[Congressional Record Volume 166, Number 117 (Thursday, June 25, 2020)]
[Senate]
[Pages S3382-S3384]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 1858. Mr. BRAUN submitted an amendment intended to be proposed by
him to the bill S. 4049, to authorize appropriations for fiscal year
2021 for military activities of the Department of Defense, for military
construction, and for defense activities of the Department of Energy,
to prescribe military personnel strengths for such fiscal year, and for
other purposes; which was ordered to lie on the table; as follows:
At the end of subtitle G of title X, add the following:
SEC. __. 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),
[[Page S3383]]
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
[[Page S3384]]
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''.
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