VET PFAS Act

II 116TH CONGRESS 1ST SESSION S. 1023 To amend title 38, United States Code, to furnish hospital care and medical services to veterans, members of the reserve components of the Armed Forces, and dependents who were stationed at military installations at which they were exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl substances, to provide for a presumption of service con- nection for those veterans and members of the reserve components, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL 3, 2019 Ms. STABENOW (for herself, Mr. PETERS, and Mr. CASEY) introduced the fol- lowing bill; which was read twice and referred to the Committee on Vet- erans’ Affairs A BILL To amend title 38, United States Code, to furnish hospital care and medical services to veterans, members of the reserve components of the Armed Forces, and dependents who were stationed at military installations at which they were exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl substances, to provide for a presump- tion of service connection for those veterans and mem- bers of the reserve components, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 2 •S 1023 IS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Veterans Exposed to 2 Toxic PFAS Act’’ or the ‘‘VET PFAS Act’’. 3 SEC. 2. HOSPITAL CARE AND MEDICAL SERVICES FOR VET- 4 ERANS, MEMBERS OF THE RESERVE COMPO- 5 NENTS, AND DEPENDENTS EXPOSED TO 6 PERFLUOROOCTANOIC ACID AND OTHER 7 PER- AND POLYFLUOROALKYL SUBSTANCES. 8 (a) HOSPITAL CARE AND MEDICAL SERVICES FOR 9 VETERANS AND MEMBERS OF THE RESERVE COMPO- 10 NENTS.— 11 (1) IN GENERAL.—Paragraph (1) of section 12 1710(e) of title 38, United States Code, is amended 13 by adding at the end the following new subpara- 14 graph: 15 ‘‘(G)(i) Beginning on the date that is 90 days after 16 the date of the enactment of this subparagraph, subject 17 to paragraph (2), a veteran who served on active duty in 18 the Armed Forces, or an individual who served as a mem- 19 ber of the reserve components of the Armed Forces, at 20 a covered military installation at which individuals were 21 exposed to substances specified in clause (ii) is eligible for 22 hospital care and medical services under subsection 23 (a)(2)(F) for the diseases, illnesses, or conditions as speci- 24 fied in such clause, notwithstanding that there is insuffi- 25 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 3 •S 1023 IS cient medical evidence to conclude that such illness or con- 1 dition is attributable to such service. 2 ‘‘(ii) The substances and diseases, illnesses, or condi- 3 tions specified in this clause are the following: 4 ‘‘(I) With respect to exposure to per- 5 fluorooctanoic acid— 6 ‘‘(aa) diagnosed high cholesterol; 7 ‘‘(bb) ulcerative colitis; 8 ‘‘(cc) thyroid disease; 9 ‘‘(dd) testicular cancer; 10 ‘‘(ee) kidney cancer; and 11 ‘‘(ff) pregnancy-induced hypertension. 12 ‘‘(II) With respect to exposure to other 13 perfluoroalkyl and polyfluoroalkyl substances, any 14 disease, illness, or condition that the Secretary, in 15 consultation with the Agency for Toxic Substances 16 and Disease Registry of the Department of Health 17 and Human Services, determines pursuant to the 18 study conducted under section 316 of the National 19 Defense Authorization Act for Fiscal Year 2018 20 (Public Law 115–91; 131 Stat. 1350) that a positive 21 association exists between exposure to perfluoroalkyl 22 and polyfluoroalkyl substances and such disease, ill- 23 ness, or condition. 24 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 4 •S 1023 IS ‘‘(iii) In this subparagraph, the term ‘covered mili- 1 tary installation’ means a military installation at which 2 individuals were exposed to perfluorooctanoic acid or other 3 perfluoroalkyl and polyfluoroalkyl substances, including 4 exposure through a well that provides water for human 5 consumption that is contaminated with such substances.’’. 6 (2) LIMITATION.—Paragraph (2)(B) of such 7 section is amended by striking ‘‘or (F)’’ and insert- 8 ing ‘‘(F), or (G)’’. 9 (b) FAMILY MEMBERS.— 10 (1) IN GENERAL.—Subchapter VIII of chapter 11 17 of title 38, United States Code, is amended by 12 inserting after section 1787 the following new sec- 13 tion: 14 ‘‘§ 1787A. Health care of family members of individ- 15 uals stationed at certain military installa- 16 tions 17 ‘‘(a) IN GENERAL.—Beginning on the date that is 90 18 days after the date of the enactment of this section, sub- 19 ject to subsection (b), a family member of a veteran de- 20 scribed in clause (i) of section 1710(e)(1)(G) of this title 21 (or who would be so described but for the condition by 22 which the individual was discharged or released from the 23 Armed Forces), or a family member of a member of the 24 reserve components of the Armed Forces described in such 25 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 5 •S 1023 IS clause, who resided at a military installation covered by 1 such clause or who was in utero while the mother of such 2 family member resided at such location shall be eligible 3 for hospital care and medical services furnished by the 4 Secretary for any disease, illness, or condition for which 5 an individual may receive hospital care and medical serv- 6 ices under clause (ii) of such section, notwithstanding that 7 there is insufficient medical evidence to conclude that such 8 disease, illness, or condition is attributable to such resi- 9 dence. 10 ‘‘(b) LIMITATIONS.—(1) The Secretary may only fur- 11 nish hospital care and medical services under subsection 12 (a) to the extent and in the amount provided in advance 13 in appropriations Acts for such purpose. 14 ‘‘(2) Hospital care and medical services may not be 15 furnished under subsection (a) for a disease, illness, or 16 condition of a family member that is found, in accordance 17 with guidelines issued by the Under Secretary for Health, 18 to have resulted from a cause other than the residence 19 of the family member described in that subsection. 20 ‘‘(3) The Secretary may provide reimbursement for 21 hospital care or medical services provided to a family 22 member under this section only after the family member 23 or the provider of such care or services has exhausted 24 without success all claims and remedies reasonably avail- 25 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 6 •S 1023 IS able to the family member or provider against a third 1 party (as defined in section 1725(f) of this title) for pay- 2 ment of such care or services, including with respect to 3 health-plan contracts (as defined in such section).’’. 4 (2) CLERICAL AMENDMENT.—The table of sec- 5 tions at the beginning of such chapter is amended 6 by inserting after the item relating to section 1787 7 the following new item: 8 ‘‘1787A. Health care of family members of individuals stationed at certain mili- tary installations.’’. (c) ANNUAL REPORTS.— 9 (1) IN GENERAL.—During the three-year period 10 beginning on the date on which the study conducted 11 under section 316 of the National Defense Author- 12 ization Act for Fiscal Year 2018 (Public Law 115– 13 91; 131 Stat. 1350) is submitted to Congress, the 14 Secretary of Veterans Affairs shall submit to the 15 Committee on Veterans’ Affairs of the Senate and 16 the Committee on Veterans’ Affairs of the House of 17 Representatives an annual report on the care and 18 services provided under sections 1710(e)(1)(G) and 19 1787A of title 38, United States Code (as added by 20 subsections (a) and (b)(1), respectively). 21 (2) ELEMENTS.—Each report under paragraph 22 (1) shall set forth the following: 23 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 7 •S 1023 IS (A) The number of veterans, members of 1 the reserve components of the Armed Forces, 2 and family members provided hospital care and 3 medical services under the provisions of law 4 specified in paragraph (1) during the period 5 covered by the report. 6 (B) The illnesses, conditions, and disabil- 7 ities for which care and services have been pro- 8 vided such veterans, members of the reserve 9 components, and family members under such 10 provisions of law during that period. 11 (C) The number of veterans, members of 12 the reserve components, and family members 13 who applied for care and services under such 14 provisions of law during that period but were 15 denied, including information on the reasons for 16 such denials. 17 (D) The number of veterans, members of 18 the reserve components, and family members 19 who applied for care and services under such 20 provisions of law and are awaiting a decision 21 from the Secretary on eligibility for such care 22 and services as of the date of such report. 23 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 8 •S 1023 IS SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CER- 1 TAIN INDIVIDUALS EXPOSED TO PER- 2 FLUOROOCTANOIC ACID OR OTHER PER- AND 3 POLYFLUOROALKYL SUBSTANCES. 4 (a) IN GENERAL.—Chapter 11 of title 38, United 5 States Code, is amended by inserting after section 1116 6 the following new section: 7 ‘‘§ 1116A. Presumption of service connection for cer- 8 tain individuals exposed to per- 9 fluorooctanoic acid or other per- and 10 polyfluoroalkyl substances 11 ‘‘(a) PRESUMPTION OF SERVICE CONNECTION.—(1) 12 For the purposes of section 1110 of this title, and subject 13 to section 1113 of this title, each disease, illness, or condi- 14 tion specified in subsection (b) that becomes manifest in 15 an individual described in paragraph (2) shall be consid- 16 ered to have been incurred or aggravated in the line of 17 duty in the active military, naval, or air service, notwith- 18 standing that there is no record of evidence of such dis- 19 ease, illness, or condition during the period of such service. 20 ‘‘(2) An individual described in this paragraph is— 21 ‘‘(A) a veteran who, during active military, 22 naval, or air service, served at a military installation 23 at which individuals were exposed to 24 perfluorooctanoic acid or other perfluoroalkyl and 25 polyfluoroalkyl substances, including exposure 26 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 9 •S 1023 IS through a well that provides water for human con- 1 sumption that is contaminated with such substances; 2 or 3 ‘‘(B) a member of the reserve components of 4 the Armed Forces who served at a military installa- 5 tion described in subparagraph (A). 6 ‘‘(b) DISEASES OR ILLNESSES.—A disease, illness, or 7 condition specified in this subsection is any of the fol- 8 lowing: 9 ‘‘(1) With respect to exposure to per- 10 fluorooctanoic acid— 11 ‘‘(A) diagnosed high cholesterol; 12 ‘‘(B) ulcerative colitis; 13 ‘‘(C) thyroid disease; 14 ‘‘(D) testicular cancer; 15 ‘‘(E) kidney cancer; and 16 ‘‘(F) pregnancy-induced hypertension. 17 ‘‘(2) With respect to exposure to other 18 perfluoroalkyl and polyfluoroalkyl substances, any 19 other disease, illness, or condition that the Sec- 20 retary, in consultation with the Agency for Toxic 21 Substances and Disease Registry of the Department 22 of Health and Human Services, determines pursuant 23 to the study conducted under section 316 of the Na- 24 tional Defense Authorization Act for Fiscal Year 25 VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS 10 •S 1023 IS 2018 (Public Law 115–91) that a positive associa- 1 tion exists between exposure to perfluoroalkyl and 2 polyfluoroalkyl substances and such disease, illness, 3 or condition.’’. 4 (b) CLERICAL AMENDMENT.—The table of sections 5 at the beginning of such chapter is amended by inserting 6 after the item relating to section 1116 the following new 7 item: 8 ‘‘1116A. Presumption of service connection for certain individuals exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl sub- stances.’’. Æ VerDate Sep 11 2014 18:39 Apr 09, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\S1023.IS S1023 pamtmann on DSKBFK8HB2PROD with BILLS