[Congressional Record Volume 146, Number 52 (Tuesday, May 2, 2000)]
[Senate]
[Pages S3260-S3262]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER:
  S. 2494. A bill to amend title 38, United States Code, to provide 
compensation and benefits to children of female Vietnam veterans who 
were born with certain birth defects, and for other purposes; to the 
Committee on Veterans' Affairs.


       children of female vietnam veterans' benefits act of 2000

  Mr. ROCKEFELLER. Mr. President, I introduce, on behalf of myself and 
Senator Murray, legislation that would aid the children born with birth 
defects to female Vietnam veterans. This legislation, the Children of 
Female Vietnam Veterans' Benefits Act of 2000, is long overdue. As we 
commemorate the 25th anniversary of the end of the war, it is a 
particularly appropriate time for passage of this important 
legislation.
  Women played a critical role in Vietnam. As nurses, they provided 
lifesaving care to the wounded and comfort to the dying. Their 
compassion and selflessness is legendary. Others served in countless 
other ways, as clerks, mapmakers, photographers, air traffic 
controllers, Red Cross and USO workers, and other volunteer roles. 
Their support was crucial to the war effort.
  Last year, the VA completed study on women Vietnam veterans which 
concluded that there was a ``statistically significant increase in 
birth defects'' in their children. VA generally does not have the legal 
authority to provide health care and compensation to the children of 
veterans, except in the case of spina bifida.
  The legislation we are sponsoring would apply to children of women 
Vietnam veterans born with birth defects, other than spina bifida, 
which resulted in permanent physical or mental disability, except for 
certain birth defects determined by the Secretary of Veterans Affairs 
to result from genetics, birth injury, or fetal or neonatal infirmities 
with well-established causes. The benefits would include health care, 
vocational rehabilitation services, and financial compensation, 
depending on the degree of disability.
  In closing, I emphasize that the health care and benefits provided by 
the Department of Veterans Affairs play a crucial role in supporting 
the healing process I spoke of earlier. While no amount of remuneration 
can ever truly compensate for bodily injury and emotional trauma, we 
have the responsibility to provide the tools for coping and to ease the 
difficulties of daily life. I urge my colleagues to support this 
measure.
  This bill will provide health care and compensation to the children 
of women Vietnam veterans who were born with permanently disabling 
birth defects. Though they have waited 25 years for this 
acknowledgment, this legislation has the ability to significantly 
improve the lives of women veterans and their disabled children. These 
women and children have endured incredible and ongoing hardships for 
this country, and their significance must be realized. We can no longer 
ignore the responsibility the government owes to women veterans.
  This bill has its origin in a study the Department of Veterans 
Affairs did on women Vietnam veterans. In response to the concerns of 
many women Vietnam Veterans, Congress required that VA perform a 
comprehensive study of any long-term adverse health effects that may 
have been suffered by these women. This mandate led to three separate 
but related epidemiologic studies of women Vietnam-era veterans: 1) a 
post Vietnam service mortality follow-up; 2) an assessment of 
psychologic health outcomes; and 3) a review of reproductive health 
outcomes. This particular study, released in 1999, analyzed the 
reproductive outcomes of over 4000 women Vietnam veterans, compared 
with 4000 women Vietnam-era veterans.
  The study revealed that the risk of a woman Vietnam veterans having a 
child with birth defects was significantly elevated, even after 
adjusting for age, demographic variables, military characteristics, and 
smoking and alcohol consumption of the mothers. Upon review of the 
resulting conclusions, the VA study's task force recommended that the 
Secretary seek statutory authority to provide health care and other 
benefits to the offspring of women veterans with birth defects. 
Secretary West approved of this recommendation. The tragic realization 
of the birth defects present in so many of the children of women 
Vietnam veterans brings light to a situation that cries out not only 
for our sympathy, but for an acceptance of governmental responsibility 
and action.
  VA does not have the authority under current law to provide health 
care or other benefits to the children of women Vietnam veterans 
disabled from birth defects other than spina bifida. Thus, the enabling 
legislation that I introduce today is absolutely necessary in order to 
address the compelling needs of these children.
  Currently, VA has the authority to compensate and aid veterans, and 
the dependents of these veterans, for disease or injury to the veteran 
due to service. Millions of veterans, from every branch of the Armed 
Forces, have been helped by this benefit. These small amounts of 
compensation can in no way fully redress the physical and psychological 
injuries that war has caused these veterans, their children, and their 
spouses. But it does serve to assist these veterans to live active and 
fulfilled lives, and it would assist with making up for lost income 
over the years, due to the injuries. However, no benefits have been 
extended to the children of veterans, for their own harm.
  In 1996, VA was given special authority to provide benefits and 
compensation to the children of Vietnam veterans for their own disease 
associated with their parent's service--for those children born with 
spina bifida. The legislation I am introducing today is modeled after 
that ground breaking spina bifida legislation. We owe that same debt to 
the children born with birth defects to women Vietnam veterans. My 
cosponsors and I believe that providing this assistance to children 
disabled by birth defects associated with their mother's military 
service would be a fitting extension of the principle of providing 
benefits for disabilities that are incurred or aggravated as a result 
of service on active duty in the Armed Forces of the United States.
  I am seeking to aid the children of women Vietnam veterans who have 
been tragically affected by birth defects. These women fought for their 
country, and served this Nation with honor and courage. They 
volunteered to be placed in harm's way, without knowledge of what 
effects their service may bring later. Many were nurses who cared for 
wounded soldiers, and offered enormously important support services to 
all those in active duty. Indeed, these women provided such an 
incredible nursing service to injured soldiers that less than 2% of all 
treated casualties during the war died. These women saw death and 
disease, and they experienced their own forms of disillusionment with 
the war. These women

[[Page S3261]]

fought on the front lines; they were not kept away in safe places 
during the conflict.
  Further, I want to add that these women performed a service for women 
who have been in any way involved in the Armed Forces since then, by 
contributing to the changes in the military structure of the 1970s and 
since. Women performed critically important roles during the Vietnam 
war. Their ongoing contributions were recognized as altogether 
essential. Disastrously, some of their children have suffered because 
their mothers were so courageous, and it is time for them to begin to 
be repaid for that suffering.
  Though long overdue perhaps, now is a particularly appropriate time 
for passage of this important legislation. As we celebrate the 25th 
anniversary of the end of the Vietnam War, we must remember the women 
Vietnam veterans who served this country so well, all those years ago. 
These women paid for their service not only with their own bodies, but 
too often with the bodies of their children who were born years later. 
It is my opinion that this legislation is late in coming, but there is 
no time like the present. As we take these recent months to remember 
the Vietnam War, I can think of no more fitting time than this for this 
bill. After all, though the fighting in Vietnam came to an end 25 years 
ago, the consequences of that fighting are still dramatically present.

  At the heart of this legislation, this bill would apply to children 
of women Vietnam veterans born with birth defects, other than spina 
bifida, which resulted in permanent physical or mental disability, 
except for birth defects determined by the Secretary of Veterans' 
Affairs to result from familial disorders, birth-related injuries, or 
fetal or neonatal infirmities with well-established causes.
  The legislation authorizes VA to provide or reimburse a contractor 
for health care delivered to the disabled children for the birth defect 
and associated conditions. This health care would include home, 
hospital, nursing home, outpatient, preventative, habilitative, 
rehabilitative and respite care. It also includes pharmaceuticals and 
supplies required by the birth defect, such as wheelchairs, if 
appropriate.
  The legislation also provides compensation from the VA to the 
children at four payment levels. The benefits would be for $100, $214, 
$743, and $1,272, per month, depending upon the severity of the child's 
disability. Future cost-of-living adjustments would be based on the 
Consumer Price Index, just as other veterans and Social Security 
benefits are adjusted.
  This bill also authorizes VA to furnish the disabled children with 
important vocational rehabilitation services. The services would 
include: VA design of a training plan that is individually designed, 
accounting for the individual needs of the child; placement and post-
placement services, personal and work adjustment training. It may also 
include education at an institution of higher learning. The programs 
would generally run 24 months, but if necessary, the Secretary may 
extend the program for an additional 24 months.
  This legislation would be effective one year after the date of 
enactment, in order to allow time for regulations to be established. VA 
estimates that the costs for this legislation would be approximately 
$25 million over five years.
  In conclusion, I believe that we must help the children born with 
disabling birth defects associated with their mother's service in 
Vietnam. It is the logical extension of our policy to provide benefits 
for disabilities that result from service. It's the compassionate thing 
to do--to ensure that these children have the health care and other 
benefits they need to survive. As a nation, it is our unwavering 
responsibility to deal with all the consequences of war, not just the 
easy and obvious ones.
  Mr. President, I ask unanimous consent that the bill fact sheet be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 2494

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Children of Female Vietnam 
     Veterans' Benefits Act of 2000''.

     SEC. 2. BENEFITS FOR THE CHILDREN OF FEMALE VIETNAM VETERANS 
                   WHO SUFFER FROM CERTAIN BIRTH DEFECTS.

       (a) In General.--Chapter 18 of title 38, United States 
     Code, is amended by adding at the end the following new 
     subchapter:

``SUBCHAPTER II--CHILDREN OF FEMALE VIETNAM VETERANS BORN WITH CERTAIN 
                             BIRTH DEFECTS

     ``Sec. 1811. Definitions

       ``In this subchapter:
       ``(1) The term `child', with respect to a female Vietnam 
     veteran, means a natural child of the female Vietnam veteran, 
     regardless of age or marital status, who was conceived after 
     the date on which the female Vietnam veteran first entered 
     the Republic of Vietnam during the Vietnam era (as specified 
     in section 101(29)(A) of this title).
       ``(2) The term `covered birth defect' means each birth 
     defect identified by the Secretary under section 1812 of this 
     title.
       ``(3) The term `female Vietnam veteran' means any female 
     individual who performed active military, naval, or air 
     service in the Republic of Vietnam during the Vietnam era (as 
     so specified), without regard to the characterization of the 
     individual's service.

     ``Sec. 1812. Birth defects covered

       ``(a) Identification.--Subject to subsection (b), the 
     Secretary shall identify the birth defects of children of 
     female Vietnam veterans that--
       ``(1) are associated with the service of female Vietnam 
     veterans in the Republic of Vietnam during the Vietnam era 
     (as specified in section 101(29)(A) of this title); and
       ``(2) result in the permanent physical or mental disability 
     of such children.
       ``(b) Limitations.--(1) The birth defects identified under 
     subsection (a) may not include birth defects resulting from 
     the following:
       ``(A) A familial disorder.
       ``(B) A birth-related injury.
       ``(C) A fetal or neonatal infirmity with well-established 
     causes.
       ``(2) The birth defects identified under subsection (a) may 
     not include spina bifida.
       ``(c) List.--The Secretary shall prescribe in regulations a 
     list of the birth defects identified under subsection (a).

     ``Sec. 1813. Benefits and assistance

       ``(a) Health Care.--(1) The Secretary shall provide a child 
     of a female Vietnam veteran who was born with a covered birth 
     defect such health care as the Secretary determines is needed 
     by the child for such birth defect or any disability that is 
     associated with such birth defect.
       ``(2) The Secretary may provide health care under this 
     subsection directly or by contract or other arrangement with 
     a health care provider.
       ``(3) For purposes of this subsection, the definitions in 
     section 1803(c) of this title shall apply with respect to the 
     provision of health care under this subsection, except that 
     for such purposes--
       ``(A) the reference to `specialized spina bifida clinic' in 
     paragraph (2) of such section 1803(c) shall treated as a 
     reference to a specialized clinic treating the birth defect 
     concerned under this subsection; and
       ``(B) the reference to `vocational training under section 
     1804 of this title' in paragraph (8) of such section 1803(c) 
     shall be treated as a reference to vocational training under 
     subsection (b).
       ``(b) Vocational Training.--(1) The Secretary may provide a 
     program of vocational training to a child of a female Vietnam 
     veteran who was born with a covered birth defect if the 
     Secretary determines that the achievement of a vocational 
     goal by the child is reasonably feasible.
       ``(2) Subsections (b) through (e) of section 1804 of this 
     title shall apply with respect to any program of vocational 
     training provided under paragraph (1).
       ``(c) Monetary Allowance.--(1) The Secretary shall pay a 
     monthly allowance to any child of a female Vietnam veteran 
     who was born with a covered birth defect for any disability 
     resulting from such birth defect.
       ``(2) The amount of the monthly allowance paid under this 
     subsection shall be based on the degree of disability 
     suffered by the child concerned, as determined in accordance 
     with a schedule for rating disabilities resulting from 
     covered birth defects that is prescribed by the Secretary.
       ``(3) In prescribing a schedule for rating disabilities 
     under paragraph (2), the Secretary shall establish four 
     levels of disability upon which the amount of the monthly 
     allowance under this subsection shall be based.
       ``(4) The amount of the monthly allowance paid under this 
     subsection shall be as follows:
       ``(A) In the case of a child suffering from the lowest 
     level of disability prescribed in the schedule for rating 
     disabilities under this subsection, $100.
       ``(B) In the case of a child suffering from the lower 
     intermediate level of disability prescribed in the schedule 
     for rating disabilities under this subsection, the greater 
     of--
       ``(i) $214; or
       ``(ii) the monthly amount payable under section 1805(b)(3) 
     of this title for the lowest level of disability prescribed 
     for purposes of that section.
       ``(C) In the case of a child suffering from the higher 
     intermediate level of disability prescribed in the schedule 
     for rating disabilities under this subsection, the greater 
     of--
       ``(i) $743; or

[[Page S3262]]

       ``(ii) the monthly amount payable under section 1805(b)(3) 
     of this title for the intermediate level of disability 
     prescribed for purposes of that section.
       ``(D) In the case of a child suffering from the highest 
     level of disability prescribed in the schedule for rating 
     disabilities under this subsection, the greater of--
       ``(i) $1,272; or
       ``(ii) the monthly amount payable under section 1805(b)(3) 
     of this title for the highest level of disability prescribed 
     for purposes of that section.
       ``(5) Amounts under subparagraphs (A), (B)(i), (C)(i), and 
     (D)(i) of paragraph (4) shall be subject to adjustment from 
     time to time under section 5312 of this title.
       ``(6) Subsections (c) and (d) of section 1805 of this title 
     shall apply with respect to any monthly allowance paid under 
     this subsection.
       ``(d) General Limitations on Availability of Benefits and 
     Assistance.--(1) No individual receiving benefits or 
     assistance under this section may receive any benefits or 
     assistance under subchapter I of this chapter.
       ``(2) In any case where affirmative evidence establishes 
     that the covered birth defect of a child results from a cause 
     other than the active military, naval, or air service in the 
     Republic of Vietnam of the female Vietnam veteran who is the 
     mother of the child, no benefits or assistance may be 
     provided the child under this section.
       ``(e) Regulations.--The Secretary shall prescribe 
     regulations for purposes of the administration of the 
     provisions of this section.''.
       (b) Administrative Provisions.--That chapter is further 
     amended by inserting after subchapter II, as added by 
     subsection (a) of this section, the following new subchapter:

                ``SUBCHAPTER III--ADMINISTRATIVE MATTERS

     ``Sec. 1821. Applicability of certain administrative 
       provisions

       ``The provisions of sections 5101(c), 5110(a), (b)(2), (g), 
     and (i), 5111, and 5112(a), (b)(1), (b)(6), (b)(9), and 
     (b)(10) of this title shall apply with respect to benefits 
     and assistance under this chapter in the same manner as such 
     provisions apply to veterans' disability compensation.

     ``Sec. 1822. Treatment of receipt of monetary allowance on 
       other benefits

       ``(a) 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) 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) 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.''.
       (c) Repeal of Superseded Matter.--Section 1806 of title 38, 
     United States Code, is repealed.
       (d) Redesignation of Existing Matter.--Chapter 18 of that 
     title is further amended by inserting before section 1801 the 
     following:

 ``SUBCHAPTER I--CHILDREN OF VIETNAM VETERANS BORN WITH SPINA BIFIDA''.

       (e) Conforming Amendments.--(1) Sections 1801 and 1802 of 
     that title are each amended by striking ``this chapter'' and 
     inserting ``this subchapter''.
       (2) Section 1805(a) of such title is amended by striking 
     ``this chapter'' and inserting ``this section''.
       (e) Clerical Amendments.--(1)(A) The chapter heading of 
     chapter 18 of that title is amended to read as follows:

       ``CHAPTER 18--BENEFITS FOR CHILDREN OF VIETNAM VETERANS''.

       (B) The tables of chapters at beginning of that title, and 
     at the beginning of part II of that title, are each amended 
     by striking the item relating to chapter 18 and inserting the 
     following new item:

``18. Benefits for Children of Vietnam Veterans.............1801''.....

       (2) The table of sections at the beginning of chapter 18 of 
     that title is amended--
       (A) by inserting after the chapter heading the following:

 ``SUBCHAPTER I--CHILDREN OF VIETNAM VETERANS BORN WITH SPINA BIFIDA'';

       (B) by striking the item relating to section 1806; and
       (C) by adding at the end the following:

``SUBCHAPTER II--CHILDREN OF FEMALE VIETNAM VETERANS BORN WITH CERTAIN 
                             BIRTH DEFECTS

``1811. Definitions.
``1812. Birth defects covered.
``1813. Benefits and assistance.

                ``SUBCHAPTER III--ADMINISTRATIVE MATTERS

``1821. Applicability of certain administrative provisions.
``1822. Treatment of receipt of monetary allowance on other 
              benefits.''.
       (f) Applicability.--(1) Except as provided in paragraph 
     (2), the amendments made by this section shall take effect on 
     the first day of the first month beginning more than one year 
     after the date of the enactment of this Act.
       (2) The Secretary of Veterans Affairs shall identify birth 
     defects under section 1822 of title 38, United States Code 
     (as added by subsection (a) of this section), and shall 
     prescribe the regulations required by subchapter II of that 
     title (as so added), not later than the effective date 
     specified in paragraph (1).
       (3) No benefit or assistance may be provided under 
     subchapter II of chapter 18 of title 38, United States Code 
     (as so added), for any period before the effective date 
     specified in paragraph (1) by reason of the amendments made 
     by this section.
                                  ____


                               Fact Sheet


                               Background

       In 1999, VA released an epidemiological study on women 
     Vietnam veterans which found a ``statistically significant 
     increase in birth defects'' in the children of women Vietnam 
     veterans, particularly moderate to severe birth defects. The 
     reproductive outcomes of over 4,000 Vietnam women veterans 
     were compared with 4,000 Vietnam-era women veterans.
       VA currently has authority to compensate veterans and 
     dependents for disease or injury of the veteran due to 
     service. VA was given special authority in 1996, to provide 
     benefits to children of Vietnam veterans for their own 
     disease resulting from their parent's service--for those 
     children born with spina bifida


                              Legislation

       This bill would apply to women Vietnam veterans' children 
     born with birth defects (other than spina bifida) which 
     result in permanent physical or mental disability, except for 
     birth defects determined by the Secretary of VA to result 
     from familial disorders, birth-related injuries, or fetal or 
     neonatal infirmities with well-established causes.
       This bill is modeled after the 1996 spina bifida 
     legislation.
       It authorizes VA to provide or reimburse a contractor for 
     health care delivered to the disabled children for the birth 
     defect and associated conditions. This health care would 
     include home, hospital, nursing home, outpatient, 
     preventative, habilitative, rehabilitative and respite care. 
     It also includes pharmaceuticals and supplies required by the 
     birth defect, such as wheel chairs, if appropriate.
       It provides compensation from the VA to the children at 
     four payment levels. The benefits would be for $100, $214, 
     $743, and $1,272, depending upon the severity of the 
     disability. Future cost of living adjustments would be 
     indexed and based on the Consumer Price Index, just as other 
     veterans' and Social Security benefits are adjusted.
       This bill also authorizes VA to furnish the disabled 
     children with vocational rehabilitation services. The 
     services would include: VA provision of a training plan that 
     is individually designed, accounting for the individual needs 
     of the child; placement and post-placement services; and 
     personal and work adjustment training. It may also include 
     education at an institution of higher learning. The programs 
     will generally run 24 months, but if necessary, the Secretary 
     may extend the program for an additional 24 months.
       The legislation would be effective one year after the date 
     of enactment, in order to allow time for regulations to be 
     established.
       VA estimates that the costs for this legislation would be 
     approximately $25 million over five years.
                                 ______