,,ii  #aahth ,,congress  #ast ,session  
,s4 #bhja  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #ad1
 #bjbc,mrs4 ,murray 7for herself1 ,ms4  
,duckworth1 ,mr4 ,hickenlooper1 ,mr4    
,coons1 ,ms4 ,warren1 ,mr4 ,sanders1    
,ms4 ,klobuchar1 ,mr4 ,blumenthal1 ,mr4 
,warnock1 ,mr4 ,whitehouse1 ,mr4 ,wyden1
 ,mrs4 ,shaheen1 ,mr4 ,murphy1 ,mrs4    
,feinstein1 ,mr4 ,brown1 ,mr4 ,kaine1   
,mr4 ,padilla1 ,mr4 ,durbin1 and ,mr4   
,heinrich7 introduced the following     
bill2 which was read twice and referred 
to the ,committee on ,veterans' ,affairs
  ,a ,,bill  ,to improve the            
reproductive assistance provided by the 
,department of ,defense and the         
,department of ,veterans ,affairs to    
certain members of the ,armed ,forces1  
veterans1 and their spouses or partners1
 and for other purposes4  #a4 ,short    
title2 table of contents  7a7 ,short    
title ,this ,act may be cited as the    
,veteran ,families ,health ,services    
,act of #bjbc4  7b7 ,table of contents  

,the table of contents for this ,act is 
as follows3 ,sec4 #a4 ,short title2     
table of contents4,,title               
,i--,reproductive and fertility         
preservation assistance for members of  
the ,armed ,forces,sec4 #aja4           
,definitions4,sec4 #ajb4 ,provision of  
fertility treatment and counseling to   
certain members of the ,armed ,forces   
and spouses1 partners1 and gestational  
surrogates of such members4,sec4 #ajc4  
,establishment of fertility preservation
 procedures after an injury or          
illness4,sec4 #ajd4 ,cryopreservation   
and storage of reproductive genetic     
material of members of the ,armed       
,forces on active duty4,sec4 #aje4      
,assistance with and continuity of care 
regarding reproductive and fertility    
preservation services4,sec4 #ajf4       
,coordination between ,department of    
,defense and ,department of ,veterans   
,affairs on furnishing of fertility     
treatment and counseling4,,title        
,,ii--,reproductive and adoption        

assistance for veterans,sec4 #bja4      
,inclusion of fertility treatment and   
counseling under the definition of      
medical services in title #ch4,sec4     
#bjb4 ,fertility treatment and          
counseling for certain veterans and     
spouses1 partners1 and gestational      
surrogates of such veterans4,sec4 #bjc4 
,adoption assistance for certain        
veterans4,sec4 #bjd4 ,assistance with   
and continuity of care regarding        
reproductive and fertility preservation 
services4,sec4 #bje4 ,facilitation of   
reproduction and infertility            
research4,sec4 #bjf4 ,regulations on    
furnishing of fertility treatment and   
counseling and adoption assistance by   
,department of ,veterans ,affairs4  ,i  
,reproductive and fertility preservation
 assistance for members of the ,armed   
,forces  #aja4 ,definitions ,in this    
title3 7#a7 ,active duty ,the term      
active duty has the meaning given that  
term in section #aja7;d77#a7 of title   
#aj1 ,united ,states ,code4  7#b7 ,armed

 ,forces ,the term ,armed ,forces has   
the meaning given the term armed forces 
in section #aja7;a77#d7 of such title4  
#ajb4 ,provision of fertility treatment 
and counseling to certain members of the
 ,armed ,forces and spouses1 partners1  
and gestational surrogates of such      
members  7a7 ,fertility treatment and   
counseling  7#a7 ,in general ,the       
,secretary of ,defense shall furnish    
fertility treatment and counseling1     
including through the use of assisted   
reproductive technology1 to a covered   
member of the ,armed ,forces or a       
spouse1 partner1 or gestational         
surrogate of such a member4  7#b7       
,eligibility for treatment and          
counseling ,fertility treatment and     
counseling shall be furnished under     
paragraph 7#a7 without regard to the    
sex1 gender identity1 sexual            
orientation1 or marital status of the   
covered member of the ,armed ,forces4   
7#c7 ,in vitro fertilization ,in the    
case of in vitro fertilization treatment

 furnished under paragraph 7#a71 the    
,secretary may furnish to an individual 
under such paragraph-- 7,a7 not more    
than three completed oocyte retrievals2 
and  7,b7 unlimited embryo transfers in 
accordance with the guidelines of the   
,american ,society for ,reproductive    
,medicine4  7b7 ,procurement of         
reproductive genetic material ,if a     
covered member of the ,armed ,forces is 
unable to provide their reproductive    
genetic material for purposes of        
fertility treatment under subsection    
7a71 the ,secretary shall1 at the       
election of such member1 allow such     
member to receive such treatment with   
donated reproductive genetic material   
and pay or reimburse such member the    
reasonable costs of procuring such      
material from a donor4  7c7 ,rule of    
construction ,nothing in this section   
shall be construed to require the       
,secretary-- 7#a7 to find or certify a  
gestational surrogate for a covered     
member of the ,armed ,forces or to      

connect a gestational surrogate with    
such a member2 or  7#b7 to find or      
certify reproductive genetic material   
from a donor for a covered member of the
 ,armed ,forces or to connect such a    
member with reproductive genetic        
material from a donor4  7d7 ,definitions
 ,in this section3 7#a7 ,assisted       
reproductive technology ,the term       
assisted reproductive technology        
includes in vitro fertilization and     
other fertility treatments in which both
 eggs and sperm are handled when        
clinically appropriate4  7#b7 ,covered  
member of the ,armed ,forces ,the term  
covered member of the ,armed ,forces    
means a member of the ,armed ,forces who
 has an infertility condition1 unless   
the ,secretary can show that the member 
was completely infertile before service 
on active duty in the ,armed ,forces4   
7#c7 ,fertility treatment ,the term     
fertility treatment includes the        
following3 7,a7 ,procedures that use    
assisted reproductive technology4  7,b7 

,sperm retrieval4  7,c7 ,egg retrieval4 
7,d7 ,artificial insemination4  7,e7    
,transfer of reproductive genetic       
material4  7,f7 ,medications as         
prescribed or necessary for fertility4  
7,g7 ,such other treatments as the      
,secretary of ,defense considers        
appropriate4  7#d7 ,infertility         
condition ,the term infertility         
condition includes-- 7,a7 a diagnosis of
 infertility2 or  7,b7 the inability to 
reproduce or safely carry a pregnancy to
 term1 including as a result of         
treatment for another condition4  7#e7  
,partner ,the term partner1 with respect
 to a member of the ,armed ,forces1     
means an individual selected by the     
member who agrees to share with the     
member the parental responsibilities    
with respect to any child born as a     
result of the use of any fertility      
treatment under this section4  #ajc4    
,establishment of fertility preservation
 procedures after an injury or illness  
7a7 ,in general ,the ,secretary of      

,defense1 acting through the ,assistant 
,secretary of ,defense for ,health      
,affairs1 shall establish procedures for
 the retrieval of reproductive genetic  
material1 as soon as medically          
appropriate1 from a member of the ,armed
 ,forces in cases in which the fertility
 of such member is potentially          
jeopardized as a result of an injury or 
illness incurred or aggravated while    
serving on active duty in the ,armed    
,forces in order to preserve the medical
 options of such member4  7b7 ,consent  
for retrieval of reproductive genetic   
material ,reproductive genetic material 
may be retrieved from a member of the   
,armed ,forces under subsection 7a7     
only-- 7#a7 with the specific consent of
 the member2 or  7#b7 if the member is  
unable to consent1 if a medical         
professional determines that-- 7,a7 the 
future fertility of the member is       
potentially jeopardized as a result of  
an injury or illness described in       
subsection 7a7 or will be potentially   

jeopardized as a result of treating such
 injury or illness2  7,b7 the member    
lacks the capacity to consent to the    
retrieval of reproductive genetic       
material and is likely to regain such   
capacity2 and  7,c7 the retrieval of    
reproductive genetic material under this
 section is in the medical interest of  
the member4  7c7 ,consent for use of    
retrieved reproductive genetic material 
,reproductive genetic material retrieved
 from a member of the ,armed ,forces    
under subsection 7a7 may be used only-- 
7#a7 with the specific consent of the   
member2 or  7#b7 if the member has lost 
the ability to consent permanently1 as  
determined by a medical professional1 as
 specified in an advance directive or   
testamentary instrument executed by the 
member4  7d7 ,disposal of reproductive  
genetic material ,in accordance with    
regulations prescribed by the ,secretary
 for purpose of this subsection1 the    
,secretary shall dispose of reproductive
 genetic material retrieved from a      

member of the ,armed ,forces under      
subsection 7a7-- 7#a7 with the specific 
consent of the member2 or  7#b7 if the  
member-- 7,a7 has lost the ability to   
consent permanently1 as determined by a 
medical professional2 and  7,b7 has not 
specified the use of their reproductive 
genetic material in an advance directive
 or testamentary instrument executed by 
the member4  #ajd4 ,cryopreservation and
 storage of reproductive genetic        
material of members of the ,armed       
,forces on active duty  7a7 ,in general 
,the ,secretary of ,defense shall       
provide members of the ,armed ,forces on
 active duty in the ,armed ,forces with 
the opportunity to cryopreserve and     
store their reproductive genetic        
material prior to-- 7#a7 deployment to a
 combat zone2 or  7#b7 a duty assignment
 that includes a hazardous assignment1  
including-- 7,a7 assignments resulting  
in exposure to perfluoroalkyl or        
polyfluoroalkyl substances2 and  7,b7   
such other assignments as determined by 

the ,secretary4  7b7 ,period of time    
7#a7 ,in general ,the ,secretary shall  
provide for the cryopreservation and    
storage of reproductive genetic material
 of any member of the ,armed ,forces    
under subsection 7a7 in a facility of   
the ,department of ,defense or of a     
private entity and the transportation of
 such material1 at no cost to the       
member1 until the date that is one year 
after the retirement1 separation1 or    
release of the member from the ,armed   
,forces4  7#b7 ,continued               
cryopreservation and storage ,at the end
 of the one-year period specified in    
paragraph 7#a71 the ,secretary shall    
permit an individual whose reproductive 
genetic material was cryopreserved and  
stored in a facility of the ,department 
as described in that paragraph to       
select1 including pursuant to an advance
 medical directive or military          
testamentary instrument completed under 
subsection 7c71 one of the following    
options3 7,a7 ,to continue such         

cryopreservation and storage in such    
facility with the cost of such          
cryopreservation and storage borne by   
the individual4  7,b7 ,to transfer the  
material to a private cryopreservation  
and storage facility selected by the    
individual4  7,c7 ,to transfer the      
material to a facility of the           
,department of ,veterans ,affairs if    
cryopreservation and storage is         
available to the individual at such     
facility4  7#c7 ,disposal of            
reproductive genetic material ,if an    
individual described in paragraph 7#b7  
does not make a selection under         
subparagraph 7,a71 7,b71 or 7,c7 of such
 paragraph1 the ,secretary may dispose  
of the reproductive genetic material of 
the individual not earlier than the date
 that is #ij days after the end of the  
one-year period specified in paragraph  
7#a7 with respect to the individual4    
7c7 ,advance medical directive and      
military testamentary instrument ,a     
member of the ,armed ,forces who elects 

to cryopreserve and store their         
reproductive genetic material under this
 section must complete an advance       
medical directive1 as defined in section
 #ajdd;c7b7 of title #aj1 ,united       
,states ,code1 and a military           
testamentary instrument1 as defined in  
section #ajdd;d7b7 of such title1 that  
explicitly specifies the use of their   
cryopreserved and stored reproductive   
genetic material if such member dies or 
otherwise loses the capacity to consent 
to the use of their cryopreserved and   
stored reproductive genetic material4   
7d7 ,agreements ,to carry out this      
section1 the ,secretary may enter into  
agreements with private entities that   
provide cryopreservation1               
transportation1 and storage services for
 reproductive genetic material4  #aje4  
,assistance with and continuity of care 
regarding reproductive and fertility    
preservation services ,the ,secretary of
 ,defense shall ensure that employees of
 the ,department of ,defense assist     

members of the ,armed ,forces-- 7#a7 in 
navigating the services provided under  
this title2  7#b7 in finding a provider 
that meets the needs of such members    
with respect to such services2 and  7#c7
 in continuing the receipt of such      
services without interruption during a  
permanent change of station for such    
members4  #ajf4 ,coordination between   
,department of ,defense and ,department 
of ,veterans ,affairs on furnishing of  
fertility treatment and counseling  7a7 
,in general ,the ,secretary of ,defense 
and the ,secretary of ,veterans ,affairs
 shall share best practices and         
facilitate referrals1 as they consider  
appropriate1 on the furnishing of       
fertility treatment and counseling to   
individuals eligible for the receipt of 
such counseling and treatment from the  
,secretaries4  7b7 ,memorandum of       
understanding ,the ,secretary of        
,defense and the ,secretary of ,veterans
 ,affairs shall enter into a memorandum 
of understanding-- 7#a7 providing that  

the ,secretary of ,defense will ensure  
access by the ,secretary of ,veterans   
,affairs to reproductive genetic        
material of veterans stored by the      
,department of ,defense for purposes of 
furnishing fertility treatment under    
section #agbj,k of title #ch1 ,united   
,states ,code1 as added by section      
#bjb7;a72 and  7#b7 authorizing the     
,department of ,veterans ,affairs to    
compensate the ,department of ,defense  
for the cryopreservation1               
transportation1 and storage of          
reproductive genetic material of        
veterans under section #ajd4  ,,ii      
,reproductive and adoption assistance   
for veterans  #bja4 ,inclusion of       
fertility treatment and counseling under
 the definition of medical services in  
title #ch ,section #agja7f7 of title    
#ch1 ,united ,states ,code1 is amended  
by adding at the end the following new  
subparagraph3  7,j7 ,fertility treatment
 and counseling1 including treatment    
using assisted reproductive technology4 

4  #bjb4 ,fertility treatment and       
counseling for certain veterans and     
spouses1 partners1 and gestational      
surrogates of such veterans  7a7 ,in    
general ,subchapter ,,ii of chapter #ag 
of title #ch1 ,united ,states ,code1 is 
amended by adding at the end the        
following new section3  #agbj,k4        
,fertility treatment and counseling for 
certain veterans and spouses1 partners1 
and gestational surrogates of such      
veterans  7a7 ,requirement  7#a7 ,in    
general ,notwithstanding any other      
provision of law1 the ,secretary shall  
furnish fertility treatment and         
counseling1 including through the use of
 assisted reproductive technology1 to a 
covered veteran and the spouse1 partner1
 or gestational surrogate of the veteran
 if the veteran1 and the spouse1        
partner1 or gestational surrogate of the
 veteran1 as applicable1 each provide   
informed consent for such treatment and 
counseling1 including for each cycle of 
treatment authorized under this section1

 through a process prescribed by the    
,secretary4  7#b7 ,provision of         
treatment and counseling ,fertility     
treatment and counseling shall be       
furnished under paragraph 7#a7 without  
regard to the sex1 gender identity1     
sexual orientation1 or marital status of
 the covered veteran4  7#c7 ,in vitro   
fertilization ,in the case of in vitro  
fertilization treatment furnished under 
paragraph 7#a71 the ,secretary may      
furnish to an individual under such     
paragraph-- 7,a7 not more than three    
completed oocyte retrievals2 and  7,b7  
unlimited embryo transfers in accordance
 with the guidelines of the ,american   
,society for ,reproductive ,medicine4   
7b7 ,procurement of reproductive genetic
 material ,if a covered veteran is      
unable to provide their reproductive    
genetic material for purposes of        
fertility treatment under subsection    
7a71 the ,secretary shall1 at the       
election of such member1 allow such     
veteran to receive such treatment with  

donated reproductive genetic material   
and pay or reimburse such veteran the   
reasonable costs of procuring such      
material from a donor4  7c7 ,outreach   
and training ,the ,secretary shall carry
 out an outreach and training program to
 ensure veterans and health care        
providers of the ,department are aware  
of-- 7#a7 the availability of and       
eligibility requirements for fertility  
treatment and counseling under this     
section2 and  7#b7 any changes to       
fertility treatment and counseling      
covered under this section4  7d7        
,ownership1 use1 disposition1 or        
destruction of reproductive genetic     
material  7#a7 ,in general ,issues or   
disputes regarding ownership of         
reproductive genetic material1 future   
use of such material1 disposition of    
such material1 or destruction of such   
material shall be the sole              
responsibility of the covered veteran1  
the spouse1 partner1 or gestational     
surrogate of the veteran1 and the       

private facility storing such material4 
7#b7 ,role of ,department ,the role of  
the ,department under this section is   
limited to furnishing the treatment and 
counseling required under this section  
when requested by a covered veteran4    
7#c7 ,ownership and custody of          
reproductive genetic material ,the      
,department will not have ownership or  
custody of any reproductive genetic     
material obtained pursuant to treatment 
under this section and will not be      
involved in the ultimate disposition of 
such material or disputes between or    
among any parties with respect to such  
material4  7e7 ,rule of construction    
,nothing in this section shall be       
construed to require the ,secretary--   
7#a7 to find or certify a gestational   
surrogate for a covered veteran or to   
connect a gestational surrogate with a  
covered veteran2 or  7#b7 to furnish    
maternity care to a covered veteran or  
spouse1 partner1 or gestational         
surrogate of a covered veteran in       

addition to what is otherwise required  
by law4  7f7 ,definitions ,in this      
section3 7#a7 ,the term assisted        
reproductive technology includes in     
vitro fertilization and other fertility 
treatments in which both eggs and sperm 
are handled when clinically appropriate4
  7#b7 ,the term covered veteran means a
 veteran who-- 7,a7 has an infertility  
condition1 unless the ,secretary can    
show that the veteran was completely    
infertile before service in the active  
military1 naval1 or air service2 and    
7,b7 is enrolled in the system of annual
 patient enrollment established under   
section #agje7;a7 of this title4  7#c7  
,the term fertility treatment includes  
the following3 7,a7 ,procedures that use
 assisted reproductive technology4  7,b7
 ,sperm retrieval4  7,c7 ,egg retrieval4
  7,d7 ,artificial insemination4  7,e7  
,transfer of reproductive genetic       
material4  7,f7 ,medications as         
prescribed or necessary for fertility4  
7,g7 ,such other treatments as the      

,secretary considers appropriate4  7#d7 
,the term gestational surrogate means an
 individual who carries a fetus through 
pregnancy and gives birth to a baby for 
another individual or couple4  7#e7 ,the
 term infertility condition includes--  
7,a7 a diagnosis of infertility2 or     
7,b7 the inability to reproduce or      
safely carry a pregnancy to term1       
including as a result of treatment for  
another condition4  7#f7 ,the term      
partner1 with respect to a covered      
veteran1 means an individual-- 7,a7     
selected by the veteran who agrees to   
share with the veteran the parental     
responsibilities with respect to any    
child born as a result of the use of any
 fertility treatment under this section2
 and  7,b7 whom the veteran certifies to
 the ,department is the partner of the  
veteran and therefore1 based on that    
certification1 is eligible for treatment
 and counseling under this section4  4  
7b7 ,clerical amendment ,the table of   
sections at the beginning of subchapter 

,,ii of chapter #ag of such title is    
amended by inserting after the item     
relating to section #agbj;,j the        
following new item3  #agbj,k4 ,fertility
 treatment and counseling for certain   
veterans and spouses1 partners1 and     
gestational surrogates of such veterans4
  4  #bjc4 ,adoption assistance for     
certain veterans  7a7 ,in general       
,subchapter ,,viii of chapter #ag of    
title #ch1 ,united ,states ,code1 is    
amended by adding at the end the        
following new section3  #agij4 ,adoption
 assistance  7a7 ,in general ,the       
,secretary may pay an amount1 not to    
exceed the limitation amount1 to assist 
a covered veteran in the adoption of one
 or more children1 without regard to the
 sex1 gender identity1 sexual           
orientation1 or marital status of the   
covered veteran4  7b7 ,limitation amount
 ,for purposes of this section1 the     
limitation amount is the amount equal to
 the cost the ,department would incur by
 paying the expenses of three adoptions 

by covered veterans1 as determined by   
the ,secretary4  7c7 ,covered veteran   
defined ,in this section1 the term      
covered veteran has the meaning given   
that term in section #agbj,k7f7 of this 
title4  4  7b7 ,clerical amendment ,the 
table of sections at the beginning of   
subchapter ,,viii of chapter #ag of such
 title is amended by inserting after the
 item relating to section #aghi the     
following new item3  #agij4 ,adoption   
assistance4  4  #bjd4 ,assistance with  
and continuity of care regarding        
reproductive and fertility preservation 
services ,the ,secretary of ,veterans   
,affairs shall ensure that employees of 
the ,department of ,veterans ,affairs   
assist veterans-- 7#a7 in navigating the
 services provided under this title and 
the amendments made by this title2  7#b7
 in finding a provider that meets the   
needs of such veterans with respect to  
such services2 and  7#c7 in continuing  
the receipt of such services without    
interruption if such veterans move to a 

different geographic location4  #bje4   
,facilitation of reproduction and       
infertility research  7a7 ,in general   
,subchapter ,,ii of chapter #gc of title
 #ch1 ,united ,states ,code1 is amended 
by adding at the end the following new  
section3  #gccj;,e4 ,facilitation of    
reproduction and infertility research   
7a7 ,facilitation of research required  
,the ,secretary shall facilitate        
research conducted collaboratively by   
the ,secretary of ,defense and the      
,secretary of ,health and ,human        
,services to improve the ability of the 
,department of ,veterans ,affairs to    
meet the long-term reproductive health  
care needs of veterans who have a       
genitourinary service-connected         
disability or a condition that was      
incurred or aggravated in line of duty  
in the active military1 naval1 or air   
service1 such as a spinal cord injury1  
military sexual trauma1 or a mental     
health condition1 that affects the      
ability of the veteran to reproduce4    

7b7 ,dissemination of information ,the  
,secretary shall ensure that information
 produced by the research facilitated   
under this section that may be useful   
for other activities of the ,veterans   
,health ,administration is disseminated 
throughout the ,veterans ,health        
,administration4  4  7b7 ,clerical      
amendment ,the table of sections at the 
beginning of subchapter ,,ii of chapter 
#gc of such title is amended by         
inserting after the item relating to    
section #gccj;,d the following new item3
  #gccj;,e4 ,facilitation of            
reproduction and infertility research4  
4  #bjf4 ,regulations on furnishing of  
fertility treatment and counseling and  
adoption assistance by ,department of   
,veterans ,affairs ,not later than two  
years after the date of the enactment of
 this ,act1 the ,secretary of ,veterans 
,affairs shall prescribe regulations--  
7#a7 to carry out section #agbj,k of    
title #ch1 ,united ,states ,code1 as    
added by section #bjb7;a72 and  7#b7 to 

carry out section #agij of such title1  
as added by section #bjc7;a74