,i #aacth ,,congress #b;d ,session ,h4 ,r4 #eebd ,,in ,,the ,,house ,,of ,,representatives ,september #ag1 #bjad ,ms4 ,speier 7for herself1 ,ms4 ,de,gette1 ,ms4 ,slaughter1 ,ms4 ,de,lauro1 ,ms4 ,brown of ,florida1 ,mr4 ,rangel1 ,ms4 ,clark of ,massachusetts1 ,mr4 ,mc,govern1 ,ms4 ,jackson ,lee1 ,mr4 ,grijalva1 ,ms4 ,del,bene1 ,mrs4 ,napolitano1 ,ms4 ,mc,collum1 ,mr4 ,hastings of ,florida1 ,ms4 ,norton1 ,mrs4 ,capps1 ,ms4 ,clarke of ,new ,york1 ,mr4 ,blumenauer1 ,mr4 ,de,fazio1 ,ms4 ,lofgren1 ,ms4 ,linda ,t4 ,snchez of ,california1 ,mr4 ,larsen of ,washington1 ,ms4 ,moore1 ,ms4 ,hahn1 ,mr4 ,carson of ,indiana1 ,mr4 ,cicilline1 ,ms4 ,lee of ,california1 ,mr4 ,bera of ,california1 ,mr4 ,cohen1 ,mr4 ,quigley1 ,ms4 ,pingree of ,maine1 ,mr4 ,ellison1 ,ms4 ,castor of ,florida1 ,mr4 ,delaney1 ,ms4 ,tsongas1 ,ms4 ,bonamici1 ,mr4 ,loebsack1 ,ms4 ,matsui1 ,mr4 ,honda1 ,mr4 ,pocan1 ,ms4 ,chu1 ,mrs4 ,carolyn ,b4 ,maloney of ,new ,york1 ,mr4 ,himes1 ,mr4 ,lowenthal1 ,mr4 ,ruiz1 ,mr4 ,kilmer1 ,mr4 ,peters of ,california1 ,ms4 ,kuster1 ,ms4 ,brownley of ,california1 ,mr4 ,bishop of ,new ,york1 ,ms4 ,esty1 ,ms4 ,schakowsky1 ,mr4 ,takano1 ,mr4 ,johnson of ,georgia1 ,ms4 ,titus1 ,ms4 ,shea-,porter1 ,ms4 ,wasserman ,schultz1 ,ms4 ,fudge1 ,mr4 ,sherman1 ,mr4 ,brady of ,pennsylvania1 and ,mr4 ,thompson of ,california7 introduced the following bill2 which was referred to the ,committee on ,armed ,services ,a ,,bill ,to amend title #aj1 ,united ,states ,code1 to ensure that women members of the ,armed ,forces and their families have access to the contraception they need in order to promote the health and readiness of all members of the ,armed ,forces1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,access to ,contraception for ,women ,servicemembers and ,dependents ,act of #bjad4 #b4 ,findings ,congress makes the following findings3 7#a7 ,women are serving in the ,armed ,forces at increasing rates1 playing a critical role in the national security of the ,united ,states4 ,more than #cej1jjj women serve on active duty in the ,armed ,forces or in the ,selected ,reserve4 7#b7 ,nearly #aj1jjj1jjj members of the ,armed ,forces 7including members of the ,national ,guard and ,reserves71 military retirees1 their families1 their survivors1 and certain former spouses1 including nearly #e1jjj1jjj female beneficiaries1 are eligible for health care through the ,department of ,defense4 7#c7 ,contraception is critical for women's health and is highly effective at reducing unintended pregnancy4 ,the ,centers for ,disease ,control and ,prevention describe contraception as one of the #aj greatest public health achievements of the twentieth century4 7#d7 ,contraception has played a direct role in the greater participation of women in education and employment4 ,increased wages and increased control over reproductive decisions provide women with educational and professional opportunities that have increased gender equality over the decades since contraception was introduced4 7#e7 ,studies have shown that when cost barriers to the full range of methods of contraception are eliminated1 and women receive comprehensive counseling on the various methods of contraception 7including highly effective ,long-,acting ,reversible ,contraceptives 7,l,a,r,cs771 rates of unintended pregnancy decline dramatically4 7#f7 ,research has also shown that investments in effective contraception save public and private dollars4 7#g7 ,the #bjaa recommendations of the ,institute of ,medicine on women's preventive health services include recommendations that health insurance plans cover all methods of contraception approved by the ,food and ,drug ,administration1 sterilization procedures1 and patient education and counseling for all women with reproductive capacity without any cost-sharing requirements4 7#h7 ,the recommendations described in paragraph 7#g7 are reflected in provisions of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh71 and thus group and individual health insurance plans must provide such coverage4 ,the recommendations have also been adopted by the ,office of ,personnel ,management1 and thus all health insurance plans that are part of the ,federal ,employees ,health ,benefits ,program must provide such coverage4 7#i7 ,under the ,,tricare program1 servicewomen on active duty have full coverage of all prescription drugs1 including contraception1 without cost-sharing requirements4 ,however1 servicewomen not on active duty1 and female dependents of members of the ,armed ,forces1 who receive health care through the ,,tricare program do not have similar coverage of all prescription methods of contraception approved by the ,food and ,drug ,administration without cost-sharing4 7#aj7 ,studies indicate that servicewomen need comprehensive counseling for pregnancy prevention1 particularly in their predeployment preparations1 and the lack thereof is contributing to unintended pregnancies among servicewomen4 7#aa7 ,an analysis by ,ibis ,reproductive ,health of the #bjjh ,survey of ,health ,related ,behaviors among ,active ,duty ,military ,personnel found a high unintended pregnancy rate among servicewomen4 ,adjusting for the difference between age distribution in the ,armed ,forces and the general population1 the rate of unintended pregnancy among servicewomen is higher than for the general population4 7#ab7 ,with the integrated use of electronic medical records throughout the ,department of ,defense1 the technological infrastructure exists to develop clinical decision support tools4 ,these tools1 which are incorporated into the electronic medical record1 allow for a point-of-care feedback loop that can be used to enhance patient decisionmaking1 case and patient management1 and care coordination4 ,benefits of clinical decision support tools include increased quality of care and enhanced health outcomes1 improved efficiency1 and provider and patient satisfaction4 7#ac7 ,the ,defense ,advisory ,committee on ,women in the ,services 7,,dacowits7 has recommended that all the ,armed ,forces1 to the extent that they have not already1 implement initiatives that inform servicemembers of the importance of family planning1 educate them on methods of contraception1 and make various methods of contraception available1 based on the finding that family planning can increase the overall readiness and quality of life of all members of the military4 7#ad7 ,health care1 including family planning for survivors of sexual assault in the ,armed ,forces is a critical issue4 ,servicewomen on active duty report rates of unwanted sexual contact at approximately #af times those of the comparable general population of women in the ,united ,states4 ,through regulations1 the ,department of ,defense already supports a policy of ensuring that servicewomen who are sexually assaulted have access to emergency contraception4 #c4 ,contraception coverage parity under the ,,tricare program 7a7 ,in general ,section #ajgd;d of title #aj1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a71 by inserting for members and former members after ,services available2 7#b7 by redesignating subsection 7b7 as subsection 7d72 and 7#c7 by inserting after subsection 7a7 the following new subsections3 7b7 ,care related to prevention of pregnancy ,female covered beneficiaries shall be entitled to care related to the prevention of pregnancy described by subsection 7d77#c74 7c7 ,prohibition on cost-,sharing for certain services ,notwithstanding section #ajgd;g7a77#f7 of this title or any other provision of law1 cost-sharing may not be imposed or collected for care related to the prevention of pregnancy provided pursuant to subsection 7a7 or 7b71 including for any method of contraception provided1 whether provided through a facility of the uniformed services1 the ,,tricare retail pharmacy program1 or the national mail-order pharmacy program4 4 7b7 ,care related to prevention of pregnancy ,subsection 7d77#c7 of such section1 as redesignated by subsection 7a77#b7 of this section1 is further amended by inserting before the period at the end the following3 7including all methods of contraception approved by the ,food and ,drug ,administration1 sterilization procedures1 and patient education and counseling in connection therewith74 7c7 ,conforming amendment ,section #ajgg7;a77#ac7 of such title is amended by striking section #ajgd;d7b7 and inserting section #ajgd;d7d74 #d4 ,access to broad range of methods of contraception approved by the ,food and ,drug ,administration for members of the ,armed ,forces and military dependents at military treatment facilities 7a7 ,in general ,commencing not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,defense shall ensure that every military treatment facility has a sufficient stock of a broad range of methods of contraception approved by the ,food and ,drug ,administration1 as recommended by the ,centers for ,disease ,control and ,prevention and the ,office of ,population ,affairs of the ,department of ,health and ,human ,services1 to be able to dispense at any time any such method of contraception to any women members of the ,armed ,forces and female covered beneficiaries who receive care through such facility4 7b7 ,covered beneficiary defined ,in this section1 the term covered beneficiary has the meaning given that term in section #ajgb7e7 of title #aj1 ,united ,states ,code4 #e4 ,comprehensive standards and access to contraception counseling for members of the ,armed ,forces 7a7 ,purpose ,the purpose of this section is to ensure that all health care providers employed by the ,department of ,defense who provide care for women members of the ,armed ,forces1 including general practitioners1 are provided1 through clinical practice guidelines1 the most current evidence-based and evidence-informed standards of care with respect to methods of contraception and counseling on methods of contraception4 7b7 ,clinical practice guidelines 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,defense shall compile clinical practice guidelines for health care providers described in subsection 7a7 on standards of care with respect to methods of contraception and counseling on methods of contraception for women members of the ,armed ,forces4 7#b7 ,sources ,the ,secretary shall compile clinical practice guidelines under this subsection from among clinical practice guidelines established by appropriate health agencies and professional organizations1 including the following3 7,a7 ,the ,united ,states ,preventive ,services ,task ,force4 7,b7 ,the ,centers for ,disease ,control and ,prevention4 7,c7 ,the ,office of ,population ,affairs of the ,department of ,health and ,human ,services4 7,d7 ,the ,american ,college of ,obstetricians and ,gynecologists4 7,e7 ,the ,association of ,reproductive ,health ,professionals4 7,f7 ,the ,american ,academy of ,family ,physicians4 7,g7 ,the ,agency for ,healthcare ,research and ,quality4 7#c7 ,updates ,the ,secretary shall from time to time update the list of clinical practice guidelines compiled under this subsection to incorporate into such guidelines new or updated standards of care with respect to methods of contraception and counseling on methods of contraception4 7#d7 ,dissemination 7,a7 ,initial dissemination ,as soon as practicable after the compilation of clinical practice guidelines pursuant to paragraph 7#a71 but commencing not later than one year after the date of the enactment of this ,act1 the ,secretary shall provide for rapid dissemination of the clinical practice guidelines to health care providers described in subsection 7a74 7,b7 ,updates ,as soon as practicable after the adoption under paragraph 7#c7 of any update to the clinical practice guidelines compiled pursuant to this subsection1 the ,secretary shall provide for the rapid dissemination of such clinical practice guidelines1 as so updated1 to health care providers described in subsection 7a74 7,c7 ,protocols ,clinical practice guidelines1 and any updates to such guidelines1 shall be disseminated under this paragraph in accordance with administrative protocols developed by the ,secretary for that purpose4 7c7 ,clinical decision support tools 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall1 in order to assist health care providers described in subsection 7a71 develop and implement clinical decision support tools that reflect1 through the clinical practice guidelines compiled pursuant to subsection 7b71 the most current evidence-based and evidence-informed standards of care with respect to methods of contraception and counseling on methods of contraception4 7#b7 ,updates ,the ,secretary shall from time to time update the clinical decision support tools developed under this subsection to incorporate into such tools new or updated guidelines on methods of contraception and counseling on methods of contraception4 7#c7 ,dissemination ,clinical decision support tools1 and any updates to such tools1 shall be disseminated under this subsection in accordance with administrative protocols developed by the ,secretary for that purpose4 ,such protocols shall be similar to the administrative protocols developed under subsection 7b77#d77;,c74 7d7 ,access to contraception counseling ,as soon as practicable after the date of the enactment of this ,act1 the ,secretary shall ensure that women members of the ,armed ,forces have access to counseling on the full range of methods of contraception provided by health care providers described in subsection 7a7 during health care visits1 including1 but not limited to1 visits as follows3 7#a7 ,during predeployment health care visits1 with the counseling to be provided during such visits emphasizing the interaction between anticipated deployment conditions and various methods of contraception4 7#b7 ,during health care visits during deployment4 7#c7 ,during annual physical examinations4 7e7 ,incorporation into surveys of questions on servicewomen experiences with family planning services and counseling 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall integrate into the ,department of ,defense surveys specified in paragraph 7#b7 questions designed to obtain information on the experiences of women members of the ,armed ,forces-- 7,a7 in accessing family planning services and counseling2 7,b7 in using family planning methods1 which method was preferred and whether deployment conditions affected the decision on which family planning method or methods to be used2 and 7,c7 if pregnant1 whether the pregnancy was intended4 7#b7 ,covered surveys ,the surveys into which questions shall be integrated as described in paragraph 7#a7 are the following3 7,a7 ,the ,health ,related ,behavior ,survey of ,active ,duty ,military ,personnel4 7,b7 ,the ,health ,care ,survey of ,department of ,defense ,beneficiaries4 #f4 ,education on family planning for members of the ,armed ,forces 7a7 ,education program 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,defense shall establish an education program for all members of the ,armed ,forces1 including both men and women members1 consisting of a uniform standard curriculum on family planning4 7#b7 ,sense of ,congress ,it is the sense of ,congress that the standard curriculum should use the latest technology available to efficiently and effectively deliver information to members of the ,armed ,forces4 7b7 ,elements ,the standard curriculum under subsection 7a7 shall include the following3 7#a7 ,information on the importance of providing comprehensive family planning for members of the ,armed ,forces1 and their commanding officers1 and on the positive impact family planning can have on the health and readiness of the ,armed ,forces4 7#b7 ,current1 medically accurate information4 7#c7 ,clear1 user-friendly information on the full range of methods of contraception and where members of the ,armed ,forces can access their chosen method of contraception4 7#d7 ,information on all applicable laws and policies so that members are informed of their rights and obligations4 7#e7 ,information on patients' rights to confidentiality4 7#f7 ,information on the unique circumstances encountered by members of the ,armed ,forces1 and the effects of such circumstances on the use of contraception4 #g4 ,pregnancy prevention assistance at military treatment facilities for women who are sexual assault survivors 7a7 ,purpose ,the purpose of this section is to provide in statute1 and to enhance1 existing regulations that require health care providers at military treatment facilities to consult with survivors of sexual assault once clinically stable regarding options for emergency contraception and any necessary follow-up care1 including the provision of the emergency contraception4 7b7 ,in general ,the assistance specified in subsection 7c7 shall be provided at every military treatment facility to the following3 7#a7 ,any woman who presents at a military treatment facility and states to personnel of the facility that she is a victim of sexual assault or is accompanied by another individual who states that the woman is a victim of sexual assault4 7#b7 ,any woman who presents at a military treatment facility and is reasonably believed by personnel of such facility to be a survivor of sexual assault4 7c7 ,assistance 7#a7 ,in general ,the assistance specified in this subsection shall include the following3 7,a7 ,the prompt provision by appropriate staff of the military treatment facility of comprehensive1 medically and factually accurate1 and unbiased written and oral information about all methods of emergency contraception approved by the ,food and ,drug ,administration4 7,b7 ,the prompt provision by such staff of emergency contraception to a woman upon her request4 7,c7 ,notification to the woman of her right to confidentiality in the receipt of care and services pursuant to this section4 7#b7 ,nature of information ,the information provided pursuant to paragraph 7#a77;,a7 shall be provided in language that is clear and concise1 is readily comprehensible1 and meets such conditions 7including conditions regarding the provision of information in languages other than ,english7 as the ,secretary may provide in the regulations under this section4