,,ii #aafth ,,congress #b;d ,session ,s4 #cfac ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #e1 #bjbj,mr4 ,braun introduced the following bill2 which was read twice and referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to amend title #ch1 ,united ,states ,code1 to strengthen existing benefits for certain descendants of veterans exposed to herbicide agents1 and for other purposes4 #a4 ,benefits for eligible descendants of veterans exposed to herbicide agents 7a7 ,in general ,chapter #ah of title #ch1 ,united ,states ,code1 is amended to read as follows3 #ah ,benefits for eligible descendants of veterans exposed to herbicide agents ,chapter #ah--;,benefits for eligible descendants of veterans exposed to herbicide agents ,sec4 #ahja4 ,definitions4 ,,subchapter ,i--,eligible descendants of veterans exposed to herbicide agents born with spina bifida ,sec4 #ahaa4 ,eligibility4 ,sec4 #ahab4 ,health care4 ,sec4 #ahac4 ,vocational training4 ,sec4 #ahad4 ,monetary allowance4 ,,subchapter ,,ii--,eligible descendants of women veterans exposed to herbicide agents born with certain birth defects ,sec4 #ahba4 ,eligibility2 definition4 ,sec4 #ahbb4 ,covered birth defects4 ,sec4 #ahbc4 ,health care4 ,sec4 #ahbd4 ,vocational training4 ,sec4 #ahbe4 ,monetary allowance4 ,sec4 #ahbf4 ,regulations4 ,,subchapter ,,iii--,administration ,sec4 #ahca4 ,determination of eligibility4 ,sec4 #ahcb4 ,care coordinators for eligible descendants4 ,sec4 #ahcc4 ,duration of health care and benefits provided4 ,sec4 #ahcd4 ,applicability of certain administrative provisions4 ,sec4 #ahce4 ,treatment of receipt of monetary allowance and other benefits4 ,sec4 #ahcf4 ,nonduplication of benefits4 #ahja4 ,definitions ,in this chapter3 7#a7 ,covered birth defect ,the term covered birth defect means a birth defect identified by the ,secretary under section #ahbb of this title4 7#b7 ,covered veteran ,the term covered veteran means an individual who-- 7,a7 served in the active military1 naval1 or air service1 without regard to the characterization of that individual's service2 and 7,b7 is determined by the ,secretary1 in consultation with the ,secretary of ,defense1 to have been exposed to a herbicide agent during such service4 7#c7 ,eligible descendant ,the term eligible descendant means-- 7,a7 for purposes of eligibility for health care and benefits under subchapter ,i1 an individual described in section #ahaa of this title2 and 7,b7 for purposes of eligibility for health care and benefits under subchapter ,,ii1 an individual described in section #ahba7;a7 of this title4 7#d7 ,facility of the ,department ,the term facility of the ,department has the meaning given the term facilities of the ,department in section #agja of this title4 7#e7 ,herbicide agent ,the term herbicide agent means a chemical in a herbicide used in support of ,united ,states and allied military operations1 as determined by the ,secretary in consultation with the ,secretary of ,defense4 ,i ,eligible descendants of veterans exposed to herbicide agents born with spina bifida #ahaa4 ,eligibility ,for purposes of this subchapter1 an eligible descendant is an individual1 regardless of age or marital status1 who-- 7#a7 7,a7 7i7 is the natural child of a covered veteran2 and 7ii7 was conceived after the date on which that veteran first was exposed to a herbicide agent during service in the active military1 naval1 or air service2 or 7,b7 is the natural child of an individual described in subparagraph 7,a72 and 7#b7 was born with any form or manifestation of spina bifida1 except spina bifida occulta4 #ahab4 ,health care 7a7 ,in general ,in accordance with regulations prescribed by the ,secretary1 the ,secretary shall provide an eligible descendant with health care under this section4 7b7 ,provision of care ,the ,secretary shall provide health care under this section-- 7#a7 through facilities of the ,department2 or 7#b7 by contract or other arrangement with any health care provider1 as coordinated by the care coordinator assigned under section #ahcb of this title for the eligible descendant4 7c7 ,definitions ,in this section3 7#a7 ,health care ,the term health care-- 7,a7 means home care1 hospital care1 nursing home care1 outpatient care1 preventive care1 habilitative and rehabilitative care1 case management1 and respite care2 and 7,b7 includes-- 7i7 the training of appropriate members of an eligible descendant's family or household in the care of the descendant2 and 7ii7 the provision of such pharmaceuticals1 supplies1 equipment1 devices1 appliances1 assistive technology1 direct transportation costs to and from approved sources of health care1 and other materials as the ,secretary determines necessary4 7#b7 ,habilitative and rehabilitative care ,the term habilitative and rehabilitative care means such professional1 counseling1 and guidance services and treatment programs 7other than vocational training under section #ahac of this title7 as are necessary to develop1 maintain1 or restore1 to the maximum extent practicable1 the functioning of a disabled person4 7#c7 ,health care provider ,the term health care provider includes specialized spina bifida clinics1 health care plans1 insurers1 organizations1 institutions1 and any other entity or individual furnishing health care services that the ,secretary determines are authorized under this section4 7#d7 ,home care ,the term home care means outpatient care1 habilitative and rehabilitative care1 preventive health services1 and health-related services furnished to an individual in the individual's home or other place of residence1 including assistance with activities of daily living and instrumental activities of daily living4 7#e7 ,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 patient4 7#f7 ,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 resident4 7#g7 ,outpatient care ,the term outpatient care means care and treatment of a disability1 and preventive health services1 furnished to an individual other than hospital care or nursing home care4 7#h7 ,preventive care ,the term preventive care means care and treatment furnished to prevent disability or illness1 including periodic examinations1 immunizations1 patient health education1 and such other services as the ,secretary determines necessary to provide effective and economical preventive health care4 7#i7 ,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 residence4 #ahac4 ,vocational training 7a7 ,authority ,pursuant to regulations prescribed by the ,secretary1 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 feasible4 7b7 ,program design ,any program of vocational training for an eligible descendant under this section shall-- 7#a7 be designed in consultation with the descendant in order to meet the descendant's individual needs2 7#b7 be set forth in an individualized written plan of vocational rehabilitation2 and 7#c7 be designed and developed before the date specified in subsection 7d77#c7 so as to permit the beginning of the program as of such date4 7c7 ,program elements 7#a7 ,in general ,a vocational training program for an eligible descendant under this section-- 7,a7 shall consist of such vocationally oriented services and assistance1 including such placement and post-placement services and personal and work adjustment training1 as the ,secretary determines are necessary to enable the descendant to prepare for and participate in vocational training or employment2 and 7,b7 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 content4 7#b7 ,exclusions ,a vocational training program under this section may not include the provision of any loan or subsistence allowance or any automobile adaptive equipment4 7d7 ,program duration 7#a7 ,in general ,except as provided in paragraph 7#b7 and subject to subsection 7e77#b71 a vocational training program under this section may not exceed #bd months4 7#b7 ,extensions ,the ,secretary may grant an extension of a vocational training program for an eligible descendant under this section for up to #bd additional months if the ,secretary determines that the extension is necessary in order for the descendant to achieve a vocational goal identified 7before the end of the first #bd months of such program7 in the written plan of vocational rehabilitation formulated for the descendant pursuant to subsection 7b74 7#c7 ,commencement ,a vocational training program under this section may begin on the eligible descendant's #ahth birthday1 or on the successful completion of the descendant's secondary schooling1 whichever first occurs1 except that1 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 thereby1 the vocational training program may begin before the descendant's #ahth birthday4 7e7 ,relationship to other programs 7#a7 ,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 #ce of this title may not receive assistance under both such programs concurrently4 ,the descendant shall elect 7in such form and manner as the ,secretary may prescribe7 the program under which the descendant is to receive assistance4 7#b7 ,aggregate period ,the aggregate period for which an eligible descendant may receive assistance under this section and chapter #ce of this title may not exceed #dh months 7or the part-time equivalent thereof74 #ahad4 ,monetary allowance 7a7 ,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 descendant4 7b7 ,schedule for rating of disabilities 7#a7 ,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 descendant1 as determined in accordance with such schedule for rating disabilities resulting from spina bifida as the ,secretary may prescribe4 7#b7 ,levels of disability ,the ,secretary shall1 in prescribing the rating schedule for purposes of this section1 establish three levels of disability upon which the amount of the allowance provided by this section shall be based4 7c7 ,amount of monthly allowance 7#a7 ,in general ,the amounts of the allowance shall be #bjj per month for the lowest level of disability prescribed1 #gjj per month for the intermediate level of disability prescribed1 and #a1bjj per month for the highest level of disability prescribed4 7#b7 ,adjustment ,amounts under paragraph 7#a7 are subject to adjustment under section #ecab of this title4 ,,ii ,eligible descendants of women veterans exposed to herbicide agents born with certain birth defects #ahba4 ,eligibility2 definition 7a7 ,eligibility ,for purposes of this subchapter1 an eligible descendant is an individual1 regardless of age or marital status1 who-- 7#a7 7,a7 7i7 is the natural child of a covered woman veteran2 and 7ii7 was conceived after the date on which that veteran first was exposed to a herbicide agent during service in the active military1 naval1 or air service2 or 7,b7 is the natural child of an individual described in subparagraph 7,a72 and 7#b7 was born with one or more covered birth defects4 7b7 ,covered woman veteran defined ,in this subchapter1 the term covered woman veteran means a covered veteran who is a woman4 #ahbb4 ,covered birth defects 7a7 ,identification ,the ,secretary shall identify the birth defects of eligible descendants that-- 7#a7 are associated with the service of covered woman veterans2 and 7#b7 result in permanent physical or mental disability4 7b7 ,exclusions ,the birth defects identified under subsection 7a7 may not include birth defects resulting from the following3 7#a7 ,a familial disorder4 7#b7 ,a birth-related injury4 7#c7 ,a fetal or neonatal infirmity with well-established causes4 7c7 ,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 military1 naval1 or air service of a covered woman veteran1 no benefits or assistance may be provided the descendant under this subchapter4 #ahbc4 ,health care 7a7 ,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 defects4 7b7 ,provision of care ,the ,secretary shall provide health care under this section-- 7#a7 through facilities of the ,department2 or 7#b7 by contract or other arrangement with a health care provider1 as coordinated by the care coordinator assigned under section #ahcb of this title for the eligible descendant4 7c7 ,definitions ,for purposes of this section1 the definitions in section #ahab7;c7 of this title shall apply with respect to the provision of health care under this section1 except that for such purposes-- 7#a7 the reference to vocational training under section #ahac of this title in paragraph 7#b7 of that section shall be treated as a reference to vocational training under section #ahbd of this title2 and 7#b7 the reference to specialized spina bifida clinic in paragraph 7#c7 of that section shall be treated as a reference to a specialized clinic treating the birth defect concerned under this section4 #ahbd4 ,vocational training 7a7 ,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 feasible4 7b7 ,applicable provisions ,subsections 7b7 through 7e7 of section #ahac of this title shall apply with respect to any program of vocational training provided under subsection 7a74 #ahbe4 ,monetary allowance 7a7 ,monetary allowance ,the ,secretary shall pay a monthly allowance to any eligible descendant for any disability resulting from the covered birth defects of that descendant4 7b7 ,schedule for rating of disabilities 7#a7 ,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 concerned1 as determined in accordance with a schedule for rating disabilities resulting from covered birth defects that is prescribed by the ,secretary4 7#b7 ,levels of disability ,in prescribing a schedule for rating disabilities for purposes of this section1 the ,secretary shall establish four levels of disability upon which the amount of the allowance provided by this section shall be based4 ,the levels of disability established may take into account functional limitations1 including limitations on cognition1 communication1 motor abilities1 activities of daily living1 and employability4 7c7 ,amount of monthly allowance ,the amount of the monthly allowance paid under this section shall be as follows3 7#a7 ,in the case of an eligible descendant suffering from the lowest level of disability prescribed in the schedule for rating disabilities under subsection 7b71 #ajj4 7#b7 ,in the case of an eligible descendant suffering from the lower intermediate level of disability prescribed in the schedule for rating disabilities under subsection 7b71 the greater of-- 7,a7 #bad2 or 7,b7 the monthly amount payable under section #ahad7;c7 of this title for the lowest level of disability prescribed for purposes of that section4 7#c7 ,in the case of an eligible descendant suffering from the higher intermediate level of disability prescribed in the schedule for rating disabilities under subsection 7b71 the greater of-- 7,a7 #gdc2 or 7,b7 the monthly amount payable under section #ahad7;c7 of this title for the intermediate level of disability prescribed for purposes of that section4 7#d7 ,in the case of an eligible descendant suffering from the highest level of disability prescribed in the schedule for rating disabilities under subsection 7b71 the greater of-- 7,a7 #a1bgb2 or 7,b7 the monthly amount payable under section #ahad7;c7 of this title for the highest level of disability prescribed for purposes of that section4 7d7 ,indexing to ,social ,security benefit increases ,amounts under paragraphs 7#a71 7#b77;,a71 7#c77;,a71 and 7#d77;,a7 of subsection 7c7 shall be subject to adjustment from time to time under section #ecab of this title4 #ahbf4 ,regulations ,the ,secretary shall prescribe regulations for purposes of the administration of this subchapter4 ,,iii ,administration #ahca4 ,determination of eligibility 7a7 ,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 chapter4 7b7 ,medical evaluation 7#a7 ,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 ,department4 7#b7 ,determination ,each director of a facility at which a medical evaluation for a descendant is conducted under paragraph 7#a7 shall determine whether such descendant is eligible for health care or benefits under this chapter4 #ahcb4 ,care coordinators for eligible descendants 7a7 ,assignment 7#a7 ,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 #ahca7;b77#b71 except as provided in paragraph 7#b71 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 descendant4 7#b7 ,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 #ahca7;b77#a71 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 descendant4 7b7 ,functions 7#a7 ,in general ,a care coordinator assigned under subsection 7a7 shall ensure that each eligible descendant to which the care coordinator is assigned receives all health care1 vocational training1 and monetary compensation for which the descendant is eligible4 7#b7 ,home modifications and equipment ,a care coordinator assigned under subsection 7a7 shall ensure that1 for each eligible descendant to which the care coordinator is assigned-- 7,a7 any home modifications that the care coordinator determines are necessary1 in consultation with the primary care provider and physical therapist of the descendant1 are completed2 and 7,b7 any durable medical equipment that the care coordinator determines is required1 in consultation with the primary care provider and physical therapist of the descendant1 is provided4 7#c7 ,home visits ,a care coordinator assigned under subsection 7a7 shall conduct not fewer than two home visits each year for each eligible descendant to which the care coordinator is assigned-- 7,a7 to evaluate the support and care being provided2 and 7,b7 to make improvements as needed4 7#d7 ,arrangements with health care providers 7,a7 ,in general ,a care coordinator assigned under subsection 7a7 shall ensure that each eligible descendant to which the care coordinator is assigned is connected with appropriate health care-- 7i7 by locating health care providers2 7ii7 by educating those providers about the health care and benefits provided to eligible descendants under this chapter2 and 7iii7 by arranging health care for the descendant from those providers4 7,b7 ,health care included ,health care arranged under subparagraph 7,a77iii7 shall include such in-home support as an eligible descendant may need for assistance in completing all activities of daily living4 7#e7 ,administrative responsibilities 7,a7 ,in general ,a care coordinator assigned under subsection 7a7 shall ensure1 with respect to each eligible descendant to which the care coordinator is assigned1 any necessary preauthorizations1 payments to providers1 and travel reimbursements are completed in a timely manner4 7,b7 ,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 7,a74 7#f7 ,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 #ahad or #ahbe of this title1 the care coordinator assigned to the descendant under subsection 7a7 shall ensure that the descendant has such a fiduciary4 7c7 ,local contract care coordinator 7#a7 ,in general ,in the case of an eligible descendant who lives a significant driving distance from a facility of the ,department1 the care coordinator assigned to the descendant under subsection 7a7 may arrange for a local contract care coordinator to coordinate care for the descendant from sources other than a facility of the ,department4 7#b7 ,oversight ,each care coordinator who arranges for a local contract care coordinator under paragraph 7#a7 shall oversee the local contract care coordinator1 including through home visits required by subsection 7b77#c74 7d7 ,performance and effectiveness ,each director of a facility of the ,department at which a care coordinator assigned under subsection 7a7 is located shall be responsible for the performance and effectiveness of the care coordinator4 #ahcc4 ,duration of health care and benefits provided ,the ,secretary shall provide an eligible descendant with health care and benefits under this chapter-- 7#a7 for the duration of the life of the descendant2 and 7#b7 notwithstanding any death of a parent of the descendant that precedes the death of the descendant4 #ahcd4 ,applicability of certain administrative provisions 7a7 ,applicability of certain provisions relating to compensation ,the provisions of this title specified in subsection 7b7 apply with respect to benefits and assistance under this chapter in the same manner as those provisions apply to compensation paid under chapter #aa of this title4 7b7 ,specified provisions ,the provisions of this title referred to in subsection 7a7 are the following3 7#a7 ,section #eaja7;c74 7#b7 ,subsections 7a71 7b77#c71 7g71 and 7i7 of section #eaaj4 7#c7 ,section #eaaa4 7#d7 ,subsection 7a7 and paragraphs 7#a71 7#f71 7#i71 and 7#aj7 of subsection 7b7 of section #eaab4 #ahce4 ,treatment of receipt of monetary allowance and other benefits 7a7 ,coordination with other benefits paid to the recipient ,notwithstanding any other provision of law1 receipt by an individual of a monetary allowance under this chapter shall not impair1 infringe1 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 ,secretary4 7b7 ,coordination with benefits based on relationship of recipients ,notwithstanding any other provision of law1 receipt by an individual of a monetary allowance under this chapter shall not impair1 infringe1 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 allowance4 7c7 ,monetary allowance not ,to be considered as income or resources for certain purposes ,notwithstanding any other provision of law1 a monetary allowance paid an individual under this chapter shall not be considered as income or resources in determining eligibility for1 or the amount of benefits under1 any ,federal or federally assisted program4 #ahcf4 ,nonduplication of benefits 7a7 ,monetary allowance ,in the case of an eligible descendant under subchapter ,,ii of this chapter whose only covered birth defect is spina bifida1 a monetary allowance shall be paid under subchapter ,i of this chapter4 ,in the case of an eligible descendant under subchapter ,,ii of this chapter who has spina bifida and one or more additional covered birth defects1 a monetary allowance shall be paid under subchapter ,,ii of this chapter4 7b7 ,vocational training ,an individual may only be provided one program of vocational training under this chapter4 4 7b7 ,conforming amendments ,such title is further amended-- 7#a7 in section #ecab1 by striking #ahje both places it appears and inserting #ahad2 and 7#b7 in section #aaaf;,b7c71 by striking has the meaning given such term in section #ahba7;d7 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 zone1 as determined by the ,secretary in consultation with the ,secretary of ,defense1 during the period beginning on ,september #a1 #aifg1 and ending on ,august #ca1 #aiga4