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

Product Information

Yes, TRICARE will continue to pay for abortions for Soldiers, dependents, or other eligible DoD beneficiaries in cases where the life of the mother would be endangered should the fetus be carried to term or in the case in which the pregnancy is the result of an act of rape or incest (described as “covered abortions”). Private sector health care facilities are subject to the laws of the state where the care is provided. When state law restricts certain types of care, that care may no longer be available through private sector health care facilities in the local area. More information on this policy is available at: www.health.mil/EnsuringAccesstoReproductiveHealth. YOU ARE ACCESSING A U.S. GOVERNMENT (USG) INFORMATION SYSTEM (IS) THAT IS PROVIDED FOR USG-AUTHORIZED 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.

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? Human Resources professionals provide special assistance during a unit inactivation November 21, 2023 What other type of support services, such as financial support, might be available to help families with pregnancies?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. Who can provide Soldiers, dependents, or other beneficiaries with women’s health care such as long acting reversible contraceptives (LARCs)? Do they have to be OB/GYNs or can they get it from a primary care physician? Where can they access this healthcare? 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.

Commanders or approval authorities must act promptly when considering a Soldier’s request for an administrative absence to access non-covered reproductive health care, with due regard to the time-sensitive nature of many non-covered reproductive health care services. Requests for administrative absence should be given all due consideration and should be granted to the greatest extent practicable unless, in the commanding officer’s judgment, the Soldier’s absence would impair proper execution of the Army mission. performing or working on a contract, service, grant, cooperative agreement, or other assignment for 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. The Soldier is in a position pre-identified by Army regulations as having mission responsibilities or being subject to occupational health hazards that would significantly risk mission accomplishment. National Discussion 2023: Leaders’ Role in Developing Healthy Climates and Prevention November 6, 2023What information does a patient need to provide, if seeking a covered abortion due to a pregnancy resulting from a sexual assault or incest? The treating DoD health care provider has determined that there are special medical circumstances that require earlier notification. An Ounce of Prevention; Fort Liberty's PAR Program Takes the Lead in Protecting Our Own November 20, 2023 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. 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?

FORSCOM Lead Sexual Assault Response Coordinators come together to discuss program changes November 17, 2023 remedying the risk of harm to individuals, the recipient agency or entity (including its information 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:SAPRO tours forward deployed Sexual Harassment/Assault Response and Prevention resources November 10, 2023

If a Soldier, dependent, or beneficiary accesses abortion services outside of the military health system and requires follow-up care, can they access care through DoD? 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. Chapter 15 - Consolidated Military and Civilian Career Fields and Principal Coordination Points by Personnel Proponent In all cases involving minors, DoD personnel should immediately consult with the servicing legal counsel. If a Soldier was sexually assaulted, what is the process by which they could access abortion services for a pregnancy resulting from the sexual assault?When an MTF provider encounters a child the provider suspects has been sexually abused, the child will be given priority for care at an MTF. MTF providers will refer DoD minor- dependents who are victims of sexual assault for follow-on care, which may include referral to a Domestic Abuse Victim Advocate (DAVA) or Family Advocacy Program. A DAVA coordinates and manages care for a victim of sexual assault that occurs within a family or between intimate partners. FAP/DAVA personnel are covered professionals who are required to report suspected child abuse directly to local civilian child welfare services in accordance with law and DoD policy. As a Soldier, what are the circumstances that would require me to notify my command of a pregnancy prior to the 20th week of pregnancy? Does the DoD provide abortion services for Soldiers or beneficiaries who have been sexually assaulted even if they have not reported the assault, there is no ongoing investigation, or if an investigation has not been completed? In addition to providing help with accessing military resources, Sexual Assault Response Coordinators can provide information about a range of off-installation services, some of which may be able to provide or assist with obtaining crime victim compensation or limited financial assistance. The availability of off-installation services varies by location and by state. Information about off- installation (no DoD affiliation) services can also be obtained from DoD Safe Helpline, the sole secure, confidential, and anonymous crisis support service specially designed for members of the Department of Defense community affected by sexual assault. (www.safehelpline.org or 877- 995-5247).