[Congressional Record Volume 168, Number 115 (Wednesday, July 13, 2022)]
[House]
[Pages H6001-H6025]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROTECTING OUR GOLD STAR FAMILIES EDUCATION ACT
Mr. TAKANO. Madam Speaker, pursuant to House Resolution 1224, I call
up the bill (S. 3373), as amended, to improve the Iraq and Afghanistan
Service Grant and the Children of Fallen Heroes Grant, and ask for its
immediate consideration in the House.
The Clerk read the title of the bill.
The SPEAKER pro tempore. Pursuant to House Resolution 1224, an
amendment in the nature of a substitute consisting of the text of Rules
Committee Print 117-56, is considered as adopted, and the bill, as
amended, is considered read.
The text of the bill, as amended, is as follows:
S. 3373
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES
CODE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Sergeant
First Class Heath Robinson Honoring our Promise to Address
Comprehensive Toxics Act of 2022'' or the ``Honoring our PACT
Act of 2022''.
(b) Matters Relating to Amendments to Title 38, United
States Code.--
(1) References.--Except as otherwise expressly provided,
when in this Act an amendment or repeal is expressed in terms
of an amendment to, or repeal of, a section or other
provision, the reference shall be considered to be made to a
section or other provision of title 38, United States Code.
(2) Amendments to tables of contents.--Except as otherwise
expressly provided, when an amendment made by this Act to
title 38, United States Code, adds a section or larger
organizational unit to that title or amends the designation
or heading of a section or larger organizational unit in that
title, that amendment also shall have the effect of amending
any table of sections in that title to alter the table to
conform to the changes made by the amendment.
(c) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; references to title 38, United States Code; table
of contents.
TITLE I--EXPANSION OF HEALTH CARE ELIGIBILITY
Subtitle A--Toxic-exposed Veterans
Sec. 101. Short title.
Sec. 102. Definitions relating to toxic-exposed veterans.
Sec. 103. Expansion of health care for specific categories of toxic-
exposed veterans and veterans supporting certain overseas
contingency operations.
Sec. 104. Assessments of implementation and operation.
Subtitle B--Certain Veterans of Combat Service and Other Matters
Sec. 111. Expansion of period of eligibility for health care for
certain veterans of combat service.
TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS
Sec. 201. Short title.
Sec. 202. Improvements to ability of Department of Veterans Affairs to
establish presumptions of service connection based on
toxic exposure.
Sec. 203. Outreach to claimants for disability compensation pursuant to
changes in presumptions of service connection.
Sec. 204. Reevaluation of claims for dependency and indemnity
compensation involving presumptions of service
connection.
TITLE III--IMPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS
FOR TOXIC-EXPOSED VETERANS
Sec. 301. Short title.
Sec. 302. Presumptions of toxic exposure.
Sec. 303. Medical nexus examinations for toxic exposure risk
activities.
TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION
Sec. 401. Treatment of veterans who participated in cleanup of Enewetak
Atoll as radiation-exposed veterans for purposes of
presumption of service connection of certain disabilities
by Department of Veterans Affairs.
Sec. 402. Treatment of veterans who participated in nuclear response
near Palomares, Spain, or Thule, Greenland, as radiation-
exposed veterans for purposes of presumption of service
connection of certain disabilities by Department of
Veterans Affairs.
Sec. 403. Presumptions of service connection for diseases associated
with exposures to certain herbicide agents for veterans
who served in certain locations.
Sec. 404. Addition of additional diseases associated with exposure to
certain herbicide agents for which there is a presumption
of service connection for veterans who served in certain
locations.
Sec. 405. Improving compensation for disabilities occurring in Persian
Gulf War veterans.
Sec. 406. Presumption of service connection for certain diseases
associated with exposure to burn pits and other toxins.
Sec. 407. Rule of construction.
TITLE V--RESEARCH MATTERS
Sec. 501. Interagency working group on toxic exposure research.
Sec. 502. Analysis and report on treatment of veterans for medical
conditions related to toxic exposure.
Sec. 503. Analysis relating to mortality of veterans who served in
Southwest Asia.
Sec. 504. Study on health trends of post-9/11 veterans.
Sec. 505. Study on cancer rates among veterans.
Sec. 506. Study on health effects of waste related to Manhattan Project
on certain veterans.
[[Page H6002]]
Sec. 507. Study on toxic exposure and mental health outcomes.
Sec. 508. Study on veterans in Territories of the United States.
Sec. 509. Department of Veterans Affairs public website for toxic
exposure research.
Sec. 510. Report on health effects of jet fuels used by Armed Forces.
TITLE VI--IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED
VETERANS
Sec. 601. Short title; definitions.
Sec. 602. Publication of list of resources of Department of Veterans
Affairs for toxic-exposed veterans and veterans who
report toxic exposures and outreach program for such
veterans and caregivers and survivors of such veterans.
Sec. 603. Incorporation of toxic exposure screening for veterans.
Sec. 604. Training for personnel of the Department of Veterans Affairs
with respect to veterans who report toxic exposures.
TITLE VII--RESOURCING
Sec. 701. Authority to use appropriations to enhance claims processing
capacity and automation.
Sec. 702. Authorization of major medical facility leases of Department
of Veterans Affairs for fiscal year 2023.
Sec. 703. Treatment of major medical facility leases of the Department
of Veterans Affairs.
Sec. 704. Authority to enter into agreements with academic affiliates
and other entities to acquire space for the purpose of
providing health-care resources to veterans.
Sec. 705. Modifications to enhanced-use lease authority of Department
of Veterans Affairs.
Sec. 706. Authority for joint leasing actions of Department of Defense
and Department of Veterans Affairs.
Sec. 707. Appropriation of amounts for major medical facility leases.
TITLE VIII--RECORDS AND OTHER MATTERS
Sec. 801. Epidemiological study on Fort McClellan veterans.
Sec. 802. Biennial briefing on Individual Longitudinal Exposure Record.
Sec. 803. Correction of exposure records by members of the Armed Forces
and veterans.
Sec. 804. Federal cause of action relating to water at Camp Lejeune,
North Carolina.
Sec. 805. Cost of War Toxic Exposures Fund.
Sec. 806. Appropriation for fiscal year 2022.
Sec. 807. Authorization of electronic notice in claims under laws
administered by the Secretary of Veterans Affairs.
Sec. 808. Burn pit transparency.
TITLE IX--IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS
Sec. 901. National rural recruitment and hiring plan for Veterans
Health Administration.
Sec. 902. Authority to buy out service contracts for certain health
care professionals in exchange for employment at rural or
highly rural facilities of Department of Veterans
Affairs.
Sec. 903. Qualifications for human resources positions within
Department of Veterans Affairs and plan to recruit and
retain human resources employees.
Sec. 904. Modification of pay cap for certain employees of Veterans
Health Administration.
Sec. 905. Expansion of opportunities for housekeeping aides.
Sec. 906. Modification of authority of the Secretary of Veterans
Affairs relating to hours, conditions of employment, and
pay for certain employees of Veterans Health
Administration.
Sec. 907. Waiver of pay limitation for certain employees of Department
of Veterans Affairs.
Sec. 908. Elimination of limitation on awards and bonus for employees
of Department of Veterans Affairs.
Sec. 909. Additional authority of the Secretary of Veterans Affairs
relating to recruitment and retention of personnel.
TITLE I--EXPANSION OF HEALTH CARE ELIGIBILITY
Subtitle A--Toxic-exposed Veterans
SEC. 101. SHORT TITLE.
This title may be cited as the ``Conceding Our Veterans'
Exposure Now and Necessitating Training Act of 2022'' or the
``COVENANT Act of 2022''.
SEC. 102. DEFINITIONS RELATING TO TOXIC-EXPOSED VETERANS.
(a) In General.--Section 1710(a)(2)(F) is amended by
striking ``who was exposed to a toxic substance, radiation,
or other conditions, as provided in subsection (e)'' and
inserting ``who is a toxic-exposed veteran, in accordance
with subsection (e)''.
(b) Definitions of Toxic Exposure and Toxic-exposed
Veteran.--Section 101 is amended by adding at the end the
following new paragraphs:
``(37) The term `toxic exposure' includes the following:
``(A) A toxic exposure risk activity, as defined in section
1710(e)(4) of this title.
``(B) An exposure to a substance, chemical, or airborne
hazard identified in the list under section 1119(b)(2) of
this title.
``(38) The term `toxic-exposed veteran' means any veteran
described in section 1710(e)(1) of this title.''.
(c) Definition of Toxic Exposure Risk Activity.--Section
1710(e)(4) is amended by adding at the end the following new
subparagraph:
``(C) The term `toxic exposure risk activity' means any
activity--
``(i) that requires a corresponding entry in an exposure
tracking record system (as defined in section 1119(c) of this
title) for the veteran who carried out the activity; or
``(ii) that the Secretary determines qualifies for purposes
of this subsection when taking into account what is
reasonably prudent to protect the health of veterans.''.
SEC. 103. EXPANSION OF HEALTH CARE FOR SPECIFIC CATEGORIES OF
TOXIC-EXPOSED VETERANS AND VETERANS SUPPORTING
CERTAIN OVERSEAS CONTINGENCY OPERATIONS.
(a) In General.--
(1) Expansion.--Subsection (e) of section 1710, as amended
by section 102(c), is further amended--
(A) in paragraph (1), by adding at the end the following
new subparagraphs:
``(G) Beginning not later than the applicable date
specified in paragraph (6), and subject to paragraph (2), a
veteran who participated in a toxic exposure risk activity
while serving on active duty, active duty for training, or
inactive duty training is eligible for hospital care
(including mental health services and counseling), medical
services, and nursing home care under subsection (a)(2)(F)
for any illness.
``(H) Beginning not later than the applicable date
specified in paragraph (6), and subject to paragraph (2), a
covered veteran (as defined in section 1119(c) of this title)
is eligible for hospital care (including mental health
services and counseling), medical services, and nursing home
care under subsection (a)(2)(F) for any illness.
``(I)(i) Beginning not later than the applicable date
specified in paragraph (6), and subject to paragraph (2), a
veteran who deployed in support of a contingency operation
specified in clause (ii) is eligible for hospital care
(including mental health services and counseling), medical
services, and nursing home care under subsection (a)(2)(F)
for any illness.
``(ii) A contingency operation specified in this clause is
any of the following:
``(I) Operation Enduring Freedom.
``(II) Operation Freedom's Sentinel.
``(III) Operation Iraqi Freedom.
``(IV) Operation New Dawn.
``(V) Operation Inherent Resolve.
``(VI) Resolute Support Mission.''; and
(B) in paragraph (2)(B)--
(i) by striking ``or (F)'' and inserting ``(F), (G), (H),
or (I)''; and
(ii) by striking ``service or testing'' and inserting
``service, testing, or activity''.
(2) Phase in.--Such subsection is further amended by adding
at the end the following new paragraph:
``(6)(A) The Secretary shall determine the dates in
subparagraphs (G), (H), and (I) of paragraph (1) as follows:
``(i) October 1, 2024, with respect to a veteran described
in such subparagraph (G) or (H) who was discharged or
released from the active military, naval, air, or space
service during the period beginning on August 2, 1990, and
ending on September 11, 2001.
``(ii) October 1, 2026, with respect to a veteran described
in such subparagraph (G) or (H) who was discharged or
released from the active military, naval, air, or space
service during the period beginning on September 12, 2001,
and ending on December 31, 2006.
``(iii) October 1, 2028, with respect to a veteran
described in such subparagraph (G) or (H) who was discharged
or released from the active military, naval, air, or space
service during the period beginning on January 1, 2007, and
ending on December 31, 2012.
``(iv) October 1, 2030, with respect to a veteran described
in such subparagraph (G) or (H) who was discharged or
released from the active military, naval, air, or space
service during the period beginning on January 1, 2013, and
ending on December 31, 2018.
``(v) October 1, 2032, with respect to a veteran described
in such subparagraph (I).
``(B)(i) The Secretary may modify a date specified in
subparagraph (A) to an earlier date, as the Secretary
determines appropriate based on the number of veterans
receiving hospital care, medical services, and nursing home
care under subparagraphs (G), (H), and (I) of paragraph (1)
and the resources available to the Secretary.
``(ii) If the Secretary determines to modify a date under
clause (i), the Secretary shall--
``(I) notify the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives of the proposed modification; and
``(II) publish such modified date in the Federal
Register.''.
(b) Outreach Plans.--With respect to each of clauses (i)
through (v) of section 1710(e)(6)(A) of title 38, United
States Code (as added by subsection (a)(2)), not later than
180 days before the date specified in the clause (including a
date modified pursuant to such section), the Secretary shall
submit to the Committee on Veterans' Affairs of the Senate
and the Committee on Veterans' Affairs of the House of
Representatives a plan to conduct outreach to the veterans
described in the clause to notify such veterans of their
eligibility for hospital care, medical services, or nursing
home care under subparagraph (G), (H), or (I), of section
1710(e)(1) of such title, as the case may be.
SEC. 104. ASSESSMENTS OF IMPLEMENTATION AND OPERATION.
(a) Initial Resource Assessment and Report.--Not later than
180 days after the date of the enactment of this Act, the
Secretary of Veterans Affairs shall--
[[Page H6003]]
(1) complete an assessment to determine--
(A) the personnel and material resources necessary to
implement section 103 (including the amendments made by such
section); and
(B) the total number of covered veterans, as such term is
defined in section 1119(c) of title 38, United States Code
(as added by section 302), who receive hospital care or
medical services furnished by the Secretary under chapter 17
of such title, disaggregated by priority group specified in
section 1705(a) of such title; and
(2) submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report containing the findings of the
assessment completed under paragraph (1), including a
specific determination as to whether the Department has the
personnel and material resources necessary to implement
section 103.
(b) Information Systems.--Not later than October 1, 2024,
the Secretary shall establish information systems to assess
the implementation of section 103, including the amendments
made by such section, and use the results of assessments
under such systems to inform the reports under subsection
(c).
(c) Annual Reports.--
(1) Reports.--Not later than October 1, 2025, and on an
annual basis thereafter until October 1, 2033, the Secretary
shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the following:
(A) The effect of the implementation of, and the provision
and management of care under, section 103 (including the
amendments made by such section) on the demand by veterans
described in subparagraphs (G), (H), and (I) of section
1710(e)(1) of title 38, United States Code (as added by such
section 103) for health care services furnished by the
Secretary.
(B) Any differing patterns of demand for health care
services by such veterans, disaggregated by factors such as
the relative distance of the veteran from medical facilities
of the Department and whether the veteran had previously
received hospital care or medical services furnished by the
Secretary under chapter 17 of such title.
(C) The extent to which the Secretary has met such demand.
(D) Any changes, during the year covered by the report, in
the delivery patterns of health care furnished by the
Secretary under chapter 17 of such title, and the fiscal
impact of such changes.
(2) Matters.--Each report under paragraph (1) shall
include, with respect to the year covered by the report,
detailed information on the following:
(A) The total number of veterans enrolled in the patient
enrollment system who, during such year, received hospital
care or medical services furnished by the Secretary under
chapter 17 of title 38, United States Code.
(B) Of the veterans specified in subparagraph (A), the
number of such veterans who, during the preceding three
fiscal years, had not received such care or services.
(C) With respect to the veterans specified in subparagraph
(B), the cost of providing health care to such veterans
during the year covered by the report, shown in total and
disaggregated by--
(i) the level of care; and
(ii) whether the care was provided through the Veterans
Community Care Program.
(D) With respect to the number of veterans described in
subparagraphs (G), (H), and (I) of section 1710(e)(1) of
title 38, United States Code (as added by section 103), the
following (shown in total and disaggregated by medical
facility of the Department, as applicable):
(i) The number of such veterans who, during the year
covered by the report, enrolled in the patient enrollment
system.
(ii) The number of such veterans who applied for, but were
denied, such enrollment.
(iii) The number of such veterans who were denied hospital
care or a medical service furnished by the Secretary that was
considered to be medically necessary but not of an emergency
nature.
(E) The numbers and characteristics of, and the type and
extent of health care furnished by the Secretary to, veterans
enrolled in the patient enrollment system (shown in total and
disaggregated by medical facility of the Department).
(F) The numbers and characteristics of, and the type and
extent of health care furnished by the Secretary to, veterans
not enrolled in the patient enrollment system (disaggregated
by each class of eligibility for care under section 1710 of
title 38, United States Code, and further shown as a total
per class and disaggregated by medical facility of the
Department).
(G) The specific fiscal impact (shown in total and
disaggregated by geographic health care delivery areas) of
changes in the delivery patterns of health care furnished by
the Secretary under chapter 17 of such title as a result of
the implementation of section 103 (including the amendments
made by such section).
(d) Definitions.--In this section:
(1) Patient enrollment system.--The term ``patient
enrollment system'' means the patient enrollment system of
the Department of Veterans Affairs established and operated
under section 1705(a) of title 38, United States Code.
(2) Veterans community care program.--The term ``Veterans
Community Care Program'' means the program established under
section 1703 of title 38, United States Code.
Subtitle B--Certain Veterans of Combat Service and Other Matters
SEC. 111. EXPANSION OF PERIOD OF ELIGIBILITY FOR HEALTH CARE
FOR CERTAIN VETERANS OF COMBAT SERVICE.
(a) Expanded Period.--Section 1710(e)(3) is amended--
(1) in subparagraph (A)--
(A) by striking ``January 27, 2003'' and inserting
``September 11, 2001''; and
(B) by striking ``five-year period'' and inserting ``10-
year period'';
(2) by amending subparagraph (B) to read as follows:
``(B) With respect to a veteran described in paragraph
(1)(D) who was discharged or released from the active
military, naval, air, or space service after September 11,
2001, and before October 1, 2013, but did not enroll to
receive such hospital care, medical services, or nursing home
care under such paragraph pursuant to subparagraph (A) before
October 1, 2022, the one-year period beginning on October 1,
2022.''; and
(3) by striking subparagraph (C).
(b) Clarification of Coverage.--Section 1710(e)(1)(D) is
amended by inserting after ``Persian Gulf War'' the
following: ``(including any veteran who, in connection with
service during such period, received the Armed Forces
Expeditionary Medal, Service Specific Expeditionary Medal,
Combat Era Specific Expeditionary Medal, Campaign Specific
Medal, or any other combat theater award established by a
Federal statute or an Executive order)''.
(c) Outreach Plan.--Not later than December 1, 2022, the
Secretary of Veterans Affairs shall submit to the Committee
on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a plan to
conduct outreach to veterans described in subparagraph (B) of
section 1710(e)(3) of title 38, United States Code, as
amended by subsection (a)(2), to notify such veterans of
their eligibility for hospital care, medical services, or
nursing home care pursuant to such subparagraph.
(d) Report on Enrollments.--Not later than January 30,
2024, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a report
identifying, with respect to the one-year period beginning on
October 1, 2022, the number of veterans described in section
1710(e)(3)(B) of title 38, United States Code, as amended by
subsection (a)(2), who, during such period, enrolled in the
patient enrollment system of the Department of Veterans
Affairs established and operated under section 1705(a) of
such title.
(e) Effective Date.--This section and the amendments made
by this section shall take effect on October 1, 2022.
TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS
SEC. 201. SHORT TITLE.
This title may be cited as the ``Toxic Exposure in the
American Military Act of 2022'' or the ``TEAM Act of 2022''.
SEC. 202. IMPROVEMENTS TO ABILITY OF DEPARTMENT OF VETERANS
AFFAIRS TO ESTABLISH PRESUMPTIONS OF SERVICE
CONNECTION BASED ON TOXIC EXPOSURE.
(a) Advisory Committees, Panels, and Boards.--Chapter 11 is
amended by adding at the end the following new subchapter:
``SUBCHAPTER VII--DETERMINATIONS RELATING TO PRESUMPTIONS OF SERVICE
CONNECTION BASED ON TOXIC EXPOSURE
``Sec. 1171. Procedures to determine presumptions of service
connection based on toxic exposure; definitions
``(a) Procedures.--The Secretary shall determine whether to
establish, or to remove, presumptions of service connection
based on toxic exposure pursuant to this subchapter,
whereby--
``(1) under section 1172 of this title--
``(A) the Secretary provides--
``(i) public notice regarding what formal evaluations the
Secretary plans to conduct; and
``(ii) the public an opportunity to comment on the proposed
formal evaluations;
``(B) the working group established under subsection (b) of
such section provides--
``(i) advice to the Secretary on toxic-exposed veterans and
cases in which veterans who, during active military, naval,
air, or space service, may have experienced a toxic exposure
or their dependents may have experienced a toxic exposure
while the veterans were serving in the active military,
naval, air, or space service;
``(ii) recommendations to the Secretary on corrections
needed in the Individual Longitudinal Exposure Record to
better reflect veterans and dependents described in clause
(i); and
``(iii) recommendations to the Secretary regarding which
cases of possible toxic exposure should be reviewed;
``(2) the Secretary provides for formal evaluations of such
recommendations under section 1173 of this title and takes
into account reports received by the Secretary from the
National Academies of Sciences, Engineering, and Medicine
under section 1176 of this title; and
``(3) the Secretary issues regulations under section 1174
of this title.
``(b) Definitions.--In this subchapter:
``(1) The term `illness' includes a disease or other
condition affecting the health of an individual, including
mental and physical health.
``(2) The term `Individual Longitudinal Exposure Record'
includes--
``(A) service records;
``(B) any database maintained by the Department of Defense
and shared with the Department of Veterans Affairs to serve
as a central portal for exposure-related data that compiles,
collates, presents, and provides available occupational and
environmental exposure information to support the needs of
the Department of Defense and the Department of Veterans
Affairs; or
``(C) any successor system to a database described in
subparagraph (B).
[[Page H6004]]
``Sec. 1172. Annual notice and opportunity for public comment
``(a) Notice Required.--(1)(A) Not less frequently than
once each year, the Secretary shall publish in the Federal
Register notice of the formal evaluations that the Secretary
plans to conduct pursuant to section 1173 of this title.
``(B) Each notice published under subparagraph (A) shall
include, for each formal evaluation referred to in the
notice, an explanation as to why the military environmental
exposures and adverse health outcomes that are the subject of
the formal evaluation were chosen by the Secretary for formal
evaluation under section 1173 of this title.
``(2)(A) With each notice published under paragraph (1),
the Secretary shall seek public comment on the military
environmental exposures and adverse health outcomes that are
the subject of the formal evaluations referred to in the
notice.
``(B) The Secretary shall--
``(i) consider all public comment received under
subparagraph (A); and
``(ii) publish in the Federal Register a response to the
comments received under subparagraph (A).
``(3)(A) For each notice published under paragraph (1), the
Secretary shall hold an open meeting for members of the
public to voice their comments in response to the notice.
``(B) To help evaluate presumptions of service connection,
the Secretary shall, not less frequently than quarterly,
collaborate with, partner with, and give weight to the advice
of veterans service organizations and such other stakeholders
as the Secretary considers appropriate.
``(4) Failure to include a military environmental exposure
or adverse health effect in a Federal Register notice
published pursuant to subsection (a) shall not preclude the
Secretary from initiating a formal evaluation of such
exposure or health effect.
``(b) Working Group.--(1) The Secretary shall establish a
working group within the Department (in this section referred
to as the `Working Group').
``(2) The Working Group shall include personnel of the
Veterans Health Administration and the Veterans Benefits
Administration.
``(3) The Secretary shall consult with, and seek the advice
of, the Working Group with respect to cases in which--
``(A) a veteran may have, during active military, naval,
air, or space service, experienced a toxic exposure; or
``(B) a dependent of a veteran may have experienced a toxic
exposure during the active military, naval, air, or space
service of the veteran.
``(c) Assessments.--(1) The Working Group shall assess
cases of the toxic exposure of veterans and their dependents
that occurred during active military, naval, air, or space
service, including by conducting ongoing surveillance and
reviewing such exposure described in scientific literature,
media reports, information from veterans, and information
from Congress.
``(2) The assessments under paragraph (1) shall cover
suspected and known toxic exposures occurring during active
military, naval, air, or space service, including by
identifying and evaluating new and emerging toxic exposures
that are not recognized under existing presumptions of
service connection.
``(3) The Working Group may conduct an assessment under
paragraph (1) in response to a comment received under
paragraph (2) or (3) of subsection (a).
``(4) The Working Group shall, in consultation with the
Secretary of Defense, on a periodic basis, assess the
Individual Longitudinal Exposure Record to ensure the
accuracy of data collected.
``(d) Development of Recommendations.--(1) Following an
assessment of a case of the toxic exposure of veterans that
occurred during active military, naval, air, or space service
under subsection (c), or their dependents, the Working Group
may develop a recommendation for formal evaluation under
section 1173 of this title to conduct a review of the health
effects related to the case of exposure if the Working Group
determines that the research may change the current
understanding of the relationship between an exposure to an
environmental hazard and adverse health outcomes in humans.
``(2) Upon receipt of evidence suggesting that previous
findings regarding the periods and locations of exposure
covered by an existing presumption of service connection are
no longer supported, the Working Group may nominate such
evidence for formal evaluation under section 1173 of this
title to modify the periods and locations.
``(e) Reports by the Working Group.--Not less frequently
than once each year, the Working Group shall submit to the
Secretary, the Committee on Veterans' Affairs of the Senate,
and the Committee on Veterans' Affairs of the House of
Representatives, and make publicly available, a report on--
``(1) recommendations developed under subsection (d), if
any; and
``(2) recommendations for such legislative or
administrative action as the Working Group considers
necessary for the Working Group to be more effective in
carrying out the requirements of this section.
``(f) Responses by Secretary.--In response to each report
submitted under subsection (e), the Secretary shall, not
later than 30 days after receiving the report, initiate a
formal evaluation pursuant to section 1173 of this title.
``Sec. 1173. Formal evaluation of recommendations
``(a) Formal Evaluations.--The Secretary shall establish a
process to conduct a formal evaluation with respect to each
recommendation made by the Working Group under section 1172
of this title.
``(b) Evidence, Data, and Factors.--The Secretary shall
ensure that each formal evaluation under subsection (a)
covers the following:
``(1) Scientific evidence, based on the review of available
scientific literature, including human, toxicological,
animal, and methodological studies, and other factors.
``(2) Claims data, based on the review of claim rate, grant
rate, and service connection prevalence, and other factors.
``(3) Other factors the Secretary determines appropriate,
such as--
``(A) the level of disability and mortality caused by the
health effects related to the case of toxic exposure being
evaluated;
``(B) the quantity and quality of the information available
and reviewed;
``(C) the feasibility of and period for generating relevant
information and evidence;
``(D) whether such health effects are combat- or
deployment-related;
``(E) the ubiquity or rarity of the health effects; and
``(F) any time frame during which a health effect must
become manifest.
``(c) Conduct of Evaluations.--(1) The Secretary shall
ensure that each formal evaluation under subsection (a)--
``(A) reviews scientific evidence in a manner that--
``(i) conforms to principles of scientific and data
integrity;
``(ii) is free from suppression or distortion of scientific
or technological findings, data, information, conclusions, or
technical results; and
``(B)(i) evaluates the likelihood that a positive
association exists between an illness and a toxic exposure
while serving in the active military, naval, air, or space
service; and
``(ii) assesses the toxic exposures and illnesses and
determines whether the evidence supports a finding of a
positive association between the toxic exposure and the
illness.
``(2) In carrying out paragraph (1)(B)(ii), a formal
evaluation under subsection (a) shall include reviewing all
relevant data to determine the strength of evidence for a
positive association based on the following four categories:
``(A) The `sufficient' category, where the evidence is
sufficient to conclude that a positive association exists.
``(B) The `equipoise and above' category, where the
evidence is sufficient to conclude that a positive
association is at least as likely as not, but not sufficient
to conclude that a positive association exists.
``(C) The `below equipoise' category, where the evidence is
not sufficient to conclude that a positive association is at
least as likely as not, or is not sufficient to make a
scientifically informed judgment.
``(D) The `against' category, where the evidence suggests
the lack of a positive association.
``(d) Recommendation for Establishing a Presumption of
Service Connection.--Not later than 120 days after the date
on which a formal evaluation is commenced, the element of the
Department that conducts the evaluation shall submit to the
Secretary a recommendation with respect to establishing a
presumption of service connection for the toxic exposure and
illness, or modifying an existing presumption of service
connection, covered by the evaluation.
``Sec. 1174. Regulations regarding presumptions of service
connection based on toxic exposure
``(a) Action Upon Recommendation.--Not later than 160 days
after the date on which the Secretary receives a
recommendation to establish or modify a presumption of
service connection under section 1173 of this title--
``(1) if the Secretary determines, in the discretion of the
Secretary, that the presumption, or modification, is
warranted, the Secretary shall--
``(A) commence issuing regulations in accordance with the
provisions of subchapter II of chapter 5 of title 5 (commonly
referred to as the Administrative Procedures Act) setting
forth the presumption or commence revising regulations to
carry out such modification; and
``(B) include in such regulations any time frame during
which a health effect must become manifest; or
``(2) if the Secretary determines, in the discretion of the
Secretary, that the presumption, or modification, is not
warranted, the Secretary shall publish in the Federal
Register a notice of the determination, including the reasons
supporting the determination.
``(b) Removal of Presumption.--(1)(A) The Secretary may--
``(i) issue a regulation to remove an illness from a
presumption of service connection previously established
pursuant to a regulation issued under subsection (a); and
``(ii) issue a regulation to remove a presumption of
service connection established pursuant to title IV of the
Sergeant First Class Heath Robinson Honoring our Promise to
Address Comprehensive Toxics Act of 2022 if the Secretary
concludes that evidence suggests the lack of a positive
association between the disease and the toxic exposure.
``(B) Under subparagraph (A)(ii), the Secretary shall not
consider the lack of evidence as sufficient to support a
decision for removal of a presumption.
``(2) Whenever an illness is removed from regulations
pursuant to paragraph (1), or the periods and locations of
exposure covered by a presumption of service connection are
modified under subsection (a)--
``(A) a veteran who was awarded compensation under chapter
11 of this title for such illness on the basis of the
presumption provided under such regulations before the
effective date of the removal or modification shall continue
to be entitled to receive compensation on that basis;
``(B) a survivor of a veteran who was awarded dependency
and indemnity compensation under
[[Page H6005]]
chapter 13 of this title for the death of a veteran resulting
from such illness on the basis of such presumption shall
continue to be entitled to receive dependency and indemnity
compensation on such basis; and
``(C) no veteran or survivor covered under subparagraph (A)
or (B) shall have their compensation reduced solely because
of the removal of an illness pursuant to paragraph (1).
``Sec. 1175. Authority to modify process; congressional
oversight
``(a) In General.--The Secretary may modify the process
under which the working group established under subsection
(b) of section 1172 of this title conducts assessments under
such section, the Secretary conducts formal evaluations under
section 1173 of this title, and issues regulations under
section 1174 of this title if--
``(1) such evaluations cover the evidence, data, and
factors required by subsection (b) of such section 1173; and
``(2) a period of 180 days has elapsed following the date
on which the Secretary submits the notice under subsection
(b) regarding the modification.
``(b) Notice.--If the Secretary proposes to modify the
process under which the working group established under
subsection (b) of section 1172 of this title conducts
assessments under such section, the process under which the
Secretary conducts formal evaluations under section 1173 of
this title, or issues regulations under section 1174 of this
title, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a notice of
the proposed modifications containing the following:
``(1) A description of the proposed modifications.
``(2) A description of any exceptions to the requirements
of such sections that are proposed because of limited
available scientific evidence, and a description of how such
evaluations will be conducted.
``Sec. 1176. Agreement with National Academies of Sciences,
Engineering, and Medicine concerning toxic exposures
``(a) Purpose.--The purpose of this section is to provide
for the National Academies of Sciences, Engineering, and
Medicine (in this section referred to as the `Academies'), an
independent nonprofit scientific organization with
appropriate expertise that is not part of the Federal
Government, to review and evaluate the available scientific
evidence regarding associations between diseases and toxic
exposures.
``(b) Agreement.--(1) The Secretary shall seek to enter
into a five-year agreement with the Academies to perform the
services covered by this section.
``(2) The Secretary shall seek to enter into an agreement
described in paragraph (1) not later than 60 days after the
date of the enactment of the Sergeant First Class Heath
Robinson Honoring our Promise to Address Comprehensive Toxics
Act of 2022.
``(3) An agreement under this section may be extended in
five-year increments.
``(c) Review of Scientific Evidence.--Under an agreement
between the Secretary and the Academies under this section,
the Academies shall review and summarize the scientific
evidence, and assess the strength thereof, concerning the
association between toxic exposures during active military,
naval, air, or space service and each disease suspected to be
associated with such exposure in the human population.
``(d) Scientific Determinations Concerning Diseases.--For
each disease reviewed under subsection (c), the Academies
shall determine, to the extent that available scientific data
permit meaningful determinations--
``(1) whether an association exists between toxic exposures
and the occurrence of the disease, taking into account the
strength of the scientific evidence and the appropriateness
of the statistical and epidemiological methods used to detect
the association;
``(2) the increased risk of the disease among those
reporting toxic exposures during active military, naval, air,
or space service;
``(3) whether there exists a plausible biological mechanism
or other evidence of a positive association between the toxic
exposure and the occurrence of the disease; and
``(4) determine the strength of evidence for a positive
association based on categories furnished under section 1173
of this title.
``(e) Cooperation of Federal Agencies.--The head of each
relevant Federal agency, including the Secretary of Defense,
shall cooperate fully with the Academies in performing the
services covered by this section.
``(f) Recommendations for Additional Scientific Studies.--
(1) Under an agreement between the Secretary and the
Academies under this section, the Academies shall make any
recommendations for additional scientific studies to resolve
areas of continuing scientific uncertainty relating to toxic
exposures.
``(2) In making recommendations under paragraph (1), the
Academies shall consider--
``(A) the scientific information that is available at the
time of the recommendation;
``(B) the value and relevance of the information that could
result from additional studies; and
``(C) the cost and feasibility of carrying out such
additional studies.
``(g) Reports.--(1)(A) Under an agreement between the
Secretary and the Academies under this section, not later
than one year after the date of the enactment of the Sergeant
First Class Heath Robinson Honoring our Promise to Address
Comprehensive Toxics Act of 2022, the Academies shall submit
to the Secretary, the Committee on Veterans' Affairs of the
Senate, and the Committee on Veterans' Affairs of the House
of Representatives an initial report on the activities of the
Academies under the agreement.
``(B) The report submitted under subparagraph (A) shall
include the following:
``(i) The determinations described in subsection (d).
``(ii) A full explanation of the scientific evidence and
reasoning that led to such determinations.
``(iii) Any recommendations of the Academies under
subsection (f).
``(2) Under an agreement between the Secretary and the
Academies under this section, not less frequently than once
every two years after the date on which the initial report is
submitted under paragraph (1)(A), the Academies shall submit
to the Secretary, the Committee on Veterans' Affairs of the
Senate, and the Committee on Veterans' Affairs of the House
of Representatives an updated report on the activities of the
Academies under the agreement.
``(h) Alternative Contract Scientific Organization.--(1) If
the Secretary is unable within the time period prescribed in
subsection (b)(2) to enter into an agreement with the
Academies for the purposes of this section on terms
acceptable to the Secretary, the Secretary shall seek to
enter into an agreement for the purposes of this section with
another appropriate scientific organization that--
``(A) is not part of the Federal Government;
``(B) operates as a not-for-profit entity; and
``(C) has expertise and objectivity comparable to that of
the Academies.
``(2) If the Secretary enters into an agreement with
another organization as described in paragraph (1), any
reference in this subchapter to the Academies shall be
treated as a reference to the other organization.''.
(b) Reports and Briefings.--
(1) Report.--
(A) In general.--Not later than two years after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the implementation of, and
recommendations for, subchapter VII of chapter 11 of title
38, United States Code, as added by subsection (a).
(B) Consultation.--The Secretary shall develop the report
under subparagraph (A) in consultation with organizations
recognized by the Secretary for the representation of
veterans under section 5902 of such title and any other
entity the Secretary determines appropriate.
(2) Briefing.--On a quarterly basis during the two-year
period beginning on the date of the enactment of this Act,
the Secretary shall provide to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a briefing on the
implementation of subchapter VII of chapter 11 of such title,
as added by subsection (a).
(c) Independent Assessment.--
(1) Agreement.--The Secretary shall seek to enter into an
agreement with the National Academies of Science,
Engineering, and Medicine (in this subsection referred to as
the ``Academies'') before the date that is 90 days after the
date of the enactment of this Act to perform the services set
forth under paragraph (2).
(2) Assessment.--
(A) In general.--Under an agreement between the Secretary
and the Academies under paragraph (1), the Academies shall
conduct an assessment of the implementation by the Department
of Veterans Affairs of the process established under
subchapter VII of chapter 11 of title 38, United States Code,
as added by subsection (a).
(B) Elements.--The assessment conducted under subparagraph
(A) shall include the following:
(i) An assessment of the Department's implementation of the
process established under subsection (a) to determine whether
the process is in accordance with current scientific
standards for assessing the link between exposure to
environmental hazards and the development of health outcomes,
(ii) assess whether the criteria is fair and consistent,
and
(iii) provide recommendations for improvements to the
process.
(3) Report.--Not later than one year after the date on
which the Secretary enters into an agreement under paragraph
(1), the Secretary shall submit to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a report on the findings of
the Academies pursuant to such agreement.
(4) Alternative contract scientific organization.--
(A) In general.--If the Secretary is unable within the time
period prescribed in paragraph (1) to enter into an agreement
with the Academies for the purposes of this subsection on
terms acceptable to the Secretary, the Secretary shall seek
to enter into an agreement for the purposes of this
subsection with another appropriate scientific organization
that--
(i) is not part of the Federal Government;
(ii) operates as a not-for-profit entity; and
(iii) has expertise and objectivity comparable to that of
the Academies.
(B) Treatment.--If the Secretary enters into an agreement
with another organization as described in subparagraph (A),
any reference in this subsection to the Academies of
Sciences, Engineering, and Medicine shall be treated as a
reference to the other organization.
(d) Conforming Amendments.--Chapter 11 is amended--
(1) in section 1116--
(A) by striking subsections (b), (c), (d), and (e);
(B) by inserting after subsection (a) the following new
subsection (b):
[[Page H6006]]
``(b) The Secretary shall ensure that any determination
made on or after the date of the enactment of the Sergeant
First Class Heath Robinson Honoring our Promise to Address
Comprehensive Toxics Act of 2022 regarding a presumption of
service connection based on exposure to an herbicide agent
under this section is made pursuant to subchapter VII of this
chapter, including with respect to assessing reports received
by the Secretary from the National Academy of Sciences under
section 3 of the Agent Orange Act of 1991 (Public Law 102-
4).''; and
(C) by redesignating subsection (f) as subsection (c);
(2) in section 1116B(b)(2)(A), by inserting ``pursuant to
subchapter VII of this chapter,'' before ``the Secretary
determines''; and
(3) in section 1118--
(A) by striking subsections (b) through (e); and
(B) by inserting after subsection (a) the following new
subsection (b):
``(b) The Secretary shall ensure that any determination
made on or after the date of the enactment of the Sergeant
First Class Heath Robinson Honoring our Promise to Address
Comprehensive Toxics Act of 2022 regarding a presumption of
service connection based on a toxic exposure under this
section is made pursuant to subchapter VII of this
chapter.''.
SEC. 203. OUTREACH TO CLAIMANTS FOR DISABILITY COMPENSATION
PURSUANT TO CHANGES IN PRESUMPTIONS OF SERVICE
CONNECTION.
(a) In General.--Subchapter VI of chapter 11 is amended by
adding at the end the following new section:
``Sec. 1167. Outreach pursuant to changes in presumptions of
service connection
``(a) In General.--Whenever a law, including through a
regulation or Federal court decision or settlement,
establishes or modifies a presumption of service connection,
the Secretary shall--
``(1) identify all claims for compensation under this
chapter that--
``(A) were submitted to the Secretary;
``(B) were evaluated and denied by the Secretary before the
date on which such provision of law went into effect; and
``(C) might have been evaluated differently had the
establishment or modification been applicable to the claim;
and
``(2) pursuant to subsection (b), conduct outreach to the
claimants.
``(b) Outreach.--(1) The Secretary shall conduct outreach
to inform claimants identified under subsection (a) that they
may submit a supplemental claim in light of the establishment
or modification of a presumption of service connection
described in subsection (a).
``(2) Outreach under paragraph (1) shall include the
following:
``(A) The Secretary shall publish on the internet website
of the Department a notice that such veterans may elect to
file a supplemental claim.
``(B) The Secretary shall notify, in writing or by
electronic means, veterans service organizations of the
ability of such veterans to file a supplemental claim.
``(C) The Secretary shall contact each claimant identified
under subsection (a) in the same manner that the Department
last provided notice of a decision.''.
(b) Application.--Section 1167 of title 38, United States
Code, as added by subsection (a), shall apply with respect to
presumptions of service connection established or modified on
or after the date of the enactment of this Act, including
pursuant to amendments made by this Act.
(c) Rule of Construction.--Nothing in this section shall be
construed as--
(1) modifying the obligations of the Department of Veterans
Affairs under Federal court decisions or settlements in
effect as of the date of the enactment of this Act; or
(2) requiring a retroactively applied effective date of a
supplemental claim earlier than the date a presumption of
service connection is established or modified.
SEC. 204. REEVALUATION OF CLAIMS FOR DEPENDENCY AND INDEMNITY
COMPENSATION INVOLVING PRESUMPTIONS OF SERVICE
CONNECTION.
(a) In General.--Subchapter I of chapter 13 is amended by
adding at the end the following new section:
``Sec. 1305. Reevaluation of dependency and indemnity
compensation determinations pursuant to changes in
presumptions of service connection
``(a) Reevaluation.--Whenever a law, including through a
regulation or Federal court decision or settlement,
establishes or modifies a presumption of service connection,
the Secretary shall--
``(1) identify all claims for dependency and indemnity
compensation under this chapter that--
``(A) were submitted to the Secretary;
``(B) were evaluated and denied by the Secretary before the
date on which such provision of law went into effect; and
``(C) might have been evaluated differently had the
establishment or modification been applicable to the claim;
``(2) allow for the reevaluation of such claims at the
election of the claimant; and
``(3) notwithstanding section 5110 of this title, with
respect to claims approved pursuant to such reevaluation,
provide compensation under this chapter effective as if the
establishment or modification of the presumption of service
connection had been in effect on the date of the submission
of the original claim described in paragraph (1).
``(b) Outreach.--(1) The Secretary shall conduct outreach
to inform relevant claimants that they may elect to have a
claim be reevaluated in light of the establishment or
modification of a presumption of service connection described
in subsection (a).
``(2) Outreach under paragraph (1) shall include the
following:
``(A) The Secretary shall publish on the internet website
of the Department a notice that such claimants may elect to
have a claim so reevaluated.
``(B) The Secretary shall notify, in writing or by
electronic means, veterans service organizations of the
ability of such claimants to elect to have a claim so
reevaluated.
``(C) The Secretary shall contact each claimant identified
under subsection (a) in the same manner that the Department
last provided notice of a decision.''.
(b) Application.--Section 1305 of title 38, United States
Code, as added by subsection (a), shall apply with respect to
presumptions of service connection established or modified on
or after the date of the enactment of this Act, including
pursuant to amendments made by this Act.
(c) Rule of Construction.--Nothing in this section shall be
construed as modifying the obligations of the Department of
Veterans Affairs under Federal court decisions or settlements
in effect as of the date of the enactment of this Act.
TITLE III--IMPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS
FOR TOXIC-EXPOSED VETERANS
SEC. 301. SHORT TITLE.
This title may be cited as the ``Veterans Burn Pits
Exposure Recognition Act of 2022''.
SEC. 302. PRESUMPTIONS OF TOXIC EXPOSURE.
Subchapter II of chapter 11 is amended by adding at the end
the following new section:
``Sec. 1119. Presumptions of toxic exposure
``(a) Consideration of Records.--If a veteran submits to
the Secretary a claim for compensation for a service-
connected disability under section 1110 of this title with
evidence of a disability and a toxic exposure that occurred
during active military, naval, air, or space service, the
Secretary may, in adjudicating such claim, consider--
``(1) any record of the veteran in an exposure tracking
record system; and
``(2) if no record of the veteran in an exposure tracking
record system indicates that the veteran was subject to a
toxic exposure during active military, naval, air, or space
service, the totality of the circumstances of the service of
the veteran.
``(b) Presumption of Specific Toxic Exposure for Members
Who Served in Certain Locations.--(1) The Secretary shall,
for purposes of section 1110 and chapter 17 of this title,
presume that any covered veteran was exposed to the
substances, chemicals, and airborne hazards identified in the
list under paragraph (2) during the service of the covered
veteran specified in subsection (c)(1), unless there is
affirmative evidence to establish that the covered veteran
was not exposed to any such substances, chemicals, or hazards
in connection with such service.
``(2) The Secretary shall--
``(A) establish and maintain a list that contains an
identification of one or more such substances, chemicals, and
airborne hazards as the Secretary, in collaboration with the
Secretary of Defense, may determine appropriate for purposes
of this section; and
``(B) determine, using procedures consistent with section
1172 of this title and through the conduct of a formal
evaluation under section 1173 of this title, whether to
establish an end date for a covered veteran to qualify for
presumptions of exposure under this section, if appropriate,
but in no case establish an end date earlier than the last
day of the period specified in section 101(33) for the
Persian Gulf War.
``(3) Beginning not later than two years after the date of
the enactment of the Sergeant First Class Heath Robinson
Honoring our Promise to Address Comprehensive Toxics Act of
2022, and not less frequently than once every two years
thereafter, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a report
identifying any additions or removals to the list under
paragraph (2) during the period covered by the report.
``(c) Definitions.--In this section:
``(1) The term `covered veteran' means any veteran who--
``(A) on or after August 2, 1990, performed active
military, naval, air, or space service while assigned to a
duty station in, including airspace above--
``(i) Bahrain;
``(ii) Iraq;
``(iii) Kuwait;
``(iv) Oman;
``(v) Qatar;
``(vi) Saudi Arabia;
``(vii) Somalia; or
``(viii) United Arab Emirates; or
``(B) on or after September 11, 2001, performed active
military, naval, air, or space service while assigned to a
duty station in, including airspace above--
``(i) Afghanistan;
``(ii) Djibouti;
``(iii) Egypt;
``(iv) Jordan;
``(v) Lebanon;
``(vi) Syria;
``(vii) Yemen;
``(viii) Uzbekistan; or
``(ix) any other country determined relevant by the
Secretary.
``(2) The term `exposure tracking record system'--
``(A) means any system, program, or pilot program used by
the Secretary of Veterans Affairs or the Secretary of Defense
to track how veterans or members of the Armed Forces have
been
[[Page H6007]]
exposed to various occupational or environmental hazards; and
``(B) includes the Individual Longitudinal Exposure Record,
or successor system.
``(3) The term `toxic exposure risk activity' has the
meaning given such term in section 1710(e)(4) of this
title.''.
SEC. 303. MEDICAL NEXUS EXAMINATIONS FOR TOXIC EXPOSURE RISK
ACTIVITIES.
Subchapter VI of chapter 11, as amended by section 203, is
further amended by adding at the end the following new
section:
``Sec. 1168. Medical nexus examinations for toxic exposure
risk activities
``(a) Medical Examinations and Medical Opinions.--(1)
Except as provided in subsection (b), if a veteran submits to
the Secretary a claim for compensation for a service-
connected disability under section 1110 of this title with
evidence of a disability and evidence of participation in a
toxic exposure risk activity during active military, naval,
air, or space service, and such evidence is not sufficient to
establish a service connection for the disability, the
Secretary shall--
``(A) provide the veteran with a medical examination under
section 5103A(d) of this title; and
``(B) obtain a medical opinion (to be requested by the
Secretary in connection with the medical examination under
subparagraph (A)) as to whether it is at least as likely as
not that there is a nexus between the disability and the
toxic exposure risk activity.
``(2) When providing the Secretary with a medical opinion
under paragraph (1)(B) for a veteran, the health care
provider shall consider--
``(A) the total potential exposure through all applicable
military deployments of the veteran; and
``(B) the synergistic, combined effect of all toxic
exposure risk activities of the veteran.
``(3) The requirement under paragraph (2)(B) shall not be
construed as requiring a health care provider to consider the
synergistic, combined effect of each of the substances,
chemicals, and airborne hazards identified in the list under
section 1119(b)(2) of this title.
``(b) Exception.--Subsection (a) shall not apply if the
Secretary determines there is no indication of an association
between the disability claimed by the veteran and the toxic
exposure risk activity for which the veteran submitted
evidence.
``(c) Toxic Exposure Risk Activity Defined.--In this
section, the term `toxic exposure risk activity' has the
meaning given that term in section 1710(e)(4) of this
title.''.
TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION
SEC. 401. TREATMENT OF VETERANS WHO PARTICIPATED IN CLEANUP
OF ENEWETAK ATOLL AS RADIATION-EXPOSED VETERANS
FOR PURPOSES OF PRESUMPTION OF SERVICE
CONNECTION OF CERTAIN DISABILITIES BY
DEPARTMENT OF VETERANS AFFAIRS.
(a) Short Title.--This section may be cited as the ``Mark
Takai Atomic Veterans Healthcare Parity Act of 2022''.
(b) Enewetak Atoll.--Section 1112(c)(3)(B) is amended by
adding at the end the following new clause:
``(v) Cleanup of Enewetak Atoll during the period beginning
on January 1, 1977, and ending on December 31, 1980.''.
SEC. 402. TREATMENT OF VETERANS WHO PARTICIPATED IN NUCLEAR
RESPONSE NEAR PALOMARES, SPAIN, OR THULE,
GREENLAND, AS RADIATION-EXPOSED VETERANS FOR
PURPOSES OF PRESUMPTION OF SERVICE CONNECTION
OF CERTAIN DISABILITIES BY DEPARTMENT OF
VETERANS AFFAIRS.
(a) Short Title.--This section may be cited as the
``Palomares or Thule Veterans Act of 2022''.
(b) Palomares or Thule.--Section 1112(c)(3)(B), as amended
by section 401, is further amended by adding at the end the
following new clauses:
``(vi) Onsite participation in the response effort
following the collision of a United States Air Force B-52
bomber and refueling plane that caused the release of four
thermonuclear weapons in the vicinity of Palomares, Spain,
during the period beginning January 17, 1966, and ending
March 31, 1967.
``(vii) Onsite participation in the response effort
following the on-board fire and crash of a United States Air
Force B-52 bomber that caused the release of four
thermonuclear weapons in the vicinity of Thule Air Force
Base, Greenland, during the period beginning January 21,
1968, and ending September 25, 1968.''.
SEC. 403. PRESUMPTIONS OF SERVICE CONNECTION FOR DISEASES
ASSOCIATED WITH EXPOSURES TO CERTAIN HERBICIDE
AGENTS FOR VETERANS WHO SERVED IN CERTAIN
LOCATIONS.
(a) Short Title.--This section may be cited as the
``Veterans Agent Orange Exposure Equity Act of 2022''.
(b) In General.--Section 1116, as amended by section 202,
is further amended--
(1) by striking ``, during active military, naval, air, or
space service, served in the Republic of Vietnam during the
period beginning on January 9, 1962, and ending on May 7,
1975'' each place it appears and inserting ``performed
covered service'';
(2) by striking ``performed active military, naval, air, or
space service in the Republic of Vietnam during the period
beginning on January 9, 1962, and ending on May 7, 1975''
each place it appears and inserting ``performed covered
service''; and
(3) by adding at the end the following new subsection:
``(d) In this section, the term `covered service' means
active military, naval, air, or space service--
``(1) performed in the Republic of Vietnam during the
period beginning on January 9, 1962, and ending on May 7,
1975;
``(2) performed in Thailand at any United States or Royal
Thai base during the period beginning on January 9, 1962, and
ending on June 30, 1976, without regard to where on the base
the veteran was located or what military job specialty the
veteran performed;
``(3) performed in Laos during the period beginning on
December 1, 1965, and ending on September 30, 1969;
``(4) performed in Cambodia at Mimot or Krek, Kampong Cham
Province during the period beginning on April 16, 1969, and
ending on April 30, 1969; or
``(5) performed on Guam or American Samoa, or in the
territorial waters thereof, during the period beginning on
January 9, 1962, and ending on July 31, 1980, or served on
Johnston Atoll or on a ship that called at Johnston Atoll
during the period beginning on January 1, 1972, and ending on
September 30, 1977.''.
(c) Eligibility for Hospital Care and Medical Services.--
Section 1710(e)(4), as amended by section 102(c), is further
amended by striking subparagraph (A) and inserting the
following new subparagraph:
``(A) The term `Vietnam-era herbicide-exposed veteran'
means a veteran who--
``(i) performed covered service, as defined in section
1116(d) of this title; or
``(ii) the Secretary finds may have been exposed during
active military, naval, air, or space service to dioxin
during the Vietnam era, regardless of the geographic area of
such service, or was exposed during such service to a toxic
substance found in a herbicide or defoliant used for military
purposes during such era, regardless of the geographic area
of such service.''.
(d) Conforming Amendment.--The heading for section 1116 is
amended by striking ``the Republic of Vietnam'' and inserting
``certain locations''.
(e) Effective Date and Applicability.--The amendments made
by this section shall take effect on the date of the
enactment of this Act and shall apply as follows:
(1) On the date of the enactment of this Act for claimants
for dependency and indemnity compensation under chapter 13 of
title 38, United States Code, and for veterans whom the
Secretary of Veterans Affairs determines are--
(A) terminally ill;
(B) homeless;
(C) under extreme financial hardship;
(D) more than 85 years old; or
(E) capable of demonstrating other sufficient cause.
(2) On October 1, 2022, for everyone not described in
paragraph (1).
SEC. 404. ADDITION OF ADDITIONAL DISEASES ASSOCIATED WITH
EXPOSURE TO CERTAIN HERBICIDE AGENTS FOR WHICH
THERE IS A PRESUMPTION OF SERVICE CONNECTION
FOR VETERANS WHO SERVED IN CERTAIN LOCATIONS.
(a) Short Title.--This section may be cited as the ``Fair
Care for Vietnam Veterans Act of 2022''.
(b) Monoclonal Gammopathy of Undetermined Significance.--
Section 1116(a)(2) of title 38, United States Code, is
amended by adding at the end the following new subparagraph:
``(L) Monoclonal gammopathy of undetermined
significance.''.
(c) Hypertension.--Such section, as amended by subsection
(b), is further amended by adding at the end the following
new subparagraph:
``(M) Hypertension.''.
(d) Effective Dates and Applicability.--
(1) Monoclonal gammopathy of undetermined significance.--
(A) In general.--The amendment made by subsection (b) shall
take effect on the date of the enactment of this Act and
shall apply as follows:
(i) On the date of the enactment of this Act for claimants
for dependency and indemnity compensation under chapter 13 of
title 38, United States Code, and for veterans whom the
Secretary of Veterans Affairs determines are--
(I) terminally ill;
(II) homeless;
(III) under extreme financial hardship;
(IV) more than 85 years old; or
(V) capable of demonstrating other sufficient cause.
(ii) On October 1, 2022, for everyone not described in
clause (i).
(B) Retroactive application.--Notwithstanding any Federal
court decisions or settlements in effect on the day before
the date of the enactment of this Act, the Secretary of
Veterans Affairs shall award retroactive claims for a
condition under section 1116(a)(2)(L) of title 38, United
States Code, as added by subsection (b) of this section, only
to claimants for dependency and indemnity compensation under
chapter 13 of such title described in subparagraph (A)(i) of
this paragraph.
(2) Hypertension.--
(A) In general.--The amendment made by subsection (c) shall
take effect on the date of the enactment of this Act and
shall apply as follows:
(i) On the date of the enactment of this Act for claimants
for dependency and indemnity compensation under chapter 13 of
title 38, United States Code, and for veterans whom the
Secretary of Veterans Affairs determines are--
(I) terminally ill;
(II) homeless;
(III) under extreme financial hardship;
(IV) more than 85 years old; or
(V) capable of demonstrating other sufficient cause.
(ii) On October 1, 2026, for everyone not described in
subparagraph (A).
[[Page H6008]]
(B) Retroactive application.--Notwithstanding any Federal
court decisions or settlements in effect on the day before
the date of the enactment of this Act, the Secretary of
Veterans Affairs shall award retroactive claims for a
condition under section 1116(a)(2)(M) of title 38, United
States Code, as added by subsection (c) of this section, only
to claimants for dependency and indemnity compensation under
chapter 13 of such title described in subparagraph (A)(i) of
this paragraph.
SEC. 405. IMPROVING COMPENSATION FOR DISABILITIES OCCURRING
IN PERSIAN GULF WAR VETERANS.
(a) Reduction in Threshold of Eligibility.--Subsection
(a)(1) of section 1117 is amended by striking ``became
manifest--'' and all that follows through the period at the
end and inserting ``became manifest to any degree at any
time.''.
(b) Permanent Extension of Period of Eligibility.--Such
section is further amended--
(1) by striking subsection (b);
(2) by redesignating subsections (c) and (d) as subsections
(b) and (c), respectively; and
(3) in subsection (a)(2)(C), by striking ``under subsection
(d)'' and inserting ``under subsection (c)''.
(c) Establishing Singular Disability-based Questionnaire.--
Such section is further amended by inserting after subsection
(c) (as redesignated by subsection (b)) the following new
subsection (d):
``(d) If a Persian Gulf veteran at a medical facility of
the Department presents with any one symptom associated with
Gulf War Illness, the Secretary shall ensure that health care
personnel of the Department use a disability benefits
questionnaire, or successor questionnaire, designed to
identify Gulf War Illness, in addition to any other
diagnostic actions the personnel determine appropriate.''.
(d) Expansion of Definition of Persian Gulf Veteran.--
Subsection (f) of such section is amended by inserting ``,
Afghanistan, Israel, Egypt, Turkey, Syria, or Jordan,'' after
``operations''.
(e) Training.--Such section is further amended by adding at
the end the following new subsection:
``(i)(1) The Secretary shall take such actions as may be
necessary to ensure that health care personnel of the
Department are appropriately trained to effectively carry out
this section.
``(2) Not less frequently than once each year, the
Secretary shall submit to Congress a report on the actions
taken by the Secretary to carry out paragraph (1).''.
SEC. 406. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN
DISEASES ASSOCIATED WITH EXPOSURE TO BURN PITS
AND OTHER TOXINS.
(a) Short Title.--This section may be cited as the
``Presumptive Benefits for War Fighters Exposed to Burn Pits
and Other Toxins Act of 2022''.
(b) In General.--Subchapter II of chapter 11, as amended by
section 302, is further amended by inserting after section
1119 the following new section:
``Sec. 1120. Presumption of service connection for certain
diseases associated with exposure to burn pits and other
toxins
``(a) Presumption of Service Connection.--For the purposes
of section 1110 of this title, and subject to section 1113 of
this title, a disease specified in subsection (b) becoming
manifest in a covered veteran shall be considered to have
been incurred in or aggravated during active military, naval,
air, or space service, notwithstanding that there is no
record of evidence of such disease during the period of such
service.
``(b) Diseases Specified.--The diseases specified in this
subsection are the following:
``(1) Asthma that was diagnosed after service of the
covered veteran as specified in subsection (c).
``(2) The following types of cancer:
``(A) Head cancer of any type.
``(B) Neck cancer of any type.
``(C) Respiratory cancer of any type.
``(D) Gastrointestinal cancer of any type.
``(E) Reproductive cancer of any type.
``(F) Lymphoma cancer of any type.
``(G) Lymphomatic cancer of any type.
``(H) Kidney cancer.
``(I) Brain cancer.
``(J) Melanoma.
``(K) Pancreatic cancer.
``(3) Chronic bronchitis.
``(4) Chronic obstructive pulmonary disease.
``(5) Constrictive bronchiolitis or obliterative
bronchiolitis.
``(6) Emphysema.
``(7) Granulomatous disease.
``(8) Interstitial lung disease.
``(9) Pleuritis.
``(10) Pulmonary fibrosis.
``(11) Sarcoidosis.
``(12) Chronic sinusitis.
``(13) Chronic rhinitis.
``(14) Glioblastoma.
``(15) Any other disease for which the Secretary
determines, pursuant to regulations prescribed under
subchapter VII that a presumption of service connection is
warranted based on a positive association with a substance,
chemical, or airborne hazard identified in the list under
section 1119(b)(2) of this title.
``(c) Covered Veteran Defined.--In this section, the term
`covered veteran' has the meaning given that term in section
1119(c) of this title.''.
(c) Conforming Amendment.--Section 1113 is amended by
striking ``or 1118'' each place it appears and inserting
``1118, or 1120''.
(d) Effective Date and Applicability.--The amendments made
by this section shall take effect on the date of the
enactment of this Act and shall apply as follows:
(1) On the date of the enactment of this Act for claimants
for dependency and indemnity compensation under chapter 13 of
title 38, United States Code, and veterans whom the Secretary
of Veterans Affairs determines are--
(A) terminally ill;
(B) homeless;
(C) under extreme financial hardship;
(D) more than 85 years old; or
(E) capable of demonstrating other sufficient cause.
(2) On the date of the enactment of this Act for everyone
not described in paragraph (1), with respect to paragraphs
(1), (2)(C), (2)(I), (5), (6), (7), (8), (9), (10), (11),
(12), (13), and (14), of section 1120(b) of title 38, United
States Code, as added by subsection (b).
(3) On October 1, 2023, for everyone not described in
paragraph (1), with respect to paragraphs (3) and (4) of
section 1120(b) of such title, as so added.
(4) On October 1, 2024, for everyone not described in
paragraph (1), with respect to subparagraphs (A), (B), (D),
(E), (F), (G), and (K) of section 1120(b)(2) of such title,
as so added.
(5) On October 1, 2025, for everyone not described in
paragraph (1), with respect to subparagraphs (H) and (J) of
section 1120(b)(2) of such title, as so added.
SEC. 407. RULE OF CONSTRUCTION.
(a) Generally.--Nothing in this Act shall be construed to
prevent the Secretary of Veterans Affairs from processing
claims for benefits under title 38, United States Code, for a
condition or disease for which this Act establishes a
presumption of service connection, as a claim for benefits
for a condition or disease with direct service connection.
(b) Effective Dates and Applicability.--The Secretary shall
not deny a claim for benefits under title 38, United States
Code, for a condition or disease for which this Act
establishes a presumption of service connection because the
claimant filed the claim prior to the effective date or date
of applicability for that particular condition or disease.
TITLE V--RESEARCH MATTERS
SEC. 501. INTERAGENCY WORKING GROUP ON TOXIC EXPOSURE
RESEARCH.
(a) Establishment.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall, in collaboration with the heads of the entities
described in paragraph (2), establish the Toxic Exposure
Research Working Group (in this section referred to as the
``Working Group'').
(2) Composition.--The Working Group shall consist of
employees, selected by the Secretary, of the following:
(A) The Department of Veterans Affairs.
(B) The Department of Defense.
(C) The Department of Health and Human Services.
(D) The Environmental Protection Agency.
(E) Other entities of the Federal Government involved in
research activities regarding the health consequences of
toxic exposures experienced during active military, naval,
air, or space service.
(b) Functions.--The Working Group shall perform the
following functions:
(1) Identify collaborative research activities and
resources available among entities represented by members of
the Working Group to conduct such collaborative research
activities.
(2) Develop a five-year strategic plan for such entities to
carry out collaborative research activities.
(c) Reporting.--The Secretary shall submit to the Committee
on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives the
following:
(1) Not later than one year after the date of the enactment
of this Act, a report on the establishment of the Working
Group under subsection (a).
(2) Not later than two years after the date of the
enactment of this Act, a report containing the collaborative
research activities identified, and the strategic plan
developed, by the Working Group under subsection (b).
(3) Not less frequently than annually during the five-year
period covered by the strategic plan under subsection (b), a
progress report on implementation of the strategic plan.
(d) Termination.--The Working Group shall terminate after
submitting the final report under subsection (c).
(e) Definitions.--In this section:
(1) Active military, naval, air, or space service.--The
term ``active military, naval, air, or space service'' has
the meaning given that term in section 101 of title 38,
United States Code.
(2) Collaborative research activity.--The term
``collaborative research activity'' means a research
activity--
(A) agreed upon by the Working Group;
(B) conducted by an entity represented by a member of the
Working Group;
(C) funded by the Federal Government; and
(D) regarding the health consequences of toxic exposures
experienced during active military, naval, air, or space
service.
(3) Toxic exposure.--The term ``toxic exposure'' has the
meaning given such term in section 101 of title 38, United
States Code, as amended by section 102(b).
SEC. 502. ANALYSIS AND REPORT ON TREATMENT OF VETERANS FOR
MEDICAL CONDITIONS RELATED TO TOXIC EXPOSURE.
(a) In General.--The Secretary of Veterans Affairs shall
analyze, on a continuous basis, all clinical data that--
(1) is obtained by the Department of Veterans Affairs in
connection with hospital care, medical services, and nursing
home care furnished under section 1710(a)(2)(F) of title 38,
United States Code; and
(2) is likely to be scientifically useful in determining
the association, if any, between the medical condition of a
veteran and a toxic exposure.
[[Page H6009]]
(b) Annual Report.--Not later than one year after the date
of the enactment of this Act, and annually thereafter, the
Secretary shall submit to the Committee on Veterans' Affairs
of the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report containing the following:
(1) The aggregate data compiled under subsection (a).
(2) An analysis of such data.
(3) A description of the types and incidences of medical
conditions identified by the Department under such
subsection.
(4) The explanation of the Secretary for the incidence of
such medical conditions and other explanations for the
incidence of such conditions as the Secretary considers
reasonable.
(5) The views of the Secretary on the scientific validity
of drawing conclusions from the incidence of such medical
conditions, as evidenced by the data compiled under
subsection (a), regarding any association between such
conditions and toxic exposures.
(c) Toxic Exposure Defined.--In this section, the term
``toxic exposure'' has the meaning given such term in section
101 of title 38, United States Code, as amended by section
102(b).
SEC. 503. ANALYSIS RELATING TO MORTALITY OF VETERANS WHO
SERVED IN SOUTHWEST ASIA.
(a) Analysis.--
(1) In general.--Not later than 270 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs,
in coordination with the Secretary of Defense, shall conduct
an updated analysis of total and respiratory disease
mortality in covered veterans.
(2) Elements.--The analysis required by paragraph (1) shall
include, to the extent practicable, the following with
respect to each covered veteran:
(A) Metrics of airborne exposures.
(B) The location and timing of deployments of the veteran.
(C) The military occupational specialty of the veteran.
(D) The Armed Force in which the veteran served.
(E) Pre-existing health status of the veteran, including
with respect to asthma.
(F) Relevant personal information of the veteran, including
cigarette and e-cigarette smoking history, diet, sex, gender,
age, race, and ethnicity.
(b) Covered Veteran Defined.--In this section, the term
``covered veteran'' means any veteran who--
(1) on or after August 2, 1990, served on active duty in--
(A) Bahrain;
(B) Iraq;
(C) Kuwait;
(D) Oman;
(E) Qatar;
(F) Saudi Arabia;
(G) Somalia; or
(H) the United Arab Emirates; or
(2) on or after September 11, 2001, served on active duty
in--
(A) Afghanistan;
(B) Djibouti;
(C) Egypt;
(D) Jordan;
(E) Lebanon;
(F) Syria; or
(G) Yemen.
SEC. 504. STUDY ON HEALTH TRENDS OF POST-9/11 VETERANS.
The Secretary of Veterans Affairs shall conduct an
epidemiological study on the health trends of veterans who
served in the Armed Forces after September 11, 2001.
SEC. 505. STUDY ON CANCER RATES AMONG VETERANS.
(a) In General.--The Secretary of Veterans Affairs shall
conduct a study on the incidence of cancer in veterans to
determine trends in the rates of the incidence of cancer in
veterans.
(b) Elements.--The study required by subsection (a) shall
assess, with respect to each veteran included in the study,
the following:
(1) The age of the veteran.
(2) The period of service and length of service of the
veteran in the Armed Forces.
(3) The military occupational specialty or specialties of
the veteran.
(4) The sex of the veteran.
(5) The type or types of cancer that the veteran has.
SEC. 506. STUDY ON HEALTH EFFECTS OF WASTE RELATED TO
MANHATTAN PROJECT ON CERTAIN VETERANS.
(a) Study.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs
shall enter into an agreement with the National Academies of
Sciences, Engineering, and Medicine for the conduct of a
study on the health trends of veterans who, while serving in
the active military, naval, air, or space service--
(1) participated in activities relating to the Manhattan
Project (including activities relating to covered waste) in
connection with such service; or
(2) resided at or near, as determined by the Secretary, the
locations described in subsection (b).
(b) Covered Locations.--The locations described in this
subsection are the following locations:
(1) In the county of St. Louis, Missouri, the following:
(A) Coldwater Creek, Missouri.
(B) The St. Louis Airport Site, Missouri.
(C) The West Lake Landfill.
(2) Oak Ridge, Tennessee.
(3) Hanford, Washington.
(4) Any other location that is proximate to covered waste,
as determined by the Secretary.
(c) Elements.--The study under subsection (a) shall assess,
with respect to each veteran included in the study, the
following:
(1) The age, sex, and race of the veteran.
(2) The period and location of exposure to covered waste.
(3) Any type of cancer, or other illness associated with
toxic exposure, that the veteran has.
(4) A comparison of the overall health condition of the
veteran, including any illness of the veteran identified
pursuant to paragraph (3), with the overall health condition
of past and present civilian populations residing at the same
location of exposure, as determined by the Secretary.
(d) Report.--Not later than three years after the date of
the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report on the study under subsection (a)
and include in such report an analysis of the data available
and data reliability.
(e) Definitions.--In this section:
(1) Active military, naval, air, or space service; toxic
exposure.--The terms ``active military, naval, air, or space
service'' and ``toxic exposure'' have the meanings given
those terms in section 101 of title 38, United States Code,
as added by section 102(b).
(2) Covered waste.--The term ``covered waste'' means any
waste arising from activities carried out in connection with
the Manhattan Project.
(3) Illness.--The term ``illness'' has the meaning given
that term in section 1171 of title 38, United States Code, as
added by section 202.
(4) Toxic exposure.--The term ``toxic exposure'' has the
meaning given such term in section 101 of title 38, United
States Code, as amended by section 102(b).
SEC. 507. STUDY ON TOXIC EXPOSURE AND MENTAL HEALTH OUTCOMES.
(a) Study Required.--Not later than 180 days after the date
of the enactment of this Act, the Secretary of Veterans
Affairs shall enter into an agreement with the National
Academies of Sciences, Engineering, and Medicine for the
conduct of a study of veterans to assess possible
relationships between toxic exposures experienced during
service in the Armed Forces and mental health conditions,
including chronic multisymptom illness, traumatic brain
injury, post-traumatic stress disorder, depression, episodes
of psychosis, schizophrenia, bipolar disorder, suicide
attempts, and suicide deaths.
(b) Elements.--For each veteran included in the study under
subsection (a), the following information shall be collected
and assessed:
(1) Age.
(2) Sex.
(3) Race and ethnicity.
(4) Period and length of service in the Armed Forces.
(5) The military occupational specialty or specialties of
the veteran.
(6) History of toxic exposure during service in the Armed
Forces.
(7) Any diagnosis of chronic multisymptom illness.
(8) Any diagnosis of a mental health or cognitive disorder.
(9) Any history of suicide attempt or suicidality.
(10) If the veteran died by suicide.
(11) Any confounding traumatic experiences that could
affect a veteran's mental health.
(c) Report.--Not later than three years after the date of
the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report containing the findings of the
National Academies of Sciences, Engineering, and Medicine
with respect to the study conducted under subsection (a).
SEC. 508. STUDY ON VETERANS IN TERRITORIES OF THE UNITED
STATES.
(a) GAO Study.--
(1) In general.--The Comptroller General of the United
States shall conduct a study on the state of access and
barriers to benefits and services furnished by the Veterans
Benefits Administration and the Veterans Health
Administration under laws administered by the Secretary of
Veterans Affairs to veterans in Territories and Freely
Associated States of the United States, including deficits in
the availability and accessibility of such benefits and
services compared to veterans elsewhere in the United States.
(2) Elements.--The study under paragraph (1) shall
include--
(A) the number of veterans in each Territory and Freely
Associated State of the United States;
(B) the number of veterans in each Territory and Freely
Associated State who are enrolled in the system of annual
patient enrollment of the Department of Veterans Affairs
under section 1705(a) of title 38, United States Code;
(C) a description of how the Department estimates the
number of veterans in each Territory and Freely Associated
State who are eligible for services under section 1710 of
such title but who are not enrolled as described in
subparagraph (B);
(D) a detailed description of obstacles facing veterans in
each Territory and Freely Associated State in accessing
health care services, including those involving the
availability of such services to veterans in the Territory or
Freely Associated State in which the veterans reside, and any
distance impediments to receiving services at a regional
medical center of the Veterans Health Administration, a
community-based outpatient clinic, another full-service
medical facility of the Department, or a Vet Center,
respectively;
(E) a detailed description of obstacles facing veterans in
each Territory and Freely Associated State in accessing
readjustment counseling
[[Page H6010]]
services, including those involving the availability of such
services to veterans in the Territory in which the veterans
reside, and any distance impediments to receiving services at
a readjustment counseling services center of the Department;
(F) a detailed description of obstacles facing veterans in
each Territory and Freely Associated State in accessing non-
health care veterans benefits, including those involving the
availability of benefits and services to veterans in the
Territory or Freely Associated State in which the veterans
reside, and any distance impediments to accessing the nearest
office of the Veterans Benefits Administration;
(G) an analysis of the staffing and quality of the offices
of the Veterans Benefits Administration and Veterans Health
Administration charged with serving veterans in the
Territories and Freely Associated States, including the
availability of the full- and part-time staff of each office
to the veterans they are charged with serving;
(H) an analysis of the availability of the Veterans
Community Care Program established under section 1703 of
title 38, United States Code, to veterans in each Territory
and Freely Associated State;
(I) an analysis of the economic and health outcomes for
veterans in each Territory or Freely Associated State
resulting from obstacles to accessing adequate assistance and
health care at facilities of the Department;
(J) an analysis of the access to benefit assistance and
health care provided to veterans in the aftermath of major
disasters declared in each of the Territories and Freely
Associated States since September 4, 2017; and
(K) such recommendations as the Comptroller General
considers appropriate for improving access of veterans in the
Territories and Freely Associated States to benefits and
health care services furnished by the Secretary, and reducing
barriers and deficits in the availability and accessibility
of such benefits and services compared to veterans elsewhere
in the United States.
(b) Briefing.--Not later than one year after the date of
the enactment of this Act, the Comptroller General shall
provide to the Committee on Veterans' Affairs of the Senate
and the Committee on Veterans' Affairs of the House of
Representatives a briefing setting forth the results of the
study conducted under subsection (a), including any
recommendations developed under paragraph (2)(K) of such
subsection.
(c) Definitions.--In this section:
(1) Freely associated state.--The term ``Freely Associated
State'' includes the Federated States of Micronesia, the
Republic of the Marshall Islands, and the Republic of Palau.
(2) Territory.--The term ``Territory'' includes American
Samoa, the Commonwealth of the Northern Marianas Islands,
Guam, Puerto Rico, and the Virgin Islands.
(3) Vet center.--The term ``Vet Center'' has the meaning
given that term in section 1712A(h) of title 38, United
States Code.
SEC. 509. DEPARTMENT OF VETERANS AFFAIRS PUBLIC WEBSITE FOR
TOXIC EXPOSURE RESEARCH.
(a) Website.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs
shall establish, and maintain thereafter, a publicly
accessible internet website of the Department of Veterans
Affairs that serves as a clearinghouse for the publication of
all toxic exposure research carried out or funded by the
executive branch of the Federal Government.
(b) Coordination.--In carrying out subsection (a), the
Secretary shall coordinate with--
(1) the heads of each Federal agency carrying out or
funding toxic exposure research;
(2) the War Related Illness and Injury Study Center of the
Department of Veterans Affairs, or successor center; and
(3) any working group of the Department of Veterans Affairs
or other similar entity responsible for coordinating toxic
exposure research.
(c) Definitions.--In this section:
(1) Toxic exposure.--The term ``toxic exposure'' has the
meaning given that term in section 101 of title 38, United
States Code, as added by section 102(b).
(2) Toxic exposure research.--The term ``toxic exposure
research'' means research on the health consequences of toxic
exposures experienced during service in the Armed Forces.
SEC. 510. REPORT ON HEALTH EFFECTS OF JET FUELS USED BY ARMED
FORCES.
(a) Initial Report.--Not later than one year after the date
of the enactment of this Act, the Secretary of Veterans
Affairs shall submit to the Committee on Veterans' Affairs of
the Senate and the Committee on Veterans' Affairs of the
House of Representatives, and make publicly available, a
report on health effects of jet fuels used by the Armed
Forces.
(b) Contents.--The report submitted under subsection (a)
shall include the following:
(1) A discussion of the effect of various different types
of jet fuels used by the Armed Forces on the health of
individuals by length of exposure.
(2) An identification of the immediate symptoms of jet fuel
exposure that may indicate future health risks.
(3) A chronology of health safeguards implemented by the
Armed Forces intended to reduce the exposure of members of
the Armed Forces to jet fuel.
(4) An identification of any areas relating to jet fuel
exposure about which new research needs to be conducted.
(c) Follow-up Report.--Not later than five years after the
date of the submittal of the report under subsection (a), the
Secretary shall submit to the committees referred to in such
subsection an update to such report.
TITLE VI--IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED
VETERANS
SEC. 601. SHORT TITLE; DEFINITIONS.
(a) Short Title.--This title may be cited as the ``Fairly
Assessing Service-related Toxic Exposure Residuals
Presumptions Act of 2022'' or the ``FASTER Presumption Act of
2022''.
(b) Definitions.--In this title, the terms ``active
military, naval, air, or space service'', ``toxic exposure'',
and ``toxic-exposed veteran'' have the meanings given those
terms in section 101 of title 38, United States Code, as
amended by section 102.
SEC. 602. PUBLICATION OF LIST OF RESOURCES OF DEPARTMENT OF
VETERANS AFFAIRS FOR TOXIC-EXPOSED VETERANS AND
VETERANS WHO REPORT TOXIC EXPOSURES AND
OUTREACH PROGRAM FOR SUCH VETERANS AND
CAREGIVERS AND SURVIVORS OF SUCH VETERANS.
(a) Publication of List of Resources.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, and annually thereafter, the
Secretary of Veterans Affairs shall publish a list of
resources of the Department of Veterans Affairs for--
(A) toxic-exposed veterans and veterans who report toxic
exposure;
(B) families and caregivers of such veterans; and
(C) survivors of such veterans who are receiving death
benefits under the laws administered by the Secretary.
(2) Update.--The Secretary shall periodically update the
list published under paragraph (1).
(b) Outreach.--The Secretary shall develop, with input from
the community, an informative outreach program for veterans
on illnesses that may be related to toxic exposures,
including outreach with respect to benefits and support
programs.
SEC. 603. INCORPORATION OF TOXIC EXPOSURE SCREENING FOR
VETERANS.
(a) In General.--Beginning not later than 90 days after the
date of the enactment of this Act, the Secretary of Veterans
Affairs shall incorporate a screening to help determine
potential toxic exposures during active military, naval, air,
or space service as part of a health care screening furnished
by the Department of Veterans Affairs to veterans enrolled in
the system of annual patient enrollment of the Department
established and operated under section 1705 of title 38,
United States Code, to improve understanding by the
Department of toxic exposures while serving in the Armed
Forces.
(b) Timing.--The Secretary shall ensure that a veteran
described in subsection (a) completes the screening required
under such subsection not less frequently than once every
five years.
(c) Determination of Questions.--
(1) In general.--The questions included in the screening
required under subsection (a) shall be determined by the
Secretary with input from medical professionals.
(2) Specific questions.--At a minimum, the screening
required under subsection (a) shall, with respect to a
veteran, include--
(A) a question about the potential exposure of the veteran
to an open burn pit; and
(B) a question regarding toxic exposures that are commonly
associated with service in the Armed Forces.
(3) Open burn pit defined.--In this subsection, the term
``open burn pit'' means an area of land that--
(A) is designated by the Secretary of Defense to be used
for disposing solid waste by burning in the outdoor air; and
(B) does not contain a commercially manufactured
incinerator or other equipment specifically designed and
manufactured for the burning of solid waste.
(d) Print Material.--In developing the screening
established under subsection (a), the Secretary shall ensure
that print materials complementary to such screening that
outline related resources for veterans are available at each
medical center of the Department to veterans who may not have
access to the internet.
(e) Screening Updates.--The Secretary shall consider
updates to the content of the screening required under
subsection (a) not less frequently than biennially to ensure
the screening contains the most current information.
SEC. 604. TRAINING FOR PERSONNEL OF THE DEPARTMENT OF
VETERANS AFFAIRS WITH RESPECT TO VETERANS WHO
REPORT TOXIC EXPOSURES.
(a) Health Care Personnel.--The Secretary of Veterans
Affairs shall provide to health care personnel of the
Department of Veterans Affairs education and training to
identify, treat, and assess the impact on veterans of
illnesses related to toxic exposures and inform such
personnel of how to ask for additional information from
veterans regarding different toxic exposures.
(b) Benefits Personnel.--
(1) In general.--The Secretary shall incorporate a training
program for processors of claims under the laws administered
by the Secretary who review claims for disability benefits
relating to service-connected disabilities based on toxic
exposures.
(2) Annual training.--Training provided to processors under
paragraph (1) shall be provided not less frequently than
annually.
TITLE VII--RESOURCING
SEC. 701. AUTHORITY TO USE APPROPRIATIONS TO ENHANCE CLAIMS
PROCESSING CAPACITY AND AUTOMATION.
(a) Authority.--The Secretary of Veterans Affairs may use,
from amounts appropriated to the Cost of War Toxic Exposures
Fund established by section 324 of title 38, United States
Code, as added by section 805 of this Act, such amounts as
may be necessary to continue the modernization, development,
and expansion of capabilities and capacity of information
technology systems and infrastructure of the Veterans
Benefits Administration, including for claims automation, to
support expected increased claims processing for newly
eligible veterans pursuant to this Act.
[[Page H6011]]
(b) Plan for Modernization of Veterans Benefits
Administration Information Technology Systems.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall submit to the appropriate congressional committees a
plan for the modernization of the information technology
systems of the Veterans Benefits Administration. The plan
shall cover the first fiscal year that begins after the date
of the enactment of this Act and the subsequent four fiscal
years and shall include each of the following:
(A) An identification of any information system to be
modernized or retired, if applicable, during the period
covered by the plan.
(B) A description of how the Secretary intends to
incorporate the following principles into the modernization
of such information systems:
(i) The purpose of automation should be to increase the
speed and accuracy of claims processing decisions.
(ii) Automation should be conducted in a manner that
enhances the productivity of employees of the Department of
Veterans Affairs.
(iii) Automation should be carried out in a manner that
achieves greater consistency in the processing and rating of
claims by relying on patterns of similar evidence in claim
files.
(iv) To the greatest extent possible, automation should be
carried out by drawing from information in the possession of
the Department, other Government agencies, and applicants for
benefits.
(v) Automation of any claims analysis or determination
process should not be end-to-end or lack intermediation.
(vi) Employees of the Department should continue to make
decisions with respect to the approval of claims and the
granting of benefits.
(vii) Automation should not be carried out in a manner that
reduces or infringes upon the due process rights of
applicants for benefits under the laws administered by the
Secretary; or the duties of the Secretary to assist and
notify claimants.
(viii) Automation should be carried out while taking all
necessary measures to protect the privacy of claimants and
their personally identifiable information.
(ix) Automation of claims processing should not eliminate
or reduce the workforce of the Veterans Benefits
Administration.
(C) An identification of targets, for each fiscal year, by
which the Secretary intends to complete the modernization of
each information system or major component or functionality
of such system identified under subparagraph (A).
(D) Cost estimates for the modernization of each
information system identified under paragraph (A) for each
fiscal year covered by the plan and in total.
(2) Appropriate congressional committees.--In this section,
the term ``appropriate congressional committees'' means--
(A) the Committee on Veterans' Affairs and the Subcommittee
on Military Construction, Veterans Affairs, and Related
Agencies of the Committee on Appropriations of the Senate;
and
(B) the Committee on Veterans' Affairs and the Subcommittee
on Military Construction, Veterans Affairs, and Related
Agencies of the Committee on Appropriations of the House of
Representatives.
SEC. 702. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES OF
DEPARTMENT OF VETERANS AFFAIRS FOR FISCAL YEAR
2023.
(a) In General.--The Secretary of Veterans Affairs may
carry out the following major medical facility leases in
fiscal year 2023:
(1) Lease for an outpatient clinic in the vicinity of
Allentown, Pennsylvania, in an estimated amount of
$31,832,000.
(2) Lease for a facility for member services for the
Veterans Health Administration in the vicinity of Atlanta,
Georgia, in an estimated amount of $27,134,000.
(3) Lease for an outpatient clinic in the vicinity of
Baltimore, Maryland, in an estimated amount of $43,041,000.
(4) Lease for an outpatient clinic in the vicinity of Baton
Rouge, Louisiana, in an estimated amount of $29,550,000.
(5) Lease for an outpatient clinic in the vicinity of
Beaufort, South Carolina, in an estimated amount of
$24,254,000.
(6) Lease for an outpatient clinic in the vicinity of
Beaumont, Texas, in an estimated amount of $15,632,000.
(7) Lease for an outpatient clinic in the vicinity of
Brainerd, Minnesota, in an estimated amount of $14,669,000.
(8) Lease for a facility for research in the vicinity of
Buffalo, New York, in an estimated amount of $11,106,000.
(9) Lease for an outpatient clinic in the vicinity of
Clarksville, Tennessee, in an estimated amount of
$75,135,000.
(10) Lease of a facility for research in the vicinity of
Columbia, Missouri, in an estimated amount of $20,726,000.
(11) Lease for an outpatient clinic in the vicinity of
Cookeville, Tennessee, in an estimated amount of $10,958,000.
(12) Lease for a residential treatment facility in the
vicinity of Denver, Colorado, in an estimated amount of
$9,133,000.
(13) Lease for an outpatient clinic in the vicinity of
Elizabethtown, Kentucky, in an estimated amount of
$16,671,000.
(14) Lease for an outpatient clinic in the vicinity of
Farmington, Missouri, in an estimated amount of $17,940,000.
(15) Lease for an outpatient clinic in the vicinity of
Hampton, Virginia, in an estimated amount of $63,085,000.
(16) Lease for an outpatient clinic in the vicinity of
Jacksonville, North Carolina, in an estimated amount of
$61,450,000.
(17) Lease for an outpatient clinic in the vicinity of
Killeen, Texas, in an estimated amount of $61,030,000.
(18) Lease for an outpatient clinic in the vicinity of
Lawrence, Indiana, in an estimated amount of $15,811,000.
(19) Lease for an outpatient clinic in the vicinity of
Lecanto, Florida, in an estimated amount of $15,373,000.
(20) Lease for an outpatient clinic in the vicinity of
Nashville, Tennessee, in an estimated amount of $58,038,000.
(21) Lease for an outpatient clinic in the vicinity of
North Kansas City, Missouri, in an estimated amount of
$40,027,000.
(22) Lease for an outpatient clinic in the vicinity of
Pflugerville, Texas, in an estimated amount of $16,654,000.
(23) Lease for an outpatient clinic in the vicinity of
Plano, Texas, in an estimated amount of $32,796,000.
(24) Lease for an outpatient clinic in the vicinity of
Prince George's County, Maryland, in an estimated amount of
$31,754,000.
(25) Lease for an outpatient clinic in the vicinity of
Rolla, Missouri, in an estimated amount of $21,352,000.
(26) Lease for an outpatient clinic in the vicinity of Salt
Lake City, Utah, in an estimated amount of $29,466,000.
(27) Lease for an outpatient clinic in the vicinity of
Sarasota, Florida, in an estimated amount of $36,517,000.
(28) Lease for an outpatient clinic in the vicinity of
Springfield, Massachusetts, in an estimated amount of
$30,918,000.
(29) Lease for a community living center in the vicinity of
Tampa, Florida, in an estimated amount of $51,682,000.
(30) Lease for an outpatient clinic in the vicinity of The
Villages, Florida, in an estimated amount of $48,267,000.
(31) Lease for an outpatient clinic in the vicinity of Tri-
Cities, Washington, in an estimated amount of $36,136,000.
(b) Treatment of Authorizations.--The authorization of
leases under subsection (a) shall be considered to be a
specific authorization by law of the funds for such leases
for purposes of section 8104(a)(2) of title 38, United States
Code, as in effect on the day before the date of the
enactment of this Act.
(c) Authorization of Appropriations.--There is authorized
to be appropriated to the Secretary of Veterans Affairs for
fiscal year 2023, or the year in which funds are appropriated
for the Medical Facilities account, $998,137,000 for the
leases authorized in subsection (a).
SEC. 703. TREATMENT OF MAJOR MEDICAL FACILITY LEASES OF THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) Congressional Approval of Major Medical Facility
Leases.--Paragraph (2) of subsection (a) of section 8104 of
title 38, United States Code, is amended--
(1) by striking ``No funds'' and inserting ``(A) No
funds'';
(2) by striking ``or any major medical facility lease'';
(3) by striking ``or lease''; and
(4) by adding at the end the following new subparagraph:
``(B) No funds may be appropriated for any fiscal year, and
the Secretary may not obligate or expend funds (other than
for advance planning and design), for any major medical
facility lease unless the Committee on Veterans' Affairs of
the Senate and the Committee on Veterans' Affairs of the
House of Representatives each adopt a resolution approving
the lease.''.
(b) Modification of Definition of Major Medical Facility
Lease.--Subparagraph (B) of paragraph (3) of such subsection
is amended to read as follows:
``(B) The term `major medical facility lease'--
``(i) means a lease for space for use as a new medical
facility approved through the General Services Administration
under section 3307(a) of title 40 at an average annual rent
equal to or greater than the appropriate dollar threshold
described in such section, which shall be subject to annual
adjustment in accordance with section 3307(h) of such title;
and
``(ii) does not include a lease for space for use as a
shared Federal medical facility for which the Department's
estimated share of the lease costs does not exceed such
dollar threshold.''.
(c) Separate Prospectus Requirement for Major Medical
Facility Leases.--Subsection (b) of such section is amended--
(1) by striking paragraph (7);
(2) in paragraph (1), by redesignating subparagraphs (A)
through (E) as clauses (i) through (v), respectively;
(3) in paragraph (6), by redesignating subparagraphs (A)
through (C) as clauses (i) through (iii), respectively;
(4) by redesignating paragraphs (1) through (6) as
subparagraphs (A) through (F), respectively;
(5) in the matter preceding subparagraph (A), as
redesignated by paragraph (4)--
(A) by striking ``Whenever the President'' and inserting
``(1) Whenever the President'';
(B) by striking ``the Congress'' and inserting
``Congress''; and
(C) by striking ``or a major medical facility lease (as
defined in subsection (a)(3)(b))'';
(6) in subparagraph (A), as redesignated by paragraph (4),
by striking ``leased,'';
(7) in subparagraph (E), as redesignated by paragraph (4)--
(A) by striking ``or lease'' each place it appears; and
(B) by striking ``or leases''; and
(8) by adding at the end the following new paragraph:
``(2) Whenever the President or the Secretary submit to
Congress a request for the funding of a major medical
facility lease (as defined in subsection (a)(3)(B)), the
Secretary shall submit to each committee, on the same day, a
prospectus of the proposed medical facility. Any such
prospectus shall include the following:
[[Page H6012]]
``(A) A description of the facility to be leased.
``(B) An estimate of the cost to the Federal Government of
the facility to be leased.
``(C) An estimate of the energy performance of the proposed
lease space, to include a description of anticipated
utilization of renewable energy, energy efficient and climate
resilient elements, and related matters.
``(D) Current and projected workload and utilization data
regarding the facility to be leased, including information on
projected changes in workload and utilization over a five-
year period, a ten-year period, and a twenty-year period.
``(E) A detailed analysis of how the lease is expected to
comply with Office of Management and Budget Circular A-11 and
section 1341 of title 31 (commonly referred to as the `Anti-
Deficiency Act'). Any such analysis shall include--
``(i) an analysis of the classification of the lease as a
`lease purchase', a `capital lease', or an `operating lease'
as those terms are defined in Office of Management and Budget
Circular A-11;
``(ii) an analysis of the obligation of budgetary resources
associated with the lease; and
``(iii) an analysis of the methodology used in determining
the asset cost, fair market value, and cancellation costs of
the lease.''.
(d) Interim Leasing Actions.--Such section is further
amended by adding at the end the following new subsection:
``(i)(1) Notwithstanding subsection (a)(2)(B), the
Secretary may carry out interim leasing actions as the
Secretary considers necessary for the following leases:
``(A) Major medical facility leases (as defined in
subsection (a)(3)(B)) approved pursuant to this section and
for which a prospectus for a replacement lease has been
submitted to Congress pursuant to subsection (b)(2).
``(B) Replacement leases that do not require approval under
this section and for which a prospectus has been submitted to
Congress pursuant to subsection (b)(2).
``(2) In this subsection, the term `interim leasing
actions' has the meaning given that term by the Administrator
of the General Services Administration.''.
(e) Purchase Options.--Such section is further amended by
adding at the end the following new subsection:
``(j) The Secretary may obligate and expend funds to
exercise a purchase option included in any major medical
facility lease (as defined in subsection (a)(3)(B)).''.
(f) Applicability.--The amendments made by this section
shall apply with respect to any lease that has not been
specifically authorized by law on or before the date of the
enactment of this Act.
SEC. 704. AUTHORITY TO ENTER INTO AGREEMENTS WITH ACADEMIC
AFFILIATES AND OTHER ENTITIES TO ACQUIRE SPACE
FOR THE PURPOSE OF PROVIDING HEALTH-CARE
RESOURCES TO VETERANS.
Section 8103 of title 38, United States Code, is amended by
adding at the end the following new subsection:
``(h)(1) Notwithstanding any other provision of law
requiring the use of competitive procedures, including
section 2304 of title 10, when the Secretary determines it to
be in the best interest of the Department, the Secretary may
enter into a lease with an academic affiliate or covered
entity to acquire space for the purpose of providing health-
care resources to veterans.
``(2) In this subsection:
``(A) The term `academic affiliate' means an institution or
organization described in section 7302(d) of this title.
``(B) The term `covered entity' means a unit or subdivision
of a State, local, or municipal government, public or
nonprofit agency, institution, or organization, or other
institution or organization as the Secretary considers
appropriate that owns property controlled by an academic
affiliate to be leased under this subsection.
``(C) The term `health -care resource' has the meaning
given that term in section 8152(1) of this title.
``(D) The term `space' means any room, unit, floor, wing,
building, parking facility, or other subdivision of a
building or facility owned or controlled by an academic
affiliate.''.
SEC. 705. MODIFICATIONS TO ENHANCED-USE LEASE AUTHORITY OF
DEPARTMENT OF VETERANS AFFAIRS.
(a) Modifications to Authority.--Paragraph (2) of section
8162(a) of title 38, United States Code, is amended to read
as follows:
``(2)(A) The Secretary may enter into an enhanced-use lease
on or after the date of the enactment of this paragraph only
if the Secretary determines--
``(i) that the lease will not be inconsistent with, and
will not adversely affect--
``(I) the mission of the Department; or
``(II) the operation of facilities, programs, and services
of the Department in the area of the leased property; and
``(ii) that--
``(I) the lease will enhance the use of the leased property
by directly or indirectly benefitting veterans; or
``(II) the leased property will provide supportive housing.
``(B) The Secretary shall give priority to enhanced-use
leases that, on the leased property--
``(i) provide supportive housing for veterans;
``(ii) provide direct services or benefits targeted to
veterans; or
``(iii) provide services or benefits that indirectly
support veterans.''.
(b) Extension of Maximum Term of Enhanced-use Lease.--
Section 8162(b)(2) of such title is amended by striking ``75
years'' and inserting ``99 years''.
(c) Modification of Use of Proceeds.--Section 8165(a)(1) of
such title is amended by striking ``shall be deposited in the
Department of Veterans Affairs Medical Care Collections Fund
established under section 1729A of this title.'' and
inserting ``shall, at the discretion of the Secretary, be
deposited in--
``(A) the Department of Veterans Affairs Medical Care
Collections Fund established under section 1729A of this
title; or
``(B) the Medical Facilities or Construction, Minor
Projects account of the Department to be used to defray the
costs of administration, maintenance, repair, and related
expenses incurred by the Department with respect to property
that is owned by or under the jurisdiction or control of the
Department.''.
(d) Repeal of Sunset.--Section 8169 of such title is
repealed.
(e) Appropriation.--In addition to amounts otherwise
available, there is appropriated for fiscal year 2022, out of
any funds in the Treasury not otherwise appropriated,
$922,000,000 for an additional amount for the Department of
Veterans Affairs, to remain available until expended, to
enter into enhanced-use leases pursuant to section 8162 of
title 38, United States Code, as amended by this section.
SEC. 706. AUTHORITY FOR JOINT LEASING ACTIONS OF DEPARTMENT
OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS.
(a) Department of Defense.--Section 1104A of title 10,
United States Code, is amended--
(1) by inserting ``, or the leasing,'' after ``design, and
construction'' each place it appears; and
(2) in subsection (c)(2), by inserting ``, or the
leasing,'' after ``design''.
(b) Department of Veterans Affairs.--Section 8111B of title
38, United States Code, is amended--
(1) in subsection (a), by inserting ``, or the leasing,''
after ``design, and construction'';
(2) in subsection (b), by adding at the end the following
new paragraph:
``(3) The Secretary of Veterans Affairs may transfer to the
Department of Defense amounts appropriated to the `Medical
Facilities' account of the Department of Veterans Affairs for
the purpose of leasing space for a shared medical facility if
the estimated share of the Department of Veterans Affairs for
the lease costs does not exceed the amount specified in
section 8104(a)(3)(B) of this title.''; and
(3) in subsection (c), by adding at the end the following
new paragraph:
``(3) Any amount transferred to the Secretary of Veterans
Affairs by the Secretary of Defense for the purpose of
leasing space for a shared medical facility may be credited
to the `Medical Facilities' account of the Department of
Veterans Affairs and may be used for such purpose.''.
SEC. 707. APPROPRIATION OF AMOUNTS FOR MAJOR MEDICAL FACILITY
LEASES.
(a) Fiscal Year 2023.--In addition to amounts otherwise
available, there is appropriated for fiscal year 2023, out of
any funds in the Treasury not otherwise appropriated,
$1,880,000,000 for an additional amount for the Medical
Facilities account of the Department of Veterans Affairs, to
remain available until expended, for major medical facility
leases authorized by section 702.
(b) Additional Years.--In addition to amounts otherwise
available, there is appropriated, out of any funds in the
Treasury not otherwise appropriated, for an additional amount
for the Medical Facilities account of the Department of
Veterans Affairs, to remain available until expended, for
major medical facility leases authorized by section 702 or
approved pursuant to subchapter I of chapter 81 of title 38,
United States Code, as amended by section 703--
(1) $100,000,000 for fiscal year 2024;
(2) $200,000,000 for fiscal year 2025;
(3) $400,000,000 for fiscal year 2026;
(4) $450,000,000 for fiscal year 2027;
(5) $600,000,000 for fiscal year 2028;
(6) $610,000,000 for fiscal year 2029;
(7) $620,000,000 for fiscal year 2030; and
(8) $650,000,000 for fiscal year 2031.
TITLE VIII--RECORDS AND OTHER MATTERS
SEC. 801. EPIDEMIOLOGICAL STUDY ON FORT MCCLELLAN VETERANS.
The Secretary of Veterans Affairs shall conduct an
epidemiological study on the health trends of veterans who
served in the Armed Forces at Fort McClellan at any time
during the period beginning January 1, 1935, and ending on
May 20, 1999.
SEC. 802. BIENNIAL BRIEFING ON INDIVIDUAL LONGITUDINAL
EXPOSURE RECORD.
(a) In General.--Not later than one year after the date on
which the Individual Longitudinal Exposure Record achieves
full operational capability, as determined by the Secretary
of Defense, and every two years thereafter, the Secretary of
Defense, in consultation with the Secretary of Veterans
Affairs, shall provide the appropriate committees of Congress
a briefing on--
(1) the quality of the databases of the Department of
Defense that provide the information presented in such
Individual Longitudinal Exposure Record; and
(2) the usefulness of such Individual Longitudinal Exposure
Record or system in supporting members of the Armed Forces
and veterans in receiving health care and benefits from the
Department of Defense and the Department of Veterans Affairs.
(b) Elements.--Each briefing required by subsection (a)
shall include, for the period covered by the report, the
following:
(1) An identification of potential exposures to
occupational or environmental hazards captured by the current
systems of the Department of Defense for environmental,
occupational, and health monitoring, and recommendations for
how to improve those systems.
[[Page H6013]]
(2) An analysis of the quality and accuracy of the location
data used by the Department of Defense in determining
potential exposures to occupational or environmental hazards
by members of the Armed Forces and veterans, and
recommendations for how to improve the quality of such data
if necessary.
(c) Definitions.--In this section:
(1) Appropriate committees of congress.--The term
``appropriate committees of Congress'' means--
(A) the Committee on Armed Services and the Committee on
Veterans' Affairs of the Senate; and
(B) the Committee on Armed Services and the Committee on
Veterans' Affairs of the House of Representatives.
(2) Individual longitudinal exposure record.--The term
``Individual Longitudinal Exposure Record'' has the meaning
given such term in section 1171 of title 38, United States
Code, as added by section 202.
SEC. 803. CORRECTION OF EXPOSURE RECORDS BY MEMBERS OF THE
ARMED FORCES AND VETERANS.
(a) In General.--The Secretary of Veterans Affairs shall
coordinate with the Secretary of Defense to provide a means
for veterans to update their records as necessary to reflect
exposures to occupational or environmental hazards by such
member or veteran in the Individual Longitudinal Exposure
Record.
(b) Evidence.--
(1) Provision of evidence.--To update a record under
subsection (a), a veteran shall provide such evidence as the
Secretary of Veterans Affairs considers necessary.
(2) Regulations.--The Secretary of Veterans Affairs shall
prescribe by regulation the evidence considered necessary
under paragraph (1).
(c) Definitions.--In this section:
(1) Individual longitudinal exposure record.--The term
``Individual Longitudinal Exposure Record'' has the meaning
given such term in section 1171 of title 38, United States
Code, as added by section 202.
(2) Toxic exposure.--The term ``toxic exposure'' has the
meaning given such term in section 101 of title 38, United
States Code, as amended by section 102(b).
SEC. 804. FEDERAL CAUSE OF ACTION RELATING TO WATER AT CAMP
LEJEUNE, NORTH CAROLINA.
(a) Short Title.--This section may be cited as the ``Camp
Lejeune Justice Act of 2022''.
(b) In General.--An individual, including a veteran (as
defined in section 101 of title 38, United States Code), or
the legal representative of such an individual, who resided,
worked, or was otherwise exposed (including in utero
exposure) for not less than 30 days during the period
beginning on August 1, 1953, and ending on December 31, 1987,
to water at Camp Lejeune, North Carolina, that was supplied
by, or on behalf of, the United States may bring an action in
the United States District Court for the Eastern District of
North Carolina to obtain appropriate relief for harm that was
caused by exposure to the water at Camp Lejeune.
(c) Burdens and Standard of Proof.--
(1) In general.--The burden of proof shall be on the party
filing the action to show one or more relationships between
the water at Camp Lejeune and the harm.
(2) Standards.--To meet the burden of proof described in
paragraph (1), a party shall produce evidence showing that
the relationship between exposure to the water at Camp
Lejeune and the harm is--
(A) sufficient to conclude that a causal relationship
exists; or
(B) sufficient to conclude that a causal relationship is at
least as likely as not.
(d) Exclusive Jurisdiction and Venue.--The United States
District Court for the Eastern District of North Carolina
shall have exclusive jurisdiction over any action filed under
subsection (b), and shall be the exclusive venue for such an
action. Nothing in this subsection shall impair the right of
any party to a trial by jury.
(e) Exclusive Remedy.--
(1) In general.--An individual, or legal representative of
an individual, who brings an action under this section for a
harm described in subsection (b), including a latent disease,
may not thereafter bring a tort action against the United
States for such harm pursuant to any other law.
(2) Health and disability benefits relating to water
exposure.--Any award made to an individual, or legal
representative of an individual, under this section shall be
offset by the amount of any disability award, payment, or
benefit provided to the individual, or legal representative--
(A) under--
(i) any program under the laws administered by the
Secretary of Veterans Affairs;
(ii) the Medicare program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.); or
(iii) the Medicaid program under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.); and
(B) in connection with health care or a disability relating
to exposure to the water at Camp Lejeune.
(f) Immunity Limitation.--The United States may not assert
any claim to immunity in an action under this section that
would otherwise be available under section 2680(a) of title
28, United States Code.
(g) No Punitive Damages.--Punitive damages may not be
awarded in any action under this section.
(h) Disposition by Federal Agency Required.--An individual
may not bring an action under this section before complying
with section 2675 of title 28, United States Code.
(i) Exception for Combatant Activities.--This section does
not apply to any claim or action arising out of the combatant
activities of the Armed Forces.
(j) Applicability; Period for Filing.--
(1) Applicability.--This section shall apply only to a
claim accruing before the date of enactment of this Act.
(2) Statute of limitations.--A claim in an action under
this section may not be commenced after the later of--
(A) the date that is two years after the date of enactment
of this Act; or
(B) the date that is 180 days after the date on which the
claim is denied under section 2675 of title 28, United States
Code.
(3) Inapplicability of other limitations.--Any applicable
statute of repose or statute of limitations, other than under
paragraph (2), shall not apply to a claim under this section.
SEC. 805. COST OF WAR TOXIC EXPOSURES FUND.
(a) In General.--Chapter 3 is amended by adding at the end
the following new section:
``Sec. 324. Cost of War Toxic Exposures Fund
``(a) Establishment.--There is hereby established in the
Treasury of the United States an account to be known as the
`Cost of War Toxic Exposures Fund' (the `Fund'), to be
administered by the Secretary.
``(b) Deposits.--There shall be deposited in the Fund such
amounts as may be appropriated to the Fund pursuant to
subsection (c).
``(c) Authorization of Appropriations.--There is authorized
to be appropriated to the Fund for fiscal year 2023 and each
subsequent fiscal year such sums as are necessary to increase
funding, over the fiscal year 2021 level, for investment in--
``(1) the delivery of veterans' health care associated with
exposure to environmental hazards in the active military,
naval, air, or space service in programs administered by the
Under Secretary for Health;
``(2) any expenses incident to the delivery of veterans'
health care and benefits associated with exposure to
environmental hazards in the active military, naval, air, or
space service, including administrative expenses, such as
information technology and claims processing and appeals, and
excluding leases as authorized or approved under section 8104
of this title; and
``(3) medical and other research relating to exposure to
environmental hazards.
``(d) Budget Scorekeeping.--(1) Immediately upon enactment
of the Sergeant First Class Heath Robinson Honoring our
Promise to Address Comprehensive Toxics Act of 2022, expenses
authorized to be appropriated to the Fund in subsection (c)
shall be estimated for fiscal year 2023 and each subsequent
fiscal year and treated as budget authority that is
considered to be direct spending--
``(A) in the baseline for purposes of section 257 of the
Balanced Budget and Emergency Deficit Control Act of 1985 (2
U.S.C. 907);
``(B) by the Chairman of the Committee on the Budget of the
Senate and the Chair of the Committee on the Budget of the
House of Representatives, as appropriate, for purposes of
budget enforcement in the Senate and the House of
Representatives;
``(C) under the Congressional Budget Act of 1974 (2 U.S.C.
621 et seq.), including in the reports required by section
308(b) of such Act (2 U.S.C. 639); and
``(D) for purposes of the Statutory Pay-As-You-Go Act of
2010 (2 U.S.C. 931 et seq.).
``(2) No amount appropriated to the Fund in fiscal year
2023 or any subsequent fiscal year pursuant to this section
shall be counted as discretionary budget authority and
outlays or as direct spending for any estimate of an
appropriation Act under the Congressional Budget and
Impoundment Control Act of 1974 (2 U.S.C. 621 et seq.) and
any other Act.
``(3) Notwithstanding the Budget Scorekeeping Guidelines
and the accompanying list of programs and accounts set forth
in the joint explanatory statement of the committee of
conference accompanying Conference Report 105-217, and for
purposes of the Balanced Budget and Emergency Deficit Control
Act of 1985 (2 U.S.C. 900 et seq.) and the Congressional
Budget Act of 1974 (2 U.S.C. 621 et seq.), the Fund shall be
treated as if it were an account designated as `Appropriated
Entitlements and Mandatories for Fiscal Year 1997' in the
joint explanatory statement of the committee of conference
accompanying Conference Report 105-217.
``(e) Estimates for Congressional Consideration.--The
Secretary shall include in documents submitted to Congress in
support of the President's budget submitted pursuant to
section 1105 of title 31 detailed estimates of the sums
described in subsection (c) for the applicable fiscal year.
``(f) Procedures for Estimates.--The Secretary may, after
consultation with the Committee on Appropriations of the
Senate and the Committee on Appropriations of the House of
Representatives, establish policies and procedures for
developing the annual detailed estimates required by
subsection (e).''.
(b) Sequestration.--Section 256(h)(4) of the Balanced
Budget and Emergency Deficit Control Act of 1985 (2 U.S.C.
906(h)(4)) is amended by adding at the end the following new
subparagraph:
``(G) Cost of War Toxic Exposures Fund.''.
SEC. 806. APPROPRIATION FOR FISCAL YEAR 2022.
(a) Appropriation.--In addition to amounts otherwise
available, there is appropriated for fiscal year 2022, out of
any funds in the Treasury not otherwise appropriated,
$500,000,000 for the Cost of War Toxic Exposures Fund,
established by section 324 of title 38, United States Code,
as added by section 805 of this Act, to remain available
until September 30, 2024.
(b) Spend Plan.--Not later than 30 days after enactment of
this Act, the Secretary of Veterans Affairs shall submit a
plan for expending amounts made available by subsection (a)
by
[[Page H6014]]
program, project or activity to the Committee on
Appropriations of the Senate and the Committee on
Appropriations of the House of Representatives. Funds may not
be obligated until such Committees issue an approval, or
absent a response, a period of 30 days has elapsed.
SEC. 807. AUTHORIZATION OF ELECTRONIC NOTICE IN CLAIMS UNDER
LAWS ADMINISTERED BY THE SECRETARY OF VETERANS
AFFAIRS.
(a) In General.--Title 38, United States Code, is amended
as follows:
(1) By striking section 5100 and inserting the following:
``Sec. 5100. Definitions
``In this chapter:
``(1) The term `claimant' means any individual applying
for, or submitting a claim for, any benefit under the laws
administered by the Secretary.
``(2) The term `notice' means a communication issued
through means (including electronic means) prescribed by the
Secretary.''.
(2) In section 5104, by adding at the end the following new
subsection:
``(c) The Secretary may provide notice under subsection (a)
electronically if a claimant (or the claimant's
representative) elects to receive such notice electronically.
A claimant (or the claimant's representative) may revoke such
an election at any time, by means prescribed by the
Secretary.
``(d) The Secretary shall annually--
``(1) solicit recommendations from stakeholders on how to
improve notice under this section; and
``(2) publish such recommendations on a publicly available
website of the Department.''.
(3) In section 5104B(c), in the matter preceding paragraph
(1) by striking ``in writing'' and inserting ``to the
claimant (and any representative of such claimant)''.
(4) In section 5112(b)(6), by striking ``(at the payee's
last address of record)''.
(5) In section 7104--
(A) in the heading, by adding ``; decisions; notice'' at
the end; and
(B) by striking subsection (e) and inserting the following:
``(e) After reaching a decision on an appeal, the Board
shall promptly issue notice (as that term is defined in
section 5100 of this title) of such decision to the
following:
``(1) The appellant.
``(2) Any other party with a right to notice of such
decision.
``(3) Any authorized representative of the appellant or
party described in paragraph (2).
``(f)(1) The Secretary may provide notice under subsection
(e) electronically if a claimant (or the claimant's
representative) elects to receive such notice electronically.
``(2) A claimant (or the claimant's representative) may
revoke such an election at any time, by means prescribed by
the Secretary.''.
(6) In section 7105(b)(1)(A), by striking ``mailing'' and
inserting ``issuance''.
(7) In section 7105A(a), by striking ``mailed'' and
inserting ``issued''.
(8) In section 7266(a), by striking ``mailed'' and
inserting ``issued''.
(b) Rule of Construction.--None of the amendments made by
this section shall be construed to apply section 5104(a) of
such title to decisions of the Board of Veterans' Appeals
under chapter 71 of such title.
SEC. 808. BURN PIT TRANSPARENCY.
(a) Annual Report on Disability Claims.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, and annually thereafter, the
Secretary of Veterans Affairs shall submit to the appropriate
congressional committees a report detailing the following:
(A) The total number of covered veterans.
(B) The total number of claimed issues for disability
compensation under chapter 11 of title 38, United States
Code, approved and the total number denied by the Secretary
of Veterans Affairs with respect to a covered veteran, and a
breakdown of the reasons for the denials.
(C) A comprehensive list of the top 10 conditions from each
body system for which the Secretary awarded service
connection for covered veterans.
(D) Any updates or trends with respect to the information
described in subparagraphs (A), (B), and (C), that the
Secretary determines appropriate.
(2) Covered veteran defined.--In this subsection, the term
``covered veteran'' means a veteran who deployed to the
Southwest Asia theater of operations any time after August
1990, or Afghanistan, Syria, Djibouti, or Uzbekistan after
September 19, 2001, and who submits a claim for disability
compensation under chapter 11 of title 38, United States
Code.
(b) Information Regarding the Airborne Hazards and Open
Burn Pit Registry.--
(1) Notice.--The Secretary of Veterans Affairs shall ensure
that a medical professional of the Department of Veterans
Affairs informs a veteran of the Airborne Hazards and Open
Burn Pit Registry if the veteran presents at a medical
facility of the Department for treatment that the veteran
describes as being related to, or ancillary to, the exposure
of the veteran to toxic airborne chemicals and fumes caused
by open burn pits.
(2) Display.--In making information public regarding the
number of participants in the Airborne Hazards and Open Burn
Pit Registry, the Secretary shall display such numbers by
both State and by congressional district.
(c) Definitions.--In this section:
(1) Airborne hazards and open burn pit registry.--The term
``Airborne Hazards and Open Burn Pit Registry'' means the
registry established by the Secretary of Veterans Affairs
under section 201 of the Dignified Burial and Other Veterans'
Benefits Improvement Act of 2012 (Public Law 112-260; 38
U.S.C. 527 note).
(2) Appropriate congressional committees.--The term
``appropriate congressional committees'' means--
(A) the Committee on Veterans' Affairs and the Committee on
Armed Services of the Senate; and
(B) The Committee on Veterans' Affairs and the Committee on
Armed Services of the House of Representatives.
(3) Open burn pit.--The term ``open burn pit'' has the
meaning given that term in section 201(c) of the Dignified
Burial and Other Veterans' Benefits Improvement Act of 2012
(Public Law 112-260; 38 U.S.C. 527 note).
TITLE IX--IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS
SEC. 901. NATIONAL RURAL RECRUITMENT AND HIRING PLAN FOR
VETERANS HEALTH ADMINISTRATION.
(a) In General.--Not later than 18 months after the date of
the enactment of this Act, the Secretary of Veterans Affairs,
in collaboration with the directors of each community-based
outpatient clinic and medical center of the Department of
Veterans Affairs, shall develop and implement a national
rural recruitment and hiring plan for the Veterans Health
Administration to--
(1) recruit health care professionals for rural and highly
rural community-based outpatient clinics and rural and highly
rural medical centers of the Department;
(2) determine which such clinics or centers have a staffing
shortage of health care professionals;
(3) develop best practices and techniques for recruiting
health care professionals for such clinics and centers;
(4) not less frequently than annually, provide virtually
based, on-demand training to human resources professionals of
the Veterans Health Administration on the best practices and
techniques developed under paragraph (3); and
(5) provide recruitment resources, such as pamphlets and
marketing material to--
(A) Veterans Integrated Service Networks of the Department;
(B) rural and highly rural community-based outpatient
clinics of the Department; and
(C) rural and highly rural medical centers of the
Department.
(b) Annual Report.--Not later than 18 months after the date
of the enactment of this Act, and annually thereafter, the
Secretary shall submit to the Committee on Veterans' Affairs
of the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report that includes--
(1) the plan developed and implemented under subsection
(a); and
(2) an assessment of the outcomes related to recruitment
and retention of employees of the Veterans Health
Administration at rural and highly rural facilities of the
Department.
(c) Definitions.--In this section, the terms ``rural'' and
``highly rural'' have the meanings given those terms under
the rural-urban commuting areas coding system of the
Department of Agriculture.
SEC. 902. AUTHORITY TO BUY OUT SERVICE CONTRACTS FOR CERTAIN
HEALTH CARE PROFESSIONALS IN EXCHANGE FOR
EMPLOYMENT AT RURAL OR HIGHLY RURAL FACILITIES
OF DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--For any covered health care professional
to whom the Secretary of Veterans Affairs has offered
employment with the Department of Veterans Affairs, the
Secretary may buy out the non-Department service contract of
such individual in exchange for such individual agreeing to
be employed at a rural or highly rural facility of the
Department for a period of obligated service specified in
subsection (c).
(b) Payment of Amounts.--
(1) In general.--Payment of any amounts for a buy out of a
service contract for a covered health care professional under
subsection (a) shall be made directly to the individual or
entity with respect to which the covered health care
professional has a service obligation under such contract.
(2) Limitation on total amount.--The total amount paid by
the Department under this section shall not exceed
$40,000,000 per fiscal year.
(c) Obligated Service.--In exchange for a contract buy out
under subsection (a), a covered health care professional
shall agree to be employed for not less than four years at a
rural or highly rural facility of the Department.
(d) Liability.--
(1) In general.--Except as provided in paragraph (2), if a
covered health care professional fails for any reason to
complete the period of obligated service of the individual
under subsection (c), the United States shall be entitled to
recover from the individual an amount equal to--
(A) the total amount paid under subsection (a) to buy out
the non-Department service contract of the individual;
multiplied by
(B) a fraction--
(i) the numerator of which is--
(I) the total number of months in the period of obligated
service of the individual; minus
(II) the number of months served by the individual; and
(ii) the denominator of which is the total number of months
in the period of obligated service of the individual.
(2) Exception.--Liability shall not arise under paragraph
(1) in the case of an individual covered by that paragraph if
the individual does not obtain, or fails to maintain,
employment as an employee of the Department due to staffing
changes approved by the Under Secretary for Health.
(e) Annual Report.--
(1) In general.--Not later than 18 months after the date of
the enactment of this Act, and not less frequently than
annually thereafter,
[[Page H6015]]
the Secretary of Veterans Affairs shall submit to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report on the use by the Secretary of the
authority under this section.
(2) Elements.--Each report required by paragraph (1) shall
include the following:
(A) The number of health care professionals for whom a
service contract buyout payment was made under subsection (a)
in the previous fiscal year, disaggregated by occupation or
specialty.
(B) The average, highest, and lowest amount of the service
contract buyout payments made under subsection (a) for each
occupation or specialty in the previous fiscal year.
(C) Each location where contract buyout authority under
subsection (a) was utilized and the number of covered health
care professionals who agreed to be employed at such location
in the previous fiscal year.
(f) Definitions.--In this section:
(1) Covered health care professional.--The term ``covered
health care professional'' means a physician, nurse
anesthetist, physician assistant, or nurse practitioner
offered employment with the Department regardless of the
authority under which such employment is offered.
(2) Rural; highly rural.--The terms ``rural'' and ``highly
rural'' have the meanings given those terms under the rural-
urban commuting areas coding system of the Department of
Agriculture.
(g) Sunset.--This section shall terminate on September 30,
2027.
SEC. 903. QUALIFICATIONS FOR HUMAN RESOURCES POSITIONS WITHIN
DEPARTMENT OF VETERANS AFFAIRS AND PLAN TO
RECRUIT AND RETAIN HUMAN RESOURCES EMPLOYEES.
(a) Establishment of Qualifications.--Not later than 180
days after the date of the enactment of this Act, the
Secretary of Veterans Affairs shall--
(1) establish qualifications for each human resources
position within the Department of Veterans Affairs in
coordination with the Office of Personnel Management;
(2) establish standardized performance metrics for each
such position; and
(3) submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report containing the qualifications and
standardized performance metrics established under paragraphs
(1) and (2).
(b) Improvement of Human Resources Actions.--Not later than
90 days after the date of the enactment of this Act, the
Secretary shall establish or enhance systems of the
Department to monitor the hiring and other human resources
actions that occur at the local, regional, and national
levels of the Department to improve the performance of those
actions.
(c) Report.--Not later than one year after the
establishment of the qualifications and performance metrics
under subsection (a), the Comptroller General of the United
States shall submit to the Committee on Veterans' Affairs of
the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report containing--
(1) a description of the implementation of such
qualifications and performance metrics;
(2) an assessment of the quality of such qualifications and
performance metrics;
(3) an assessment of performance and outcomes based on such
metrics; and
(4) such other matters as the Comptroller General considers
appropriate.
(d) Plan to Recruit and Retain Human Resources Employees.--
Not later than one year after the date of the enactment of
this Act, the Secretary of Veterans Affairs shall submit to
the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a plan for the recruitment and retention of
human resources employees within the Department of Veterans
Affairs.
SEC. 904. MODIFICATION OF PAY CAP FOR CERTAIN EMPLOYEES OF
VETERANS HEALTH ADMINISTRATION.
(a) In General.--Section 7455(c) is amended--
(1) in paragraph (1), by striking ``30 percent'' inserting
``50 percent'';
(2) in paragraph (2), by striking ``level IV'' inserting
``level II''; and
(3) by adding at the end the following new paragraph:
``(3)(A) Notwithstanding section 5304 of title 5 or any
other provision of law, but subject to the limitation under
paragraph (2), pursuant to an increase under subsection (a),
the Secretary may pay a special rate or an adjusted rate of
basic pay in excess of the rate of basic pay payable for
level IV of the Executive Schedule.
``(B) If an employee is in receipt of a special rate of pay
under subparagraph (A) in excess of the rate of basic pay
payable for level IV of the Executive Schedule with an
established special rate supplement of greater value than a
supplement based on the applicable locality-based
comparability payment percentage under section 5304 of title
5, but a pay adjustment would cause such established special
rate supplement to be of lesser value, the special rate
supplement shall be converted to a supplement based on the
applicable locality-based comparability percentage unless the
Secretary determines that some other action is
appropriate.''.
(b) Pay for Critical Positions.--Section 7404(a)(1)(B) is
amended by inserting ``7306 or'' before ``7401(4)''.
SEC. 905. EXPANSION OF OPPORTUNITIES FOR HOUSEKEEPING AIDES.
Section 3310 of title 5, United States Code, is amended by
inserting ``(other than for positions of housekeeping aides
in the Department of Veterans Affairs)'' after ``competitive
service''.
SEC. 906. MODIFICATION OF AUTHORITY OF THE SECRETARY OF
VETERANS AFFAIRS RELATING TO HOURS, CONDITIONS
OF EMPLOYMENT, AND PAY FOR CERTAIN EMPLOYEES OF
VETERANS HEALTH ADMINISTRATION.
(a) Expansion of Eligibility of Employees for Certain
Awards.--Section 7404(c) is amended--
(1) by striking ``Notwithstanding'' and inserting ``(1)
Notwithstanding'';
(2) by inserting ``or 7401(4)'' after ``section 7306'';
(3) by striking ``who is not eligible for pay under
subchapter III'' and inserting ``or in a covered executive
position under section 7401(1) of this title'';
(4) by striking ``sections 4507 and 5384'' and inserting
``section 4507''; and
(5) by adding at the end the following new paragraph:
``(2) In this subsection, the term `covered executive
position' means a position that the Secretary has determined
is of equivalent rank to a Senior Executive Service position
(as such term is defined in section 3132(a) of title 5) and
is subject to an agency performance management system.''.
(b) Authority for Awards Programs of Department of Veterans
Affairs.--
(1) In general.--Subchapter I of chapter 74 is amended by
inserting after section 7404 the following new section:
``Sec. 7404A. Awards
``(a) Superior Accomplishments and Performance Awards
Program.--The Secretary may establish an awards program for
personnel listed in section 7421(b) of this title consistent
with chapter 45 of title 5, to the extent practicable.
``(b) Executive Performance Awards Program.--
Notwithstanding section 7425 of this title or any other
provision of law, the Secretary may establish a performance
awards program consistent with section 5384 of title 5 for--
``(1) personnel appointed under section 7401(1) of this
title for a position that the Secretary has determined is of
equivalent rank to a Senior Executive Service position (as
such term is defined in section 3132(a) of title 5) and is
subject to an agency performance management system; and
``(2) personnel appointed under section 7306 or 7401(4) of
this title.
``(c) Payment of Awards.--Awards under this section may be
paid based on criteria established by the Secretary and shall
not be considered in calculating the limitation under section
7431(e)(4) of this title.
``(d) Not Considered Basic Pay.--Awards under this section
shall not be considered basic pay for any purpose.
``(e) Regulations.--The Secretary may prescribe regulations
for the administration of this section.''.
(2) Limitation on past awards.--Notwithstanding any other
provision of law, awards made by the Secretary of Veterans
Affairs for any period on or after January 1, 2017, and
before the date of the enactment of this Act for an employee
under section 7306 or 7401(4) of title 38, United States
Code, or for a position described in section 7401(1) of such
title that the Secretary has determined is of equivalent rank
to a Senior Executive Service position (as such term is
defined in section 3132(a) of title 5, United States Code),
may be subject to section 7404A of title 38, United States
Code, as added by paragraph (1).
(c) Modification of Employees Subject to Regulation by
Secretary of Veterans Affairs of Hours and Conditions of
Employment and Leaves of Absence.--
(1) In general.--Section 7421 is amended--
(A) in subsection (a), by striking ``chapter'' and
inserting ``title''; and
(B) in subsection (b), by adding at the end the following
new paragraph:
``(9) Any position for which the employee is appointed
under section 7306 or 7401(4) of this title.''.
(2) Administration of full-time employees.--Section 7423 is
amended--
(A) in subsection (a)(2), by adding at the end the
following new subparagraph:
``(D) The Secretary may exclude from the requirements of
paragraph (1) employees hired under section 7306 or 7401(4)
of this title or for a position described in section 7401(1)
of this title that the Secretary has determined is of
equivalent rank to a Senior Executive Service position (as
such term is defined in section 3132(a) of title 5).''; and
(B) in subsection (e)(1), by striking ``7401(1)'' and
inserting ``7421(b)''.
(3) Additional pay authorities.--Section 7410(a) is
amended--
(A) by striking ``The Secretary'' and inserting ``(1) The
Secretary'';
(B) by striking ``the personnel described in paragraph (1)
of section 7401 of this title'' and inserting ``personnel
appointed under section 7306 of this title or section 7401(4)
of this title, or personnel described in section 7401(1) of
this title,''; and
(C) by striking ``in the same manner, and subject to the
same limitations, as in the case of'' and inserting ``in a
manner consistent with''; and
(D) by adding at the end the following new paragraph:
``(2) Payments under paragraph (1) shall not be considered
in calculating the limitation under section 7431(e)(4) of
this title.''.
(4) Treatment of pay authority changes.--For the purposes
of the amendments made by paragraph (3), the Secretary of
Veterans Affairs shall treat any award or payment made by the
Secretary between January 1, 2017, and the date of the
enactment of this Act to employees appointed under sections
7306, 7401(1), and 7401(4) of title 38, United States Code,
that the Secretary has determined are of equivalent rank to a
Senior Executive Service position (as such
[[Page H6016]]
term is defined in section 3132(a) of title 5, United States
Code), as if such amendments had been in effect at the time
of such award or payment.
(5) Treatment of prior leave balances.--Notwithstanding any
other provision of law, the Secretary may adjust the leave
balance and carryover leave balance of any employee described
in section 7421(b)(9) of title 38, United States Code, as
amended by paragraph (1)(B), to ensure any leave accrued or
carried over before the date of the enactment of this Act
remains available to such employee.
(d) Treatment of Certain Employees as Appointed Under
Section 7306.--Section 7306 is amended--
(1) in subsection (a), by redesignating the second
paragraph (11) as paragraph (12); and
(2) by adding at the end the following new subsection:
``(g) For purposes of applying any provision of chapter 74
of this title, including sections 7404, 7410, and 7421, or
any other provision of law, the Secretary may treat any
appointment for a position under this chapter to be an
appointment under this section.''.
(e) Conforming Amendment.--Section 7431(e)(4) is amended by
striking ``In no case'' and inserting ``Except as provided in
sections 7404A(c) and 7410(a)(2) of this title, in no case''.
SEC. 907. WAIVER OF PAY LIMITATION FOR CERTAIN EMPLOYEES OF
DEPARTMENT OF VETERANS AFFAIRS.
Subchapter I of chapter 7 is amended by inserting after
section 703 the following new section:
``Sec. 704. Waiver of pay limitation for certain employees
``(a) Employees of Veterans Health Administration Impacted
by Closure or Realignment.--Notwithstanding any other
provision of law, the Secretary may waive any annual premium
or aggregate limitation on pay for an employee of the
Veterans Health Administration for the calendar year during
which--
``(1) the official duty station of the employee is closed;
or
``(2) the office, facility, activity, or organization of
the employee is realigned.
``(b) Employees Providing Care to Veterans Exposed to Open
Burn Pits.--
``(1) In general.--Notwithstanding any other provision of
law, the Secretary may waive any annual premium or aggregate
limitation on pay for an employee of the Department whose
primary duties include providing expanded care for veterans
exposed to open burn pits.
``(2) Open burn pit defined.--In this subsection, the term
`open burn pit' has the meaning given that term in section
201(c) of the Dignified Burial and Other Veterans' Benefits
Improvement Act of 2012 (Public Law 112-260; 38 U.S.C. 527
note).
``(c) Coordination With Office of Personnel Management.--In
implementing this section, the Secretary shall coordinate
with the Director of the Office of Personnel Management.
``(d) Reports.--
``(1) In general.--For each quarter that the Secretary
waives a limitation under this section, the Secretary shall
submit to the Committee on Veterans' Affairs of the Senate,
the Committee on Veterans' Affairs of the House of
Representatives, and the Office of Personnel Management a
report on the waiver or waivers.
``(2) Contents.--Each report submitted under paragraph (1)
with respect to a waiver or waivers shall include the
following:
``(A) Where the waiver or waivers were used, including in
which component of the Department and, as the case may be,
which medical center of the Department.
``(B) For how many employees the waiver or waivers were
used, disaggregated by component of the Department and, if
applicable, medical center of the Department.
``(C) The average amount by which each payment exceeded the
pay limitation that was waived, disaggregated by component of
the Department and, if applicable, medical center of the
Department.
``(e) Employee Defined.--In this section, the term
`employee' means any employee regardless of the authority
under which the employee was hired.
``(f) Termination.--This section shall terminate on
September 30, 2027.''.
SEC. 908. ELIMINATION OF LIMITATION ON AWARDS AND BONUS FOR
EMPLOYEES OF DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Section 705(a) of the Veterans Access,
Choice, and Accountability Act of 2014 (Public Law 113-146;
38 U.S.C. 703 note) is amended by striking paragraph (3).
(b) Applicability.--Subsection (a) shall take effect on the
date of the enactment of this Act and apply as if such
subsection had been enacted on September 30, 2021.
SEC. 909. ADDITIONAL AUTHORITY OF THE SECRETARY OF VETERANS
AFFAIRS RELATING TO RECRUITMENT AND RETENTION
OF PERSONNEL.
Subchapter I of chapter 7 is amended by inserting after
section 705 the following new section:
``Sec. 706. Additional authority relating to recruitment and
retention of personnel
``(a) Recruitment and Relocation Bonuses.--The Secretary
may pay a recruitment or relocation bonus under section
5753(e) of title 5 without regard to any requirements for
certification or approval under that section.
``(b) Retention Bonuses.--(1) The Secretary may pay a
retention bonus under section 5754(f) of title 5 without
regard to any requirement for certification or approval under
that subsection.
``(2) The Secretary may pay a retention bonus as specified
in subsection (e)(2) of section 5754 of title 5 and may pay
the bonus as a single lump-sum payment at the beginning of
the full period of service required by an agreement under
subsection (d) of such section.
``(c) Merit Awards.--The Secretary may grant a cash award
under section 4502(b) of title 5 without regard to any
requirement for certification or approval under that section.
``(d) Incentives for Critical Skills.--(1) Subject to the
provisions of this paragraph, the Secretary may provide a
critical skill incentive to an employee in a case in which
the Secretary determines--
``(A) the employee possesses a high-demand skill or skill
that is at a shortage;
``(B) such skill is directly related to the duties and
responsibilities of the employee's position; and
``(C) employment of an individual with such skill in such
position serves a critical mission-related need of the
Department.
``(2) An incentive provided to an employee under paragraph
(1) may not to exceed 25 percent of the basic pay of the
employee.
``(3) Provision of an incentive under paragraph (1) shall
be contingent on the employee entering into a written
agreement to complete a period of employment with the
Department.
``(4) An incentive provided under paragraph (1) shall not
be considered basic pay for any purpose.
``(5) The Secretary may prescribe conditions, including
with respect to eligibility, and limitations on provision of
incentive under paragraph (1).
``(6) Incentive provided under paragraph (1) shall not be
included in the calculation of total amount of compensation
under section 7431(e)(4) of this title.
``(e) Student Loan Repayments.--(1) Subject to the
provisions of this subsection, the Secretary may repay a
student loan pursuant to section 5379(b) of title 5.
``(2) Paragraph (2) of such section shall not apply to
payment under this subsection.
``(3) Payment under this subsection shall be made subject
to such terms, limitations, or conditions as may be mutually
agreed to by the Secretary and the employee concerned, except
that the amount paid by the Secretary under this subsection
may not exceed--
``(A) $40,000 for any employee in any calendar year; or
``(B) a total of $100,000 in the case of any employee.
``(f) Expedited Hiring Authority for College Graduates;
Competitive Service.--(1) Subject to paragraph (2) of this
subsection, the Secretary may expedite hiring for college
graduates under section 3115 of title 5 without regard to
subsection (e) of such section or any regulations prescribed
by the Office of Personnel Management for administration of
such subsection.
``(2) The number of employees the Secretary may appoint
under section 3115 of title 5 may not exceed the number equal
to 25 percent of individuals that the Secretary appointed
during the previous fiscal year to a position in the
competitive service classified in a professional or
administrative occupational category, at the GS-11 level, or
an equivalent level, or below, under a competitive examining
procedure.
``(g) Expedited Hiring Authority for Post-secondary
Students; Competitive Service.--(1) Subject to paragraph (2)
of this subsection, the Secretary may expedite hiring of
post-secondary students under section 3116 of title 5,
without regard to subsection (d) of such section or any
regulations prescribed by the Office of Personnel Management
for administration of such subsection.
``(2) The number of employees the Secretary may appoint
under section 3116 of title 5 may not exceed the number equal
to 25 percent of the number of students that the Secretary
appointed during the previous fiscal year to a position at
the GS-11 level, or an equivalent level, or below.
``(h) Pay Authority for Critical Positions.--(1) Subject to
the provisions of this subsection, the Secretary may
authorize the fixing of the rate of pay for a critical
position in the Department consistent with the authorities
and requirements of section 5377 of title 5 that apply to the
Office of Personnel Management.
``(2) The Secretary may fix the rate of pay for a critical
position under this subsection in excess of the limitation
set forth by section 5377(d)(2) of such title.
``(3) Basic pay may not be fixed under this subsection at a
rate greater than the rate payable for the Vice President of
the United States established under section 104 of title 3,
except upon written approval of the President.
``(4) Notwithstanding section 5377(f) of title 5, the
Secretary may authorize the exercise of authority under this
subsection with respect to up to 200 positions at any time.
``(i) Rates of Special Pay.--(1) The Secretary may
establish a rate for special pay under section 5305(a)(1) of
title 5.
``(2) In applying such section to the Secretary's authority
under paragraph (1)--
``(A) `50 percent' shall be substituted for `30 percent';
and
``(B) `level II of the Executive Schedule' shall be
substituted for `level IV of the Executive Schedule'.
``(j) Waiver of Limitations on Certain Payments Under Pay
Comparability System.--The Secretary may waive the limitation
in section 5307 of title 5 for an employee or a payment.
``(k) Termination.--The authorities under this section
shall terminate on September 30, 2027.''.
The SPEAKER pro tempore. The bill, as amended, shall be debatable for
1 hour equally divided and controlled by the chair and ranking minority
member of the Committee on Veterans' Affairs or their respective
designees.
The gentleman from California (Mr. Takano) and the gentleman from
Illinois (Mr. Bost), each will control 30 minutes.
[[Page H6017]]
The Chair recognizes the gentleman from California.
General Leave
Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members
may have 5 legislative days in which to revise and extend their remarks
and to insert extraneous material on S. 3373, as amended.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume.
Madam Speaker, I stand before this Chamber in support of S. 3373, as
amended, which is now the Sergeant First Class Heath Robinson Honoring
our Promise to Address Comprehensive Toxics Act of 2022.
This measure addresses a technical drafting error in the Senate
amendment to my PACT Act. As you know, the PACT Act passed the House
with strong bipartisan support in March of this year.
Today, despite the current rancorous political debates taking place
across America, this Chamber has the chance to help the country heal
after 20 years of war.
We have an opportunity to make good on the promise we made to our
servicemembers when our country sent them into harm's way: that we
would take care of them and pay for that care when they come home.
For too long, veterans have faced an uphill battle to prove that the
rare illnesses and cancers they were experiencing stemmed from their
time in the military.
For too long, Congress and the Department of Veterans Affairs have
been slow to accept responsibility and cost of that care, and for too
long the United States has not made good on our promise to our
veterans.
But today, I make a plea for unity so that we may right this wrong
and make good on our commitment to honor our pact with America's
veterans. Today, we can finally recognize toxic exposure as a cost of
war.
{time} 1345
In the past, we saw Vietnam war veterans living with the effects of
Agent Orange, fighting the VA for the care and benefits they were due.
The Blue Water Navy Vietnam Veterans Act was signed into law in 2019,
but it came nearly four decades too late. This bill could have been
passed 2 years earlier when my friend, then-Republican chairman, Dr.
Phil Roe, was leading this committee, but two Senators held up that
bill. During that needless delay, many veterans succumbed to their
illnesses, and their families were not compensated. Now is our chance
to make amends for that.
There is absolutely no reason for veterans and their survivors to
fight the VA for the care and benefits they have earned through their
service. Never again should veterans be made to suffer the indignity of
fighting their own government.
After Blue Water, I vowed that we would never again fail to live up
to our promises to our veterans. That is why, at the beginning of the
117th Congress, I made addressing the effects of toxic exposure my top
priority as chairman.
Throughout our history, America has cast aside party affiliation on
behalf of veterans, coming together to pass landmark legislation to
properly recognize those who have served, such as in 1944 when Congress
passed the GI Bill. The GI Bill was transformational for a generation
of veterans. By 1956, nearly 8 million veterans had used the GI Bill's
education benefits and millions more still benefit from it today.
We have an opportunity to make a generational impact today. The PACT
Act will directly affect one out of every five veterans, or 3.5 million
people. It will also send a strong message to future generations of
veterans that America will take care of them when their service ends.
The way this country has dealt with toxic exposure has been piecemeal
and inadequate. President Biden recognizes this, too. Shortly after he
was sworn in, I met with the President about our shared priorities for
veterans. Upon learning of my goal to pass comprehensive legislation to
help toxic-exposed veterans, the President leaned over to me and talked
about his son, Beau, who served near burn pits in Iraq and Kosovo.
It might be hard for most Americans to imagine what a burn pit looks
like because they are illegal in the United States. Picture walking
next to and breathing fumes from a burning pit the size of a football
field. This pit contained everything from household trash, plastics,
and human waste to jet fuel and discarded equipment burning day and
night. Beau Biden lived near these burn pits and breathed the fumes
that emanated from them.
President Biden believes that constant exposure to these burn pits,
and the toxic fumes they emitted, led to Beau's cancer and early death.
It was during that meeting when I knew I had a partner in President
Biden.
At the State of the Union, President Biden called on Congress to pass
bipartisan legislation to comprehensively address the effects of toxic
exposure and improve the delivery of benefits for toxic-exposed
veterans. I cannot thank him enough for throwing his support behind
this effort and placing those who have served our country at the center
of his unity agenda.
To my colleagues who previously voted ``no'' on the PACT Act in
March, I ask you the same question I asked you then: Are you willing to
support our troops and honor our Nation's promise to them? Or will you
allow naked partisanship to once again deny our veterans the care they
deserve?
Just this Congress alone, every single Democrat in this body voted to
make sure each day in uniform counts toward GI Bill benefits. Every
single Democrat voted to ensure a smooth transition from Active Duty to
civilian life. Every single Democrat voted to honor our pact with
toxic-exposed veterans. There is no question as to where Democrats
stand on prioritizing America's veterans. We are backing up our thank-
you with concrete action.
Frankly, all the bills that I mentioned should have passed with
unanimous support. If the American people knew the context of these
bills and knew the content of them, they would demand unanimous support
from this Chamber.
But I take this moment now to recognize my Republican colleagues in
this Chamber who put keeping our promise to veterans above
partisanship. I thank the Republican cosponsors of this bill,
Representatives Fitzpatrick and Cline.
Further, I recognize the 34 Republicans who in March showed their
support for veterans by voting ``yes'' on final passage, including
Veterans' Affairs Committee members, General Bergman and Representative
Mace. I also recognize the commitment of Representatives Bilirakis and
Kinzinger, who do not serve on this committee, but demonstrated early
leadership by supporting this legislation. I am also glad to see my
colleague, Ranking Member Bost, finally stand in support of this bill
today.
Moreover, in June, an overwhelming bipartisan majority of 84 Senators
voted in favor of the PACT Act in the Senate. This proved the value of
the cause and showed that it had momentum, so the trajectory of this
effort is clear.
But here is also a very rare situation where there is a chance for
redemption. For those of my Republican colleagues who previously
hesitated, sat on the sidelines, or chose politics over veterans, you
get a second chance to do the right thing. There is no reason why this
time this measure should not garner at least 400 votes in this Chamber.
Why is it that a Republican leader and Republican whip, who aspire to
be in the majority but do not show the fortitude to govern, are
continuing to oppose this bill and are asking you to do the same? Do
not let them stand in the way with unconvincing arguments about
budgetary constraints when the true cost of war, the human cost of war,
is abundantly clear.
For example, as the House considers the National Defense
Authorization Act this week, a bill that authorizes $838.8 billion,
spending which I believe could be justifiable, I am reminded of the
stark reality of how this Congress approaches Federal spending.
It has become a battle of defense spending versus everything else.
That everything else includes veterans, schoolchildren, the elderly,
and our constituents. I vigorously object to veterans being pitted
against their fellow Americans to fight for funding. Do
[[Page H6018]]
we really want to support veterans by limiting school lunches for
children? Do we support veterans by limiting help for seniors? You can
be damn sure our veterans didn't sign up to serve our country, watch
their families make sacrifices, or go to war far from home so Members
of this body could perpetuate a false choice that pits Americans
against one another.
The right choice, the choice we are going to make today, is simple:
Recognize toxic exposure as a cost of war, period.
Using hypocritical arguments about fiscal responsibility as a reason
to oppose this bill when the truth of the moral responsibility of
caring for our veterans is made crystal clear, is not consistent with
American values. Make no mistake: When our country goes to war, we
don't nickel and dime the Department of Defense, and we shouldn't try
to pinch pennies when it comes to covering the care for toxic-exposed
veterans.
We don't hear these arguments about needing offsets when we are asked
rightly to support more body armor or protection from IEDs. This
Congress steps up to the plate to provide our servicemembers with what
they need to fight our wars. So why are Members of this body arguing
that we need to scrounge around to find money for our veterans? It is
time for Congress to fully support toxic-exposed veterans as they fight
the rare cancers and illnesses after returning home.
Now, I must express dismay also about the procedural steps we must
now undertake because a single Senator is preventing the Senate from
quickly fixing the technical issue in this bill. This Senator, already
having watched the bill pass the Senate the first time with strong
support, knowing the veteran sacrifice behind it, and the blood, sweat,
and tears shed by the veteran community to finally get this done, chose
instead to object because he doesn't like the funding mechanism in this
bill.
His position is the losing one, it was the losing one, and he has
held up this bill for no other reason other than sour grapes; and to
what end is unclear when veterans suffer in the meantime. Therefore, we
Members of the House must take this route to push forward and do what
we know is right.
The Honoring our PACT Act would not have been possible were it not
for the veterans who selflessly shared their stories, their pain, and
their trauma, opening the eyes of their fellow Americans to the
realities of being exposed to toxic substances.
Throughout this process, I have met many toxic-exposed veterans whose
sacrifice and courage continued long after they hung up their uniform.
I am forever humbled by the courage of Dr. Kate Hendricks Thomas, a
Marine veteran who served near a burn pit in Fallujah who later fought
the VA for 3 years to get the care she needed.
I am sorry to say she passed away this spring, but not before
selflessly fighting for a comprehensive bill that would aid over 3.5
million veterans like her living with the effects of toxic exposure, a
bill that she herself would not benefit from. We also honor the valor
of Wesley Black, Heath Robinson, Jennifer Kepner, and so many others
who are no longer with us.
This bill would also not have been possible without the support of
over 40 veteran service organizations. Each of these organizations
understand that toxic-exposed veterans are still in the heat of battle.
I thank them for their impact and advocacy for the Honoring our PACT
Act.
I also thank my staff, who worked tirelessly to listen and engage
with advocates and stakeholders and spent countless hours drafting and
redrafting this bill to get it right.
I also thank Speaker Pelosi for always being a tireless advocate for
veterans, along with Majority Leader Hoyer.
I also thank Senate Majority Leader Schumer for his work with
Senators Tester and Moran and the Senate Veterans' Affairs Committee to
pass this bill.
I also point out that Jon Stewart and John Feal kept us accountable.
Most importantly, to the families of veterans who tragically lost
their lives as a result of being exposed to toxic substances during
their time in service, I thank you for your sacrifices.
This legislative effort will help our veterans heal, and it offers
hope that our country can do the same. It sends a message to all
Americans that their Government will not allow their grievances to go
unaddressed. It acknowledges the suffering endured by our Vietnam war
veterans and demonstrates to them that we have learned from our
mistakes and that their struggle and their suffering was not in vain.
We are setting a new standard with the PACT Act. We are telling our
veterans: The burden of proof is not on you. Because of your sacrifice
to our country, this Congress and the American people are giving you
the benefit of the doubt that you have earned.
Let's pass this bill and ease the anxiety in the minds of our
veterans who are living with cancer or other illnesses and terminal
diseases and let them know that their families are going to be taken
care of. I believe this is what the American people want and what
everyone in this Chamber should want. It is what our veterans deserve,
and it is the right thing to do.
Madam Speaker, I encourage all my colleagues to honor their pact with
the veterans by voting ``yes'' on this bill.
Madam Speaker, I reserve the balance of my time.
Mr. BOST. Madam Speaker, I yield myself as much time as I may
consume.
Madam Speaker, I rise in support of S. 3373, as amended, the Sergeant
First Class Heath Robinson Honoring our Promise to Address
Comprehensive Toxics Act.
When we were debating the House version of the PACT Act 4 months ago,
I couldn't have said that. I am glad that I can today.
The bill is not perfect, but expanding healthcare and benefits for
veterans who were exposed to burn pits or other dangerous toxins while
serving our country is the right thing to do.
I come from a long line of veterans. My grandfather, Marines; my
father, Army; my uncle, Marines; I was in the Marines; my son, Marines;
my grandson, Marines; and my granddaughter enlisted this year in the
United States Navy.
{time} 1400
I know exactly how high the stakes are when this country sends young
men and young women to serve. I know exactly how high the stakes are
when they come home. I know exactly how often we have failed to meet
them and give them what they need. That is why I helped lead the charge
to provide disability benefits to blue water Navy Vietnam veterans a
few years ago.
We were decades late in giving those veterans the help they need. My
vow then and now was to make sure that other generations of veterans
don't have to wait for benefits they earned while they were serving or
the healthcare they require.
DOD estimates that 3.5 million veterans have been exposed to
dangerous toxins in Iraq and Afghanistan over the past 20 years. Some
of them are already sick and suffering from the health effects of that
exposure. They need help, and this bill will give it to them.
This bill will also make sure that the VA can actually give that help
to them, unlike the earlier PACT Act that could not.
I am grateful for the hard work of the Senate Committee on Veterans'
Affairs Chairman Jon Tester and Ranking Member Jerry Moran. They took a
flawed House bill and made it better.
There are several aspects of their work that make today's vote on the
PACT Act very different than the prior one. This is a better bill than
the one the House passed in March.
It reflects bipartisan negotiations and input from VA, which is
ultimately responsible for putting this into practice.
It incorporates the good work the VA is already doing to address
toxic exposure--namely, the scientific framework that the VA has been
using since last year to expand benefits to toxic-exposed veterans.
It removes certain provisions from the House bill that VA told us
could not and would not get done. It adds other provisions that would
make VA work more transparently to veterans and taxpayers, more
flexible, and more scientifically sound.
All of those things were missing from the prior House version. Most
importantly, the earlier version of the bill ignored the massive
operational impacts this effort will have on VA's
[[Page H6019]]
healthcare and benefit systems. In contrast, this bill addresses this
head-on.
To ensure that the VA has the staff capacity it needs to better serve
toxic-exposed veterans, this bill would: authorize 31 VA medical
facility leases; make it easier for Congress to authorize additional VA
medical facility leases going forward, something the committee has been
trying to do for decades; make it easier for VA to recruit and retain
the staff it needs to implement the bill; and give VA resources to
process claims faster using modern technology.
These changes and additions are critical to the bill's success, and
they give me confidence to vote for this bill without fearing that it
would be impossible to implement or risk breaking the VA for veterans
everywhere, those who are already receiving benefits.
Many of us are concerned about the CBO score for this bill and the
funding mechanism it contains. The total score went from $325 billion
over 10 years in the prior version to $681 billion in this version. I
don't criticize my colleagues for being concerned about that. That is
an increase of $356 billion.
That number gives me a lot of pause when I consider the strain that
rising inflation is already putting on American families. Anyone who is
trying to serve these veterans, it should give them pause, too, because
not only is it the veterans that will be paying, but it is their
children and grandchildren, as well.
However, only about $285 billion of the score is truly new spending.
The costs of expanding care and benefits for toxic exposure actually
decreased by about $40 billion from the prior version of this bill to
this one. The rest of the score is a result of the cost of war toxic
exposure fund.
The fund pays for expanding healthcare for veterans who experience
toxic exposure. That is reasonable. However, the fund is also a
budgetary ploy by the Democrats to take existing healthcare costs that
have nothing to do with toxic exposure and transfer them from
discretionary to mandatory spending. That is causing CBO's score to be
artificially high because almost $400 billion in costs that are already
funded by current law are being scored against the bill.
Even worse, this ploy would put even more government spending on
autopilot and limit our ability to control and oversee it, which is our
right under the Constitution. That is wrong.
Now, some of my colleagues will vote against the bill because of
that, and like I said before, I don't blame them. I am not. I am voting
for it because, as the Republican leader of the Veterans' Affairs
Committee and as a veteran, I know that, on balance, this is a good
bill that will help millions of veterans, servicemembers, survivors,
and military families. That is why I will be supporting this bill
today.
I have already thanked our Senate colleagues for their work on this
bill, but I also thank many Members on both sides of the aisle who have
introduced the various standalone bills that make up the PACT Act,
including Chairman Takano for his hard work and commitment to this
issue. I thank our staff because they also have worked to make sure
that this bill would come about, not only that it would come about, but
it would be able to be implemented.
I recognize the many veterans service organizations who have held our
feet to the fire every step of the way to get it done. I know they will
stay by our side every day ahead to make sure VA does it right. I look
forward to doing the work with them.
Madam Speaker, I reserve the balance of my time.
Mr. TAKANO. Madam Speaker, I certainly welcome the support of the
ranking member on this bill.
May I inquire as to the time remaining in debate.
The SPEAKER pro tempore. The gentleman from California has 14\1/2\
minutes remaining. The gentleman from Illinois has 22 minutes
remaining.
Mr. TAKANO. Madam Speaker, I yield 2 minutes to the gentlewoman from
Virginia (Mrs. Luria), my good friend who is the chairwoman of the
Disability Assistance and Memorial Affairs Subcommittee.
Mrs. LURIA. Madam Speaker, I rise in strong support of the Honoring
our PACT Act. As we near final passage of this historic and
comprehensive legislation to address toxic exposures afflicting
veterans across several generations, it has been a privilege to lay the
groundwork for this endeavor as chair of the Disability Assistance and
Memorial Affairs Subcommittee.
Many pieces of legislation that have passed through our jurisdiction
are on their way to being included in this package and becoming law. In
particular, I am honored to have introduced the COVENANT Act, a
cornerstone of the PACT Act.
This bill is best known for providing access to care for those
veterans exposed to burn pits and many others who have struggled too
long to receive care for health conditions caused by burn pits and
other toxic exposures. To put it simply, this bill will see that 3.5
million veterans are eligible for Priority Group 6 VA healthcare. It
concedes exposure to airborne hazards and recognizes 23 new airborne
hazard-related conditions as presumptively service-connected.
When signed into law, I don't think I would be wrong in saying that
this is possibly the largest increase in access to veterans healthcare
that any of us have seen in our lifetimes. This legislation will assist
many of our fellow servicemembers and veterans who have suffered for
too long.
The PACT Act has been a long time coming, but today the House is
prepared to send this essential veterans assistance package back to the
Senate and, ultimately, to the President's desk. We are finally
recognizing the true cost of war for all who deployed in defense of our
Nation.
I thank Chairman Takano for his unwavering leadership through this
process, as well as my fellow Members on and off the committee for
their important contributions to this historic legislation.
Lastly, I thank the veterans, the survivors, and the veterans service
organizations, VSOs, who have made their voices heard. This is for you.
I wholeheartedly urge my colleagues to vote ``yes'' on the Honoring
our PACT Act.
Mr. BOST. Madam Speaker, I yield 2 minutes to the gentleman from
Michigan (Mr. Bergman), the highest ranking officer that serves in
Congress today. He has served with many of the men and women who will
benefit from this bill today.
Mr. BERGMAN. Madam Speaker, I rise in strong support today of S.
3373, the Sergeant First Class Heath Robinson Honoring our Promise to
Address Comprehensive Toxics Act of 2022.
I associate myself with the comments of our Republican leader on the
Veterans' Affairs Committee, Mr. Bost, who also happens to be a fellow
marine. He articulated very well the elements of where we were, where
we are, and where we are going.
This is the latest version of what many of my constituents know as
the PACT Act, and it has only improved since it passed the House last
March.
As a Vietnam veteran myself and as the ranking member of the House
Veterans' Affairs Subcommittee on Health, I am more than familiar with
the struggles faced by veterans, young and old, across our Nation who
have been exposed to toxic substances during their time of service.
This legislation will finally establish a comprehensive framework for
the VA to provide veterans and their survivors for generations to come
with the toxic exposure-related care and benefits that they deserve.
For example, this bill will instantly provide presumptive benefits
for veterans and survivors who are terminally ill, homeless, over the
age of 85, experiencing extreme financial hardship, or able to show
another emergent need.
It will also supercharge toxic exposure research, improve the way in
which the VA interacts with toxic-exposed veterans, and authorize 31
major medical facility leases.
Whether it is from burn pits or Agent Orange, toxic exposure is
perhaps the most widespread and urgent issue facing our military
community.
Madam Speaker, I urge my colleagues to join me in supporting this
bipartisan solution based on what the veterans themselves have been
telling us for a long time. It is time to act.
Mr. TAKANO. Madam Speaker, I yield 1 minute to the gentleman from
Indiana (Mr. Mrvan), my good friend who is the chairman of the
Subcommittee on Technology Modernization and on the Veterans' Affairs
Committee.
[[Page H6020]]
Mr. MRVAN. Madam Speaker, I rise today in support of the final
version of the Honoring our PACT Act, which will uphold our obligation
to ensure that veterans receive the world-class healthcare they
deserve.
As a Member of Congress and a member of the Veterans' Affairs
Committee, we have a responsibility to support all veterans when they
return home from protecting our freedoms and defending our democracy.
As I walked the parade routes of the Fourth of July and visited the
veterans service organizations, it is not enough to simply say ``thank
you for your service'' to our veterans. It is through our actions that
we provide proof we have our veterans' backs and value their service.
Ultimately, veterans living with toxic exposures must not be denied
the care and benefits they have earned.
I encourage all of my colleagues to join me in supporting this
measure. Again, I thank Chairman Takano, all the Members, and all of my
colleagues on the House Veterans' Affairs Committee for their
leadership to finalize this critical legislation to have our veterans'
backs.
Mr. BOST. Madam Speaker, I yield 3 minutes to the gentleman from
Texas (Mr. Roy), who has served from the time of being in Congress on
the Veterans' Affairs Committee.
Mr. ROY. Madam Speaker, I thank the ranking member for yielding.
As a member of the Veterans' Affairs Committee and as someone who
represents San Antonio, an inordinate number of veterans, Joint Base
San Antonio, Army Futures Command, I regret to rise in opposition to
the legislation before us.
I respect the enormous amount of work that has gone into this
legislation by the committee staff, by the ranking member, by the
chairman, by the Senate. Obviously, it is an important issue, and it is
critical. I have many friends here, particularly veterans, who support
this measure, and I understand why.
Every single one of us wants to make sure that we take care of this
issue, and frankly, it has been way too long in getting to it. I agree
with that completely. But, unfortunately, I cannot support this bill
because this bill spends about $285 billion that we don't have.
{time} 1415
We have to address the issue in this body of spending money we don't
have. The chairman said: Well, why don't you raise it on other issues?
I raised it on every single issue. I raised it on a $2 million bill
about 30 minutes ago on the floor.
At some point, we have to pay for the stuff that we are spending it
on or the very things that these veterans sacrificed for will be made
completely and utterly worthless. We are destroying the Republic that
these men and women sacrificed for, and we are destroying it in this
Chamber by our incompetence and by our irresponsible refusal to
actually manage the affairs of the Republic appropriately.
Putting this bill on autopilot to the tune of $680 billion of
mandatory spending with $280 billion unpaid for, which we can pay for
right now with existing COVID funds, we could pay for it right now with
the elimination of the SALT deduction, we could pay for it right now
with any number of spending cuts and/or tax increases--if we wanted to
have that debate on the floor of the House--but we are not doing it.
We do a disservice to the veterans who are sick because of the burn
pits. We do a disservice to the veterans who laid their lives on the
line and died for this country. We do a disservice to the military that
we say that we support when we are not spending money that we actually
have, as opposed to printing money and borrowing money.
Putting it on autopilot, when 60 percent of our spending every year
is already on autopilot--when we are $30.5 trillion in debt. Instead of
the established scientific framework, we put 20 conditions in without
scientific evidence which will cause a backlog, which the VA even
acknowledges will cause a backlog. These are real concerns that we
ought to address.
Fundamentally, you have to pay for that which we are spending. We are
undermining the sacrifice of the very veterans that we say that we are
helping with this measure by not doing it with fiscal responsibility.
Mr. TAKANO. Madam Speaker, nothing could be more important or a
higher priority in defense of our Republic than to address the
unaddressed grievances of our veterans. We are keeping our promise to
our veterans. We are saying today that doing so is a cost of war.
Madam Speaker, I yield 1 minute to the gentleman from Maryland (Mr.
Trone), a member of the House Veterans' Affairs Committee and active
member of the Economic Opportunity Subcommittee.
Mr. TRONE. Madam Speaker, today I rise to urge my colleagues to pass
the Honoring our PACT Act to give our veterans the healthcare they
earned.
Over 3.5 million veterans have been exposed to toxins, such as burn
pits, during deployment, causing horrific health impacts. To add insult
to injury, the disability benefit claims process places the burden on
our vets themselves to jump through hoops. This is a shameful problem--
a shameful problem--one we are determined to fix.
This legislation, which includes my FASTER Presumptions Act, will
help cut the red tape and streamline procedures for veterans who have
earned it to access their healthcare benefits faster. Our veterans
served our country with honor and we have to honor their service.
Madam Speaker, I urge my colleagues to honor our PACT through this
bill, and I thank Chairman Takano for his leadership.
Mr. BOST. Madam Speaker, I yield 3 minutes to the gentlewoman from
Iowa (Mrs. Miller-Meeks), who has actually served in health situations
in our military, a veteran herself, and is very aware of the things
that we are dealing with here.
Mrs. MILLER-MEEKS. Madam Speaker, I rise in support of the Sergeant
First Class Heath Robinson Honoring our PACT Act.
When the House first passed the PACT Act in March, I spoke on the
floor and urged my colleagues to find a bipartisan solution to give
toxic-exposed veterans the care and support that we as a country owe
them. This bill is that bipartisan solution, and I am proud to support
it.
As a 24-year military veteran, I have seen firsthand the effects that
toxic exposure has had on my fellow servicemembers, whether it is
herbicides like Agent Orange in southeast Asia or burn pits in the
Middle East.
In fact, my knowledge is so intimate that my husband, who is also a
30-year veteran, and I, have a close friend, Jay, who, after his
deployment to Desert Storm, that very brief conflict, in coming back to
the United States came off of the plane and collapsed. He developed a
heart condition called cardiomyopathy, which led this 30-year-old to
have a heart transplant, aseptic necrosis of his hip with a replacement
of his hip, and soon his untimely and young death.
Exposure to these substances can lead to severe life-altering
diseases. However, under the current system at the VA, it can be
extraordinarily costly, time-consuming, and in some cases, impossible
for a sick or disabled veteran to prove that their condition is related
to the toxins to which they were exposed during their military service.
The bill we are voting on today ensures that this will no longer be
the case. Under the framework created by the PACT Act, toxic-exposed
veterans will finally receive the care and benefits they deserve and
have earned. This bill ensures the VA will administer those benefits in
a responsible, fair way.
This new version of the PACT Act includes important reforms to build
on the VA's existing framework for toxic-exposed veterans, and it
ensures that the VA has the flexibility to respond and adapt to new
scientific evidence on toxic substances.
Importantly, it also ensures that veterans who are most in need--
those who are terminally ill, homeless, elderly, or experiencing
hardship--receive their benefits immediately so they do not have to
wait any longer for our government to act.
Madam Speaker, I urge all my colleagues to support the PACT Act. This
bill is not perfect by any means, but we should not allow perfect to be
the enemy of the good. Make no mistake, this is a good bill for our
Nation's veterans. I am proud to support this bill and I am proud to
stand with the men and women of our Armed Forces.
[[Page H6021]]
Mr. TAKANO. Madam Speaker, I yield 1 minute to the gentlewoman from
Michigan (Ms. Slotkin), my good friend who serves on the Disability
Assistance and Memorial Affairs Subcommittee of the Veterans' Affairs
Committee.
Ms. SLOTKIN. Madam Speaker, I rise in support of the PACT Act and my
bill contained within on burn pits.
Most of us here all know about Agent Orange and the horrible effects
it had on our veterans in Vietnam. We also remember how long it took
for Congress and the VA to respond and make sure our veterans had the
care and benefits they needed.
The bill we will vote on today is a landmark piece of legislation
that will address the Agent Orange of the post-9/11 generation: burn
pits.
For anyone who doesn't know, burn pits are used to dispose of waste
on a military base, usually abroad in a combat zone, with jet fuel used
to light the fuse. For years, we have used these burn pits in places
like Iraq and Afghanistan. I lived near one in Iraq on three tours.
Just as with Agent Orange, we have learned over the years that the
toxins our servicemembers have been exposed to have horrible
consequences, strange cancer diagnoses, respiratory issues that have
affected millions of veterans, including those in Michigan.
This issue has been deeply personal to me as an Army wife and someone
who lived near those burn pits while with the CIA.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mr. TAKANO. Madam Speaker, I yield an additional 30 seconds to the
gentlewoman.
Ms. SLOTKIN. Madam Speaker, for years, 9/11 veterans have walked into
their local VA center only to be turned away.
Madam Speaker, one of the most important things I have worked on in
my short 3\1/2\ years here is this bill. It is the biggest veterans'
healthcare bill we have passed in decades.
Last week, I visited our local VA in Lansing--and they know it is
coming--another 3.5 veterans will have access to healthcare because of
this bill.
We do important things in this body all the time, but I think fewer
are more important than this one we are going to vote on today.
Madam Speaker, I urge my colleagues on both sides of the aisle--I am
glad many of my colleagues on the other side of the aisle have switched
their positions--to now vote on this bill.
Mr. BOST. Madam Speaker, I yield 3 minutes to the gentleman from
Montana (Mr. Rosendale), the ranking member of the Technology
Modernization Subcommittee of the Veterans' Affairs Committee.
Mr. ROSENDALE. Madam Speaker, the Senate version of the PACT Act
helps connect veterans who were exposed to burn pits or dangerous
toxins in service to our country with the healthcare and benefits they
have earned and were promised.
This legislation also codifies the scientific framework that the VA
is already using to provide benefits to toxic-exposed veterans, better
reflects current practice, and improves transparency.
The previous House-passed version, which I voted against, ignored the
work the VA is already doing to improve services to toxic-exposed
veterans.
This bill improves and codifies the pilot program that the VA
established last year to extend compensation benefits to toxic-exposed
veterans.
This bill also includes provisions to increase transparency, provide
flexibility, and keep pace with scientific advancements for toxic
exposure.
In addition, this legislation includes workforce enhancements, and
other changes, to ensure the VA can improve services to toxic-exposed
veterans without compromising care and benefits.
The prior House version of the PACT Act failed to address the
operational impact on the VA of servicing the benefits of toxic-exposed
veterans, which would have left veterans waiting in a backlog of 1.5
million claims. This new version includes provisions that address the
operational impacts head-on.
Madam Speaker, this legislation is not perfect. I do not support
everything that is in this piece of legislation. But as the saying
goes: We cannot let the search for perfect be the enemy of the good,
or, in this case, what is right and necessary.
Our veterans have waited far too long to receive the help that they
were promised. It is far past time for Congress to stop screwing
around, breaking our own rules, while America's veterans suffer and
literally die.
Since my time in Congress began, I have been a strong advocate for
Montana veterans, and I work tirelessly in the House Veterans' Affairs
Committee to ensure that all America's veterans are able to receive the
quality care that they were promised, and the care that they have
earned.
We are willing to spend far too much money to engage in conflict, and
far too little to care for our warriors once they come home.
Madam Speaker, I intend to vote for this legislation and I encourage
my colleagues to do the same.
Mr. TAKANO. Madam Speaker, I welcome the support of the gentleman
from Montana.
Madam Speaker, I yield 1 minute to gentleman from California (Mr.
Ruiz), my good friend and member of the House Veterans' Affairs
Committee, where he is an active member of the Disability Assistance
and Memorial Affairs Subcommittee.
Mr. RUIZ. Madam Speaker, once again, we stand at the precipice of
making a monumental change in the lives of our servicemen and
servicewomen and veterans.
Yet, here we are voting on the Honoring our PACT Act for the third
time because of a Senate technical issue. Enough is enough. Our
veterans do not have time for technicalities. Their lives are literally
on the line.
As a cofounder of the bipartisan, bicameral Burn Pits Caucus, I have
spent years fighting to ensure that our veterans exposed to toxins from
burn pits get the care and benefits they need and deserve.
My bill, the Presumptive Benefits for War Fighters Exposed to Burn
Pits and Other Toxins Act is the foundation that the Honoring our PACT
Act is built on. It removes the burden from the veterans to prove that
23 illnesses or conditions--including various cancers--that they are
suffering from are due to their service near burn pits.
Madam Speaker, I implore the House to pass this fix to the Senate's
blue slip error, and I urge the Senate to pass the Honoring our PACT
Act immediately. Our veterans' lives are on the line.
Mr. BOST. Madam Speaker, I yield to the gentleman from Texas (Mr.
Ellzey), a Navy veteran and F-18 pilot.
Mr. ELLZEY. Madam Speaker, I come before the House of Representatives
to discuss the newest and best version of the PACT Act before us today.
Putting the needs of our veterans first is something we can all agree
on. On March 3, the House passed a version of the PACT Act that was
unworkable and unaffordable. At that time, I joined my colleagues in
calling for negotiations and refinements that would best help the
veterans and gain bipartisan support, and I voted ``no'' on that
original bill.
The bill that we have before us today is the result of those long and
difficult negotiations. This version of the bill reinforces why I
opposed it during the initial passage. When we work together and put
the well-being of veterans above partisan politics, we get a workable,
effective bill that will save the lives of those who have given so much
for us.
It is not a perfect bill. There remains language, including the costs
and mandatory spending that are somewhat troubling, but I am confident
that we will be vigilant about carrying out our oversight of the
implementation of those provisions and the spending associated with
them. I also call on the moneys moved to mandatory spending be moved
back to discretionary when we take back the majority.
America's veterans who were exposed to toxins during their voluntary
military service in combat to preserve America's liberty and freedoms
will finally receive the healthcare and benefits they need.
{time} 1430
I support this legislation because it requires the VA to contact
every single veteran who filed a claim for benefits that related to
toxic exposure but had
[[Page H6022]]
the claim originally denied, allowing them to refile their claim. I
support this legislation because it expands the screening of possible
toxic exposure to every veteran receiving VA care.
America's obligation to our veterans is best conveyed by the words of
Abraham Lincoln: ``To care for him who shall have borne the battle, and
for his widow, and his orphan.''
Madam Speaker, I urge all Members to vote in favor of the amendments
to H.R. 3967.
Mr. TAKANO. Madam Speaker, may I inquire as to the time remaining.
The SPEAKER pro tempore. The gentleman from California has 8 minutes
remaining. The gentleman from Illinois has 10 minutes remaining.
Mr. TAKANO. Madam Speaker, I yield 1 minute to the gentleman from
Arizona (Mr. Gallego), who is my good friend. He is an active member of
the House Veterans' Affairs Committee and serves on the Economic
Opportunity Subcommittee.
Mr. GALLEGO. Madam Speaker, I rise in support of the Honoring Our
PACT Act--overdue, desperately needed legislation providing care for
veterans who have been exposed to toxic substances while serving their
country.
I am especially grateful for the provisions in this bill that provide
healthcare to veterans harmed by burn pits. When I was in Iraq,
exposure to burn pits was an everyday, constant fact of life.
Too many veterans--my dear friends from Lima Company 325 and other
marines--are sick from that exposure with respiratory diseases, cancer,
and other chronic conditions that young men should not be having right
now.
Too many veterans live in fear that their next doctor's appointment
will reveal an illness that--in addition to harming their health--could
drive them into bankruptcy because the VA refuses to care for them. I
am one of those people who does have that fear.
Every day we go without fighting for those veterans is a choice to
let down those who have sacrificed most for our Nation. We will not let
them down today.
Madam Speaker, I am proud to vote for this bill on behalf of my
fellow veterans, and I urge all my colleagues to join me in doing so.
Mr. BOST. Madam Speaker, I yield 1 minute to the gentleman from the
State of Michigan (Mr. Meijer).
Mr. MEIJER. Madam Speaker, I rise today in support of the Sergeant
First Class Heath Robinson Honoring our PACT Act.
We have an urgent moral obligation to take care of the men and women
who have served and sacrificed in uniform to defend our Nation. I have
seen the impacts of burn pit and toxic exposure hazards firsthand both
as a U.S. Army soldier in Iraq and also as somebody who has served
alongside others in the Veterans' Affairs Committee and who have
constituents today who are suffering from those ailments.
This comprehensive, bipartisan package will expand VA coverage; and
to those 3.45 million toxic-exposed veterans, provide the VA additional
resources so it can better care for our veterans and also create the
framework for establishing future toxic exposure-related presumptions
of service connection so we don't have to go through this again.
I am especially proud that a bill I introduced last year with my
colleague from Michigan, Congresswoman Slotkin, the Veterans Burn Pit
Exposure Recognition Act, was included in this final package.
Madam Speaker, I look forward to supporting final passage of this
bill, and I encourage all my colleagues to ensure its swift passage.
With this bill, we will make good on the promises we made to our
Nation's servicemembers and veterans.
Mr. TAKANO. Madam Speaker, I yield 1 minute to the distinguished
gentlewoman from California (Ms. Pelosi) who has been a tremendous
supporter of this legislation.
Ms. PELOSI. Madam Speaker, I thank the gentleman for yielding, and I
thank him for his leadership as chair of the Veterans' Affairs
Committee. I am grateful for the bipartisan support that the bill is
receiving here.
Madam Speaker, I rise today in strong support of the landmark
Honoring our PACT Act. As you know, PACT stands for Promise to Address
Comprehensive Toxics Act, now named after Sergeant First Class Heath
Robinson. I am going to talk about him in a moment.
This bipartisan legislation honors our duty to deliver healthcare
that millions of veterans need and that they have certainly earned.
This is the second time the House has voted on this important bill, and
we are proud that after the Senate passes this version, we will finally
send it to the President to be signed into law.
For their relentless leadership on this legislation, let me salute
Chairman Mark Takano and his ranking member as well who made addressing
toxic exposure a top priority in this Congress; Congressman Raul Ruiz,
whose experience as a physician informed a key provision of this bill
establishing presumption of exposure; and Congresswoman Elaine Luria, a
Navy veteran who authored a provision expanding health benefits to
veterans exposed to burn pits.
Also included in this legislation--and I am so pleased about it--is
legislation by Congressman Matt Cartwright, author of the Camp Lejeune
Justice Act, to allow veterans or their loved ones to seek damages
related to injuries incurred while serving at Camp Lejeune.
We have had many people come from the area. The legislators from
North Carolina, David Price and others, have been relentless in their
pursuit of this legislation. Families would come here and tell their
stories of their loved ones' service at Camp Lejeune where the water
supply was causing serious health problems not only for the
servicemember, which would be horrible enough, but for their family
members as well. This is corrected in this legislation and is a very
important improvement.
From the deserts of Iraq to the mountains of Afghanistan and on the
bases and military theaters around the world, a generation of
courageous Americans have donned the Stars and Stripes to protect our
freedom. These heroes have put their lives on the line to fight the
enemy. Yet, tragically, many of them have confronted another deadly
threat: exposure to burn pits and toxins which have taken a severe toll
on their health.
Make no mistake: burn pit exposures are pervasive. Eighty-six percent
of the Iraq and Afghanistan veterans report having been exposed to
these toxic fumes. I don't want to go into what is in these pits. It is
so disgusting.
They are deadly. The VA has seen over a 60 percent increase in rates
of cancers tied to toxic exposure in the last 20 years. But when these
veterans come home, they are forced into a convoluted claims process
which cruelly saddles them with the burden of proof, and nearly three-
quarters of burn pit-related claims are denied. Think of the injustice
of that.
Tragically, this problem is not new to our Nation. Many veterans of
the Vietnam war were forced to wait four long decades before their
exposure to Agent Orange was recognized and they could claim benefits.
This was, of course, addressed with the Blue Water Navy Vietnam Act
that was passed by the Congress in 2019. Some Agent Orange provisions
have been in subsequent NDAA legislation.
I know this issue well. Before I was in Congress, I was participating
in sit-ins with hunger strikes for Vietnam vets in the early eighties.
More than one time we were joined by Dick Gregory who had experience in
hunger strikes for civil rights reasons, and he was instructing the
veterans on how to hydrate, et cetera, so that they could survive the
hunger strikes hopefully in time to make a difference. But it took
decades. We cannot and will not let that happen to another generation.
There are potentially up to 3.5 million veterans deployed after the
attacks of September 11--3.5 million deployed since September 11--who
may have been exposed to toxic fumes and substances, and we must act
now to save lives.
The PACT Act is a comprehensive bill--others have discussed what it
does--that meets the challenge of toxic exposures for veterans in three
ways. First, it expands access to VA healthcare to post-9/11 combat
veterans exposed to toxins. Second, it grants presumptions of exposure
for veterans with rare cancers, COPD, and other debilitating diseases.
Third, it creates a permanent, streamlined process to ensure that
future Secretaries will review and approve new exposure swiftly.
[[Page H6023]]
Why do we have these burn pits?
We always keep saying here that on the battlefield we leave no
soldier behind and when they come home, we leave no veteran behind. And
yet, they come home with hidden injuries--whether they are
psychological or exposures to a burn pit--the consequences of which do
not show up for a while.
We have spent more than $6 trillion recruiting, training, and
deploying our servicemembers overseas during the last 20 years. But
let's be clear: This is only part of the price tag. When we send our
troops into conflict, we have to understand that we are responsible for
the consequences. Burn pit exposure is one of them. Toxic exposures are
a cost of war, and we must treat it as such. This is not a question of
dollars. It is a matter of values.
In all of the Congress' work for veterans, it is imperative that
veterans' groups, our veterans, their families, and the veterans
service organizations, the VSOs, are not only at the table, but they
are also leading the way. Mr. Takano has been a leader at that table
for years.
The overwhelming support of VSOs, especially a group now called Burn
Pits 360, was absolutely crucial to crafting this bill, steering it
through the legislative process, and securing its passage in the House
today.
I have quoted Lincoln over and over again. Lincoln said: ``Public
sentiment is everything. With it, nothing can fail; against it, nothing
can succeed.''
Well, our veterans caused public sentiment to be aroused to such a
point that here we are getting this done. They enlisted Jon Stewart and
John Feal, two people who had been there with us on the 9/11 health
benefits for people exposed at the time of 9/11. And they had been real
champions in the public visibility of this issue; not only to help
mobilize support for us to pass it, but to give hope to people who have
been affected to know that there is a chance that this can be
accomplished.
So I thank Jon Stewart, and I thank John Feal.
At the same time, it is with great pride and patriotism that the PACT
Act has strong bipartisan and bicameral support worthy of our heroic
veterans. This Congress is also grateful to Secretary McDonough, the
VA, and the entire administration for their support.
Mr. Speaker, I thank President Biden for making this a priority in
his State of the Union Address, especially when he talked about his
beloved son, Beau.
Madam Speaker, since we passed the PACT Act, it has been renamed. It
has a new name of a veteran we lost from toxic exposure.
Sergeant First Class Heath Robinson was exposed to burn pits while
deployed to Kosovo and Iraq, and afterward he battled a rare, deadly
lung cancer. Sadly, he died in 2020 at just age 39, leaving behind his
wife and daughter. Today, in his memory, we redouble our efforts to
ensure tragic stories like his can never happen again. He is
representative of so many other stories and the toll that this has
taken.
Again, we say that when our troops go to war on the battlefield, we
leave no soldier behind. When they come home, we leave no veteran
behind. Our PACT Act is an historic victory for our veterans and for
their advocacy that honors that pledge now and for the future.
Madam Speaker, I urge a bipartisan vote on the Honoring our PACT Act.
I hope it will be almost unanimous. I look forward to seeing it swiftly
passed by the Senate and signed into law by the President.
Madam Speaker, again, I am grateful for the leadership of Mr. Takano.
{time} 1445
Mr. BOST. Madam Speaker, I yield 1 minute to the gentleman from
Florida (Mr. Bilirakis), a gentleman who has served on this committee
and has understood these issues for all of his time in Congress.
Mr. BILIRAKIS. Madam Speaker, inspired by the story of my constituent
Lauren Price, I first filed comprehensive burn pit legislation with my
colleague, Congressman Ruiz, in 2018.
Lauren developed a terminal illness due to her exposure to burn pit
toxins in Iraq. Despite her illness, she was passionate about making
sure her brothers and sisters in arms would finally be able to access
the medical care and benefits they have earned. Lauren worked
tirelessly to help me craft legislation and testified at multiple
congressional hearings.
Since 2018, I have continued to work with my colleagues in the House
and the Senate to push this critical issue forward. While Lauren
tragically passed before she was able to get help, today, finally, we
will pass the PACT Act to make sure no other veterans have to go
through what Lauren went through.
Mr. TAKANO. Mr. Speaker, I so welcome the support of the gentleman
from Florida. He got it right the first time. He voted ``yes'' the
first time. I know he is going to vote ``yes'' the second time.
Mr. Speaker, I yield 1 minute to the gentlewoman from Minnesota (Ms.
Omar), my good friend who serves on the Education and Labor Committee
and the Foreign Affairs Committee.
Ms. OMAR. Mr. Speaker, I rise today in support of the Honoring our
PACT Act. I thank Chairman Takano for yielding and for his incredible
leadership on this bill.
We ask young men and women to serve our country in uniform. We should
not also be asking them to be exposing their bodies to toxins and to
live with the consequences of those toxins for the rest of their lives.
Whether it is Agent Orange in Vietnam or burn pits or other toxic
exposures in Iraq and Afghanistan, this has been part of our military's
history. This bill helps us correct the historic injustices for
veterans and communities like the ones in Camp Lejeune, North Carolina.
I am proud today that we will pass the most comprehensive legislation
in decades to address the severe health problems that so many of our
veterans are facing and to make it easier for them to get the relief
and the care they need.
Mr. Speaker, thousands of my constituents will benefit from what we
are doing here today, and it is my great honor to support this bill.
Mr. BOST. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from
Georgia (Mr. Carter), a gentleman who is very much in support of our
veterans.
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for
yielding.
Mr. Speaker, today, I rise in support of H.R. 3967, the Honoring our
PACT Act. However, I want to make sure that my colleagues across the
aisle know how disappointed I am in these budget gimmicks that have
become a part of this final legislation.
As many of you are aware, I have the honor and privilege of
representing the First Congressional District of Georgia. We have every
branch of the military in our district. With every branch represented
in my district, I take pride in my ability to serve and aid our men and
women in uniform.
I promised them I would vote for this bill. I am going to vote for
this bill. But I do so begrudgingly, and the reason why is because I
think it is despicable, Mr. Speaker, that my colleagues on the other
side of the aisle are using our veterans in order to gain the ability
to use billions of dollars, almost $700 billion, on pet projects that
they want to spend on. I think that is a slap in the face of our
veterans.
Our veterans did not sacrifice, did not serve, in order to bankrupt
our country. But that is what our colleagues on the other side of the
aisle want to do.
Now, they deserve this. They need it. There is no question about
that. Anyone who votes for it or against it agrees they need this, and
we are going to make sure they get it. But I want to make sure that the
point is made that this is despicable to use a budget gimmick like this
against our veterans in order to be able to fund pet projects that my
colleagues on the other side of the aisle want to fund.
Mr. TAKANO. Mr. Speaker, I welcome the even begrudging ``yes'' vote
from the gentleman from Georgia. I will just say there is no budget
gimmick here. This vote is going to unite America. It is going to heal
America.
Mr. Speaker, I yield 1 minute to the gentlewoman from Michigan (Mrs.
Dingell), my good friend who serves on the Energy and Commerce
Committee and the Natural Resources Committee.
Mrs. DINGELL. Mr. Speaker, I rise in support of the Honoring our PACT
Act.
Toxic exposure has devastating health consequences for our veterans,
[[Page H6024]]
including many in my district. I talk to them every week when I am
home.
One is the Michigan president of the VFW, Kevin Hensley, who is a
veteran of the U.S. Air Force who was stationed near open burn pits and
has been diagnosed with several severe illnesses after inhaling that
toxic smoke. Despite his sacrifices and his dedication yet today, he
faces challenges every day receiving care through the VA, and that is
simply unacceptable.
With the passage and enactment of this legislation, we can lift the
barriers that have been blocking veterans from accessing the life-
changing care they need. This bipartisan package will expand healthcare
access to veterans across the country, and it will finally ensure that
veterans receive the support they deserve.
I thank the chairman of the Veterans' Affairs Committee for his
leadership in advancing the PACT Act, the ranking member, and all the
members of the Veterans' Affairs Committee.
Mr. BOST. Mr. Speaker, I yield 1 minute to the gentleman from Ohio
(Mr. Davidson).
Mr. DAVIDSON. Mr. Speaker, during deployments and war, the military
incinerated waste in large burn pits. Many contained hazardous
materials that emitted toxic fumes. Our veterans have long suffered
from the practice, but the VA has not been able to adequately recognize
the effects and provide care for those who suffer from such exposures.
To be clear, this is not a benefit. It is a moral obligation to care
for these veterans.
It is not a great bill. Congress has already squandered two decades
trying to do the right thing here. When BP spilled oil and contaminated
the Gulf, their responsibility for cleanup was not optional. Why should
America's government have less responsibility for the harm caused to
our veterans?
It is free to join our military, but for some, service costs
everything. Others return with wounds that are seen and unseen. We must
recognize the cost of war, and the bill for our veterans harmed by
toxic burn pits is long overdue. Please pass this bill.
Mr. TAKANO. Mr. Speaker, I have no further speakers. I am prepared to
close, and I reserve the balance of my time.
Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
While I wholeheartedly support the intent of the PACT Act and intend
to vote for it, I am opposed to the precedent that the funding
mechanism in this bill sets.
Later, I will be offering a motion to commit that would prohibit
creation of the cost of war toxic exposure fund. Democrats are using
the fund to move almost $400 billion of existing VA healthcare spending
from the discretionary to the mandatory side of the ledger for purposes
completely unrelated to veterans.
We should not use this bill to create more entitlement spending. That
is dangerous, and it is a very dangerous budget ploy. It will put more
spending on autopilot. It will limit our ability to do our job,
constitutionally, of oversight of the second-largest bureaucracy in the
world that serves millions of veterans and survivors. It will hurt
taxpayers who are already suffering everywhere, from the gas pump to
the grocery store.
My motion to commit is simple, and I hope my colleagues will support
it.
Mr. Speaker, I ask unanimous consent to include the text of the
amendment in the Record immediately prior to the vote on the motion to
commit.
The SPEAKER pro tempore (Mr. Kilmer). Is there objection to the
request of the gentleman from Illinois?
There was no objection.
Mr. BOST. Mr. Speaker, I reserve the balance of my time.
Mr. TAKANO. Mr. Speaker, I yield myself the balance of my time.
I am delighted that the ranking member is offering his support for
this bill. I accept that support, but I do not accept his objections.
This bill, I mean, yes, I do say that we are creating entitlements.
But the entitlements we are creating are 3.5 million veterans eligible
for healthcare, veterans that were exposed to toxic substances. We are
conceding exposure to them. We are making it possible for them to not
have to fight their government.
Yes, we are creating entitlements with our 23 presumptive illnesses.
It is going to mean that those veterans are entitled to benefits, and
their families will be entitled to benefits, so those veterans that are
suffering from terminal illnesses are not going to have to worry about
their families being without resources after they pass.
Mr. Speaker, I ask that all of my colleagues join me in finally doing
what is right and passing this very important piece of legislation, S.
3373, as amended. I hope we get 400 votes.
Mr. Speaker, I yield back the balance of my time.
Mr. BOST. Mr. Speaker, I yield myself the balance of my time.
Nineteen months ago, when I took over as the lead Republican on the
Veterans' Affairs Committee, I told my colleagues that helping toxic-
exposed veterans was my top priority. Today, I am proud to say that we
are delivering on that promise.
It was not an easy road to get here, but the PACT Act will make a
difference for veterans, their families, and their survivors.
Today, I am thinking of veterans like Lauren Price, Heath Robinson,
Kate Hendricks Thomas, veterans who raised their right hands like I
did. They did their duty, and they did it well. But unlike me, their
lives were cut short.
They were young, seemingly healthy adults who had endured a different
battle on the stateside. Their lives were changed in an instant when
they developed rare cancers in the blink of an eye, possibly due to
their repeated exposure to burning chemicals while they served
overseas.
Lauren left behind her husband, Jim, and five children. Heath left
behind his wife and a young daughter. Kate left behind her husband and
a young son.
The bill we will vote on today is in honor of them and the hundreds
of thousands of veterans just like them. Lauren, Heath, and Kate left
us too soon and would want us to do everything in our power to try to
prevent what happened to them from happening to their fellow brothers
and sisters in arms.
The PACT Act will grant their wish for generations. It will help over
3 million veterans get the care and benefits they are due before it is
too late.
We have made this mistake in the past. We don't need to make it
again. We need to move forward with this bill, and we will work in a
bipartisan way to make sure that is exactly what happens once it is
signed into law and implemented by the VA.
Mr. Speaker, I encourage my colleagues to support the bill, and I
yield back the balance of my time.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 1224, the previous question is ordered
on the bill, as amended.
The question is on third reading of the bill.
The bill was ordered to be read a third time and was read a third
time.
Motion to Commit
Mr. BOST. Mr. Speaker, I have a motion to commit at the desk.
The SPEAKER pro tempore. The Clerk will report the motion to commit.
The Clerk read as follows:
Mr. Bost of Illinois moves to commit the bill S. 3373 to
the Committee on Veterans' Affairs.
The material previously referred to by Mr. Bost is as follows:
Beginning on page 117, strike line 14 and all that follows
through page 119, line 13, and insert the following:
``(c) Authorization of Appropriations.--(1) There is
authorized to be appropriated to the Fund for fiscal year
2023 and each subsequent fiscal year such sums as are
necessary, pursuant to the limitation in paragraph (2), to
increase funding, over the fiscal year 2021 level, for
investment in--
``(A) the delivery of veterans' health care associated with
exposure to environmental hazards in the active military,
naval, air, or space service in programs administered by the
Under Secretary for Health;
``(B) any expenses incident to the delivery of veterans'
health care and benefits associated with exposure to
environmental hazards in the active military, naval, air, or
space service, including administrative expenses, such as
information technology and claims processing and appeals, and
excluding leases as authorized or approved under section 8104
of this title; and
``(C) medical and other research relating to exposure to
environmental hazards.
``(2) Limitation.--For the period of fiscal years 2023
through 2031, amounts authorized to be appropriated to the
Fund may not exceed a cumulative total of $116,800,000,000.
[[Page H6025]]
``(d) Budget Scorekeeping.--(1) Immediately upon enactment
of the Sergeant First Class Heath Robinson Honoring our
Promise to Address Comprehensive Toxics Act of 2022, expenses
authorized to be appropriated to the Fund in subsection (c)
shall be estimated for fiscal year 2023 through fiscal year
2031 and treated as budget authority that is considered to be
direct spending--
``(A) in the baseline for purposes of section 257 of the
Balanced Budget and Emergency Deficit Control Act of 1985 (2
U.S.C. 907);
``(B) by the Chairman of the Committee on the Budget of the
Senate and the Chair of the Committee on the Budget of the
House of Representatives, as appropriate, for purposes of
budget enforcement in the Senate and the House of
Representatives;
``(C) under the Congressional Budget Act of 1974 (2 U.S.C.
621 et seq.), including in the reports required by section
308(b) of such Act (2 U.S.C. 639); and
``(D) for purposes of the Statutory Pay-As-You-Go Act of
2010 (2 U.S.C. 931 et seq.).
``(2)(A) Except as provided in subparagraph (B), amounts
appropriated to the Fund for fiscal years 2023 through 2031
pursuant to this section shall be counted as direct spending
under the Congressional Budget and Impoundment Control Act of
1974 (2 U.S.C. 621 et seq.) and any other Act.
``(B) Any amounts appropriated to the Fund in excess of the
amount specified under subsection (c)(2) shall be scored as
discretionary budget authority and outlays for any estimate
of an appropriations Act.''.
The SPEAKER pro tempore. Pursuant to clause 2(b) of rule XIX, the
previous question is ordered on the motion to commit.
The question is on the motion to commit.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Mr. BOST. Mr. Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to section 8 of rule XX, further proceedings on this
question are postponed.
____________________