[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3613 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  2d Session
                                S. 3613

To amend title 38, United States Code, to strengthen existing benefits 
 for certain descendants of veterans exposed to herbicide agents, and 
                          for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 5, 2020

   Mr. Braun introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to strengthen existing benefits 
 for certain descendants of veterans exposed to herbicide agents, and 
                          for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. BENEFITS FOR ELIGIBLE DESCENDANTS OF VETERANS EXPOSED TO 
              HERBICIDE AGENTS.

    (a) In General.--Chapter 18 of title 38, United States Code, is 
amended to read as follows:

``CHAPTER 18--BENEFITS FOR ELIGIBLE DESCENDANTS OF VETERANS EXPOSED TO 
                            HERBICIDE AGENTS

``Chapter 18--Benefits for Eligible Descendants of Veterans Exposed to 
                            Herbicide Agents

``Sec. 1801. Definitions.
 ``subchapter i--eligible descendants of veterans exposed to herbicide 
                     agents born with spina bifida

``Sec. 1811. Eligibility.
``Sec. 1812. Health care.
``Sec. 1813. Vocational training.
``Sec. 1814. Monetary allowance.
   ``subchapter ii--eligible descendants of women veterans exposed to 
            herbicide agents born with certain birth defects

``Sec. 1821. Eligibility; definition.
``Sec. 1822. Covered birth defects.
``Sec. 1823. Health care.
``Sec. 1824. Vocational training.
``Sec. 1825. Monetary allowance.
``Sec. 1826. Regulations.
                    ``subchapter iii--administration

``Sec. 1831. Determination of eligibility.
``Sec. 1832. Care coordinators for eligible descendants.
``Sec. 1833. Duration of health care and benefits provided.
``Sec. 1834. Applicability of certain administrative provisions.
``Sec. 1835. Treatment of receipt of monetary allowance and other 
                            benefits.
``Sec. 1836. Nonduplication of benefits.
``Sec. 1801. Definitions
    ``In this chapter:
            ``(1) Covered birth defect.--The term `covered birth 
        defect' means a birth defect identified by the Secretary under 
        section 1822 of this title.
            ``(2) Covered veteran.--The term `covered veteran' means an 
        individual who--
                    ``(A) served in the active military, naval, or air 
                service, without regard to the characterization of that 
                individual's service; and
                    ``(B) is determined by the Secretary, in 
                consultation with the Secretary of Defense, to have 
                been exposed to a herbicide agent during such service.
            ``(3) Eligible descendant.--The term `eligible descendant' 
        means--
                    ``(A) for purposes of eligibility for health care 
                and benefits under subchapter I, an individual 
                described in section 1811 of this title; and
                    ``(B) for purposes of eligibility for health care 
                and benefits under subchapter II, an individual 
                described in section 1821(a) of this title.
            ``(4) Facility of the department.--The term `facility of 
        the Department' has the meaning given the term `facilities of 
        the Department' in section 1701 of this title.
            ``(5) Herbicide agent.--The term `herbicide agent' means a 
        chemical in a herbicide used in support of United States and 
        allied military operations, as determined by the Secretary in 
        consultation with the Secretary of Defense.

 ``SUBCHAPTER I--ELIGIBLE DESCENDANTS OF VETERANS EXPOSED TO HERBICIDE 
                     AGENTS BORN WITH SPINA BIFIDA

``Sec. 1811. Eligibility
    ``For purposes of this subchapter, an eligible descendant is an 
individual, regardless of age or marital status, who--
            ``(1)(A)(i) is the natural child of a covered veteran; and
            ``(ii) was conceived after the date on which that veteran 
        first was exposed to a herbicide agent during service in the 
        active military, naval, or air service; or
            ``(B) is the natural child of an individual described in 
        subparagraph (A); and
    ``(2) was born with any form or manifestation of spina bifida, 
except spina bifida occulta.
``Sec. 1812. Health care
    ``(a) In General.--In accordance with regulations prescribed by the 
Secretary, the Secretary shall provide an eligible descendant with 
health care under this section.
    ``(b) Provision of Care.-- The Secretary shall provide health care 
under this section--
            ``(1) through facilities of the Department; or
            ``(2) by contract or other arrangement with any health care 
        provider, as coordinated by the care coordinator assigned under 
        section 1832 of this title for the eligible descendant.
    ``(c) Definitions.--In this section:
            ``(1) Health care.--The term `health care'--
                    ``(A) means home care, hospital care, nursing home 
                care, outpatient care, preventive care, habilitative 
                and rehabilitative care, case management, and respite 
                care; and
                    ``(B) includes--
                            ``(i) the training of appropriate members 
                        of an eligible descendant's family or household 
                        in the care of the descendant; and
                            ``(ii) the provision of such 
                        pharmaceuticals, supplies, equipment, devices, 
                        appliances, assistive technology, direct 
                        transportation costs to and from approved 
                        sources of health care, and other materials as 
                        the Secretary determines necessary.
            ``(2) Habilitative and rehabilitative care.--The term 
        `habilitative and rehabilitative care' means such professional, 
        counseling, and guidance services and treatment programs (other 
        than vocational training under section 1813 of this title) as 
        are necessary to develop, maintain, or restore, to the maximum 
        extent practicable, the functioning of a disabled person.
            ``(3) Health care provider.--The term `health care 
        provider' includes specialized spina bifida clinics, health 
        care plans, insurers, organizations, institutions, and any 
        other entity or individual furnishing health care services that 
        the Secretary determines are authorized under this section.
            ``(4) Home care.--The term `home care' means outpatient 
        care, habilitative and rehabilitative care, preventive health 
        services, and health-related services furnished to an 
        individual in the individual's home or other place of 
        residence, including assistance with activities of daily living 
        and instrumental activities of daily living.
            ``(5) Hospital care.--The term `hospital care' means care 
        and treatment for a disability furnished to an individual who 
        has been admitted to a hospital as a patient.
            ``(6) Nursing home care.--The term `nursing home care' 
        means care and treatment for a disability furnished to an 
        individual who has been admitted to a nursing home as a 
        resident.
            ``(7) Outpatient care.--The term `outpatient care' means 
        care and treatment of a disability, and preventive health 
        services, furnished to an individual other than hospital care 
        or nursing home care.
            ``(8) Preventive care.--The term `preventive care' means 
        care and treatment furnished to prevent disability or illness, 
        including periodic examinations, immunizations, patient health 
        education, and such other services as the Secretary determines 
        necessary to provide effective and economical preventive health 
        care.
            ``(9) Respite care.--The term `respite care' means care 
        furnished on an intermittent basis for a limited period to an 
        individual who resides primarily in a private residence when 
        such care will help the individual to continue residing in such 
        private residence.
``Sec. 1813. Vocational training
    ``(a) Authority.--Pursuant to regulations prescribed by the 
Secretary, the Secretary may provide vocational training under this 
section to an eligible descendant if the Secretary determines that the 
achievement of a vocational goal by such descendant is reasonably 
feasible.
    ``(b) Program Design.--Any program of vocational training for an 
eligible descendant under this section shall--
            ``(1) be designed in consultation with the descendant in 
        order to meet the descendant's individual needs;
            ``(2) be set forth in an individualized written plan of 
        vocational rehabilitation; and
            ``(3) be designed and developed before the date specified 
        in subsection (d)(3) so as to permit the beginning of the 
        program as of such date.
    ``(c) Program Elements.--
            ``(1) In general.--A vocational training program for an 
        eligible descendant under this section--
                    ``(A) shall consist of such vocationally oriented 
                services and assistance, including such placement and 
                post-placement services and personal and work 
                adjustment training, as the Secretary determines are 
                necessary to enable the descendant to prepare for and 
                participate in vocational training or employment; and
                    ``(B) may include a program of education at an 
                institution of higher learning if the Secretary 
                determines that the program of education is 
                predominantly vocational in content.
            ``(2) Exclusions.--A vocational training program under this 
        section may not include the provision of any loan or 
        subsistence allowance or any automobile adaptive equipment.
    ``(d) Program Duration.--
            ``(1) In general.--Except as provided in paragraph (2) and 
        subject to subsection (e)(2), a vocational training program 
        under this section may not exceed 24 months.
            ``(2) Extensions.--The Secretary may grant an extension of 
        a vocational training program for an eligible descendant under 
        this section for up to 24 additional months if the Secretary 
        determines that the extension is necessary in order for the 
        descendant to achieve a vocational goal identified (before the 
        end of the first 24 months of such program) in the written plan 
        of vocational rehabilitation formulated for the descendant 
        pursuant to subsection (b).
            ``(3) Commencement.--A vocational training program under 
        this section may begin on the eligible descendant's 18th 
        birthday, or on the successful completion of the descendant's 
        secondary schooling, whichever first occurs, except that, if 
        the descendant is above the age of compulsory school attendance 
        under applicable State law and the Secretary determines that 
        the descendant's best interests will be served thereby, the 
        vocational training program may begin before the descendant's 
        18th birthday.
    ``(e) Relationship to Other Programs.--
            ``(1) In general.--An eligible descendant who is pursuing a 
        program of vocational training under this section and is also 
        eligible for assistance under a program under chapter 35 of 
        this title may not receive assistance under both such programs 
        concurrently. The descendant shall elect (in such form and 
        manner as the Secretary may prescribe) the program under which 
        the descendant is to receive assistance.
            ``(2) Aggregate period.--The aggregate period for which an 
        eligible descendant may receive assistance under this section 
        and chapter 35 of this title may not exceed 48 months (or the 
        part-time equivalent thereof).
``Sec. 1814. Monetary allowance
    ``(a) Monetary Allowance.--The Secretary shall pay a monthly 
allowance under this section to an eligible descendant for any 
disability resulting from spina bifida suffered by such descendant.
    ``(b) Schedule for Rating of Disabilities.--
            ``(1) In general.--The amount of the allowance paid to an 
        eligible descendant under this section shall be based on the 
        degree of disability suffered by the descendant, as determined 
        in accordance with such schedule for rating disabilities 
        resulting from spina bifida as the Secretary may prescribe.
            ``(2) Levels of disability.--The Secretary shall, in 
        prescribing the rating schedule for purposes of this section, 
        establish three levels of disability upon which the amount of 
        the allowance provided by this section shall be based.
    ``(c) Amount of Monthly Allowance.--
            ``(1) In general.--The amounts of the allowance shall be 
        $200 per month for the lowest level of disability prescribed, 
        $700 per month for the intermediate level of disability 
        prescribed, and $1,200 per month for the highest level of 
        disability prescribed.
            ``(2) Adjustment.--Amounts under paragraph (1) are subject 
        to adjustment under section 5312 of this title.

  ``SUBCHAPTER II--ELIGIBLE DESCENDANTS OF WOMEN VETERANS EXPOSED TO 
            HERBICIDE AGENTS BORN WITH CERTAIN BIRTH DEFECTS

``Sec. 1821. Eligibility; definition
    ``(a) Eligibility.--For purposes of this subchapter, an eligible 
descendant is an individual, regardless of age or marital status, who--
            ``(1)(A)(i) is the natural child of a covered woman 
        veteran; and
            ``(ii) was conceived after the date on which that veteran 
        first was exposed to a herbicide agent during service in the 
        active military, naval, or air service; or
            ``(B) is the natural child of an individual described in 
        subparagraph (A); and
    ``(2) was born with one or more covered birth defects.
    ``(b) Covered Woman Veteran Defined.--In this subchapter, the term 
`covered woman veteran' means a covered veteran who is a woman.
``Sec. 1822. Covered birth defects
    ``(a) Identification.--The Secretary shall identify the birth 
defects of eligible descendants that--
            ``(1) are associated with the service of covered woman 
        veterans; and
            ``(2) result in permanent physical or mental disability.
    ``(b) Exclusions.--The birth defects identified under subsection 
(a) may not include birth defects resulting from the following:
            ``(1) A familial disorder.
            ``(2) A birth-related injury.
            ``(3) A fetal or neonatal infirmity with well-established 
        causes.
    ``(c) Other Cause.--In any case where affirmative evidence 
establishes that a covered birth defect of an eligible descendant 
results from a cause other than the active military, naval, or air 
service of a covered woman veteran, no benefits or assistance may be 
provided the descendant under this subchapter.
``Sec. 1823. Health care
    ``(a) Needed Care.--The Secretary shall provide an eligible 
descendant such health care as the Secretary determines is needed by 
the descendant for that descendant's covered birth defects or any 
disability that is associated with those birth defects.
    ``(b) Provision of Care.--The Secretary shall provide health care 
under this section--
            ``(1) through facilities of the Department; or
            ``(2) by contract or other arrangement with a health care 
        provider, as coordinated by the care coordinator assigned under 
        section 1832 of this title for the eligible descendant.
    ``(c) Definitions.--For purposes of this section, the definitions 
in section 1812(c) of this title shall apply with respect to the 
provision of health care under this section, except that for such 
purposes--
            ``(1) the reference to `vocational training under section 
        1813 of this title' in paragraph (2) of that section shall be 
        treated as a reference to vocational training under section 
        1824 of this title; and
            ``(2) the reference to `specialized spina bifida clinic' in 
        paragraph (3) of that section shall be treated as a reference 
        to a specialized clinic treating the birth defect concerned 
        under this section.
``Sec. 1824. Vocational training
    ``(a) Authority.--The Secretary may provide a program of vocational 
training to an eligible descendant if the Secretary determines that the 
achievement of a vocational goal by the descendant is reasonably 
feasible.
    ``(b) Applicable Provisions.--Subsections (b) through (e) of 
section 1813 of this title shall apply with respect to any program of 
vocational training provided under subsection (a).
``Sec. 1825. Monetary allowance
    ``(a) Monetary Allowance.--The Secretary shall pay a monthly 
allowance to any eligible descendant for any disability resulting from 
the covered birth defects of that descendant.
    ``(b) Schedule for Rating of Disabilities.--
            ``(1) In general.--The amount of the monthly allowance paid 
        under this section shall be based on the degree of disability 
        suffered by the eligible descendant concerned, as determined in 
        accordance with a schedule for rating disabilities resulting 
        from covered birth defects that is prescribed by the Secretary.
            ``(2) Levels of disability.--In prescribing a schedule for 
        rating disabilities for purposes of this section, the Secretary 
        shall establish four levels of disability upon which the amount 
        of the allowance provided by this section shall be based. The 
        levels of disability established may take into account 
        functional limitations, including limitations on cognition, 
        communication, motor abilities, activities of daily living, and 
        employability.
    ``(c) Amount of Monthly Allowance.--The amount of the monthly 
allowance paid under this section shall be as follows:
            ``(1) In the case of an eligible descendant suffering from 
        the lowest level of disability prescribed in the schedule for 
        rating disabilities under subsection (b), $100.
            ``(2) In the case of an eligible descendant suffering from 
        the lower intermediate level of disability prescribed in the 
        schedule for rating disabilities under subsection (b), the 
        greater of--
                    ``(A) $214; or
                    ``(B) the monthly amount payable under section 
                1814(c) of this title for the lowest level of 
                disability prescribed for purposes of that section.
            ``(3) In the case of an eligible descendant suffering from 
        the higher intermediate level of disability prescribed in the 
        schedule for rating disabilities under subsection (b), the 
        greater of--
                    ``(A) $743; or
                    ``(B) the monthly amount payable under section 
                1814(c) of this title for the intermediate level of 
                disability prescribed for purposes of that section.
            ``(4) In the case of an eligible descendant suffering from 
        the highest level of disability prescribed in the schedule for 
        rating disabilities under subsection (b), the greater of--
                    ``(A) $1,272; or
                    ``(B) the monthly amount payable under section 
                1814(c) of this title for the highest level of 
                disability prescribed for purposes of that section.
    ``(d) Indexing to Social Security Benefit Increases.--Amounts under 
paragraphs (1), (2)(A), (3)(A), and (4)(A) of subsection (c) shall be 
subject to adjustment from time to time under section 5312 of this 
title.
``Sec. 1826. Regulations
    ``The Secretary shall prescribe regulations for purposes of the 
administration of this subchapter.

                    ``SUBCHAPTER III--ADMINISTRATION

``Sec. 1831. Determination of eligibility
    ``(a) Notification.--Each director of a facility of the Department 
shall notify each covered veteran who receives care at the facility of 
the health care and benefits available to eligible descendants under 
this chapter.
    ``(b) Medical Evaluation.--
            ``(1) In general.--The Secretary shall ensure that each 
        descendant of a covered veteran who seeks health care or 
        benefits under this chapter receives a medical evaluation 
        conducted at a facility of the Department.
            ``(2) Determination.--Each director of a facility at which 
        a medical evaluation for a descendant is conducted under 
        paragraph (1) shall determine whether such descendant is 
        eligible for health care or benefits under this chapter.
``Sec. 1832. Care coordinators for eligible descendants
    ``(a) Assignment.--
            ``(1) In general.--If a director of a facility of the 
        Department determines that a descendant of a covered veteran is 
        eligible for health care and benefits under this chapter under 
        section 1831(b)(2), except as provided in paragraph (2), the 
        director shall assign to the eligible descendant a social 
        worker or registered nurse employed by the Department at the 
        facility to serve as the care coordinator for the descendant.
            ``(2) Alternate location.--If another facility of the 
        Department is more geographically convenient for an eligible 
        descendant than the facility at which the descendant received a 
        medical evaluation under section 1831(b)(1), the director of 
        such other facility shall assign to the descendant a social 
        worker or registered nurse employed by the Department at the 
        facility to serve as the care coordinator for the descendant.
    ``(b) Functions.--
            ``(1) In general.--A care coordinator assigned under 
        subsection (a) shall ensure that each eligible descendant to 
        which the care coordinator is assigned receives all health 
        care, vocational training, and monetary compensation for which 
        the descendant is eligible.
            ``(2) Home modifications and equipment.--A care coordinator 
        assigned under subsection (a) shall ensure that, for each 
        eligible descendant to which the care coordinator is assigned--
                    ``(A) any home modifications that the care 
                coordinator determines are necessary, in consultation 
                with the primary care provider and physical therapist 
                of the descendant, are completed; and
                    ``(B) any durable medical equipment that the care 
                coordinator determines is required, in consultation 
                with the primary care provider and physical therapist 
                of the descendant, is provided.
            ``(3) Home visits.--A care coordinator assigned under 
        subsection (a) shall conduct not fewer than two home visits 
        each year for each eligible descendant to which the care 
        coordinator is assigned--
                    ``(A) to evaluate the support and care being 
                provided; and
                    ``(B) to make improvements as needed.
            ``(4) Arrangements with health care providers.--
                    ``(A) In general.--A care coordinator assigned 
                under subsection (a) shall ensure that each eligible 
                descendant to which the care coordinator is assigned is 
                connected with appropriate health care--
                            ``(i) by locating health care providers;
                            ``(ii) by educating those providers about 
                        the health care and benefits provided to 
                        eligible descendants under this chapter; and
                            ``(iii) by arranging health care for the 
                        descendant from those providers.
                    ``(B) Health care included.--Health care arranged 
                under subparagraph (A)(iii) shall include such in-home 
                support as an eligible descendant may need for 
                assistance in completing all activities of daily 
                living.
            ``(5) Administrative responsibilities.--
                    ``(A) In general.--A care coordinator assigned 
                under subsection (a) shall ensure, with respect to each 
                eligible descendant to which the care coordinator is 
                assigned, any necessary preauthorizations, payments to 
                providers, and travel reimbursements are completed in a 
                timely manner.
                    ``(B) Resolution of issues.--The care coordinator 
                shall work with the eligible descendant and the office 
                of the Department that administers health care and 
                benefits under this chapter to resolve any issues 
                relating to the matters described in subparagraph (A).
            ``(6) Assignment of fiduciary.--If the Under Secretary for 
        Benefits determines that a fiduciary is required for an 
        eligible descendant for purposes of managing compensation 
        provided under section 1814 or 1825 of this title, the care 
        coordinator assigned to the descendant under subsection (a) 
        shall ensure that the descendant has such a fiduciary.
    ``(c) Local Contract Care Coordinator.--
            ``(1) In general.--In the case of an eligible descendant 
        who lives a significant driving distance from a facility of the 
        Department, the care coordinator assigned to the descendant 
        under subsection (a) may arrange for a local contract care 
        coordinator to coordinate care for the descendant from sources 
        other than a facility of the Department.
            ``(2) Oversight.--Each care coordinator who arranges for a 
        local contract care coordinator under paragraph (1) shall 
        oversee the local contract care coordinator, including through 
        home visits required by subsection (b)(3).
    ``(d) Performance and Effectiveness.--Each director of a facility 
of the Department at which a care coordinator assigned under subsection 
(a) is located shall be responsible for the performance and 
effectiveness of the care coordinator.
``Sec. 1833. Duration of health care and benefits provided
    ``The Secretary shall provide an eligible descendant with health 
care and benefits under this chapter--
            ``(1) for the duration of the life of the descendant; and
            ``(2) notwithstanding any death of a parent of the 
        descendant that precedes the death of the descendant.
``Sec. 1834. Applicability of certain administrative provisions
    ``(a) Applicability of Certain Provisions Relating to 
Compensation.--The provisions of this title specified in subsection (b) 
apply with respect to benefits and assistance under this chapter in the 
same manner as those provisions apply to compensation paid under 
chapter 11 of this title.
    ``(b) Specified Provisions.--The provisions of this title referred 
to in subsection (a) are the following:
            ``(1) Section 5101(c).
            ``(2) Subsections (a), (b)(3), (g), and (i) of section 
        5110.
            ``(3) Section 5111.
            ``(4) Subsection (a) and paragraphs (1), (6), (9), and (10) 
        of subsection (b) of section 5112.
``Sec. 1835. Treatment of receipt of monetary allowance and other 
              benefits
    ``(a) Coordination With Other Benefits Paid to the Recipient.--
Notwithstanding any other provision of law, receipt by an individual of 
a monetary allowance under this chapter shall not impair, infringe, or 
otherwise affect the right of the individual to receive any other 
benefit to which the individual is otherwise entitled under any law 
administered by the Secretary.
    ``(b) Coordination With Benefits Based on Relationship of 
Recipients.--Notwithstanding any other provision of law, receipt by an 
individual of a monetary allowance under this chapter shall not impair, 
infringe, or otherwise affect the right of any other individual to 
receive any benefit to which such other individual is entitled under 
any law administered by the Secretary based on the relationship of such 
other individual to the individual who receives such monetary 
allowance.
    ``(c) Monetary Allowance Not To Be Considered as Income or 
Resources for Certain Purposes.--Notwithstanding any other provision of 
law, a monetary allowance paid an individual under this chapter shall 
not be considered as income or resources in determining eligibility 
for, or the amount of benefits under, any Federal or federally assisted 
program.
``Sec. 1836. Nonduplication of benefits
    ``(a) Monetary Allowance.--In the case of an eligible descendant 
under subchapter II of this chapter whose only covered birth defect is 
spina bifida, a monetary allowance shall be paid under subchapter I of 
this chapter. In the case of an eligible descendant under subchapter II 
of this chapter who has spina bifida and one or more additional covered 
birth defects, a monetary allowance shall be paid under subchapter II 
of this chapter.
    ``(b) Vocational Training.--An individual may only be provided one 
program of vocational training under this chapter.''.
    (b) Conforming Amendments.--Such title is further amended--
            (1) in section 5312, by striking ``1805'' both places it 
        appears and inserting ``1814''; and
            (2) in section 1116B(c), by striking ``has the meaning 
        given such term in section 1821(d) of this title'' and 
        inserting ``means a chemical in a herbicide used in support of 
        United States and allied military operations in or near the 
        Korean demilitarized zone, as determined by the Secretary in 
        consultation with the Secretary of Defense, during the period 
        beginning on September 1, 1967, and ending on August 31, 
        1971''.
                                 <all>