VET PFAS Act

I 116TH CONGRESS 1ST SESSION H. R. 2102 To amend title 38, United States Code, to furnish hospital care and medical services to veterans and dependents who were stationed at military instal- lations at which the veterans and dependents were exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl substances, to provide for a presumption of service connection for certain veterans who were stationed at military installations at which the veterans were exposed to such substances, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 4, 2019 Mr. KILDEE (for himself, Mrs. DINGELL, Ms. SLOTKIN, Mr. LEVIN of Michi- gan, Ms. TLAIB, Mr. KHANNA, Mr. DELGADO, Ms. TORRES SMALL of New Mexico, Mr. PAPPAS, Mr. BRENDAN F. BOYLE of Pennsylvania, Mr. SEAN PATRICK MALONEY of New York, Ms. DEAN, Mr. COHEN, Ms. KUSTER of New Hampshire, Mrs. LAWRENCE, Ms. STEVENS, Mrs. TRAHAN, and Mr. KIM) introduced the following bill; which was referred to the Committee on Veterans’ Affairs A BILL To amend title 38, United States Code, to furnish hospital care and medical services to veterans and dependents who were stationed at military installations at which the veterans and dependents were exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl substances, to provide for a presumption of service con- nection for certain veterans who were stationed at mili- tary installations at which the veterans were exposed to such substances, and for other purposes. VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 2102 IH Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Veterans Exposed to 4 Toxic PFAS Act’’ or the ‘‘VET PFAS Act’’. 5 SEC. 2. HOSPITAL CARE AND MEDICAL SERVICES FOR VET- 6 ERANS AND DEPENDENTS EXPOSED TO 7 PERFLUOROOCTANOIC ACID AND OTHER 8 PER- AND POLYFLUOROALKYL SUBSTANCES. 9 (a) HOSPITAL CARE AND MEDICAL SERVICES FOR 10 VETERANS.— 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 16 after the date of the enactment of this subpara- 17 graph, subject to paragraph (2), a veteran who 18 served on active duty in the Armed Forces at a cov- 19 ered military installation at which individuals were 20 exposed to substances specified in clause (ii) is eligi- 21 ble for hospital care and medical services under sub- 22 section (a)(2)(F) for the diseases, illnesses, or condi- 23 tions as specified in such clause, notwithstanding 24 that there is insufficient medical evidence to con- 25 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 2102 IH clude that such illness or condition is attributable to 1 such service. 2 ‘‘(ii) The substances and diseases, illnesses, or 3 conditions specified in this clause are the following: 4 ‘‘(I) With respect to exposure to perfluoro- 5 octanoic 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 per- and polyfluoroalkyl substances, any dis- 14 ease, illness, or condition that the Secretary of 15 Veterans Affairs, in consultation with the Ad- 16 ministrator of the Agency for Toxic Substances 17 and Disease Registry of the Department of 18 Health and Human Services, determines pursu- 19 ant to the study conducted under section 316 of 20 the National Defense Authorization Act for Fis- 21 cal Year 2018 (Public Law 115–91) that a 22 positive association exists between exposure to 23 per- and polyfluoroalkyl substances and such 24 disease, illness, or condition. 25 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 2102 IH ‘‘(iii) For purposes of this subparagraph, any 1 service by a member of the reserve components for 2 a period specified by the Secretary at a covered mili- 3 tary installation at which individuals were exposed to 4 substances specified in clause (ii) shall be treated as 5 active duty service, notwithstanding section 101(21) 6 of this title. 7 ‘‘(iv) In this subparagraph, the term ‘covered 8 military installation’ means a military installation at 9 which individuals were exposed to perfluorooctanoic 10 acid or other per- and polyfluoroalkyl substances, in- 11 cluding exposure through a well that provides water 12 for human consumption that is contaminated with 13 such substances.’’. 14 (2) LIMITATION.—Paragraph (2)(B) of such 15 section is amended by striking ‘‘or (F)’’ and insert- 16 ing ‘‘(F), or (G)’’. 17 (b) FAMILY MEMBERS.— 18 (1) IN GENERAL.—Subchapter VIII of chapter 19 17 is amended by adding at the end the following 20 new section: 21 ‘‘§ 1787A. Health care of family members of veterans 22 stationed at certain military installations 23 ‘‘(a) IN GENERAL.—Beginning on the date that is 90 24 days after the date of the enactment of this section, sub- 25 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 2102 IH ject to subsection (b), a family member of a veteran de- 1 scribed in clause (i) of section 1710(e)(1)(G) of this title 2 (or who would be so described but for the condition by 3 which the individual was discharged or released from the 4 Armed Forces) who resided at a military installation cov- 5 ered by such clause or who was in utero while the mother 6 of such family member resided at such location shall be 7 eligible for hospital care and medical services furnished 8 by the Secretary for any disease, illness, or condition for 9 which a veteran may receive hospital care and medical 10 services under clause (ii) of such section, notwithstanding 11 that there is insufficient medical evidence to conclude that 12 such disease, illness, or condition is attributable to such 13 residence. 14 ‘‘(b) LIMITATIONS.—(1) The Secretary may only fur- 15 nish hospital care and medical services under subsection 16 (a) to the extent and in the amount provided in advance 17 in appropriations Acts for such purpose. 18 ‘‘(2) Hospital care and medical services may not be 19 furnished under subsection (a) for a disease, illness, or 20 condition of a family member that is found, in accordance 21 with guidelines issued by the Under Secretary for Health, 22 to have resulted from a cause other than the residence 23 of the family member described in that subsection. 24 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 2102 IH ‘‘(3) The Secretary may provide reimbursement for 1 hospital care or medical services provided to a family 2 member under this section only after the family member 3 or the provider of such care or services has exhausted 4 without success all claims and remedies reasonably avail- 5 able to the family member or provider against a third 6 party (as defined in section 1725(f) of this title) for pay- 7 ment of such care or services, including with respect to 8 health-plan contracts (as defined in such section).’’. 9 (2) CLERICAL AMENDMENT.—The table of sec- 10 tions at the beginning of such chapter is amended 11 by inserting after the item relating to section 1787 12 the following new item: 13 ‘‘1787A. Health care of family members of veterans stationed at certain military installations.’’. (c) ANNUAL REPORTS.— 14 (1) IN GENERAL.—During the three-year period 15 beginning in the year in which the study conducted 16 under section 316 of the National Defense Author- 17 ization Act for Fiscal Year 2018 (Public Law 115– 18 91) is submitted to Congress, the Secretary of Vet- 19 erans Affairs shall submit to the Committee on Vet- 20 erans’ Affairs of the Senate and the Committee on 21 Veterans’ Affairs of the House of Representatives an 22 annual report on the care and services provided 23 under sections 1710(e)(1)(G) and 1787A of title 38, 24 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 2102 IH United States Code (as added by subsections (a) and 1 (b)(1), respectively). 2 (2) ELEMENTS.—Each report under paragraph 3 (1) shall set forth the following: 4 (A) The number of veterans and family 5 members provided hospital care and medical 6 services under the provisions of law specified in 7 paragraph (1) during the period covered by the 8 report. 9 (B) The illnesses, conditions, and disabil- 10 ities for which care and services have been pro- 11 vided such veterans and family members under 12 such provisions of law during that period. 13 (C) The number of veterans and family 14 members who applied for care and services 15 under such provisions of law during that period 16 but were denied, including information on the 17 reasons for such denials. 18 (D) The number of veterans and family 19 members who applied for care and services 20 under such provisions of law and are awaiting 21 a decision from the Secretary on eligibility for 22 such care and services as of the date of such re- 23 port. 24 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 2102 IH (3) VETERAN DEFINED.—In this subsection, 1 the term ‘‘veteran’’ includes a former member of the 2 reserve components of the Armed Forces covered by 3 such section 1710(e)(1)(G). 4 SEC. 3. PRESUMPTION OF SERVICE CONNECTION FOR CER- 5 TAIN VETERANS EXPOSED TO PERFLUORO- 6 OCTANOIC ACID OR OTHER PER- AND 7 POLYFLUOROALKYL SUBSTANCES. 8 (a) IN GENERAL.—Chapter 11 of title 38, United 9 States Code, is amended by inserting after section 1116 10 the following new section: 11 ‘‘§ 1116A. Presumption of service connection for cer- 12 tain veterans exposed to perfluoro- 13 octanoic acid or other per- and poly- 14 fluoroalkyl substances 15 ‘‘(a) PRESUMPTION OF SERVICE CONNECTION.—(1) 16 For the purposes of section 1110 of this title, and subject 17 to section 1113 of this title, each disease or illness speci- 18 fied in subsection (b) that becomes manifest in a veteran 19 described in paragraph (2) shall be considered to have 20 been incurred or aggravated in the line of duty in the ac- 21 tive military, naval, or air service, notwithstanding that 22 there is no record of evidence of such disease or illness 23 during the period of such service. 24 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 2102 IH ‘‘(2) A veteran described in this paragraph is a vet- 1 eran who, during active military, naval, or air service, 2 served at a military installation at which individuals were 3 exposed to perfluorooctanoic acid or other per- and 4 polyfluoroalkyl substances, including exposure through a 5 well that provides water for human consumption that is 6 contaminated with such substances. 7 ‘‘(b) DISEASES OR ILLNESSES.—A disease or illness 8 specified in this subsection is any of the following: 9 ‘‘(1) With respect to exposure to perfluoro- 10 octanoic 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 per- and 18 polyfluoroalkyl substances, any other disease, illness, 19 or condition that the Secretary of Veterans Affairs, 20 in consultation with the Administrator of the Agency 21 for Toxic Substances and Disease Registry of the 22 Department of Health and Human Services, deter- 23 mines pursuant to the study conducted under section 24 316 of the National Defense Authorization Act for 25 VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 2102 IH Fiscal Year 2018 (Public Law 115–91) that a posi- 1 tive association exists between exposure to per- and 2 polyfluoroalkyl substances and such disease or ill- 3 ness. 4 ‘‘(c) ACTIVE MILITARY, NAVAL, OR AIR SERVICE.— 5 For purposes of this section, any service by a member of 6 the reserve components for a period specified by the Sec- 7 retary at a military installation described in subsection 8 (a)(2) shall be treated as active military, naval, or air serv- 9 ice, notwithstanding section 101(24) of this title.’’. 10 (b) CLERICAL AMENDMENT.—The table of sections 11 at the beginning of such chapter is amended by inserting 12 after the item relating to section 1116 the following new 13 item: 14 ‘‘1116A. Presumption of service connection for certain veterans exposed to perfluorooctanoic acid or other per- and polyfluoroalkyl sub- stances.’’. Æ VerDate Sep 11 2014 01:26 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\H2102.IH H2102 pamtmann on DSKBFK8HB2PROD with BILLS