Veteran Families Health Services Act of 2021

II 117TH CONGRESS 1ST SESSION S. 1280 To improve the reproductive assistance provided by the Department of De- fense and the Department of Veterans Affairs to certain members of the Armed Forces, veterans, and their spouses or partners, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL 21, 2021 Mrs. MURRAY (for herself, Ms. DUCKWORTH, Mr. DURBIN, Ms. WARREN, Mr. MARKEY, Mr. SANDERS, Mr. BLUMENTHAL, Mr. BENNET, Mr. COONS, Mr. WYDEN, Mr. BROWN, Mrs. SHAHEEN, Mr. WARNOCK, Ms. HASSAN, and Ms. KLOBUCHAR) introduced the following bill; which was read twice and referred to the Committee on Veterans’ Affairs A BILL To improve the reproductive assistance provided by the De- partment of Defense and the Department of Veterans Affairs to certain members of the Armed Forces, vet- erans, and their spouses or partners, and for other pur- poses. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Veteran Families Health Services Act of 2021’’. 5 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1280 IS (b) TABLE OF CONTENTS.—The table of contents for 1 this Act is as follows: 2 Sec. 1. Short title; table of contents. TITLE I—REPRODUCTIVE AND FERTILITY PRESERVATION ASSISTANCE FOR MEMBERS OF THE ARMED FORCES Sec. 101. Definitions. Sec. 102. Provision of fertility treatment and counseling to certain members of the Armed Forces and spouses, partners, and gestational sur- rogates of such members. Sec. 103. Establishment of fertility preservation procedures after an injury or illness. Sec. 104. Cryopreservation and storage of gametes of members of the Armed Forces on active duty. Sec. 105. Assistance with and continuity of care regarding reproductive and fertility preservation services. Sec. 106. Coordination between Department of Defense and Department of Veterans Affairs on furnishing of fertility treatment and coun- seling. TITLE II—REPRODUCTIVE AND ADOPTION ASSISTANCE FOR VETERANS Sec. 201. Inclusion of fertility treatment and counseling under the definition of medical services in title 38. Sec. 202. Fertility treatment and counseling for certain veterans and spouses, partners, and gestational surrogates of such veterans. Sec. 203. Adoption assistance for certain veterans. Sec. 204. Assistance with and continuity of care regarding reproductive and fertility preservation services. Sec. 205. Facilitation of reproduction and infertility research. Sec. 206. Annual report on fertility treatment and counseling furnished by De- partment of Veterans Affairs. Sec. 207. Report on timeliness and adequacy of access by veterans to fertility treatment and counseling services furnished by Department of Veterans Affairs. Sec. 208. Regulations on furnishing of fertility treatment and counseling and adoption assistance by Department of Veterans Affairs. TITLE I—REPRODUCTIVE AND 3 FERTILITY PRESERVATION 4 ASSISTANCE FOR MEMBERS 5 OF THE ARMED FORCES 6 SEC. 101. DEFINITIONS. 7 In this title: 8 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1280 IS (1) ACTIVE DUTY.—The term ‘‘active duty’’ has 1 the meaning given that term in section 101(d)(1) of 2 title 10, United States Code. 3 (2) ARMED FORCES.—The term ‘‘Armed 4 Forces’’ has the meaning given the term ‘‘armed 5 forces’’ in section 101(a)(4) of such title. 6 SEC. 102. PROVISION OF FERTILITY TREATMENT AND 7 COUNSELING TO CERTAIN MEMBERS OF THE 8 ARMED FORCES AND SPOUSES, PARTNERS, 9 AND GESTATIONAL SURROGATES OF SUCH 10 MEMBERS. 11 (a) FERTILITY TREATMENT AND COUNSELING.— 12 (1) IN GENERAL.—The Secretary of Defense 13 shall furnish fertility treatment and counseling, in- 14 cluding through the use of assisted reproductive 15 technology, to a covered member of the Armed 16 Forces or a spouse, partner, or gestational surrogate 17 of such a member. 18 (2) ELIGIBILITY FOR TREATMENT AND COUN- 19 SELING.—Fertility treatment and counseling shall be 20 furnished under paragraph (1) without regard to the 21 sex, gender identity, sexual orientation, or marital 22 status of the covered member of the Armed Forces. 23 (3) IN VITRO FERTILIZATION.—In the case of 24 in vitro fertilization treatment furnished under para- 25 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1280 IS graph (1), the Secretary may furnish not more than 1 three completed cycles or six attempted cycles of in 2 vitro fertilization, whichever occurs first, to an indi- 3 vidual under such paragraph. 4 (b) PROCUREMENT OF GAMETES.—If a covered 5 member of the Armed Forces is unable to provide their 6 gametes for purposes of fertility treatment under sub- 7 section (a), the Secretary shall, at the election of such 8 member, allow such member to receive such treatment 9 with donated gametes and pay or reimburse such member 10 the reasonable costs of procuring gametes from a donor. 11 (c) RULE OF CONSTRUCTION.—Nothing in this sec- 12 tion shall be construed to require the Secretary— 13 (1) to find or certify a gestational surrogate for 14 a covered member of the Armed Forces or to con- 15 nect a gestational surrogate with such a member; or 16 (2) to find or certify gametes from a donor for 17 a covered member of the Armed Forces or to con- 18 nect such a member with gametes from a donor. 19 (d) DEFINITIONS.—In this section: 20 (1) ASSISTED REPRODUCTIVE TECHNOLOGY.— 21 The term ‘‘assisted reproductive technology’’ in- 22 cludes in vitro fertilization and other fertility treat- 23 ments in which both eggs and sperm are handled 24 when clinically appropriate. 25 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1280 IS (2) COVERED MEMBER OF THE ARMED 1 FORCES.—The term ‘‘covered member of the Armed 2 Forces’’ means a member of the Armed Forces who 3 has an infertility condition, unless the Secretary can 4 show that the member was completely infertile be- 5 fore service on active duty in the Armed Forces. 6 (3) FERTILITY TREATMENT.—The term ‘‘fer- 7 tility treatment’’ includes the following: 8 (A) Procedures that use assisted reproduc- 9 tive technology. 10 (B) Sperm retrieval. 11 (C) Egg retrieval. 12 (D) Artificial insemination. 13 (E) Embryo transfer. 14 (F) Such other treatments as the Sec- 15 retary of Defense considers appropriate. 16 (4) INFERTILITY CONDITION.—The term ‘‘in- 17 fertility condition’’ includes— 18 (A) a diagnosis of infertility; or 19 (B) the inability to conceive or safely carry 20 a pregnancy to term, including as a result of 21 treatment for another condition. 22 (5) PARTNER.—The term ‘‘partner’’, with re- 23 spect to a member of the Armed Forces, means an 24 individual selected by the member who agrees to 25 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1280 IS share with the member the parental responsibilities 1 with respect to any child born as a result of the use 2 of any fertility treatment under this section. 3 SEC. 103. ESTABLISHMENT OF FERTILITY PRESERVATION 4 PROCEDURES AFTER AN INJURY OR ILLNESS. 5 (a) IN GENERAL.—The Secretary of Defense, acting 6 through the Assistant Secretary of Defense for Health Af- 7 fairs, shall establish procedures for the retrieval of 8 gametes, as soon as medically appropriate, from a member 9 of the Armed Forces in cases in which the fertility of such 10 member is potentially jeopardized as a result of an injury 11 or illness incurred or aggravated while serving on active 12 duty in the Armed Forces in order to preserve the medical 13 options of such member. 14 (b) CONSENT FOR RETRIEVAL OF GAMETES.— 15 Gametes may be retrieved from a member of the Armed 16 Forces under subsection (a) only— 17 (1) with the specific consent of the member; or 18 (2) if the member is unable to consent, if a 19 medical professional determines that— 20 (A) the future fertility of the member is 21 potentially jeopardized as a result of an injury 22 or illness described in subsection (a) or will be 23 potentially jeopardized as a result of treating 24 such injury or illness; 25 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1280 IS (B) the member lacks the capacity to con- 1 sent to the retrieval of gametes and is likely to 2 regain such capacity; and 3 (C) the retrieval of gametes under this sec- 4 tion is in the medical interest of the member. 5 (c) CONSENT FOR USE OF RETRIEVED GAMETES.— 6 Gametes retrieved from a member of the Armed Forces 7 under subsection (a) may be used only— 8 (1) with the specific consent of the member; or 9 (2) if the member has lost the ability to consent 10 permanently, as determined by a medical profes- 11 sional, as specified in an advance directive or testa- 12 mentary instrument executed by the member. 13 (d) DISPOSAL OF GAMETES.—In accordance with 14 regulations prescribed by the Secretary for purpose of this 15 subsection, the Secretary shall dispose of gametes re- 16 trieved from a member of the Armed Forces under sub- 17 section (a)— 18 (1) with the specific consent of the member; or 19 (2) if the member— 20 (A) has lost the ability to consent perma- 21 nently, as determined by a medical professional; 22 and 23 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1280 IS (B) has not specified the use of their 1 gametes in an advance directive or testa- 2 mentary instrument executed by the member. 3 SEC. 104. CRYOPRESERVATION AND STORAGE OF GAMETES 4 OF MEMBERS OF THE ARMED FORCES ON AC- 5 TIVE DUTY. 6 (a) IN GENERAL.—The Secretary of Defense shall 7 provide members of the Armed Forces on active duty in 8 the Armed Forces with the opportunity to cryopreserve 9 and store their gametes prior to— 10 (1) deployment to a combat zone; or 11 (2) a duty assignment that includes a haz- 12 ardous assignment, as determined by the Secretary. 13 (b) PERIOD OF TIME.— 14 (1) IN GENERAL.—The Secretary shall provide 15 for the cryopreservation and storage of gametes of 16 any member of the Armed Forces under subsection 17 (a) in a facility of the Department of Defense or of 18 a private entity and the transportation of such 19 gametes, at no cost to the member, until the date 20 that is one year after the retirement, separation, or 21 release of the member from the Armed Forces. 22 (2) CONTINUED CRYOPRESERVATION AND 23 STORAGE.—At the end of the one-year period speci- 24 fied in paragraph (1), the Secretary shall permit an 25 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1280 IS individual whose gametes were cryopreserved and 1 stored in a facility of the Department as described 2 in that paragraph to select, including pursuant to an 3 advance medical directive or military testamentary 4 instrument completed under subsection (c), one of 5 the following options: 6 (A) To continue such cryopreservation and 7 storage in such facility with the cost of such 8 cryopreservation and storage borne by the indi- 9 vidual. 10 (B) To transfer the gametes to a private 11 cryopreservation and storage facility selected by 12 the individual. 13 (C) To transfer the gametes to a facility of 14 the Department of Veterans Affairs if cryopre- 15 servation and storage is available to the indi- 16 vidual at such facility. 17 (3) DISPOSAL OF GAMETES.—If an individual 18 described in paragraph (2) does not make a selection 19 under subparagraph (A), (B), or (C) of such para- 20 graph, the Secretary may dispose of the gametes of 21 the individual not earlier than the date that is 90 22 days after the end of the one-year period specified 23 in paragraph (1) with respect to the individual. 24 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1280 IS (c) ADVANCE MEDICAL DIRECTIVE AND MILITARY 1 TESTAMENTARY INSTRUMENT.—A member of the Armed 2 Forces who elects to cryopreserve and store their gametes 3 under this section must complete an advance medical di- 4 rective, as defined in section 1044c(b) of title 10, United 5 States Code, and a military testamentary instrument, as 6 defined in section 1044d(b) of such title, that explicitly 7 specifies the use of their cryopreserved and stored gametes 8 if such member dies or otherwise loses the capacity to con- 9 sent to the use of their cryopreserved and stored gametes. 10 (d) AGREEMENTS.—To carry out this section, the 11 Secretary may enter into agreements with private entities 12 that provide cryopreservation, transportation, and storage 13 services for gametes. 14 SEC. 105. ASSISTANCE WITH AND CONTINUITY OF CARE RE- 15 GARDING REPRODUCTIVE AND FERTILITY 16 PRESERVATION SERVICES. 17 The Secretary of Defense shall ensure that employees 18 of the Department of Defense assist members of the 19 Armed Forces— 20 (1) in navigating the services provided under 21 this title; 22 (2) in finding a provider that meets the needs 23 of such members with respect to such services; and 24 VerDate Sep 11 2014 04:42 May 19, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1280.IS S1280 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1280 IS (3) in continuing the receipt of such services 1 without interruption during a permanent change of 2 station for such members. 3 SEC. 106. COORDINATION BETWEEN DEPARTMENT OF DE- 4 FENSE AND DEPARTMENT OF VETERANS AF- 5 FAIRS ON FURNISHING OF FERTILITY TREAT- 6 MENT AND COUNSELING. 7 (a) IN GENERAL.—The Secretary of Defense and the 8 Secretary of Veterans Affairs shall share best practices 9 and facilitate referrals, as they consider appropriate, on 10 the furnishing of fertility treatment and counseling to in- 11 dividuals eligible for the receipt of such counseling and 12 treatment from the Secretaries. 13 (b) MEMORANDUM OF UNDERSTANDING.—The Sec- 14 retary of Defense and the Secretary of Veterans Affairs 15 shall enter into a memorandum of understanding— 16 (1) providing that the Secretary of Defense will 17 ensure access by the Secretary of Veterans Affairs 18 to gametes of v [Text truncated for display. Full text available on Congress.gov.]