Victims of Agent Orange Relief Act of 2021
Bill: H.R.3518 | Sponsor: Rep. Lee, Barbara (D-CA)
Policy area: Armed Forces and National Security

Summary:
Victims of Agent Orange Relief Act of 2021
This bill requires the Department of State, the Department of Health and Human Services (HHS), and the Department of Veterans Affairs (VA) to provide assistance to people in Vietnam in relation to Agent Orange exposure.
Specifically, the State Department must provide assistance (1) to address the health care needs of certain residents of Vietnam affected by Agent Orange exposure, (2) to institutions in Vietnam that provide health care to such individuals, (3) to improve housing and reduce poverty for specified individuals and their families, and (4) to remediate areas of Vietnam that contain high levels of Agent Orange.
HHS must (1) make grants to public health organizations and Vietnamese American organizations to conduct a broad health assessment of Vietnamese Americans who may have been exposed to Agent Orange and their descendants; and (2) establish centers in U.S. locations where large populations of Vietnamese Americans reside to provide assessment, counseling, and treatment for conditions related to Agent Orange exposure.
Under the bill, certain benefits will be made available to the children of male Vietnam veterans who are affected by certain birth defects. Currently, these benefits are only available to the children of women Vietnam veterans. The VA shall require any health care provider with whom the VA enters into a contract for the provision of health care to such children to provide the VA access to their medical records for research into the intergenerational effects of Agent Orange exposure.

To direct the Secretary of State, the Secretary of Health and Human 
 Services, and the Secretary of Veterans Affairs to provide assistance 
  for individuals affected by exposure to Agent Orange, and for other 
                               purposes.

    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 ``Victims of Agent Orange Relief Act 
of 2021''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) From 1961 to 1971, approximately 19,000,000 gallons of 
        15 different herbicides were sprayed over the southern region 
        of Vietnam.
            (2) The herbicides included 13,000,000 gallons of Agent 
        Orange, 4,500,000 gallons of Agent White, 1,000,000 gallons of 
        Agent Blue, 420,000 gallons of Agent Purple, and relatively 
        smaller quantities of the other herbicides. Many of the 
        herbicides, including Agents Orange, Purple, Green, Pink, 
        Dinoxol, and Trinoxol contained the toxic contaminant dioxin 
        (TCDD). Agent Blue contained high levels of arsenic. The 
        aforementioned 15 herbicides, including the contaminant dioxin, 
        are usually collectively referred to as Agent Orange.
            (3) Between 1968 and 1971, a total of 6,500 spraying 
        missions were carried out in an area of about 1,500,000 
        hectares, which represented about 12 percent of South Vietnam 
        and portions of Laos and Cambodia.
            (4) Studies show that between 2,100,000 and 4,800,000 
        Vietnamese and tens of thousands of Americans were exposed to 
        Agent Orange during the spraying. Many other Vietnamese were or 
        continue to be exposed to Agent Orange through contact with the 
        environment and food that was contaminated. Many offspring of 
        those who were exposed have birth defects, developmental 
        disabilities, and other diseases.
            (5) Today, there are still dozens of environmental hot 
        spots that continue to contaminate the food, soil, sediment, 
        livestock, and wildlife with Agent Orange. Concentrations of 
        TCDD as high as 1,000 mg/kg have been found in soil and 
        sediment samples more than 50 years after Agent Orange was 
        sprayed in Vietnam.
            (6) The United States has provided some assistance to 
        Vietnam in remediating Agent Orange contamination at the 
        largest of these hotspots, which are the airbases that handled 
        the spray missions. The Da Nang Airport has been fully cleaned 
        up, and the United States has committed funds to contribute to 
        cleaning up the Bien Hoa Airbase, which is the most 
        contaminated site in Vietnam. There are at least two dozen 
        other smaller hotspots scattered throughout southern and 
        central Vietnam that also must be remediated, since they 
        continue to expose local populations to dioxin and arsenic.
            (7) Agent Orange exposure continues to negatively affect 
        the lives of veterans of the United States Armed Forces, 
        Vietnamese people, Vietnamese Americans, and their children. 
        The lives of many victims are cut short and others live with 
        disease, disabilities, and pain, often untreated or 
        unrecognized.
            (8) The Department of Veterans Affairs recognizes 15 
        illnesses and diseases, including AL amyloidosis, chronic B-
        cell leukemia, chloracne, diabetes mellitus type 2, Hodgkin's 
        disease, ischemic heart disease, multiple myeloma, non-
        Hodgkin's lymphoma, Parkinson's disease, acute and sub-acute 
        peripheral neuropathy, porphyria cutanea tarda, prostate 
        cancer, respiratory cancers, and soft-tissue sarcomas as 
        associated with the spraying and use of Agent Orange by the 
        United States Armed Forces during the Vietnam era.
            (9) No similar consideration has been given to affected 
        Vietnamese or Vietnamese Americans.
            (10) The Department of Veterans Affairs provides 
        compensation for many severe birth defects among the children 
        of American women veterans who served in Vietnam. The list of 
        birth defects covered includes but is not limited to: 
        Achondroplasia, cleft lip, cleft palate, congenital heart 
        disease, congenital talipes equinovarus (clubfoot), esophageal 
        and intestinal atresia, Hallerman-Streiff syndrome, hip 
        dysplasia, Hirschsprung's disease (congenital megacolon), 
        hydrocephalus due to aqueductal stenosis, hypospadias, 
        imperforate anus, neural tube defects, Poland syndrome, pyloric 
        stenosis, syndactyly (fused digits), tracheoesophageal fistula, 
        undescended testes, and Williams syndrome. Affected children of 
        these women veterans receive medical care and other benefits. 
        However, the care and compensation provided by the Department 
        of Veterans Affairs to the covered children of United States 
        veterans is insufficient to meet their needs.
            (11) The only birth defect recognized for the children of 
        male American veterans is spina bifida (but not occulta). 
        However, many children of male Vietnam War veterans have the 
        same range of birth defects and diseases, resulting in most 
        affected children of United States veterans receiving no care 
        or benefits.
            (12) No assistance has been given to the children of male 
        or female Vietnamese or Vietnamese Americans connected with 
        their exposure, or their parents' or grandparents' exposure.
            (13) The Institute of Medicine for the past several years 
        has noted that ``it is considerably more plausible than 
        previously believed that exposure to the herbicides sprayed in 
        Vietnam might have caused paternally mediated transgenerational 
        effects . . . attributable to the TCCD contaminant in Agent 
        Orange.''. In recent years, scientific studies have identified 
        likely epigenetic links between exposure to toxins and birth 
        defects and developmental disorders in subsequent generations. 
        Some of the children and grandchildren of exposed persons 
        (Americans, Vietnamese, and Vietnamese Americans) who were in 
        southern Vietnam during the Vietnam era likely suffer from 
        disorders, birth defects, and illnesses related to Agent 
        Orange.
            (14) Since 2007, the United States has engaged in 
        environmental remediation of contamination at the Da Nang 
        airport, and more recently the Bien Hoa airport, and has 
        provided funds for public health and disabilities activities 
        for individuals residing in some affected areas.
            (15) Laos and Cambodia were also sprayed with Agent Orange 
        during the Vietnam era. At least 527,000 gallons of Agent 
        Orange were sprayed in Laos and significant amounts were 
        sprayed in Cambodia. Affected Lao and Cambodian people over 
        several generations suffer from medical conditions, birth 
        defects and disabilities similar to those seen in Vietnam and 
        in the United States. The United States has the responsibility 
        to take action to mitigate and provide compensations for those 
        effects. Further action will be needed to ascertain and 
        effectively address this legacy of the Vietnam War.
    (b) Purpose.--It is the purpose of this Act to address and 
remediate the ongoing damage that arose or will arise from the use of 
Agent Orange during the Vietnam era.

SEC. 3. ASSISTANCE FOR INDIVIDUALS AFFECTED BY HEALTH ISSUES RELATED TO 
              EXPOSURE TO AGENT ORANGE.

    (a) For Covered Individuals.--The Secretary of State shall provide 
assistance to address the health care needs of covered individuals. 
Such assistance shall include the provision of medical and chronic care 
services, nursing services, vocational employment training, and medical 
equipment.
    (b) For Caregivers.--The Secretary of State shall provide 
assistance to institutions in Vietnam that provide health care for 
covered individuals. Such assistance shall include--
            (1) medicines and medical equipment;
            (2) custodial care, home care, respite care, and daycare 
        programs;
            (3) training programs for caregivers;
            (4) medical, physical rehabilitation, and counseling 
        services and equipment for illnesses and deformities associated 
        with exposure to Agent Orange; and
            (5) reconstructive surgical programs.
    (c) For Housing and Poverty Reduction.--The Secretary of State 
shall provide assistance to repair and rebuild substandard homes in 
Vietnam for covered individuals and the families of covered 
individuals. The Secretary of State shall provide micro grants and 
loans to facilitate subsistence payments and poverty reduction for 
covered individuals and families of covered individuals.
    (d) For Environmental Remediation.--
            (1) In general.--The Secretary of State shall provide 
        assistance to remediate those geographic areas of Vietnam that 
        the Secretary determines contain high levels of Agent Orange.
            (2) Priority.--In providing assistance under this 
        subsection, the Secretary of State shall give priority to 
        heavily sprayed areas, particularly areas that served as 
        military bases where Agent Orange was handled, and areas where 
        heavy spraying and air crashes resulted in harmful deposits of 
        Agent Orange.
    (e) Administrative Authorities.--The Secretary of State shall--
            (1) provide assistance under this section (other than 
        assistance under subsection (d)) through appropriate Vietnamese 
        community and nongovernmental organizations and, where 
        necessary, public agencies;
            (2) provide assistance under this section to affected 
        persons in all areas of Vietnam, including rural, mountainous, 
        and urban areas;
            (3) encourage strategic alliances between private and 
        public sector partners as a business model for achieving the 
        goals of this section; and
            (4) seek out and actively encourage other bilateral donors 
        as well as United States and foreign business enterprises in 
        Vietnam to support the goals of this section through 
        development assistance and corporate philanthropy programs.
    (f) Covered Individual Defined.--In this section, the term 
``covered individual'' means an individual who--
            (1) is a resident of Vietnam; and
            (2)(A) is affected by health issues related to exposure to 
        Agent Orange which took place during the period beginning on 
        January 1, 1961, and ending on May 7, 1975, or who lives or has 
        lived in or near those geographic areas in Vietnam that 
        continue to contain high levels of Agent Orange as described in 
        subsection (d); or
            (B) is the child or descendant of an individual described 
        in subparagraph (A), and is affected by health issues described 
        in subparagraph (A).

SEC. 4. PUBLIC RESEARCH.

    (a) Support for Research.--The Secretary of State and the Secretary 
of Veterans Affairs shall identify and provide assistance to support 
research relating to health issues of individuals affected by Agent 
Orange. Such research should include recommended focus provided by the 
United States Institute of Medicine as identified in their biennial 
Veterans and Agent Orange Update, and supported by the active 
involvement of schools of public health and medicine located in the 
United States, Vietnam, and other interested countries.
    (b) Survey.--The Secretary of Veterans Affairs shall conduct a 
survey of children of veterans who were exposed to Agent Orange and who 
have received health care under subchapter II of chapter 18 of title 
38, United States Code. The survey shall be designed to determine the 
extent to which such children are receiving adequate treatment for 
their medical conditions and disabilities. The Secretary shall make 
recommendations based on the survey as to any actions necessary to 
remedy any deficiencies identified pursuant to the survey.

SEC. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENT AND 
              ASSISTANCE FOR VIETNAMESE AMERICANS.

    (a) Health Assessment.--The Secretary of Health and Human Services 
shall make grants to appropriate public health organizations and 
Vietnamese-American organizations for the purpose of conducting a broad 
health assessment of Vietnamese Americans who may have been exposed to 
Agent Orange and their children or descendants to determine the effects 
to their health of such exposure.
    (b) Assistance.--The Secretary of Health and Human Services shall 
establish centers in locations in the United States where large 
populations of Vietnamese Americans reside for the purpose of providing 
assessment, counseling, and treatment for conditions related to 
exposure to Agent Orange. The Secretary may carry out this subsection 
through appropriate community and nongovernmental organizations or 
other suitable organizations, as determined by the Secretary.

SEC. 6. PROVISION OF BENEFITS FOR CHILDREN OF MALE VETERANS WHO SERVED 
              IN VIETNAM WHO ARE AFFECTED BY CERTAIN BIRTH DEFECTS.

    (a) In General.--Subchapter II of chapter 18 of title 38, United 
States Code, is amended--
            (1) by striking ``woman Vietnam veteran'' each place it 
        appears and inserting ``Vietnam veteran'';
            (2) by striking ``women Vietnam veterans'' each place it 
        appears and inserting ``Vietnam veterans''; and
            (3) in the heading of such subchapter, by striking 
        ``WOMEN''.
    (b) Access to Records for Research Purposes.--Section 1813(b) of 
such title is amended--
            (1) by striking ``The Secretary'' and inserting ``(1) The 
        Secretary''; and
            (2) by adding at the end the following new paragraph:
    ``(2) The Secretary shall require any health care provider with 
whom the Secretary enters into a contract under this subsection to 
provide access to the medical records of individuals who receive health 
care under this section to the Department of Veterans Affairs for the 
purpose of conducting research or providing support for research into 
the intergenerational effects of Agent Orange exposure.''.
    (c) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by striking the item relating to subchapter II 
and inserting the following new item:

 ``subchapter ii. children of vietnam veterans born with certain birth 
                               defects''.

    (d) Effective Date.--The amendments made by this section shall take 
effect on the date that is 30 days after the date of the enactment of 
this Act.

SEC. 7. DEADLINE FOR IMPLEMENTATION.

    Not later than 180 days after the date of the enactment of this 
Act, the Secretary of State, the Secretary of Health and Human 
Services, and the Secretary of Veterans Affairs shall each complete a 
plan for the implementation of the provisions of this Act, and the 
amendments made by this Act, applicable to such Secretary and shall 
issue a request for proposals, if applicable. The Secretary of State, 
the Secretary of Health and Human Services, and the Secretary of 
Veterans Affairs shall each implement the provisions of this Act 
applicable to such Secretary by not later than 18 months after the date 
of the enactment of this Act.

SEC. 8. QUARTERLY REPORTS.

    Not later than 30 days after the last day of each fiscal quarter 
beginning on or after 18 months after the date of the enactment of this 
Act, the Secretary of State, the Secretary of Health and Human 
Services, and the Secretary of Veterans Affairs shall each submit to 
Congress a report on the implementation of the provisions of this Act 
applicable to such Secretary during the immediately preceding fiscal 
quarter.

SEC. 9. DEFINITION.

    For purposes of this Act, the term ``Agent Orange'' includes any 
chemical compound which became part, either by design or through 
impurities, of an herbicide agent used in support of the United States 
and allied military operations in the Republic of Vietnam.
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