IB 
Union Calendar No. 226 
116TH CONGRESS 
1ST SESSION H. R. 3224 
[Report No. 116–281] 
To amend title 38, United States Code, to provide for increased access 
to Department of Veterans Affairs medical care for women veterans. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 12, 2019 
Ms. BROWNLEY of California introduced the following bill; which was referred 
to the Committee on Veterans’ Affairs 
NOVEMBER 12, 2019 
Additional sponsors: Mr. AGUILAR, Ms. WILD, Ms. ROYBAL-ALLARD, Ms. 
KUSTER of New Hampshire, Mr. GONZALEZ of Texas, Mrs. HAYES, Mr. 
CISNEROS, Mr. PAPPAS, Mr. ROSE of New York, Ms. MENG, Ms. 
GABBARD, Ms. VELA´ZQUEZ, Mrs. WATSON COLEMAN, Ms. SPEIER, Mr. 
TAKANO, Ms. MOORE, Mr. CUELLAR, Mr. RUSH, Mr. RYAN, Ms. NOR-
TON, Mr. SABLAN, Mr. RUIZ, Ms. CASTOR of Florida, Mrs. RADEWAGEN, 
Mr. VISCLOSKY, Mr. CORREA, Mrs. LEE of Nevada, Ms. SCANLON, Mr. 
PETERSON, Mr. DELGADO, Mr. LEVIN of California, Mr. CICILLINE, Mr. 
LAMB, Ms. HAALAND, Mr. BEYER, and Ms. HOULAHAN 
NOVEMBER 12, 2019 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on June 12, 2019] 
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A BILL 
To amend title 38, United States Code, to provide for in-
creased access to Department of Veterans Affairs med-
ical care for women veterans. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Deborah Sampson Act’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
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 pro-
vide 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 De-
partment 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 train-
ing 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 Depart-
ment of Veterans Affairs. 
Sec. 305. Report regarding veterans who receive benefits under laws administered 
by the Secretary of Veterans Affairs. 
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Sec. 306. Study on Women Veteran Coordinator program. 
Subtitle B—Other Matters 
Sec. 321. Anti-harassment and anti-sexual assault policy of the Department of 
Veterans Affairs. 
Sec. 322. Support for organizations that have a focus on providing assistance to 
women veterans and their families. 
Sec. 323. Gap analysis of Department of Veterans Affairs programs that provide 
assistance to women veterans who are homeless. 
Sec. 324. Department of Veterans Affairs public-private partnership on legal serv-
ices 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. 
TITLE I—VETERANS HEALTH 
ADMINISTRATION 
SEC. 101. OFFICE OF WOMEN’S HEALTH IN THE DEPART-
MENT OF VETERANS AFFAIRS. 
(a) DIRECTOR OF WOMEN’S HEALTH.—Subsection (a) 
of section 7306 of title 38, United States Code, is amend-
ed— 
(1) by redesignating paragraph (10) as para-
graph (11); and 
(2) by inserting after paragraph (9) the fol-
lowing new paragraph: 
‘‘(10) The Director of Women’s Health.’’. 
(b) ORGANIZATION OF OFFICE.— 
(1) IN GENERAL.—Subchapter I of chapter 73 of 
title 38, United States Code, is amended by adding 
at the end of the following new sections: 
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‘‘§ 7310. Office of Women’s Health 
‘‘(a) ESTABLISHMENT.—(1) The Under Secretary for 
Health shall establish and operate in the Veterans Health 
Administration the Office of Women’s Health (hereinafter 
in this section referred to as the ‘Office’). The Office shall 
be located at the Central Office of the Department of Vet-
erans Affairs. 
‘‘(2) The head of the Office is the Director of Women’s 
Health (hereinafter in this section referred to as the ‘Direc-
tor’). The Director shall report to the Under Secretary for 
Health. 
‘‘(3) The Under Secretary for Health shall provide the 
Office with such staff and other support as may be nec-
essary for the Office to carry out effectively its functions 
under this section. 
‘‘(4) The Under Secretary for Health may reorganize 
existing offices within the Veterans Health Administration 
as of the date of the enactment of this section in order to 
avoid duplication with the functions of the Office. 
‘‘(b) PURPOSE.—The functions of the Office include the 
following: 
‘‘(1) To provide a central office for monitoring 
and encouraging the activities of the Veterans Health 
Administration with respect to the provision, evalua-
tion, and improvement of women veterans’ health care 
services in the Department. 
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‘‘(2) To develop and implement standards of care 
for the provision of health care for women veterans in 
the Department. 
‘‘(3) To monitor and identify deficiencies in 
standards of care for the provision of health care for 
women veterans in the Department, to provide tech-
nical assistance to medical facilities of the Depart-
ment to address and remedy deficiencies, and to per-
form oversight of implementation of standards of care 
for women veterans’ health care in the Department. 
‘‘(4) To monitor and identify deficiencies in 
standards of care for the provision of health care for 
women veterans provided through the community 
pursuant to this title, and to provide recommenda-
tions to the appropriate office to address and remedy 
any deficiencies. 
‘‘(5) To oversee distribution of resources and in-
formation related to women veterans’ health program-
ming under this title. 
‘‘(6) To promote the expansion and improvement 
of clinical, research, and educational activities of the 
Veterans Health Administration with respect the 
health care of women veterans. 
‘‘(7) To provide, as part of the annual budgeting 
process, recommendations with respect to the amount 
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of funds to be requested for furnishing hospital care 
and medical services to women veterans pursuant to 
chapter 17 of this title, including, at a minimum, 
recommendations that ensure that such amount of 
funds either reflect or exceed the proportion of vet-
erans enrolled in the patient enrollment system under 
section 1705 of this title who are women. 
‘‘(8) To provide recommendations to the Under 
Secretary for Health with respect to modifying the 
Veterans Equitable Resource Allocation system to en-
sure that resource allocations under such system re-
flect the health care needs of women veterans. 
‘‘(9) To carry out such other duties as the Under 
Secretary for Health may require. 
‘‘(c) RECOMMENDATIONS.—If the Under Secretary for 
Health determines not to implement any recommendation 
made by the Director with respect to the allocation of re-
sources to address the health care needs of women veterans, 
the Secretary shall notify the appropriate congressional 
committees of such determination by not later than 30 days 
after the date on which the Under Secretary for Health re-
ceives the recommendation. Each such notification shall in-
clude the following: 
‘‘(1) The reasoning of the Under Secretary for 
Health in making such determination. 
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‘‘(2) An alternative, if one is selected, to such 
recommendation that the Under Secretary for Health 
will carry out to fulfill the health care needs of 
women veterans. 
‘‘(d) STANDARDS OF CARE.—In this section, the stand-
ards of care for the provision of health care for women vet-
erans in the Department shall include, at a minimum, the 
following: 
‘‘(1) Requirement for— 
‘‘(A) at least one designated women’s health 
primary care provider at each medical center 
whose duties include, to the extent practicable, 
providing training to other health care providers 
of the Department with respect to the needs of 
women veterans; and 
‘‘(B) at least one designated women’s health 
primary care provider at each community-based 
outpatient clinic of the Department who may 
serve female patients as a percentage of the total 
duties of the provider. 
‘‘(2) Other requirements as determined by the 
Under Secretary for Health. 
‘‘(e) OUTREACH.—The Director shall ensure that— 
‘‘(1) not less frequently than biannually, each 
medical facility of the Department holds a public 
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forum for women veterans that occurs outside of reg-
ular business hours; and 
‘‘(2) not less frequently than quarterly, each 
medical facility of the Department convenes a focus 
group of women veterans that includes a discussion of 
harassment occurring at such facility. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘appropriate congressional com-
mittees’ has the meaning given that term in section 
7310A of this title. 
‘‘(2) The term ‘facility of the Department’ has 
the meaning given the term in section 1701(3). 
‘‘(3) The term ‘Veterans Equitable Resource Allo-
cation system’ means the resource allocation system 
established pursuant to section 429 of the Depart-
ments of Veterans Affairs and Housing and Urban 
Development, and Independent Agencies Appropria-
tions Act, 1997 (Public Law 104–204; 110 Stat. 
2929). 
‘‘§ 7310A. Annual reports on women’s health 
‘‘(a) ANNUAL REPORTS.—Not later than December 1 
of each year, the Director of Women’s Health shall submit 
to the appropriate congressional committees a report con-
taining the matters under subsections (b) through (g). 
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‘‘(b) OFFICE
OF WOMEN’S HEALTH.—Each report 
under subsection (a) shall include a description of— 
‘‘(1) actions taken by the Office of Women’s 
Health in the preceding fiscal year to improve the De-
partment’s provision of health care to women vet-
erans; 
‘‘(2) any identified deficiencies related to the De-
partment’s provision of health care to women veterans 
and the standards of care established in section 7310 
of this title, and the Department’s plan to address 
such deficiencies; 
‘‘(3) the funding and personnel provided to the 
Office and whether additional funding or personnel 
are needed to meet the requirements of such section; 
and 
‘‘(4) other information that would be of interest 
to the appropriate congressional committees with re-
spect to oversight of the Department’s provision of 
health care to women veterans. 
‘‘(c) ACCESS TO GENDER-SPECIFIC SERVICES.—Each 
report under subsection (a) shall include an analysis of the 
access of women veterans to gender-specific services under 
contracts, agreements, or other arrangements with non-De-
partment medical providers entered into by the Secretary 
for the provision of hospital care or medical services to vet-
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