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Department of the Army Pamphlet DA PAM 600-25 U.S. Army Noncommissioned Officer (NCO) Professional Development Guide December 2018

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Will TRICARE continue to provide coverage for abortion services in the case of rape, incest or when the life of the mother would be endangered? What if state law restricts my ability to receive an abortion? other information, indicates a violation or potential violation of law, whether criminal, civil, or What other type of support services, such as financial support, might be available to help families with pregnancies? Human Resources professionals provide special assistance during a unit inactivation November 21, 2023

There is no requirement for a patient to formally report or participate in a formal investigation of a sexual assault for the patient to access abortion services at an MTF. The treating provider is required to notify the Sexual Assault Response Coordinator or Family Advocacy Program that they are treating a patient who indicates they are a victim of sexual assault and the pregnancy was the result of a sexual assault, so that information on available resources and reporting options can be provided; however, a beneficiary is not required to utilize any of the services or make a formal restricted or unrestricted report of a sexual assault to be eligible for the abortion. In addition, the provider does not provide the name of the patient to the SARC when the patient declines to make a report of sexual assault or speak with the SARC. The health care provider will document that they, in good faith, believe the pregnancy is a result of rape or incest, based on the patient’s report. o TRICARE Select: For non-Active Duty patients enrolled in TRICARE Select, a referral will be made but there is no associated reimbursement for travel costs. All necessary medical and psychological services and supplies related to a covered abortion may be provided by the MTF or by a TRICARE authorized provider for eligible dependents of a Soldier. This may include ultrasound performed prior to the abortion, pathology services, pregnancy tests, office visits, and any applicable requirements mandated by state and/or local laws. Complete care generally includes an initial diagnosis of pregnancy, counseling regarding pregnancy options, any necessary pre-procedural evaluation, peri-operative care (care provided around the time of a surgical procedure), contraception counseling and provision, screening for sexually transmitted infections, referral for mental health services, and follow-up/post-operative care as required. Sexual Assault Response Coordinators (SARCs) or the Family Advocacy Program (FAP) are notified by a DoD medical provider at an MTF if a patient informs the provider that the patient is a victim of a sexual assault so that the SARC or FAP can inform the victim of services and reporting options. There is no requirement that the health care provider inform the SARC or FAP that the patient requested an abortion. Health care provider communications to a SARC or FAP are confidential. As a result, if the patient has made, or desires to make, a Restricted Report, that option is not affected by health care provider notifications to a SARC or FAP.FORSCOM Lead Sexual Assault Response Coordinators come together to discuss program changes November 17, 2023 G-1 has established a Memorandum of Agreement (MOA) with APD on the disposition of DA PAMs 600-3, 600-25, 601-280, and 611-21. This MOA allows us to have base pamphlets posted for each of these PAMs (containing basic information) with Uniform Resource Locator (URL) links to the additional supporting, extended content that changes frequently.

What is the new policy on travel and transportation allowances for non-covered reproductive health care? What is non-covered reproductive health care? The MOA provides specific procedures to the management of the supporting, extended content (also known as “smartbooks”) for these DA PAMs: 600-3; 600-25; 621-11; 601-280. However, providers must not attempt to gain information from other sources in making their good faith determination (other than a consultation with SMEs as noted above) or compromise an adult patient’s reporting options by notifying the chain of command, or law enforcement, unless otherwise indicated in DoD Instruction 6310.09 “Health Care Management for Patients Associated With a Sexual Assault,” May 7, 2019, or advised by MTF legal counsel. National Discussion 2023: Leaders’ Role in Developing Healthy Climates and Prevention November 6, 2023 Patients may seek assistance from a Sexual Assault Response Coordinator (SARC), Sexual Assault Prevention and Response Victim Advocate (SAPR VA) or the Family Advocacy Program (FAP) who can connect them with the appropriate health care provider. They may also seek assistance through their primary care manager (PCM), a women’s health provider, or at an emergency room. MTFs either have providers who perform abortion services or have the ability to refer patients to an appropriate provider in the private sector or at another MTF.YOU ARE ACCESSING A U.S. GOVERNMENT (USG) INFORMATION SYSTEM (IS) THAT IS PROVIDED FOR USG-AUTHORIZED What other care does DoD provide when a Soldier, dependent, or other beneficiary receives a covered abortion? Yes. Eligible DoD beneficiaries are encouraged to follow-up with their Primary Care Manager or Women’s Health Provider following a pregnancy termination to obtain necessary follow-up care, to include convalescent leave (as indicated) or provision of contraception. This follow-up care is available regardless of whether the abortion service was a covered or non-covered procedure. Additionally, if a patient comes to a MTF with acute complications following a pregnancy termination, it is the duty of the receiving provider to care for these acute issues. By regulation, Active Duty Service members who experience complications resulting from a non- covered treatment also may be authorized for treatment in the private sector if necessary, consistent with applicable law.

There are other special circumstances, determined on a case-by-case basis by a DoD health care provider, where the military mission outweighs the interests served by delaying notification. o TRICARE Prime: For non-Active Duty patients enrolled in TRICARE Prime, if the closest available care is more than 100 miles away from their primary care manager’s office, TRICARE may reimburse reasonable travel expenses for covered abortions in accordance with applicable rules and regulations.

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Military OneSource is available 24/7 (http://www.militaryonesource.mil or 800-342-9647) to support the holistic needs of military families. Services include confidential non-medical counseling, financial counseling, peer-to-peer support, and specialty consultation sessions for expectant parents. Depending on the specific need or request, Military OneSource can also facilitate connections to installation- and community-based services. There are military duties, occupational health hazards, and medical conditions where the proper execution of the military mission outweighs the interests served by delaying commander notification of a pregnancy. If the DoD health care provider makes the notification to a commander, the Soldier will be notified prior to the command notification except in exigent circumstances. A commander will be notified of a pregnancy prior to the 20th week if: When a covered abortion is not available in the local area, does DoD provide travel and transportation allowances for a Soldier or other health care beneficiary to receive a covered abortion? What is the process for requesting these allowances?

Privacy Act Statement

Federal law restricts the Department from performing abortions or paying to have them performed unless the life of the mother would be endangered if the fetus were carried to term, or unless the pregnancy is the result of rape or incest. In the case of a Soldier who seeks an abortion related to a sexual assault, the Soldier would seek these services through their medical provider and does not need to obtain permission or other forms of documentation from their Command. The treating provider must document their good faith belief that the pregnancy is a result of rape, and would then either perform the procedure at the MTF or refer to another provider within the same MTF to provide the abortion. If the abortion cannot be performed at the MTF, the provider would refer the patient to the private sector or transfer the patient to another MTF with the capability to perform the abortion. If the Soldier reported a sexual assault to a Sexual Assault Response Coordinator (SARC), a Sexual Assault Prevention and Response Victim Advocate (SAPR VA), or the Family Advocacy Program (FAP), the Soldier would be asked if they want referrals for services, to include for medical and mental health services. The member could receive a referral from the SARC, SAPR VA, or FAP to an appropriate health care provider wherein their request for an abortion could be made. SARCs, SAPR VAs, and FAP would not discuss the details of health care with victims, since they are not qualified or authorized to discuss health-related matters or to provide personal opinions on health care issues.

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