost the Department would incur if the 

5 Secretary were to provide a covered veteran with one 

6 cycle of in vitro fertilization, as determined by the 

7 Secretary; and 

8 ‘‘(2) the cost the Department would incur by 

9 paying the expenses of three adoptions by covered 

10 veterans, as determined by the Secretary.’’. 

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

12 at the beginning of chapter 17 of such title, as amended 

13 by section 3, is further amended by inserting after the 

14 item relating to section 1788 the following new item: 

‘‘1789. Adoption assistance.’’. 

15 SEC. 5. ANNUAL REPORT ON PROVISION OF FERTILITY 

16 COUNSELING AND TREATMENT FURNISHED 

17 BY DEPARTMENT OF VETERANS AFFAIRS. 

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

19 date of the enactment of this Act and not less frequently 

20 than once each year thereafter, the Secretary of Veterans 

21 Affairs shall submit to the Committee on Veterans’ Affairs 

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

23 the House of Representatives a report on the fertility 

24 counseling and treatment furnished by the Department of 


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1 Veterans Affairs during the year preceding the submittal 

2 of the report. 

3 (b) ELEMENTS.—Each report submitted under sub4 section (a) shall include, for the period covered by the re5 port, the following: 

6 (1) The number of veterans who received fer7 tility counseling or treatment furnished by the De8 partment of Veterans Affairs, disaggregated by era 

9 of military service of such veterans. 

10 (2) The number of spouses and surrogates of 

11 veterans who received fertility counseling or treat12 ment furnished by the Department. 

13 (3) The cost to the Department of furnishing 

14 fertility counseling and treatment, disaggregated by 

15 cost of services and administration. 

16 (4) The average cost to the Department per re17 cipient of such counseling and treatment. 

18 (5) In cases in which the Department furnished 

19 fertility treatment through the use of assisted repro20 ductive technology, the average number of cycles per 

21 person furnished. 

22 (6) A description of how fertility counseling and 

23 treatment services of the Department are coordi24 nated with similar services of the Department of De25 fense. 


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1 SEC. 6. REGULATIONS ON FURNISHING OF FERTILITY 

2 COUNSELING AND TREATMENT AND ADOP3 TION ASSISTANCE BY DEPARTMENT OF VET4 ERANS AFFAIRS. 

5 (a) IN GENERAL.—Not later than 540 days after the 

6 date of the enactment of this Act, the Secretary of Vet7 erans Affairs shall prescribe regulations— 

8 (1) on the furnishing of fertility treatment to 

9 veterans using assisted reproductive technology; 

10 (2) to carry out section 1788 of title 38, United 

11 States Code, as added by section 3; and 

12 (3) to carry out section 1789 of such title, as 

13 added by section 4. 

14 (b) LIMITATION.—Notwithstanding any other provi15 sion of law, during the period beginning on the date of 

16 the enactment of this Act and ending on the date on which 

17 the Secretary prescribes regulations under subsection (a), 

18 the Secretary may not furnish— 

19 (1) to a veteran any fertility treatment that 

20 uses an assisted reproductive technology that the 

21 Secretary has not used in the provision of a fertility 

22 treatment to a veteran before the date of the enact23 ment of this Act; 

24 (2) any fertility counseling or treatment under 

25 section 1788 of title 38, United States Code, as 

26 added by section 3; or 


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1 (3) any assistance under section 1789 of such 

2 title, as added by section 4. 

3 (c) ASSISTED REPRODUCTIVE TECHNOLOGY DE4 FINED.—In this section, the term ‘‘assisted reproductive 

5 technology’’ has the meaning given the term in section 

6 1788 of such title, as added by section 3. 

7 SEC. 7. COORDINATION BETWEEN DEPARTMENT OF VET8 ERANS AFFAIRS AND DEPARTMENT OF DE9 FENSE ON FURNISHING OF FERTILITY COUN10 SELING AND TREATMENT. 

11 The Secretary of Veterans Affairs and the Secretary 

12 of Defense shall share best practices and facilitate refer13 rals, as they consider appropriate, on the furnishing of fer14 tility counseling and treatment. 

15 SEC. 8. FACILITATION OF REPRODUCTION AND INFER16 TILITY RESEARCH. 

17 (a) IN GENERAL.—Subchapter II of chapter 73 of 

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

19 end the following new section: 

20 ‘‘§ 7330B. Facilitation of reproduction and infertility 

21 research 

22 ‘‘(a) FACILITATION OF RESEARCH REQUIRED.—The 

23 Secretary shall facilitate research conducted collabo24 ratively by the Secretary of Defense and the Secretary of 

25 Health and Human Services to improve the ability of the 


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1 Department of Veterans Affairs to meet the long-term re2 productive health care needs of veterans who have a geni3 tourinary service-connected disability or a condition that 

4 was incurred or aggravated in line of duty in the active 

5 military, naval, or air service, such as spinal cord injury, 

6 that affects the veterans’ ability to reproduce. 

7 ‘‘(b) DISSEMINATION OF INFORMATION.—The Sec8 retary shall ensure that information produced by the re9 search facilitated under this section that may be useful 

10 for other activities of the Veterans Health Administration 

11 is disseminated throughout the Veterans Health Adminis12 tration.’’. 

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

14 at the beginning of chapter 73 of such title is amended 

15 by inserting after the item relating to section 7330A the 

16 following new item: 

‘‘7330B. Facilitation of reproduction and infertility research.’’. 

17 (c) REPORT.—Not later than three years after the 

18 date of the enactment of this Act, the Secretary of Vet19 erans Affairs shall submit to Congress a report on the re20 search activities conducted by the Secretary under section 

21 7330B of title 38, United States Code, as added by sub22 section (a). 


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1 SEC. 9. REQUIREMENT TO IMPROVE DEPARTMENT OF VET2 ERANS AFFAIRS WOMEN VETERANS CONTACT 

3 CENTER. 

4 The Secretary of Veterans Affairs shall enhance the 

5 capabilities of the Department of Veterans Affairs women 

6 veterans contact center— 

7 (1) to respond to requests by women veterans 

8 for assistance with accessing health care and bene9 fits furnished under laws administered by the Sec10 retary; and 

11 (2) for referral of such veterans to community 

12 resources to obtain assistance with services not fur13 nished by the Department. 

14 SEC. 10. MODIFICATION OF PILOT PROGRAM ON COUN15 SELING IN RETREAT SETTINGS FOR WOMEN 

16 VETERANS NEWLY SEPARATED FROM SERV17 ICE IN THE ARMED FORCES. 

18 (a) INCREASE IN NUMBER OF LOCATIONS.—Sub19 section (c) of section 203 of the Caregivers and Veterans 

20 Omnibus Health Services Act of 2010 (Public Law 111– 

21 163; 38 U.S.C. 1712A note) is amended by striking ‘‘three 

22 locations’’ and inserting ‘‘14 locations’’. 

23 (b) EXTENSION OF DURATION.—Subsection (d) of 

24 such section is amended by striking ‘‘2-year’’ and insert25 ing ‘‘four-year’’. 


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1 (c) AUTHORIZATION OF APPROPRIATIONS.—Sub2 section (f) of such section is amended— 

3 (1) by striking ‘‘Secretary of Veterans Affairs 

4 for each’’ and inserting the following: ‘‘Secretary of 

5 Veterans Affairs— 

6 ‘‘(1) for each’’; 

7 (2) in paragraph (1), as designated by para8 graph (1), by striking the period at the end and in9 serting ‘‘; and’’; and 

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

11 paragraph: 

12 ‘‘(2) for each of fiscal years 2013 and 2014, 

13 $400,000 to carry out the pilot program.’’. 

14 SEC. 11. PROGRAM ON ASSISTANCE FOR CHILD CARE FOR 

15 CERTAIN VETERANS. 

16 (a) ASSISTANCE FOR CHILD CARE FOR CERTAIN

17 VETERANS RECEIVING HEALTH CARE.— 

18 (1) IN GENERAL.—Subchapter I of chapter 17 

19 of title 38, United States Code, is amended by add20 ing at the end the following new section: 

21 ‘‘§ 1709B. Assistance for child care for certain vet22 erans receiving health care 

23 ‘‘(a) PROGRAM REQUIRED.—The Secretary shall 

24 carry out a program to provide, subject to subsection (b), 

25 assistance to qualified veterans described in subsection (c) 


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1 to obtain child care so that such veterans can receive 

2 health care services described in subsection (c). 

3 ‘‘(b) LIMITATION ON PERIOD OF PAYMENTS.—As4 sistance may only be provided to a qualified veteran under 

5 this section for receipt of child care during the period that 

6 the qualified veteran— 

7 ‘‘(1) receives the types of health care services 

8 described in subsection (c) at a facility of the De9 partment; and 

10 ‘‘(2) requires travel to and return from such fa11 cility for the receipt of such health care services. 

12 ‘‘(c) QUALIFIED VETERANS.—For purposes of this 

13 section, a qualified veteran is a veteran who is— 

14 ‘‘(1) the primary caretaker of a child or chil15 dren; and 

16 ‘‘(2)(A) receiving from the Department— 

17 ‘‘(i) regular mental health care services; 

18 ‘‘(ii) intensive mental health care services; 

19 or 

20 ‘‘(iii) such other intensive health care serv21 ices that the Secretary determines that provi22 sion of assistance to the veteran to obtain child 

23 care would improve access to such health care 

24 services by the veteran; or 


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1 ‘‘(B) in need of regular or intensive mental 

2 health care services from the Department, and but 

3 for lack of child care services, would receive such 

4 health care services from the Department. 

5 ‘‘(d) LOCATIONS.—The Secretary shall carry out the 

6 program in no fewer than three Veterans Integrated Serv7 ice Networks selected by the Secretary for purposes of the 

8 program. 

9 ‘‘(e) FORMS OF CHILD CARE ASSISTANCE.—(1) 

10 Child care assistance under this section may include the 

11 following: 

12 ‘‘(A) Stipends for the payment of child care of13 fered by licensed child care centers (either directly 

14 or through a voucher program) which shall be, to 

15 the extent practicable, modeled after the Depart16 ment of Veterans Affairs Child Care Subsidy Pro17 gram established pursuant to section 630 of the 

18 Treasury and General Government Appropriations 

19 Act, 2002 (Public Law 107–67; 115 Stat. 552). 

20 ‘‘(B) Direct provision of child care at an on-site 

21 facility of the Department of Veterans Affairs. 

22 ‘‘(C) Payments to private child care agencies. 

23 ‘‘(D) Collaboration with facilities or programs 

24 of other Federal departments or agencies. 


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1 ‘‘(E) Such other forms of assistance as the Sec2 retary considers appropriate. 

3 ‘‘(2) In the case that child care assistance under this 

4 section is provided as a stipend under paragraph (1)(A), 

5 such stipend shall cover the full cost of such child care.’’. 

6 (2) CONFORMING AMENDMENT.—Section 

7 205(e) of the Caregivers and Veterans Omnibus 

8 Health Services Act of 2010 (Public Law 111–163; 

9 38 U.S.C. 1710 note) is amended by inserting ‘‘but 

10 not after the date of the enactment of the Women 

11 Veterans and Other Health Care Improvements Act 

12 of 2013’’ before the period at the end. 

13 (3) CLERICAL AMENDMENT.—The table of sec14 tions at the beginning of such chapter is amended 

15 by inserting after the item relating to section 1709A 

16 the following new item: 

‘‘1709B. Assistance for child care for certain veterans receiving health care.’’. 

17 (b) ASSISTANCE FOR CHILD CARE FOR CERTAIN

18 VETERANS RECEIVING READJUSTMENT COUNSELING

19 AND RELATED MENTAL HEALTH SERVICES.— 

20 (1) IN GENERAL.—Subchapter I of chapter 17 

21 of such title, as amended by subsection (a)(1), is 

22 further amended by adding at the end the following 

23 new section: 


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1 ‘‘§ 1709C. Assistance for child care for certain vet2 erans receiving readjustment counseling 

3 and related mental health services 

4 ‘‘(a) PROGRAM REQUIRED.—The Secretary shall 

5 carry out a program to provide, subject to subsection (b), 

6 assistance to qualified veterans described in subsection (c) 

7 to obtain child care so that such veterans can receive read8 justment counseling and related mental health services. 

9 ‘‘(b) LIMITATION ON PERIOD OF PAYMENTS.—As10 sistance may only be provided to a qualified veteran under 

11 this section for receipt of child care during the period that 

12 the qualified veteran receives readjustment counseling and 

13 related health care services at a Vet Center. 

14 ‘‘(c) QUALIFIED VETERANS.—For purposes of this 

15 section, a qualified veteran is a veteran who is— 

16 ‘‘(1) the primary caretaker of a child; and 

17 ‘‘(2)(A) receiving from the Department regular 

18 readjustment counseling and related mental health 

19 services; or 

20 ‘‘(B) in need of readjustment counseling and 

21 related mental health services from the Department, 

22 and but for lack of child care services, would receive 

23 such counseling and services from the Department. 

24 ‘‘(d) LOCATIONS.—The Secretary shall carry out the 

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1 justment Counseling Service Regions selected by the Sec2 retary for purposes of the program. 

3 ‘‘(e) FORMS OF CHILD CARE ASSISTANCE.—(1) 

4 Child care assistance under this section may include the 

5 following: 

6 ‘‘(A) Stipends for the payment of child care of7 fered by licensed child care centers (either directly 

8 or through a voucher program) which shall be, to 

9 the extent practicable, modeled after the Depart10 ment of Veterans Affairs Child Care Subsidy Pro11 gram established pursuant to section 630 of the 

12 Treasury and General Government Appropriations 

13 Act, 2002 (Public Law 107–67; 115 Stat. 552). 

14 ‘‘(B) Payments to private child care agencies. 

15 ‘‘(C) Collaboration with facilities or programs 

16 of other Federal departments or agencies. 

17 ‘‘(D) Such other forms of assistance as the Sec18 retary considers appropriate. 

19 ‘‘(2) In the case that child care assistance under this 

20 subsection is provided as a stipend under paragraph 

21 (1)(A), such stipend shall cover the full cost of such child 

22 care. 

23 ‘‘(f) VET CENTER DEFINED.—In this section, the 

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1 seling and related mental health services for veterans 

2 under section 1712A of this title.’’. 

3 (2) CLERICAL AMENDMENT.—The table of sec4 tions at the beginning of such chapter, as amended 

5 by subsection (a)(3), is further amended by inserting 

6 after the item relating to section 1709B the fol7 lowing new item: 

‘‘1709C. Assistance for child care for certain veterans receiving readjustment 

counseling and related mental health services.’’. 

8 SEC. 12. CONTRACTOR USER FEES. 

9 (a) IN GENERAL.—Chapter 3 of title 38, United 

10 States Code, is amended by adding at the end the fol11 lowing new section: 

12 ‘‘§ 323. Contractor user fees 

13 ‘‘(a) FEE REQUIREMENT.—Except as provided in 

14 subsection (c) and subject to subsection (d), the Secretary 

15 shall impose a fee upon each person with whom the Sec16 retary engages in a contract for a good or service as a 

17 condition of the contract. 

18 ‘‘(b) FEE AMOUNT.—(1) The amount of a fee im19 posed upon a person under subsection (a) with respect to 

20 a contract shall be equal to the lesser of— 

21 ‘‘(A) the amount which is equal to seven per22 cent of the total value of the contract; and 


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1 ‘‘(B) the amount which is equal to the total 

2 value of the contract multiplied by the applicable 

3 percentage for such fiscal year. 

4 ‘‘(2) The applicable percentage for a fiscal year shall 

5 be equal to the percentage by which— 

6 ‘‘(A) the annual estimate of the total value of 

7 contracts for such fiscal year, exceeds 

8 ‘‘(B) the annual estimate of the total cost of 

9 fertility counseling and treatment for such fiscal 

10 year. 

11 ‘‘(3) Before each fiscal year, the Secretary shall es12 tablish, for purposes of this section, the annual estimate 

13 of the total value of contracts for the next fiscal year, 

14 which shall be the Secretary’s estimate of what the aggre15 gate value will be of all contracts in which the Secretary 

16 will engage in the next fiscal year. 

17 ‘‘(4) Before each fiscal year, the Secretary shall es18 tablish, for purposes of this section, the annual estimate 

19 of the total cost of fertility counseling and treatment for 

20 the next fiscal year, which shall be the Secretary’s esti21 mate of what the total cost to the Department will be in 

22 the next fiscal year of— 

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1 ductive technology, to individuals under laws admin2 istered by the Secretary in the next fiscal year; and 

3 ‘‘(B) making payments under section 1789 of 

4 this title in the next fiscal year. 

5 ‘‘(c) WAIVER.—The Secretary may waive the fee re6 quired by subsection (a) for a person as the Secretary con7 siders appropriate if the person is an individual or a small 

8 business concern. 

9 ‘‘(d) LIMITATION ON COLLECTION.—No fee may be 

10 collected under subsection (a) except to the extent that 

11 the expenditure of the fee to pay the costs of activities 

12 and services for which the fee is imposed is provided for 

13 in advance in an appropriations Act. 

14 ‘‘(e) DEPARTMENT OF VETERANS AFFAIRS FER15 TILITY COUNSELING AND TREATMENT FUND.—(1) There 

16 is in the Treasury a fund to be known as the Department 

17 of Veterans Affairs Fertility Counseling and Treatment 

18 Fund. 

19 ‘‘(2) All amounts received by the Secretary under 

20 subsection (a) shall be deposited in the fund. 

21 ‘‘(3)(A) Subject to the provisions of appropriations 

22 Acts, amounts in the fund shall be available, without fiscal 

23 year limitation, to the Secretary for the following pur24 poses: 


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1 ‘‘(i) To furnish fertility counseling and treat2 ment, including through the use of assisted repro3 ductive technology, to individuals under laws admin4 istered by the Secretary. 

5 ‘‘(ii) To make payments under section 1789 of 

6 this title. 

7 ‘‘(B) Amounts available under subparagraph (A) may 

8 not be used for any purposes other than a purpose set 

9 forth in clause (i) or (ii) of that subparagraph. 

10 ‘‘(4) Amounts received by the Secretary under sub11 section (a) shall be treated for the purposes of sections 

12 251 and 252 of the Balanced Budget and Emergency Def13 icit Control Act of 1985 (2 U.S.C. 901, 902) as offsets 

14 to discretionary appropriations (rather than as offsets to 

15 direct spending) to the extent that such amounts are made 

16 available for expenditure in appropriations Acts for the 

17 purposes specified in paragraph (3) of this subsection. 

18 ‘‘(f) SMALL BUSINESS CONCERN DEFINED.—In this 

19 section, the term ‘small business concern’ has the meaning 

20 given such term under section 3 of the Small Business 

21 Act (15 U.S.C. 632).’’. 

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

23 at the beginning of chapter 3 of such title is amended by 


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1 adding after the item relating to section 322 the following 

2 new item: 

‘‘323. Contractor user fees.’’. 

Æ 


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