,,ii #aaith ,,congress #b;d ,session ,s4 #edfd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #bc1 #bjbf,mr4 ,boozman 7for himself and ,ms4 ,duckworth7 introduced the following bill2 which was read twice and referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to amend title #ch1 ,united ,states ,code1 to modify the report on the health of women veterans1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,veterans' ,outcomes1 ,inclusion1 ,care1 and ,experience for ,women ,veterans ,act or the ,,voice for ,women ,veterans ,act4 #b4 ,modification of report on health of women veterans ,section #gcaj;,a of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a7-- 7,a7 by striking ,chief ,officer of ,women's ,health and inserting ,secretary2 and 7,b7 by striking through 7g7 and inserting through 7l72 7#b7 by striking subsection 7c72 7#c7 by redesignating subsections 7d7 through 7g7 as subsections 7e71 7g71 7h71 and 7m71 respectively2 7#d7 by inserting after subsection 7b7 the following3 7c7 ,utilization of services ,each report under subsection 7a7 shall include the following3 7#a7 ,the number of women veterans who reside in each ,state1 territory1 or possession of the ,united ,states4 7#b7 ,the number of women veterans enrolled in the system of annual patient enrollment of the ,department established and operated under section #agje7;a7 of this title1 disaggregated by-- 7,a7 ,state1 territory1 or possession of the ,united ,states2 and 7,b7 medical facility of the ,department at which the veteran is registered4 7#c7 ,the number of women veterans newly enrolled in such system since the submittal of the previous report under subsection 7a71 disaggregated by ,state1 territory1 or possession of the ,united ,states4 7#d7 ,of the women veterans enrolled in such system1 the number who received health care under the laws administered by the ,secretary at least once during the one-year period preceding the submittal of the report4 7#e7 ,the number of unique women veterans who received health care at each medical facility of the ,department during such one-year period1 disaggregated by facility4 7#f7 ,the number of appointments completed by women veterans at medical facilities of the ,department during such one-year period1 disaggregated by-- 7,a7 medical facility2 7,b7 type of care1 including-- 7i7 primary care2 7ii7 specialty care2 and 7iii7 mental health care2 and 7,c7 modality of care1 including-- 7i7 in-person care2 and 7ii7 care furnished through the use of telehealth4 7#g7 ,a summary of the geographic distribution of health care furnished by the ,department to women veterans1 including any significant geographic trends in enrollment or utilization4 7#h7 ,an assessment of utilization of health care furnished by the ,department to women veterans1 disaggregated1 to the extent practicable1 by-- 7,a7 age2 7,b7 era of service2 and 7,c7 military occupational specialty or other comparable career specialty in the ,armed ,forces4 7#i7 ,a summary of-- 7,a7 enrollment of women veterans in1 and utilization by women veterans of1 ,centers of ,excellence of the ,department2 and 7,b7 participation by women veterans in clinical1 disease1 and exposure-based condition registries of the ,department4 7#aj7 ,an identification of-- 7,a7 the medical facility of the ,department in each ,veterans ,integrated ,service ,network with the greatest rate of increase in the population of women veteran patients1 as measured by the change in unique women veteran patient utilization since the previous reporting period2 and 7,b7 the medical facility of the ,department in each ,veterans ,integrated ,service ,network with the greatest rate of decrease in the population of women veteran patients1 as measured by the change in unique women veteran patient utilization since the previous reporting period4 7#aa7 ,a comparison of the information required under paragraphs 7#a7 through 7#aj7 with the corresponding information from previous reporting periods1 to the extent such information is available4 7d7 ,access to gender-,specific services 7#a7 ,each report under subsection 7a7 shall include an analysis of the access of women veterans to and the use by women veterans of gender-specific services-- 7,a7 furnished by the ,department at ,department facilities2 and 7,b7 furnished by the ,department under contracts1 agreements1 or other arrangements with non-,department medical providers entered into by the ,secretary for the provision of hospital care or medical services to veterans4 7#b7 ,the analysis under paragraph 7#a7 shall include data and performance measures for the availability of gender-specific services1 disaggregated by services described in subparagraphs 7,a7 and 7,b71 including-- 7,a7 the average wait time between the preferred appointment date of the veteran and the date on which the appointment is completed2 7,b7 the average driving time required for veterans to attend appointments2 7,c7 reasons why appointments could not be scheduled with non-,department medical providers2 and 7,d7 the number of women veterans utilizing non-,department care4 2 7#e7 by inserting after subsection 7e71 as redesignated by paragraph 7#c71 the following3 7f7 ,other care items ,each report under subsection 7a7 shall include a description of the following3 7#a7 ,the referral process1 timeliness1 and effectiveness of referrals to primary or specialty care for the provision of gender-specific services by providers of the ,department4 7#b7 ,the referral process1 timeliness1 and effectiveness of referrals to primary or specialty care for the provision of gender-specific services by non-,department providers4 7#c7 ,the utilization and effectiveness of the self-referral gynecology appointment process of the ,department1 or any successor similar process4 7#d7 ,mechanisms of the ,department to provide oversight of care quality and timeliness regarding gender-specific services4 7#e7 ,utilization by women veterans of ,centers of ,excellence of the ,department1 including registration and actual appointments served4 7#f7 ,health care sought by women veterans relating to exposure to toxic substances1 including an identification of the presumptive location1 type of exposure1 and type of disease treated4 2 7#f7 in subsection 7g71 as so redesignated-- 7,a7 in the matter preceding paragraph 7#a71 by striking paragraph 7#d7 and inserting paragraph 7#e72 7,b7 by redesignating paragraphs 7#d7 through 7#f7 as paragraphs 7#e7 through 7#g72 7,c7 by inserting after paragraph 7#c7 the following3 7#d7 ,the number of full- and part-time specialized providers of the ,department who provide gender-specific services1 disaggregated by gender-specific service4 2 and 7,d7 by adding at the end the following3 7#h7 ,vacant positions for designated women's health care providers1 disaggregated by medical center of the ,department1 including an assessment of barriers experienced by the ,department when hiring such providers and an assessment of active efforts by the ,department to address such vacancies4 7#i7 ,any positions relating to women's health that have been realigned1 removed1 or are otherwise no longer dedicated to providing gender-specific services since the submittal of the previous report1 including an identification of the facilities at which those positions were located4 7#aj7 ,provider training standards for the provision of gender-specific services4 7#aa7 ,training offered by the ,department for community care providers1 including the number of community care providers who provide gender-specific services who have received certified training for cultural competency1 suicide prevention1 lethal means safety training1 military sexual trauma training1 and any other training the ,department offers or requires of providers of gender-specific services4 2 7#g7 by inserting after subsection 7h71 as so redesignated1 the following3 7i7 ,oversight of the ,deborah ,sampson ,act ,each report under subsection 7a7 shall include a description of the efforts of the ,department in implementing sections #eajd1 #eajg1 #eajh1 #ecjb1 and #ecje of the ,deborah ,sampson ,act of #bjbj 7title ,v of ,public ,law #aaf-cae2 #acd ,stat4 #ejba71 including the amendments made by those sections4 7j7 ,unique diseases ,each report under subsection 7a7 shall include a description of-- 7#a7 emerging diseases and other medical conditions affecting women veterans and the ability of the ,department to provide treatment for such diseases and other medical conditions2 and 7#b7 existing diseases and other medical conditions unique to women veterans1 the rate at which the ,department is diagnosing and treating such diseases and other medical conditions1 and the number of claims for benefits relating to such diseases and other medical conditions1 including the number of such claims subject to appeal and the outcomes of such appeals4 7k7 ,veterans ,benefits ,administration data 7#a7 ,each report under subsection 7a7 shall include1 to the extent practicable-- 7,a7 data collected in connection with reports on claims for benefits under the laws administered by the ,secretary submitted by women veterans for adjudication relating to emerging diseases or other medical conditions1 including-- 7i7 the number of such claims2 7ii7 the ratio of favorable and unfavorable adjudications2 7iii7 the number of such claims for which a higher-level review is requested1 a supplemental claim is filed1 or an appeal to the ,board of ,veterans' ,appeals is initiated2 and 7iv7 the outcomes of those reviews and appeals2 and 7,b7 information regarding the utilization by women veterans of benefits administered by the ,veterans ,benefits ,administration1 including-- 7i7 the number of women veterans who are using or have used educational assistance under the laws administered by the ,secretary2 7ii7 the number of women veterans who are receiving or have received services or assistance under chapter #ca of this title2 7iii7 with respect to compensation under chapter #aa of this title-- 7,i7 the number of women veterans receiving disability compensation2 7,,ii7 the number of women veterans with pending claims for disability compensation2 7,,iii7 the number of women veterans whose claims for disability compensation were denied during the reporting period2 7,,iv7 the average disability rating for women veterans receiving compensation2 and 7,v7 such other information as the ,secretary determines appropriate regarding the use by women veterans of benefits administered by the ,veterans ,benefits ,administration4 7#b7 ,to the extent practicable1 the information required under this subsection shall be disaggregated by age1 era of service1 and other demographic characteristics as the ,secretary determines appropriate4 7l7 ,consolidation of reports 7#a7 ,subject to paragraph 7#b71 the ,secretary may consolidate into the report under subsection 7a7 other reports required by law if-- 7,a7 such consolidation will not delay the delivery by the ,department of the report under subsection 7a7 or any other report by more than #cj days2 and 7,b7 all information required for the other report is addressed in the report under subsection 7a74 7#b7 ,the ,secretary may not take any action under paragraph 7#a7 to consolidate reports until the date that is #de days after the ,secretary submits to the appropriate congressional committees a report that describes the proposed consolidation and the reasons for such proposed consolidation4 2 and 7#h7 in subsection 7m71 as so redesignated1 by amending paragraph 7#b7 to read as follows3 7#b7 ,the term gender-specific services means reproductive health services1 specialized mental health services1 counseling and treatment for military sexual trauma1 gynecological care1 maternity care1 ovarian cancer care1 breast cancer care1 cervical cancer care1 endometrial cancer care1 thyroid cancer care1 mammography1 obstetric care1 uterine cancer care1 fallopian tube cancer care1 primary peritoneal cancer care1 vaginal cancer care1 vulvar cancer care1 gestational trophoblastic neoplasia care1 care relating to other prevalent diseases and conditions affecting women veterans1 and such other services as the ,secretary determines appropriate4 4