ALCOAST 087/23 - MAR 2023 UPDATE TO REPRODUCTIVE HEALTH CARE

R 011949Z MAR 23 MID200080772908U
FM COMDT COGARD WASHINGTON DC
TO ALCOAST
BT
UNCLAS
ALCOAST 087/23
SSIC 1000
SUBJ: UPDATE TO REPRODUCTIVE HEALTH CARE
A. Pregnancy in the Coast Guard, COMDTINST 1000.9
B. Military Assignments and Authorized Absences, COMDTINST M1000.8A
C. The Joint Travel Regulations (JTR)
1. This ALCOAST announces policies to support Service members and
their families by ensuring access to reproductive health care and
appropriate command notification.
2. Notification. The following is added to Section 7 of REF (A):
"Service members who believe they are pregnant should confirm the
pregnancy and receive prenatal care as soon as possible, but no
later than 12 weeks gestation. Members may delay pregnancy
notification to their command up to but not later than 20 weeks
gestation unless a member meets one of the below situations:
    a. Duties, Hazards, and Conditions. There are military duties,
occupational health hazards, and medical conditions where the proper
execution of the military mission outweighs the interests served by
delaying command notification. In these situations, the health care
provider will place the pregnant service member on a medical
temporary non-deployable status, limited duty status, or light duty
status with limitations specific to a medically confirmed pregnancy.
      (1) Special Personnel. The service member is in a position
pre-identified by the command as having mission responsibilities or
being subject to occupational health hazards that would
significantly risk mission accomplishment should notification to
the command be delayed. This will include many operational billets
attached to cutters, air stations, and shore forces units (Sectors,
MSUs, MSDs, Stations, ATON units).
      (2) Acute Medical Conditions Interfering with Duty. The
treating health care provider has determined that there are special
medical circumstances related to the service member's pregnancy that
would interfere with their ability to safely accomplish their
military mission.
      (3) Other Special Circumstances. The notification is based on
special circumstances in which proper execution of the military
mission outweighs the interests served by delaying notification, as
determined on a case-by-case basis by the cognizant clinic's Senior
Health Services Officer (SHSO) or, in the absence of the cognizant
SHSO, the Regional Senior Medical Executive or Regional Practice
Director.
    b. Required Pregnancy Testing. When pregnancy testing is included
as part of health screening for pre-deployment, specific job
training, theater entry requirements, or other authorized reasons,
test results will first be reviewed by the health care provider and
will not be automatically sent to the appropriate command authority.
In the event of a positive pregnancy test the health care provider
will consult with the service member to determine a preferred course
of action.
    c. Deployed or Underway. If a service member is confirmed to be
pregnant while deployed or underway, the treating health care
provider will consult with the service member and place them on
temporary non-deployable status with limitations.
    d. Any language in this Instruction that is contrary to this
policy is hereby cancelled."
3. Duty Status. The following is added to Section 7 of REF (A):
"When a member is delaying command notification of pregnancy in
accordance with this policy, Medical Providers who become aware that
a service member is pregnant will place the service member in a
medical temporary non-deployable status and limited duty or light
duty status without making any reference to the service member's
pregnancy. The service member will be advised by their health care
provider that such delay in pregnancy notification to their command
could result in delayed access to non-medical resources or
assessments related to their pregnancy or health, which may benefit
the member."
4. Administrative Absence. REF (B) is updated to add section f. to
Chapter 2.A.10:
"Service members may be granted an administrative absence from their
normal duty station to receive, or to accompany a dual-military
spouse or a dependent who receives, non-covered reproductive health
care without loss of pay or earned leave.
    a. The period of absence will be up to 21 days per request, and
will be limited to the minimum number of days essential to receive
the required care and travel needed to access the care by the most
expeditious means or transportation practicable.
    b. Members may need to disclose a minimum amount of health care
information that is necessary for the CO to authorize the
administrative absence.
    c. An administrative absence should be granted whether or not
such care is available within the local area. If medical care is
not within reasonable commuting distance of the PDS, the member may
be authorized entitlements and travel reimbursements per REF (C) but
if used would no longer be eligible for the administrative absence.
    d. Requests for administrative absence should be given all due
consideration and should be granted to the greatest extent
practicable. CO/OICs may not levy additional requirements on the
member (including, but not limited to, consultation with a chaplain,
medical testing, or other forms of counseling) prior to approving
or denying the absence.
    e. Convalescent Leave. CO/OIC's may also grant convalescent
leave following receipt of non-covered reproductive health care
based on recommendation from a CG Medical Officer or a civilian
healthcare provider from whom the member is receiving care.
    f. Reproductive health care is defined as:
      (1) Covered Abortion. An abortion, either medical or surgical,
where the life of the mother would be endangered if the fetus were
carried to term or in a case in which the pregnancy is the result
of an act of rape or incest.
      (2) Non-covered abortion. An abortion, either medical or
surgical, that is not a covered abortion.
      (3) Non-covered reproductive health care. Lawfully available
assisted reproductive technology and non-covered abortion.
      (4) Assisted Reproductive Technology (ART). Only the following
components of ART are included:
          (a) Ovarian stimulation and egg retrieval, including any
needed medications and procedures required for retrieval, processing
and utilization for ART or cryopreservation.
          (b) Sperm collection and processing for ART or
cryopreservation.
          (c) Intrauterine insemination (IUI)
          (d) In vitro fertilization (IVF) inclusive of the following
procedures for beneficiaries when clinically indicated:
               (i) In vitro fertilization with fresh embryo transfer
               (ii) Gamete Intrafallopian transfer (GIFT)
               (iii) Zygote intrafallopian transfer (ZIFT)
               (iv) Pronuclear stage tubal transfer (PROST)
               (v) Tubal embryo transfer (TET)
               (vi) Frozen embryo transfer."
5. Travel for Non-Covered Reproductive Health Care Services. For
general awareness, Section 033013 of REF (C) has previously been
updated to include: Service members and authorized dependents may be
eligible for travel and transportation allowances to receive
non-covered reproductive health care services when timely access to
reproductive health care services is not available within the local
area of the member's PDS, TDY location, or the last location to
which the dependent was transported on Government orders. Specific
policy for travel and transportation entitlements is located in
REF (C). The process for requesting travel and transportation
entitlements will be outlined in future ALCGPSC message.
6. These changes will be reflected in the next revisions of
REFs (A) and (B), which will be released within the next year.
All other policies outlined in REFs (A) and (B) not addressed
remain unchanged.
7. This message will be cancelled on 29 FEB 2024.
8. Questions regarding this ALCOAST may be directed to Office of
Military Personnel Policy (CG-133) at:
HQSPolicyandStandards@uscg.mil.
9. CAPT M. M. Roebuck, Acting Director of Military Personnel
(CG-13), sends.
10. Internet release is authorized.