[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6659 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 6659
To amend title 38, United States Code, to improve health care and
services for veterans exposed to toxic substances, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 9, 2022
Mr. Bost (for himself, Mrs. Radewagen, Mr. Bergman, Mr. Banks, Mr.
Mann, Mr. Moore of Alabama, Ms. Mace, Mr. Cawthorn, Mr. Nehls, Mr.
Rosendale, Mrs. Miller-Meeks, Mr. Ellzey, Ms. Houlahan, Mr. McKinley,
Mr. Newhouse, Mr. Posey, Mr. Rutherford, Ms. Van Duyne, Mr. Rodney
Davis of Illinois, Mr. Wenstrup, Mr. Jacobs of New York, Mr. Meijer,
Mrs. Rodgers of Washington, Mr. C. Scott Franklin of Florida, and Mrs.
Cammack) introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to improve health care and
services for veterans exposed to toxic substances, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Care for Burn Pit Veterans
Act''.
SEC. 2. EXPANSION OF ELIGIBILITY FOR HEALTH CARE FROM DEPARTMENT OF
VETERANS AFFAIRS FOR CERTAIN VETERANS EXPOSED TO TOXIC
SUBSTANCES.
(a) In General.--Section 1710(e)(3) of title 38, United States
Code, 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
``ten-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) of such title
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) Report.--Not later than October 1, 2024, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans' Affairs of
the House of Representatives and the Senate a report on--
(1) the number of veterans who enrolled in the system of
annual patient enrollment of the Department of Veterans Affairs
established and operated under section 1705(a) of title 38,
United States Code, to receive care pursuant to eligibility
under subparagraph (B) of section 1710(e)(3) of such title, as
amended by subsection (a)(2); and
(2) of the veterans described in paragraph (1), the number
of such veterans who reported a health concern related to
exposure to a toxic substance or radiation.
(d) Outreach Plan.--Not later than December 1, 2022, the Secretary
shall submit to the Committees on Veterans' Affairs of the House of
Representatives and the Senate 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 under such subparagraph.
(e) Effective Date.--This section and the amendments made by this
section shall take effect on October 1, 2022.
SEC. 3. 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 exposures to toxic
substances during active military, naval, air, or space service as part
of a health care screening furnished by the Secretary to veterans
enrolled in the system of annual patient enrollment of the Department
of Veterans Affairs established and operated under section 1705 of
title 38, United States Code, to improve understanding by the
Department of exposures of veterans to toxic substances 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 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.
(f) Active Military, Naval, Air, or Space Service Defined.--In this
section, the term ``active military, naval, air, or space service'' has
the meaning given that term in section 101(24) of title 38, United
States Code.
SEC. 4. TRAINING FOR PERSONNEL OF THE DEPARTMENT OF VETERANS AFFAIRS
WITH RESPECT TO VETERANS EXPOSED TO TOXIC SUBSTANCES.
(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 exposure to toxic substances and
inform such personnel of how to ask for additional information from
veterans regarding different 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 exposure to
toxic substances.
(2) Annual training.--Training provided to processors under
paragraph (1) shall be provided not less frequently than
annually.
SEC. 5. 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 the exposure of the veteran to a toxic substance.
(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 Committees on Veterans' Affairs of the House of
Representatives and the Senate a report containing--
(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; and
(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
exposure to a toxic substance.
SEC. 6. 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. 7. 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. 8. 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 gender of the veteran.
(5) The type or types of cancer that the veteran has.
SEC. 9. PUBLICATION OF LIST OF RESOURCES OF DEPARTMENT OF VETERANS
AFFAIRS FOR VETERANS EXPOSED TO TOXIC SUBSTANCES 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) veterans who were exposed to toxic substances;
(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 exposure to toxic substances, including outreach
with respect to benefits and support programs.
SEC. 10. REPORT 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, the Secretary of Veterans Affairs shall submit to the
appropriate congressional committees a report on the data quality of
the Individual Longitudinal Exposure Record and the usefulness of the
Individual Longitudinal Exposure Record in supporting veterans in
receiving health care and benefits from the Department of Veterans
Affairs.
(b) Elements.--The report required by subsection (a) shall include
the following:
(1) An identification of exposures to toxic substances that
may not be fully captured by the current systems for
environmental and occupational health monitoring and
recommendations for how to improve those systems.
(2) An analysis of the quality of the location data in
determining exposures of veterans to toxic substances and
recommendations for how to improve the quality of that location
data.
(3) Recommendations on how to improve the usefulness of the
Individual Longitudinal Exposure Record.
(c) Definitions.--In this section:
(1) The term ``appropriate congressional committees''
means--
(A) the Committee on Armed Services and the
Committee on Veterans' Affairs of the House of
Representatives; and
(B) the Committee on Armed Services and the
Committee on Veterans' Affairs of the Senate.
(2) The term ``Individual Longitudinal Exposure Record''
includes any pilot program or other program used by the
Department of Veterans Affairs or the Department of Defense to
track how members of the Armed Forces or veterans have been
exposed to various occupational or environmental hazards.
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