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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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Non-covered reproductive health care is defined in policy as lawfully available assisted reproductive technology and non-covered abortion. Non-covered reproductive health care is at the patient’s expense. If a Soldier is a victim of sexual assault and seeking an abortion for a pregnancy resulting from the sexual assault, with whom would they need to disclose their rape or sexual assault? Commanders or approval authorities will not levy additional requirements on the eligible Soldier (including, but not limited to, consultations with a chaplain, medical testing, or other forms of counseling) prior to approving or denying the administrative absence request. 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. agency or entity in (1) responding to a suspected or confirmed breach or (2) preventing, minimizing,

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?Installation-based Military and Family Support Centers provide programs and services to increase resilience. These programs and services include non-medical counseling, personal and family life education, financial readiness, and information and referral services. 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. remedying the risk of harm to individuals, the recipient agency or entity (including its information 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.

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.

Disclaimer

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.

o The New Parent Support Program is a program for expectant parents or those with children ages three and younger and offers pregnancy and parenting education and support primarily through home visitation services. New Parent Support Program staff are child development professionals, including registered nurses and clinical social workers, who are able to connect new and expectant parents to local pregnancy and parenting related resources. It is available to Soldiers, eligible spouses and partners. In some locations, they may also offer pregnancy and parenting related groups and classes.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.

other information, indicates a violation or potential violation of law, whether criminal, civil, orYes. 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. 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?

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