II 116th CONGRESS 1st Session S. 514 IN THE SENATE OF THE UNITED STATES February 14, 2019 Mr. Tester (for himself, Mr. Boozman , Mrs. Capito , Mrs. Blackburn , Ms. Stabenow , Mr. Schatz , Ms. Sinema , Ms. Warren , Mr. Menendez , Ms. Hassan , Mr. Reed , Mr. Whitehouse , Ms. Baldwin , Ms. Duckworth , Mr. Blumenthal , Mrs. Shaheen , Mrs. Murray , Ms. Cortez Masto , Mr. Van Hollen , Ms. Harris , Mrs. Gillibrand , Mr. Merkley , Mr. Booker , Mr. Casey , Mr. Brown , Mr. Peters , and Mrs. Feinstein ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to improve the benefits and services provided by the Department of Veterans Affairs to women veterans, and for other purposes.

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—Readjustment and Related Assistance Sec. 101. Provision of reintegration and readjustment services to veterans and family members in group retreat settings. Sec. 102. Expansion of capabilities of Women Veterans Call Center to include text messaging. TITLE II—Legal and Supportive Services Sec. 201. Department of Veterans Affairs public-private partnership on legal services for women veterans. Sec. 202. Additional amount for Supportive Services for Veteran Families grant program to support organizations that have a focus on providing assistance to women veterans and their families. Sec. 203. Gap analysis of Department of Veterans Affairs programs that provide assistance to women veterans who are homeless. TITLE III—Newborn Care Sec. 301. Extension of period of eligibility for care for newborn children from the Department of Veterans Affairs. TITLE IV—Eliminating Barriers to Access Sec. 401. Women Veterans Retrofit Initiative. Sec. 402. Staffing of women's health primary care providers at medical facilities of the Department of Veterans Affairs. Sec. 403. Additional funding for primary care and emergency care clinicians in Women Veterans Health Care Mini-Residency Program. Sec. 404. Establishment of women veteran training module for non-Department of Veterans Affairs health care providers. Sec. 405. Study on staffing of Women Veteran Program Manager program at medical centers of the Department of Veterans Affairs and training of staff. TITLE V—Data Collection and Reporting Sec. 501. Requirement for collection and analysis of data on Department of Veterans Affairs benefits and services and disaggregation of such data by sex and minority status. Sec. 502. Report on availability of prosthetics for women veterans from the Department of Veterans Affairs. Sec. 503. Requirement for Department of Veterans Affairs internet website to provide information on services available to women veterans. Sec. 504. Report on locations where women veterans are using health care from Department of Veterans Affairs. Sec. 505. Report on models of medical facilities of Department of Veterans Affairs for the treatment of women. Sec. 506. Report on staffing of Department of Veterans relating to the treatment of women. I Readjustment and related assistance 101. Provision of reintegration and readjustment services to veterans and family members in group retreat settings (a) In general Section 1712A of title 38, United States Code, is amended— (1) in subsection (a)(1)(B)— (A) in clause (ii), by redesignating subclauses (I) and (II) as items (aa) and (bb); (B) by redesignating clauses (i) and (ii) as subclauses (I) and (II); (C) in the matter preceding subclause (I), as redesignated by subparagraph (B), by striking Counseling and inserting (i) Counseling ; and (D) by adding at the end the following new clause: (ii) (I) Except as provided in subclause (IV), counseling furnished to an individual under subparagraph (A) may include reintegration and readjustment services described in subclause (II) furnished in group retreat settings. (II) Reintegration and readjustment services described in this subclause are the following: (aa) Information on reintegration of the individual into family, employment, and community. (bb) Financial counseling. (cc) Occupational counseling. (dd) Information and counseling on stress reduction. (ee) Information and counseling on conflict resolution. (ff) Such other information and counseling as the Secretary considers appropriate to assist the individual in reintegration into family, employment, and community. (III) In furnishing reintegration and readjustment services under subclause (I), the Secretary shall offer women the opportunity to receive such services in group retreat settings in which the only participants are women. (IV) An individual referred to in subparagraph (C)(v) may receive reintegration and readjustment services under subclause (I) only if the individual receives such services with a family member described in subclause (I) or (II) of such subparagraph. . (b) Request for services Subsection (a)(2) of such section is amended— (1) by striking Upon and inserting (A) Upon ; (2) by striking paragraph (1)(B) and inserting paragraph (1)(B)(i) ; and (3) by adding at the end the following new subparagraph: (B) Upon the request of an individual described in paragraph (1)(C), the Secretary shall furnish the individual reintegration and readjustment services in group retreat settings under paragraph (1)(B)(ii). . 102. Expansion of capabilities of Women Veterans Call Center to include text messaging The Secretary of Veterans Affairs shall expand the capabilities of the Women Veterans Call Center of the Department of Veterans Affairs to include a text messaging capability. II Legal and supportive services 201. Department of Veterans Affairs public-private partnership on legal services for women veterans (a) Partnership required The Secretary of Veterans Affairs shall establish a partnership with at least one nongovernmental organization to provide legal services to women veterans. (b) Focus The focus of the partnership established under subsection (a) shall be on the 10 highest unmet needs of women veterans as set forth in the most recently completed Community Homelessness Assessment, Local Education and Networking Groups for Veterans (CHALENG for Veterans) survey. 202. Additional amount for Supportive Services for Veteran Families grant program to support organizations that have a focus on providing assistance to women veterans and their families Section 2044(e) of title 38, United States Code, is amended— (1) in paragraph (1), by adding at the end the following new subparagraph: (F) $400,000,000 for each of fiscal years 2020 through 2022. ; and (2) by adding at the end the following new paragraph: (4) Not less than $20,000,000 shall be available under paragraph (1)(H) for the provision of financial assistance under subsection (a) to organizations that have a focus on providing assistance to women veterans and their families. . 203. Gap analysis of Department of Veterans Affairs programs that provide assistance to women veterans who are homeless (a) In general The Secretary of Veterans Affairs shall complete an analysis of programs of the Department of Veterans Affairs that provide assistance to women veterans who are homeless or precariously housed to identify the areas in which such programs are failing to meet the needs of such women. (b) Report Not later than 270 days after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the analysis completed under subsection (a). III Newborn care 301. Extension of period of eligibility for care for newborn children from the Department of Veterans Affairs Section 1786(a) of title 38, United States Code, is amended, in the matter preceding paragraph (1), by striking seven days and inserting 14 days . IV Eliminating barriers to access 401. Women Veterans Retrofit Initiative (a) In general The Secretary of Veterans Affairs shall retrofit existing medical facilities of the Department of Veterans Affairs with fixtures, materials, and other outfitting measures to support the provision of care to women veterans at such facilities. (b) Plan Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a plan to address deficiencies in environment of care for women veterans at medical facilities of the Department. (c) Authorization of appropriations There is authorized to be appropriated to the Secretary $20,000,000 to carry out subsection (a) in addition to amounts otherwise made available to the Secretary for the purposes set forth in such subsection. 402. Staffing of women's health primary care providers at medical facilities of the Department of Veterans Affairs The Secretary of Veterans Affairs shall ensure that each medical facility of the Department of Veterans Affairs has not fewer than one full-time or part-time women's health primary care provider whose duties include, to the extent possible, providing training to other health care providers of the Department on the needs of women veterans. 403. Additional funding for primary care and emergency care clinicians in Women Veterans Health Care Mini-Residency Program (a) In general There is authorized to be appropriated to the Secretary of Veterans Affairs $1,000,000 for each fiscal year for the Women Veterans Health Care Mini-Residency Program of the Department of Veterans Affairs to provide opportunities for participation in such program for primary care and emergency care clinicians. (b) Treatment of amounts The amounts authorized to be appropriated under subsection (a) shall be in addition to amounts otherwise made available to the Secretary for the purposes set forth in such subsection. 404. Establishment of women veteran training module for non-Department of Veterans Affairs health care providers (a) In general Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish and make available to community providers a training module that is specific to women veterans. (b) Community provider defined In this section, the term community provider means a non-Department of Veterans Affairs health care provider who provides health care to veterans under the laws administered by the Secretary of Veterans Affairs. 405. Study on staffing of Women Veteran Program Manager program at medical centers of the Department of Veterans Affairs and training of staff (a) Study The Secretary of Veterans Affairs shall conduct a study on the use of the Women Veteran Program Manager program of the Department of Veterans Affairs to determine— (1) if the program is appropriately staffed at each medical center of the Department; (2) whether each medical center of the Department is staffed with a Women Veteran Program Manager; and (3) whether it would be feasible and advisable to have a Women Veteran Program Ombudsman at each medical center of the Department. (b) Report Not later than 270 days after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the study conducted under subsection (a). (c) Training The Secretary shall ensure that all Women Veteran Program Managers and Women Veteran Program Ombudsmen receive the proper training to carry out their duties. V Data collection and reporting 501. Requirement for collection and analysis of data on Department of Veterans Affairs benefits and services and dis­ag­gre­ga­tion of such data by sex and minority status The Secretary of Veterans Affairs shall— (1) collect and analyze data on each program of the Department of Veterans Affairs that provides a service or benefit to a veteran, including the program carried out under section 1144 of title 10, United States Code; (2) disaggregate such data by sex and minority status, when the data lends itself to such dis­ag­gre­ga­tion; and (3) publish the data collected and analyzed under paragraph (1), except for such cases in which the Secretary determines that some portions of the data would undermine the anonymity of a veteran. 502. Report on availability of prosthetics for women veterans from the Department of Veterans Affairs Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the availability from the Department of Veterans Affairs of prosthetics made for women veterans, including an assessment of the availability of such prosthetics at each medical facility of the Department. 503. Requirement for Department of Veterans Affairs internet website to provide information on services available to women veterans (a) In general The Secretary of Veterans Affairs shall survey the internet websites and information resources of the Department of Veterans Affairs in effect on the day before the date of the enactment of this Act and publish an internet website that serves as a centralized source for the provision to women veterans of information about the benefits and services available to them under laws administered by the Secretary. (b) Elements The internet website published under subsection (a) shall provide to women veterans information regarding all of the services available in the district in which that the veteran is seeking such services, including, with respect to each medical center and community-based outpatient clinic in the applicable Veterans Integrated Service Network— (1) the name and contact information of each women's health coordinator; (2) a list of appropriate staff for other benefits available from the Veterans Benefits Administration, the National Cemetery Administration, and such other entities as the Secretary considers appropriate; and (3) such other information as the Secretary considers appropriate. (c) Updated information The Secretary shall ensure that the information described in subsection (b) that is published on the internet website required by subsection (a) is updated not less frequently than once every 90 days. (d) Outreach In carrying out this section, the Secretary shall ensure that the outreach conducted under section 1720F(i) of title 38, United States Code, includes information regarding the internet website required by subsection (a). (e) Derivation of funds Amounts used by the Secretary to carry out this section shall be derived from amounts made available to the Secretary to publish internet websites of the Department. 504. Report on locations where women veterans are using health care from Department of Veterans Affairs (a) In general Not later than 90 days after the date of the enactment of this Act, and annually thereafter, the Secretary of Veterans Affairs shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the use by women veterans of health care from the Department of Veterans Affairs. (b) Elements Each report required by subsection (a) shall include the following information: (1) The number of women veterans who reside in each State. (2) The number of women veterans in each State who are enrolled in the system of patient enrollment of the Department established and operated under section 1705(a) of title 38, United States Code. (3) Of the women veterans who are so enrolled, the number who have received health care under the laws administered by the Secretary at least one time during the one-year period preceding the submittal of the report. (4) The number of women veterans who have been seen at each medical facility of the Department during such year. (5) The number of appointments that women veterans have had at each such facility during such year. (6) If known, an identification of the medical facility of the Department in each Veterans Integrated Service Network with the largest rate of increase in patient population of women veterans as measured by the increase in unique women veteran patient use. (7) If known, an identification of the medical facility of the Department in each Veterans Integrated Service Network with the largest rate of decrease in patient population of women veterans as measured by the decrease in unique women veterans patient use. 505. Report on models of medical facilities of Department of Veterans Affairs for the treatment of women (a) In general Not later than 90 days after the date of the enactment of this Act, and annually thereafter, the Secretary of Veterans Affairs shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the use by the Department of Veterans Affairs of general primary care clinics, separate but shared spaces, and women's health centers as models of providing health care to women veterans. (b) Elements Each report required by subsection (a) shall include the following: (1) The number of facilities of the Department that fall into each model described in subsection (a), disaggregated by Veterans Integrated Service Network and State. (2) A description of the criteria used by the Department to determine which such model is most appropriate for each facility of the Department. (3) An assessment of how the Department decides to make investments to upgrade facilities to the next higher-level model. (4) A description of what, if any, plans the Department has to upgrade facilities from the lowest-level model, general primary care clinics, to another model. (5) An assessment of whether any facilities could be upgraded to the next higher-level model within planned investments under the strategic capital investment planning process of the Department. (6) An assessment of whether any facilities could be upgraded to the next higher-level model with minor modifications to existing plans under the strategic capital investment planning process of the Department. (7) An assessment of whether the Department has a goal for how many facilities should fall into each such model. 506. Report on staffing of Department of Veterans relating to the treatment of women (a) In general Not later than 90 days after the date of the enactment of this Act, and annually thereafter, the Secretary of Veterans Affairs shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the staffing of the Department of Veterans Affairs relating to the treatment of women. (b) Elements Each report required by subsection (a) shall include the following, disaggregated by Veterans Integrated Service Network and State (except with respect to paragraph (4)): (1) The number of women’s health centers. (2) The number of patient aligned care teams of the Department relating to women's health. (3) The number of full- and part-time gynecologists of the Department. (4) The number of designated women’s health care providers of the Department, disaggregated by facility of the Department. (5) The number of health care providers of the Department who have completed a mini-residency for women’s health care through Women Veterans Health Care Mini-Residency Program of the Department during the one-year period preceding the submittal of the report, and the number that plan to participate in such a mini-residency during the one-year period following such date. (6) The number of designated women’s health care providers of the Department who have sufficient female patients to retain their competencies and proficiencies.