Veteran Families Health Services Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 2734 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 HOUSE OF REPRESENTATIVES APRIL 21, 2021 Mr. LARSEN of Washington (for himself, Mr. CONNOLLY, Ms. NORTON, Mr. RUSH, Mr. MCGOVERN, Ms. HOULAHAN, Mrs. HAYES, Ms. CHU, Ms. OMAR, Mrs. DINGELL, Mr. KRISHNAMOORTHI, Ms. TITUS, and Mr. MOULTON) introduced the following bill; which was referred to the Com- mittee on Veterans’ Affairs, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned 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 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2734 IH SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 1 (a) SHORT TITLE.—This Act may be cited as the 2 ‘‘Veteran Families Health Services Act of 2021’’. 3 (b) TABLE OF CONTENTS.—The table of contents for 4 this Act is as follows: 5 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. VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6211 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2734 IH TITLE I—REPRODUCTIVE AND 1 FERTILITY PRESERVATION 2 ASSISTANCE FOR MEMBERS 3 OF THE ARMED FORCES 4 SEC. 101. DEFINITIONS. 5 In this title: 6 (1) The term ‘‘active duty’’ has the meaning 7 given that term in section 101(d)(1) of title 10, 8 United States Code. 9 (2) The term ‘‘Armed Forces’’ has the meaning 10 given the term ‘‘armed forces’’ in section 101(a)(4) 11 of such title. 12 SEC. 102. PROVISION OF FERTILITY TREATMENT AND 13 COUNSELING TO CERTAIN MEMBERS OF THE 14 ARMED FORCES AND SPOUSES, PARTNERS, 15 AND GESTATIONAL SURROGATES OF SUCH 16 MEMBERS. 17 (a) FERTILITY TREATMENT AND COUNSELING.— 18 (1) IN GENERAL.—The Secretary of Defense 19 shall furnish fertility treatment and counseling, in- 20 cluding through the use of assisted reproductive 21 technology, to a covered member of the Armed 22 Forces or a spouse, partner, or gestational surrogate 23 of such a member. 24 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2734 IH (2) ELIGIBILITY FOR TREATMENT AND COUN- 1 SELING.—Fertility treatment and counseling shall be 2 furnished under paragraph (1) without regard to the 3 sex, gender identity, sexual orientation, or marital 4 status of the covered member of the Armed Forces. 5 (3) IN VITRO FERTILIZATION.—In the case of 6 in vitro fertilization treatment furnished under para- 7 graph (1), the Secretary may furnish not more than 8 three completed cycles or six attempted cycles of in 9 vitro fertilization, whichever occurs first, to an indi- 10 vidual under such paragraph. 11 (b) PROCUREMENT OF GAMETES.—If a covered 12 member of the Armed Forces is unable to provide their 13 gametes for purposes of fertility treatment under sub- 14 section (a), the Secretary shall, at the election of such 15 member, allow such member to receive such treatment 16 with donated gametes and pay or reimburse such member 17 the reasonable costs of procuring gametes from a donor. 18 (c) RULE OF CONSTRUCTION.—Nothing in this sec- 19 tion shall be construed to require the Secretary— 20 (1) to find or certify a gestational surrogate for 21 a covered member of the Armed Forces or to con- 22 nect a gestational surrogate with such a member; or 23 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 2734 IH (2) to find or certify gametes from a donor for 1 a covered member of the Armed Forces or to con- 2 nect such a member with gametes from a donor. 3 (d) DEFINITIONS.—In this section: 4 (1) The term ‘‘assisted reproductive tech- 5 nology’’ includes in vitro fertilization and other fer- 6 tility treatments in which both eggs and sperm are 7 handled when clinically appropriate. 8 (2) The term ‘‘covered member of the Armed 9 Forces’’ means a member of the Armed Forces who 10 has an infertility condition, unless the Secretary can 11 show that the member was completely infertile be- 12 fore service on active duty in the Armed Forces. 13 (3) The term ‘‘fertility treatment’’ includes the 14 following: 15 (A) Procedures that use assisted reproduc- 16 tive technology. 17 (B) Sperm retrieval. 18 (C) Egg retrieval. 19 (D) Artificial insemination. 20 (E) Embryo transfer. 21 (F) Such other treatments as the Sec- 22 retary of Defense considers appropriate. 23 (4) The term ‘‘infertility condition’’ includes— 24 (A) a diagnosis of infertility; or 25 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 2734 IH (B) the inability to conceive or safely carry 1 a pregnancy to term, including as a result of 2 treatment for another condition. 3 (5) The term ‘‘partner’’, with respect to a mem- 4 ber of the Armed Forces, means an individual se- 5 lected by the member who agrees to share with the 6 member the parental responsibilities with respect to 7 any child born as a result of the use of any fertility 8 treatment under this section. 9 SEC. 103. ESTABLISHMENT OF FERTILITY PRESERVATION 10 PROCEDURES AFTER AN INJURY OR ILLNESS. 11 (a) IN GENERAL.—The Secretary of Defense, acting 12 through the Assistant Secretary of Defense for Health Af- 13 fairs, shall establish procedures for the retrieval of 14 gametes, as soon as medically appropriate, from a member 15 of the Armed Forces in cases in which the fertility of such 16 member is potentially jeopardized as a result of an injury 17 or illness incurred or aggravated while serving on active 18 duty in the Armed Forces in order to preserve the medical 19 options of such member. 20 (b) CONSENT FOR RETRIEVAL OF GAMETES.— 21 Gametes may be retrieved from a member of the Armed 22 Forces under subsection (a) only— 23 (1) with the specific consent of the member; or 24 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 2734 IH (2) if the member is unable to consent, if a 1 medical professional determines that— 2 (A) the future fertility of the member is 3 potentially jeopardized as a result of an injury 4 or illness described in subsection (a) or will be 5 potentially jeopardized as a result of treating 6 such injury or illness; 7 (B) the member lacks the capacity to con- 8 sent to the retrieval of gametes and is likely to 9 regain such capacity; and 10 (C) the retrieval of gametes under this sec- 11 tion is in the medical interest of the member. 12 (c) CONSENT FOR USE OF RETRIEVED GAMETES.— 13 Gametes retrieved from a member of the Armed Forces 14 under subsection (a) may be used only— 15 (1) with the specific consent of the member; or 16 (2) if the member has lost the ability to consent 17 permanently, as determined by a medical profes- 18 sional, as specified in an advance directive or testa- 19 mentary instrument executed by the member. 20 (d) DISPOSAL OF GAMETES.—In accordance with 21 regulations prescribed by the Secretary for purpose of this 22 subsection, the Secretary shall dispose of gametes re- 23 trieved from a member of the Armed Forces under sub- 24 section (a)— 25 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 2734 IH (1) with the specific consent of the member; or 1 (2) if the member— 2 (A) has lost the ability to consent perma- 3 nently, as determined by a medical professional; 4 and 5 (B) has not specified the use of their 6 gametes in an advance directive or testa- 7 mentary instrument executed by the member. 8 SEC. 104. CRYOPRESERVATION AND STORAGE OF GAMETES 9 OF MEMBERS OF THE ARMED FORCES ON AC- 10 TIVE DUTY. 11 (a) IN GENERAL.—The Secretary of Defense shall 12 provide members of the Armed Forces on active duty in 13 the Armed Forces with the opportunity to cryopreserve 14 and store their gametes prior to— 15 (1) deployment to a combat zone; or 16 (2) a duty assignment that includes a haz- 17 ardous assignment, as determined by the Secretary. 18 (b) PERIOD OF TIME.— 19 (1) IN GENERAL.—The Secretary shall provide 20 for the cryopreservation and storage of gametes of 21 any member of the Armed Forces under subsection 22 (a) in a facility of the Department of Defense or of 23 a private entity and the transportation of such 24 gametes, at no cost to the member, until the date 25 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 2734 IH that is one year after the retirement, separation, or 1 release of the member from the Armed Forces. 2 (2) CONTINUED CRYOPRESERVATION AND 3 STORAGE.—At the end of the one-year period speci- 4 fied in paragraph (1), the Secretary shall permit an 5 individual whose gametes were cryopreserved and 6 stored in a facility of the Department as described 7 in that paragraph to select, including pursuant to an 8 advance medical directive or military testamentary 9 instrument completed under subsection (c), one of 10 the following options: 11 (A) To continue such cryopreservation and 12 storage in such facility with the cost of such 13 cryopreservation and storage borne by the indi- 14 vidual. 15 (B) To transfer the gametes to a private 16 cryopreservation and storage facility selected by 17 the individual. 18 (C) To transfer the gametes to a facility of 19 the Department of Veterans Affairs if 20 cryopreservation and storage is available to the 21 individual at such facility. 22 (3) DISPOSAL OF GAMETES.—If an individual 23 described in paragraph (2) does not make a selection 24 under subparagraph (A), (B), or (C) of such para- 25 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 2734 IH graph, the Secretary may dispose of the gametes of 1 the individual not earlier than the date that is 90 2 days after the end of the one-year period specified 3 in paragraph (1) with respect to the individual. 4 (c) ADVANCE MEDICAL DIRECTIVE AND MILITARY 5 TESTAMENTARY INSTRUMENT.—A member of the Armed 6 Forces who elects to cryopreserve and store their gametes 7 under this section must complete an advance medical di- 8 rective, as defined in section 1044c(b) of title 10, United 9 States Code, and a military testamentary instrument, as 10 defined in section 1044d(b) of such title, that explicitly 11 specifies the use of their cryopreserved and stored gametes 12 if such member dies or otherwise loses the capacity to con- 13 sent to the use of their cryopreserved and stored gametes. 14 (d) AGREEMENTS.—To carry out this section, the 15 Secretary may enter into agreements with private entities 16 that provide cryopreservation, transportation, and storage 17 services for gametes. 18 SEC. 105. ASSISTANCE WITH AND CONTINUITY OF CARE RE- 19 GARDING REPRODUCTIVE AND FERTILITY 20 PRESERVATION SERVICES. 21 The Secretary of Defense shall ensure that employees 22 of the Department of Defense assist members of the 23 Armed Forces— 24 VerDate Sep 11 2014 02:37 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2734.IH H2734 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 2734 IH (1) in navigating the services provided under 1 this title; 2 (2) in finding a provider that meets the needs 3 of such members with respect to such services; and 4 (3) in continuing the receipt of such services 5 without interruption during a permanent change of 6 station for such members. 7 SEC. 106. COORDINATION BETWEEN DEPARTMENT OF DE- 8 FENSE AND DEPARTMENT OF VETERANS AF- 9 FAIRS ON FURNISHING OF FERTILITY TREAT- 10 MENT AND COUNSELING. 11 (a) IN GENERAL.—The Secretary of Defense and the 12 Secretary of Veterans Affairs shall share best practices 13 and facilitate referrals, as they consider appropriate, on 14 the furnishing of fertility treatment and counseling to in- 15 dividuals eligible for the receipt of such counseling and 16 treatment from the Secretaries. 17 (b) MEMORANDUM OF UNDERSTANDING.—The Sec- 18 retary of Defense and the Secretary of Veterans Affairs 19 shall enter into a memorandum of understanding— 20 (1) providing that the Secretary of Defense will 21 ensure access by the Se [Text truncated for display. Full text available on Congress.gov.]