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114th Congress   }                                   {   Rept. 114-592
                        HOUSE OF REPRESENTATIVES
 2d Session      }                                   {          Part 1

======================================================================



 
                  TOXIC EXPOSURE RESEARCH ACT OF 2016

                                _______
                                

  May 24, 2016.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Miller of Florida, from the Committee on Veterans' Affairs, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 1769]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Veterans' Affairs, to whom was referred 
the bill (H.R. 1769) to establish in the Department of Veterans 
Affairs a national center for research on the diagnosis and 
treatment of health conditions of the descendants of veterans 
exposed to toxic substances during service in the Armed Forces 
that are related to that exposure, to establish an advisory 
board on such health conditions, and for other purposes, having 
considered the same, report favorably thereon with an amendment 
and recommend that the bill as amended do pass.








                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     6
Background and Need for Legislation..............................     7
Hearings.........................................................    10
Subcommittee Consideration.......................................    11
Committee Consideration..........................................    11
Committee Votes..................................................    11
Committee Oversight Findings.....................................    11
Statement of General Performance Goals and Objectives............    11
New Budget Authority, Entitlement Authority, and Tax Expenditures    11
Earmarks and Tax and Tariff Benefits.............................    12
Committee Cost Estimate..........................................    12
Congressional Budget Office Estimate.............................    12
Federal Mandates Statement.......................................    15
Advisory Committee Statement.....................................    15
Constitutional Authority Statement...............................    15
Applicability to Legislative Branch..............................    15
Exchange of Committee Correspondence.............................    15
Statement on Duplication of Federal Programs.....................    16
Disclosure of Directed Rulemaking................................    16
Section-by-Section Analysis of the Legislation...................    16
Changes in Existing Law Made by the Bill as Reported.............    21





                               AMENDMENT

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Toxic Exposure Research Act of 2016''.

SEC. 2. DEFINITIONS.

  In this Act:
          (1) Armed force.--The term ``Armed Force'' means the United 
        States Army, Navy, Marine Corps, Air Force, or Coast Guard, 
        including the reserve components thereof.
          (2) Descendant.--The term ``descendant'' means, with respect 
        to an individual, the biological child or grandchild of that 
        individual.
          (3) Exposed.--The term ``exposed'' means, with respect to a 
        toxic substance, that an individual came into contact with that 
        toxic substance in a manner that could be hazardous to the 
        health of that individual, that may include if that toxic 
        substance was inhaled, ingested, or touched the skin or eyes.
          (4) Exposure.--The term ``exposure'' means, with respect to a 
        toxic substance, an event during which an individual was 
        exposed to that toxic substance.
          (5) Toxic substance.--The term ``toxic substance'' means any 
        substance determined by the Administrator of the Environmental 
        Protection Agency to be harmful to the environment or hazardous 
        to the health of an individual if inhaled or ingested by or 
        absorbed through the skin of that individual.
          (6) Veteran.--The term ``veteran'' has the meaning given that 
        term in section 101 of title 38, United States Code.

SEC. 3. NATIONAL CENTER FOR RESEARCH ON THE DIAGNOSIS AND TREATMENT OF 
                    HEALTH CONDITIONS OF THE DESCENDANTS OF INDIVIDUALS 
                    EXPOSED TO TOXIC SUBSTANCES DURING SERVICE IN THE 
                    ARMED FORCES THAT ARE RELATED TO SUCH SERVICE.

  (a) National Center.--
          (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall, in consultation with the Advisory Board established 
        under section 4, select a medical center of the Department of 
        Veterans Affairs to serve as the national center for research 
        on the diagnosis and treatment of health conditions of 
        descendants of individuals exposed to toxic substances while 
        serving as members of the Armed Forces that are related to such 
        exposure (in this Act referred to as the ``National Center'').
          (2) Criteria for selection.--
                  (A) In general.--The National Center shall be 
                selected under paragraph (1) from among medical centers 
                of the Department with expertise described in 
                subparagraph (B), or that are affiliated with research 
                medical centers or teaching hospitals with such 
                expertise, that seek to be selected under this section.
                  (B) Expertise described.--The expertise described in 
                this subparagraph is--
                          (i) expertise in diagnosing and treating 
                        functional and structural birth defects; or
                          (ii) expertise in caring for individuals 
                        exposed to toxic substances and diagnosing and 
                        treating any health conditions resulting from 
                        such exposure.
                  (C) Preference.--Preference for selection under 
                paragraph (1) shall be given to medical centers of the 
                Department with expertise described in clauses (i) and 
                (ii) of subparagraph (B), or that are affiliated with 
                research medical centers or teaching hospitals with 
                such expertise.
  (b) Research.--
          (1) In general.--The National Center shall conduct research 
        on the diagnosis and treatment of health conditions of 
        descendants of individuals exposed to toxic substances while 
        serving as members of the Armed Forces that are related to that 
        exposure.
          (2) Studies.--In conducting research under paragraph (1), the 
        National Center shall study individuals, at the election of the 
        individual, for whom the Secretary has made one of the 
        following determinations:
                  (A)(i) The individual is a descendant of an 
                individual who served as a member of the Armed Forces;
                  (ii) such member was exposed to a toxic substance 
                while serving as a member of the Armed Forces; and
                  (iii) such descendant is afflicted with a health 
                condition that is related to the exposure of such 
                member to such toxic substance.
                  (B)(i) The individual was exposed to a toxic 
                substance while serving as a member of the Armed 
                Forces; and
                  (ii) such individual is afflicted with a health 
                condition that is related to the exposure of such 
                individual to such toxic substance.
          (3) Use of records.--
                  (A) In general.--The Secretary of Defense or the head 
                of a Federal agency shall make available to the 
                Secretary of Veterans Affairs for review records held 
                by the Department of Defense, an Armed Force, or that 
                Federal agency, as appropriate, that might assist the 
                Secretary of Veterans Affairs in making the 
                determinations required by paragraph (2).
                  (B) Mechanism.--The Secretary of Veterans Affairs and 
                the Secretary of Defense or the head of the appropriate 
                Federal agency shall jointly establish a mechanism for 
                the availability and review of records by the Secretary 
                of Veterans Affairs under subparagraph (A).
  (c) Social Workers.--The National Center shall employ not less than 
one licensed clinical social worker to coordinate access of individuals 
to appropriate Federal, State, and local social and healthcare programs 
and to handle case management.
  (d) Reimbursement for Necessary Travel and Room and Board.--The 
National Center shall reimburse any individual participating in a study 
pursuant to subsection (b), and any parent, guardian, spouse, or 
sibling who accompanies such individual, for the reasonable cost of--
          (1) travel to the National Center for participation in such 
        study; and
          (2) room and board during the period in which such individual 
        is participating in such study at the National Center.
  (e) Reports.--
          (1) Annual report.--
                  (A) In general.--Not less frequently than annually, 
                the National Center shall submit to Congress and the 
                Advisory Board established under section 4 a report on 
                the functions of the National Center during the year 
                preceding the submittal of the report that includes a 
                summary of the research efforts of the National Center 
                that have been completed during such year and that are 
                ongoing as of the date of the submittal of the report.
                  (B) Upon request.--Upon the request of any 
                organization exempt from taxation under section 
                501(c)(19) of the Internal Revenue Code of 1986, the 
                National Center shall submit a copy of a report 
                submitted under subparagraph (A) to such organization.
          (2) Quarterly report to advisory board.--Not less frequently 
        than quarterly, the National Center shall submit to the 
        Advisory Board a report on the functions of the National Center 
        during the quarter preceding the submittal of the report that 
        includes the following:
                  (A) A summary of the research efforts of the National 
                Center during such quarter.
                  (B) A description of any determinations made by the 
                National Center pursuant to such research efforts 
                regarding whether health conditions of descendants of 
                individuals exposed to toxic substances while serving 
                as members of the Armed Forces are related to that 
                exposure.

SEC. 4. ADVISORY BOARD.

  (a) Establishment.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall 
establish an advisory board (in this section referred to as the 
``Advisory Board'') to oversee and assess the National Center 
established under section 3 and to advise the Secretary of Veterans 
Affairs with respect to the work of the National Center.
  (b) Membership.--
          (1) Composition.--Not later than 120 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs, 
        in consultation with the Secretary of Health and Human 
        Services, the Director of the National Institute of 
        Environmental Health Sciences, and other heads of Federal 
        agencies as the Secretary of Veterans Affairs determines 
        appropriate--
                  (A) shall select not less than 13 voting members of 
                the Advisory Board, of whom--
                          (i) not less than three shall be members of 
                        organizations exempt from taxation under 
                        section 501(c)(19) of the Internal Revenue Code 
                        of 1986;
                          (ii) not less than one shall be--
                                  (I) a descendant of an individual who 
                                was exposed to toxic substances while 
                                serving as a member of the Armed Forces 
                                and the descendant has manifested a 
                                structural or functional birth defect 
                                or a health condition that is related 
                                to the exposure of such individual to 
                                such toxic substance; or
                                  (II) a parent or child of that 
                                descendant;
                          (iii) not less than six shall be health 
                        professionals, scientists, or academics who are 
                        not employees of the Federal Government and 
                        have expertise in--
                                  (I) birth defects;
                                  (II) developmental disabilities;
                                  (III) epigenetics;
                                  (IV) public health;
                                  (V) the science of environmental 
                                exposure or environmental exposure 
                                assessment;
                                  (VI) the science of toxic substances; 
                                or
                                  (VII) medical and research ethics; 
                                and
                          (iv) additional members may be selected from 
                        among social workers and advocates for veterans 
                        or members of the Armed Forces who are not 
                        employees of the Federal Government; and
                  (B) may select nonvoting members from among 
                individuals described in clause (iii) or (iv) of 
                subparagraph (A) who are employees of the Federal 
                Government.
          (2) Chairperson.--The Secretary shall select a Chairperson 
        from among the members of the Advisory Board.
          (3) Terms.--
                  (A) In general.--Each member of the Advisory Board 
                shall serve a term of two or three years as determined 
                by the Secretary.
                  (B) Reappointment.--At the end of the term of a 
                member of the Advisory Board, the Secretary may 
                reselect the member for another term, except that no 
                member may serve more than four consecutive terms.
  (c) Duties.--The Advisory Board shall--
          (1) oversee and assess the work of the National Center;
          (2) not less frequently than quarterly, meet with the 
        director or another representative of the National Center on 
        the work conducted at the National Center, including the 
        research efforts of the National Center;
          (3) review the annual report submitted by the National Center 
        to Congress and the Advisory Board under section 3(e)(1); and
          (4) advise the Secretary of Veterans Affairs on--
                  (A) issues related to the research conducted at the 
                National Center;
                  (B) health conditions of descendants of individuals 
                exposed to toxic substances while serving as members of 
                the Armed Forces that are related to the exposure of 
                such individual to such toxic substance;
                  (C) health care services that are needed by the 
                descendants of individuals exposed to toxic substances 
                while serving as members of the Armed Forces for health 
                conditions that are related to the exposure of such 
                individual to such toxic substance; and
                  (D) any determinations or recommendations that the 
                Advisory Board may have with respect to the feasibility 
                and advisability of the Department providing health 
                care services described in subparagraph (C) to 
                descendants described in such subparagraph, including a 
                description of changes to existing policy.
  (d) Report.--
          (1) In general.--Not later than one year after the 
        establishment of the Advisory Board under subsection (a), and 
        not less frequently than once each year thereafter, the 
        Advisory Board shall submit to the Committee on Veterans' 
        Affairs of the Senate, the Committee on Veterans' Affairs of 
        the House of Representatives, and the Secretary of Veterans 
        Affairs a report on the recommendations of the Advisory Board.
          (2) Elements.--Each report submitted under paragraph (1) 
        shall include recommendations for administrative or legislative 
        action, including recommendations for further research by the 
        National Center, with respect to each health condition of a 
        descendant of an individual exposed to a toxic substance while 
        serving as a member of the Armed Forces for which the National 
        Center has made one of the following determinations in 
        conducting research under section 3(b):
                  (A) The health condition is related to the exposure 
                of such individual to such toxic substance.
                  (B) It is unclear whether the health condition is 
                related to the exposure of such individual to such 
                toxic substance.
                  (C) The health condition is not related to the 
                exposure of such individual to such toxic substance.
  (e) Meetings.--The Advisory Board shall meet at the call of the 
Chair, but not less frequently than quarterly.
  (f) Compensation.--The members of the Advisory Board shall serve 
without compensation.
  (g) Expenses.--The Secretary of Veterans Affairs shall determine the 
appropriate expenses of the Advisory Board.
  (h) Personnel.--
          (1) In general.--The Chairperson may, without regard to the 
        civil service laws and regulations, appoint an executive 
        director of the Advisory Board, who shall be a civilian 
        employee of the Department of Veterans Affairs, and such other 
        personnel as may be necessary to enable the Advisory Board to 
        perform its duties.
          (2) Approval.--The appointment of an executive director under 
        paragraph (1) shall be subject to approval by the Advisory 
        Board.
          (3) Compensation.--The Chairperson may fix the compensation 
        of the executive director and other personnel without regard to 
        the provisions of chapter 51 and subchapter III of chapter 53 
        of title 5, United States Code, except that the rate of pay for 
        the executive director and other personnel may not exceed the 
        rate payable for level V of the Executive Schedule under 
        section 5316 of such title.

SEC. 5. DECLASSIFICATION REVIEW BY DEPARTMENT OF DEFENSE OF CERTAIN 
                    INCIDENTS OF EXPOSURE OF MEMBERS OF THE ARMED 
                    FORCES TO TOXIC SUBSTANCES.

  (a) Review.--The Secretary of Defense shall conduct a 
declassification review to determine what information may be made 
publicly available relating to any known incident in which not less 
than 100 members of the Armed Forces were exposed to a toxic substance 
that resulted in at least one case of a disability that a specialist in 
the field of occupational medicine has determined to be credibly 
associated with that toxic substance.
  (b) Release of Declassified Information.--To the extent practicable, 
and subject to subsection (c) and consistent with national security, 
the Secretary of Defense shall make publicly available information 
declassified following the review required by subsection (a).
  (c) Limitation.--Information made publicly available pursuant to 
subsection (b) shall be limited to information necessary for an 
individual who was potentially exposed to a toxic substance to 
determine the following:
          (1) Whether that individual was exposed to that toxic 
        substance.
          (2) The potential severity of the exposure of that individual 
        to that toxic substance.
          (3) Any potential health conditions that may have resulted 
        from exposure to that toxic substance.

SEC. 6. NATIONAL OUTREACH CAMPAIGN ON POTENTIAL LONG-TERM HEALTH 
                    EFFECTS OF EXPOSURE TO TOXIC SUBSTANCES BY MEMBERS 
                    OF THE ARMED FORCES AND THEIR DESCENDANTS.

  (a) In General.--The Secretary of Veterans Affairs shall, in 
consultation with the Secretary of Health and Human Services and the 
Secretary of Defense, conduct a national outreach and education 
campaign directed toward members of the Armed Forces, veterans, and 
their family members to communicate the following information:
          (1) Information on--
                  (A) incidents of exposure of members of the Armed 
                Forces to toxic substances;
                  (B) health conditions resulting from such exposure; 
                and
                  (C) the potential long-term effects of such exposure 
                on the individuals exposed to those substances and the 
                descendants of those individuals.
          (2) Information on the National Center established under 
        section 3 for individuals eligible to participate in studies 
        conducted at the National Center.
  (b) Department of Veterans Affairs.--In carrying out this section, 
the Secretary of Veterans Affairs shall design and implement the 
national outreach and education campaign conducted under subsection 
(a), including--
          (1) by distributing printed materials containing the 
        information described in subsection (a) to veterans;
          (2) by publishing such information on an Internet website of 
        the Department of Veterans Affairs that is available to the 
        public;
          (3) by presenting such information in person at facilities 
        that serve a large number of veterans or members of the Armed 
        Forces; and
          (4) by educating employees of all medical facilities of the 
        Department with respect to such information and providing such 
        employees with printed materials containing such information.
  (c) Department of Defense.--The Secretary of Defense shall assist the 
Secretary of Veterans Affairs in implementing the national outreach and 
education campaign conducted under subsection (a)--
          (1) by making the information described in subsection (a) 
        available to all members of the Armed Forces and their 
        families;
          (2) by notifying all members of the Armed Forces of such 
        information; and
          (3) by publishing such information on an Internet website of 
        the Department of Defense that is available to the public.
  (d) Department of Health and Human Services.--The Secretary of Health 
and Human Services shall assist the Secretary of Veterans Affairs in 
implementing the national outreach and education campaign conducted 
under subsection (a)--
          (1) by making the information described in subsection (a) 
        available to members of the health care profession;
          (2) by notifying such members of such information; and
          (3) by publishing such information on an Internet website of 
        the Department of Health and Human Services that is available 
        to the public.

SEC. 7. PROHIBITION ON NEW APPROPRIATIONS.

  No additional funds are authorized to be appropriated to carry out 
this Act and this Act shall be carried out using amounts otherwise made 
available for the purposes of this Act.

                          PURPOSE AND SUMMARY

    H.R. 1769, the ``Toxic Exposure Research Act of 2016,'' was 
introduced by Representative Dan Benishek of Michigan, the 
Chairman of the Committee on Veterans' Affairs Subcommittee on 
Health, on April 14, 2015. H.R. 1769, as amended, was ordered 
to be favorably reported to the full House on February 25, 
2016, by voice vote.
    H.R. 1769, as amended, would require the Department of 
Veterans Affairs (VA) to select a VA medical center (VAMC) to 
serve as the national center for research on the diagnosis and 
treatment of health conditions of descendants of individuals 
exposed to toxic substances while serving in the Armed Forces 
and establish an Advisory Board to oversee and assess the 
National Center. The bill would also authorize the Department 
of Defense (DOD) to conduct a declassification review to 
determine what, if any, information can be made publicly 
available regarding a known incident of toxic exposure that 
resulted in at least one case of a disability that an 
occupational medicine specialist has determined to be credibly 
associated with such exposure.
    H.R. 1769, as amended, would further require VA--in 
consultation with DOD and the Department of Health and Human 
Services (HHS)--to conduct a national outreach and education 
campaign toward members of the Armed Services, veterans, and 
their families on potential long-term health effects of 
exposure to toxic substances.

                  BACKGROUND AND NEED FOR LEGISLATION

Section 3. National Center for Research on the diagnosis and treatment 
        of health conditions of the descendants of individuals exposed 
        to toxic substances during service in the Armed Forces that are 
        related to such service

    It is well known that servicemembers may be exposed to a 
variety of chemical, environmental, and other toxic hazards 
during their service in the Armed Forces. In some instances, 
these exposures may result in long-term adverse health effects. 
As a result, VA conducts or sponsors a number of epidemiology 
research studies on illnesses or conditions related to toxic 
exposures in military service and provides a number of 
benefits--including health care and compensation--to certain 
veterans who have experienced toxic exposure.
    Less well known are the potential multi-generational health 
effects of toxic exposure for veterans' descendants. VA does 
provide the biological children of certain veterans who served 
in Vietnam or Korea and have spina bifida or other birth 
defects with benefits--including health care and compensation--
based on the degree of their disability. These benefits are 
based on reports dating back to 1996 by the Institute of 
Medicine (IOM) that found limited, suggestive evidence of an 
association between exposure to Agent Orange in military 
service and birth defects in the children of certain 
veterans.\1\ More recently, in 2013, the IOM found that there 
was a plausible basis that adult children and grandchildren of 
male veterans who were exposed to Agent Orange in Vietnam could 
experience adverse health effects as a result of such 
exposure.\2\ In light of these findings, individual 
servicemembers, veterans, and military families as well as 
veterans service organizations and other advocates, have 
expressed increasing concern about the lack of an entity--
within VA or otherwise--dedicated to researching the long-term 
health impact of toxic exposure on veterans' children and 
grandchildren, both in Vietnam and Korea and in other 
conflicts.
---------------------------------------------------------------------------
    \1\http://www.nationalacademies.org/hmd/Reports/1997/Veterans-and-
Agent-Orange-Update-1996-Summary-and-Research-Highlights.aspx.
    \2\http://www.nationalacademies.org/hmd/Reports/2013/Veterans-and-
Agent-Orange-Update-2012.aspx.
---------------------------------------------------------------------------
    In recognition of this, section 3 of the bill would require 
VA, not later than one year after the date of enactment, to 
select a VAMC to serve as the national center for research on 
the diagnosis and treatment of health conditions of descendants 
of individuals exposed to toxic substances while serving as 
members of the Armed Forces that are related to such exposure. 
To be eligible to be selected as the national center, a VAMC 
would be required to: (1) have expertise in diagnosing and 
treating functional and structural birth defects; (2) have 
expertise in caring for individuals exposed to toxic substances 
and diagnosing and treating health conditions resulting from 
such exposure; or (3) be affiliated with a research medical 
center or teaching hospital with such expertise. When making 
such a selection, VA would be required to give preference to 
VAMCs that have both the internal expertise listed in (1) and 
(2) and the affiliate relationship described in (3). The 
national center would be required to employ at least one 
licensed clinical social worker to coordinate access to 
appropriate Federal, State, and local social and health care 
programs and to handle case management.
    In terms of research, the national center would be 
responsible for conducting research on the diagnosis and 
treatment of health conditions of descendants of individuals 
exposed to toxic substances while service as members of the 
Armed Forces that are related to such exposure. In conducting 
such research, the national center would be required to study 
individuals who (1) were exposed to a toxic substance while 
serving in the Armed Forces and are afflicted with a health 
condition related to such exposure or (2) are descendants of an 
individual exposed to a toxic substance during service in the 
Armed Forces and are afflicted with a health condition related 
to such exposure.
    To assist with such research, Section 3 of the bill would 
further require that DOD or another Federal agency make 
applicable records available to VA for review and jointly 
establish a mechanism for the availability and review of such 
records. Section 3 of the bill would further require the 
national center to submit regular reports to Congress and to 
the Advisory Board created in section 4 of the bill as well as, 
upon request, to any organization exempt from taxation under 
section 501(c)(19) of the Internal Revenue Code of 1986. The 
Committee recognizes that there are a number of governmental 
and non-governmental scientific organizations--including the 
National Institute of Environmental Health Sciences, the 
Centers for Disease Control and Prevention, the Agency for 
Toxic Substances and Disease Registry, the VA War Related 
Illness and Injury Study Center, the VA Office of Research and 
Development, and the VA Office of Public Health--that are 
conducting worthwhile research on the myriad of possible health 
effects associated with environmental exposures and intends for 
the national center that would be created by section 3 of the 
bill to build on, rather than duplicate, the efforts of such 
entities.

Section 4. Advisory Board

    VA's advisory committee management guide defines an 
``advisory committee'' as, ``any committee, board, commission, 
council, conference, panel, task force, or other similar group, 
which is established or utilized by the President or by an 
agency official, for the purpose of obtaining advice or 
recommendations for the President or on issues or policies 
within the scope of an agency official's responsibilities.''\3\ 
According to information VA provided the Committee in November 
2015, the Veterans Health Administration--which operates the VA 
health care system--currently oversees twenty-one advisory 
committees and thirty three advisory boards. While some of 
those entities do advise VA on issues relating to toxic 
exposure among veterans, there is no current advisory entity on 
issues relating to the long-term effects toxic exposure 
incidents may have on veterans' descendants.
---------------------------------------------------------------------------
    \3\Department of Veterans Affairs Advisory Committee Management 
Guide, October 2015, http://www.va.gov/ADVISORY/docs/
October%202015%20ACMO%20Guide.pdf.
---------------------------------------------------------------------------
    Section 4 of the bill would require VA to establish an 
advisory board to oversee and assess the efforts of the 
national center that would be created under section 3 of the 
bill. Membership on the advisory board would consist of at 
least 13 voting members and would be selected by VA in 
consultation with HHS, the Director of the National Institute 
of Environmental Health Sciences, and other appropriate federal 
agencies. The board membership must include: at least three 
members from tax exempt organizations; at least one member who 
is the descendant of an individual who was exposed to a toxic 
substance while serving in the Armed Forces and who has 
manifested a structural or functional birth defect or a health 
condition that is related to such exposure, or the parent or 
child of such descendant; and not less than six who are health 
professionals, scientists, or academics who are not Federal 
government employees and who have expertise in birth defects, 
development disabilities, epigenetics, public health, 
environmental exposure or environmental exposure assessment, or 
medical and research ethics. Federal government employees with 
similar expertise may be selected as non-voting members of the 
advisory board.
    VA would be required to select a Chairperson and authorized 
to select additional members to include social workers, 
veterans' advocates, or members of the Armed Forces. Advisory 
board members would be required to meet regularly, to serve 
without compensation, to serve a term of two or three years, as 
determined by VA, with VA allowed to reselect a member for 
additional terms so long as no member serves more than four 
consecutive terms.
    The advisory board would be responsible for overseeing and 
assessing the national center, regularly meeting with 
representatives of the national center, reviewing the national 
center's annual report, and advising VA on issues related to 
the national center and toxic exposure among veterans' 
descendants. The advisory committee would also be required to 
report regularly to the Congress. To assist the advisory board 
in completing their duties, the chairperson would be allowed to 
appoint an executive director, subject to the approval of the 
advisory board, and other personnel, without regard to civil 
service laws and regulations, as well as to fix their 
compensation.

Section 5. Declassification review by Department of Defense of certain 
        incidents of exposure of Members of the Armed Forces to toxic 
        substances

    While VA is responsible for providing veterans--and, in 
limited circumstances, veterans' children--who have experienced 
toxic exposure during military service and are experiencing 
negative health effects as a result with health care and 
compensation, instances of toxic exposure occur during active 
duty under the jurisdiction of DOD. As such, documentation 
regarding particular instances of toxic exposure belongs to 
DOD. The Committee recognizes and respects the need for certain 
information regarding potential instances of toxic exposure to 
be protected from public disclosure for national security 
purposes. However, it is essential that DOD publicly release 
whatever information can be appropriately disclosed so that 
servicemembers, veterans, their families, and researchers can 
determine whether a servicemember or veteran may have been 
exposed to a toxic substance, the potential severity of such 
exposure, and potential health impacts that may result from 
such exposure on the servicemember, veteran, or descendant.
    Section 5 of the bill would require DOD to conduct a 
declassification review to determine what information may be 
made publicly available relating to any known incident in which 
not less than 100 members of the Armed Forces were exposed to a 
toxic substance that resulted in at least one case of a 
disability that a specialist in the field of occupational 
medicine has determined to be credibly associated with that 
toxic substance. Following such review, DOD would be required 
to make information regarding the declassification review 
publicly available to the extent practicable and consistent 
with national security. However, such information would be 
limited to information necessary for an individual who was 
potentially exposed to a toxic substance to determine whether 
that individual was exposed to that toxic substance, the 
potential severity of that exposure, or any potential health 
conditions that may have resulted from exposure to that toxic 
substance.

Section 6. National Outreach Campaign on potential long-term health 
        effects of exposure to toxic substances by Members of the Armed 
        Forces and their descendants

    As described above, VA does provide veterans--and in some 
cases their family members--with a number of benefits in 
response to disabilities or birth defects that occurred as a 
result of toxic exposure incidents in the Armed Forces. 
However, the Committee is concerned that VA does not conduct 
sufficient outreach so that those who may have been impacted by 
toxic exposure are aware of recent developments in research or 
the availability of benefits.
    As such, section 6 of the bill would require VA to consult 
with DOD and HHS to conduct a national outreach and education 
campaign directed toward members of the Armed Forces, veterans, 
and their family members to communicate information regarding 
incidents of exposure of members of the Armed Forces, health 
conditions resulting from such exposure, and the potential 
long-term effects of such exposure on the individuals exposed 
to those substances and their descendants as well as the 
national center created by section 3 of the bill. Under this 
section VA would be required to design and implement the 
campaign while DOD and HHS would be required to assist VA in 
implementing it.

                                HEARINGS

    There were no full Committee hearings held on H.R. 1769, as 
amended. On April 23, 2015, the Subcommittee on Health 
conducted a legislative hearing on various bills introduced in 
the 114th Congress, including H.R. 1769. The following 
witnesses testified:

The Honorable Gus Bilirakis, U.S. House of Representatives, 
12th District, Florida; The Honorable Janice Hahn, U.S. House 
of Representatives, 44th District, California; The Honorable 
Jackie Walorski, U.S. House of Representatives, 2nd District, 
Indiana; Blake Ortner, Deputy Government Relations Director, 
Paralyzed Veterans of America; Louis J. Celli Jr., Director, 
National Veterans Affairs and Rehabilitation Division, The 
American Legion; John Rowan, National President, Vietnam 
Veterans of America; Adrian Atizado, Assistant National 
Legislative Director, Disabled American Veterans; Rajiv Jain 
M.D., the Assistant Deputy Under Secretary for Health for 
Patient Care Services, Veterans Health Administration, U.S. 
Department of Veterans Affairs, accompanied by Janet Murphy, 
Acting Deputy Under Secretary for Health for Operations and 
Management, Veterans Health Administration, U.S. Department of 
Veterans Affairs, and Jennifer Gray, Attorney, Office of the 
General Counsel, U.S. Department of Veterans Affairs.
    Statements for the Record were submitted by:

The Honorable Corrine Brown, U.S. House of Representatives, 5th 
District, Florida; the American Health Care Association; the 
American Society for Reproductive Medicine; Concerned Veterans 
for America; and, RESOLVE: National Infertility Association.

                       SUBCOMMITTEE CONSIDERATION

    There were no Subcommittee markups involving H.R. 1769, as 
amended.

                        COMMITTEE CONSIDERATION

    On February 25, 2016, the Full Committee met in open markup 
session, a quorum being present, and ordered H.R. 1769, as 
amended, to be reported favorably to the House of 
Representatives by voice vote.
    During consideration of H.R. 1769, the following amendment 
was considered and agreed to by voice vote:

An amendment in the nature of a substitute offered by 
Representative Dan Benishek of Michigan.

                            COMMITTEE VOTES

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, there were no recorded votes 
taken on amendments or in connection with ordering H.R. 1769, 
as amended, reported to the House. A motion by Ranking Member 
Corrine Brown of Florida to report H.R. 1769, as amended, 
favorably to the House of Representatives was agreed to by 
voice vote.

                      COMMITTEE OVERSIGHT FINDINGS

    In compliance with clause 3(c)(1) of rule XIII and clause 
(2)(b)(1) of rule X of the Rules of the House of 
Representatives, the Committee's oversight findings and 
recommendations are reflected in the descriptive portions of 
this report.

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the Committee's performance 
goals and objective is to advance VA's understanding of 
potential multi-generational health effects of toxic exposure 
for veteran's descendants.

   NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee adopts as its 
own the estimate of new budget authority, entitlement 
authority, or tax expenditures or revenues contained in the 
cost estimate prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

                  EARMARKS AND TAX AND TARIFF BENEFITS

    H.R. 1769, as amended, does not contain any Congressional 
earmarks, limited tax benefits, or limited tariff benefits as 
defined in clause 9 of rule XXI of the Rules of the House of 
Representatives.

                        COMMITTEE COST ESTIMATE

    The Committee adopts as its own the cost estimate on H.R. 
1769, as amended, prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

               CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
for H.R. 1769, as amended, provided by the Congressional Budget 
Office pursuant to section 402 of the Congressional Budget Act 
of 1974:

                                                      May 17, 2016.
Hon. Jeff Miller,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1769, the Toxic 
Exposure Research Act of 2016.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Ann E. 
Futrell.
            Sincerely,
                                                        Keith Hall.
    Enclosure.

H.R. 1769--Toxic Exposure Research Act of 2016

    Summary: H.R. 1769 would require the Department of Veterans 
Affairs (VA) to establish a national center to conduct research 
on health conditions affecting descendants of veterans who were 
exposed to toxic substances during their service in the armed 
forces. The bill also would create an advisory board to oversee 
and provide support to the center. CBO estimates that 
implementing those provisions would cost $74 million over the 
2017-2021 period, subject to appropriation of the necessary 
amounts. Another provision would require the Department of 
Defense (DoD) to review a potentially large number of records, 
with the goal of declassifying material related to the exposure 
of service members to toxic substances. CBO cannot provide an 
estimate of the cost of implementing that provision.
    Pay-as-you-go procedures do not apply because enacting the 
legislation would not affect direct spending or revenues. CBO 
estimates that enacting H.R. 1769 would not increase net direct 
spending or on-budget deficits in any of the four consecutive 
10-year periods beginning in 2027.
    H.R. 1769 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would not affect the budgets of state, local, or tribal 
governments.
    Estimated cost to the Federal government: The estimated 
budgetary effect of H.R. 1769 is shown in the following table. 
The costs of this legislation fall within budget function 700 
(veterans benefits and services).

----------------------------------------------------------------------------------------------------------------
                                                                 By fiscal year, in millions of dollars--
                                                         -------------------------------------------------------
                                                            2017     2018     2019     2020     2021   2017-2021
----------------------------------------------------------------------------------------------------------------
                                 INCREASES IN SPENDING SUBJECT TO APPROPRIATIONa
National Research Center:
    Estimated Authorization Level.......................        0        7       14       22       30        73
    Estimated Outlays...................................        0        6       13       21       29        69
Advisory Board:
    Estimated Authorization Level.......................        0        *        1        1        1         4
    Estimated Outlays...................................        0        *        1        1        1         4
Outreach:
    Estimated Authorization Level.......................        *        *        *        *        *         1
    Estimated Outlays...................................        *        *        *        *        *         1
    Total Increases:
        Estimated Authorization Level...................        1        8       15       23       31        78
        Estimated Outlays...............................        1        7       14       22       30        74
----------------------------------------------------------------------------------------------------------------
Note: * = less than $500,000.
aIn addition to the costs shown above, CBO estimates that implementing section 5, which would require the
  Department of Defense to review certain records, could have very large costs; however, CBO is unable to
  estimate the magnitude of those costs. Our analysis of that provision is discussed in the body of the
  estimate.

    Basis of estimate: For this estimate, CBO assumes that H.R. 
1769 will be enacted near the start of fiscal year 2017, that 
the estimated amounts will be appropriated each year, and that 
outlays will follow historical spending patterns for affected 
programs.

National Research Center

    Section 3 would require VA to establish a national center 
to conduct research on diagnosing and treating health 
conditions affecting descendants of veterans that are related 
to the exposure of those veterans to toxic substances during 
their service in the armed forces. Within one year of 
enactment, VA would be required to identify an existing VA 
medical center to serve as that center.
    The center would study volunteers who have health 
conditions that are related to exposure to toxic substances. On 
the basis of information from VA, CBO estimates that the center 
would begin at least three new studies each year, which would 
continue for multiple years, at an annual cost of $2 million 
per study. Those costs include the salaries of the research 
staff and the cost of travel and room and board for 
participants in the studies.
    The section also would require the center to employ at 
least one licensed clinical social worker to coordinate the 
health care and support services for participants in the 
research studies. In order to facilitate the growing number of 
participants, CBO estimates that VA would gradually hire seven 
social workers by 2021, at an average compensation of about 
$130,000 per year.
    After accounting for the necessary time to implement this 
section, CBO estimates that section 3 would cost $69 million 
over the 2018-2021 period.

Advisory Board

    Section 4 would establish a board to oversee the new center 
and to advise the Secretary of VA on research conducted at the 
center and on the potential for treatment of health conditions 
for individuals participating in the studies. The board would 
consist of 13 voting members composed of representatives from 
veteran service organizations, family members of veterans 
exposed to toxins, and health professionals. Voting members of 
the board would serve without compensation. The executive 
director and support staff would receive compensation; CBO 
expects that the board would hire about five people at a cost 
of about $200,000 per person. Thus, CBO estimates that staff 
and administrative costs for the advisory board would total $4 
million over the 2018-2021 period.

Review of Department of Defense records

    Section 5 would require the Department of Defense to review 
the records of service personnel who may have been exposed to 
toxins while serving in the armed forces. DoD would be required 
to declassify, where possible, information related to incidents 
in which at least 100 service members were exposed to a toxic 
substance that resulted in at least one individual being 
diagnosed by a specialist in the field of occupational medicine 
as having a disability linked to that exposure.
    DoD expects that this proposal would require the department 
to set up a process to investigate requests from VA on whether 
any veterans met that criteria and to have specialists 
available to participate in the determination. This proposal 
could have substantial costs, depending on the number of cases 
reviewed and the extent to which each case is reviewed by DoD. 
Because the goal of H.R. 1769 is to determine the effects of 
veterans' exposure to toxic substances on their children, 
grandchildren, and subsequent generations of descendants, DoD 
could be required to review records from decades ago that have 
not been digitalized and must be examined individually. In 
addition, it is unclear how DoD would determine whether service 
members who were exposed to toxic substances were later 
diagnosed by an appropriate specialist as having a disability 
that was associated with that exposure.
    Because CBO is unable to project the number of records 
reviews that would be required under this provision or the 
extent of those reviews, we are unable to estimate the cost of 
implementing section 5.

Outreach

    Section 6 would require VA and DoD to carry out an outreach 
campaign to inform the public of the potential for long-term, 
multigenerational, health effects from exposure to toxic 
substances. Based on similar outreach efforts by the VA, we 
estimate this section would cost $1 million over the 2017-2021 
period.
    Pay-As-You-Go considerations: None.
    Increase in long-term direct spending and deficits: CBO 
estimates that enacting H.R. 1769 would not increase net direct 
spending or on-budget deficits in any of the four consecutive 
10-year periods beginning in 2027.
    Intergovernmental and private-sector impact: H.R. 1769 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would not affect the budgets of state, 
local, or tribal governments.
    Estimate prepared by: Federal costs: Ann E. Futrell; Impact 
on state, local, and tribal governments: Jon Sperl; Impact on 
the private sector: Paige Piper/Bach.
    Estimate approved by: H. Samuel Papenfuss, Deputy Assistant 
Director for Budget Analysis.

                       FEDERAL MANDATES STATEMENT

    The Committee adopts as its own the estimate of Federal 
mandates regarding H.R. 1769, as amended, prepared by the 
Director of the Congressional Budget Office pursuant to section 
423 of the Unfunded Mandates Reform Act.

                      ADVISORY COMMITTEE STATEMENT

    Section 4 of H.R. 1769, as amended, would create an 
advisory committee within the meaning of section 5(b) of the 
Federal Advisory Committee Act.

                 STATEMENT OF CONSTITUTIONAL AUTHORITY

    Pursuant to Article I, section 8 of the United States 
Constitution, H.R. 1769, as amended, is authorized by Congress' 
power to ``provide for the common Defense and general Welfare 
of the United States.''

                  APPLICABILITY TO LEGISLATIVE BRANCH

    The Committee finds that H.R. 1769, as amended, does not 
relate to the terms and conditions of employment or access to 
public services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

                  EXCHANGE OF COMMITTEE CORRESPONDENCE

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                      Washington, DC, May 18, 2016.
Hon. William M. ``Mac'' Thornberry,
Chairman, Committee on Armed Services,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: Thank you for your letter regarding H.R. 
1769, as amended, the Toxic Exposure Research Act of 2016.
    I agree that the Committee on Armed Services has valid 
jurisdictional claims to certain provisions in this legislation 
and I appreciate your decision not to request a referral in the 
interest of expediting consideration of the bill.
    I agree that by foregoing a sequential referral to H.R. 
1769, as amended, the Committee on Armed Services is not 
waiving its jurisdiction.
    This exchange of letters will be included in the 
Committee's report on H.R. 1769, as amended.
    If you have any further questions or concerns, please 
contact Christine Hill, Staff Director for the Subcommittee on 
Health, at [email protected] or by calling (202) 
225-9154.
    Thank you for your commitment to the well-being of our 
nation's veterans.
    With warm personal regards I am,
            Sincerely,
                                               Jeff Miller,
                                                          Chairman.
                              ----------                              

                          House of Representatives,
                               Committee on Armed Services,
                                      Washington, DC, May 11, 2016.
Hon. Jeff Miller,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: I am writing to you concerning the bill 
H.R. 1769, as amended, the Toxic Exposure Research Act of 2016. 
There are certain provisions in the legislation which fall 
within the Rule X jurisdiction of the Committee on Armed 
Services.
    In the interest of permitting your committee to proceed 
expeditiously to floor consideration of this important bill, I 
am willing to waive this committees' right to sequential 
referral. I do so with the understanding that by waiving 
consideration of the bill the Committee on Armed Services does 
not waive any future jurisdictional claim over the subject 
matters contained in the bill which fall within its Rule X 
jurisdiction. I request that you urge the Speaker to name 
members of this committee to any conference committee which is 
named to consider such provisions.
    Please place this letter into the committee report on H.R. 
1769 and into the Congressional Record during consideration of 
the measure on the House Floor. Thank you for the cooperative 
spirit which you have worked regarding this matter and others 
between our respective committees.
            Sincerely,
                             William M. ``Mac'' Thornberry,
                                                          Chairman.

              STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS

    Pursuant to section 3(g) of H. Res. 5, 114th Cong. (2015), 
the Committee finds that no provision of H.R. 1769, as amended, 
establishes or reauthorizes a program of the Federal Government 
known to be duplicative of another Federal program, a program 
that was included in any report from the Government 
Accountability Office to Congress pursuant to section 21 of 
Public Law 111-139, or a program related to a program 
identified in the most recent Catalog of Federal Domestic 
Assistance.

                   DISCLOSURE OF DIRECTED RULEMAKING

    Pursuant to section 3(i) of H. Res. 5, 114th Cong. (2015), 
the Committee estimates that H.R. 1769, as amended, contains no 
directed rule making that would require the Secretary to 
prescribe regulations.

             SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title

    Section 1 of the bill would provide the short title to H.R. 
1769 as the ``Toxic Exposure Research Act of 2015.''

Section 2. Definitions

    Section 2 of the bill would define: (1) the term ``Armed 
Forces'' to mean the United States Army, Navy, Marine Corps, 
Air Force, or Coast Guard, including the reserve components of 
those branches; (2) the term ``descendant'' to mean an 
individual's child or grandchild; (3) the term ``exposed'' to 
mean an individual has made contact with a toxic substance in a 
manner that could be hazardous to their health, including 
through inhalation, ingestion, or contact with skin or eyes; 
(4) the term ``exposure'' to mean an event during which an 
individual was exposed to that toxic substance; (5) the term 
``toxic substance'' to mean any substance determined by the 
Environmental Protection Agency to be harmful to the 
environment or hazardous to an individual's health if inhaled, 
ingested, or absorbed through the skin; (6) the term 
``veteran'' to have the same meaning as the term found in 
section 101 of title 38, U.S.C.

Section 3. National Center for Research on the diagnosis and treatment 
        of health conditions of the descendants of individuals exposed 
        to toxic substances during service in the Armed Forces that are 
        related to such service

    Section 3(a)(1) of the bill would require that, no later 
than one year after the enactment of this Act, the Secretary of 
VA select, in consultation with the advisory board established 
under Section 4, a VA medical center to serve as the national 
center for research on the diagnosis and treatment of health 
conditions of descendants of individuals exposed to toxic 
substances while serving as a member of the Armed Forces that 
are related to such exposure (the ``National Center'').
    Section 3(a)(2) of this bill would require that the 
National Center be selected from among VA's medical centers 
with the expertise described in this Section, or that are 
affiliated with research medical centers or teaching hospitals 
with such expertise, that seek to be selected under this 
Section. This Section would require that the selected medical 
center have expertise in diagnosing and treating functional and 
structural birth defects, or expertise in caring for 
individuals exposed to toxic substances and diagnosing and 
treating any health conditions resulting from such exposure. 
This paragraph would also require that, when selecting the 
National Center, the Secretary give preference to VA medical 
centers with the expertise described, or that are affiliated 
with research medical centers or teaching hospitals with such 
expertise.
    Section 3(b)(1) would require that the National Center 
conduct research on the diagnosis and treatment of health 
conditions of descendants of individuals who have been exposed 
to toxic substances while serving in the Armed Forces that are 
related to that exposure.
    Section 3(b)(2) would require that while conducting that 
research, the National Center study individuals, with those 
individuals' permission, for whom the Secretary has made of the 
following determinations: the individual is a descendant of a 
member of the Armed Forces and such member was exposed to a 
toxic substance while serving as a member of the Armed Forces; 
such descendant is afflicted with a health condition that is 
related to the exposure of such member to such toxic substance.
    Section 3(b)(3) would require that the Secretary of Defense 
or the head of a Federal agency make available to the Secretary 
of VA records held by DOD, an Armed Force, or that Federal 
Agency, as appropriate, that might assist in making the 
determinations required by paragraph (2). This paragraph would 
also require that VA and DOD or that Federal agency jointly 
establish a mechanism to make available those records for VA's 
review.
    Section 3(c) of the bill would require that the National 
Center employ not less than one licensed clinical social worker 
to coordinate access of individuals to appropriate Federal, 
State, and local social and health care programs and to handle 
case management.
    Section 3(d) of the bill would require that the National 
Center reimburse any individual participating in a study 
pursuant to subsection (b), and any parent, guardian, spouse, 
or sibling who accompanies such individual, for the reasonable 
cost of: travel to the National Center for participation in 
such study and room and board during the period in which such 
individual is participating in such study at the National 
Center.
    Section 3(e)(1) of the bill would require that at least 
once a year, the National Center submit to Congress, and to the 
advisory board established under Section 4, a report that 
includes a summary of the research efforts of the National 
Center that have been completed during that year, and efforts 
that are ongoing as of the date of submittal of the report. 
This paragraph would also require that, upon the request of any 
organization exempt from taxation under section 501(c)(19) of 
the Internal Revenue Code of 1986, the National Center submit a 
copy of such report.
    Section 3(e)(2) of the bill would require that at least 
once a quarter, the National Center submit to the advisory 
board a report on the functions of the National Center during 
the preceding quarter, including: a summary of the National 
Center's research efforts that quarter; and a description of 
any determinations made by the National Center pursuant to such 
research efforts regarding whether health conditions of 
descendants of individuals exposed to toxic substances while 
serving as members of the Armed Forces are related to that 
exposure.

Section 4. Advisory Board

    Section 4(a) of the bill would require that, within 180 
days of the enactment of this act, VA establish an advisory 
board (the ``Advisory Board'') to oversee and assess the 
National Center established under Section 3 and to advise the 
Secretary with respect to the National Center's work.
    Section 4(b)(1) of the bill would require that, within 120 
days of the enactment of this Act, the Secretary of VA, in 
consultation with the Secretary of HHS, the Director of the 
National Institute of Environmental Health Sciences, and other 
heads of Federal agencies as the Secretary of VA determines 
appropriate: (A) select no less than 13 voting members of the 
Advisory Board, of whom no less than three must be members of 
organizations exempt from taxation under section 501(c)(19) of 
the Internal Revenue Code of 1986; no less than one must be a 
descendant of an individual who was exposed to toxic substances 
while serving as a member of the Armed Forces and the 
descendant has manifested a structural or functional birth 
defect or a health condition that is related to the exposure of 
such individual to such toxic substance, or a parent or child 
of that descendant; no less than six must be professionals, 
scientists, or academics who are not employees of the Federal 
Government and have expertise in birth defects, developmental 
disabilities, epigenetics, public health, the science of 
environmental exposure or environmental exposure assessment, 
the science of toxic substances, or medical and research 
ethics; and additional members may be selected from among 
social workers and advocates for veterans or members of the 
Armed Forces who are not employees of the Federal Government; 
(B) and may select nonvoting members from among individuals 
described in subparagraph (A) who are employees of the Federal 
Government.
    Section 4(b)(2) of the bill would require the Secretary to 
select a Chairperson from among the members of the Advisory 
Board.
    Section 4(b)(3) of the bill would require that each member 
of the Advisory Board serve a term of two or three years, as 
determined by the Secretary. This paragraph would also require 
that, at the end of each member's term, the Secretary be 
allowed to reselect the member for another term, except that no 
member may serve more than four consecutive terms.
    Section 4(c) of the bill would require the Advisory Board 
to: (1) oversee and assess the work of the National Center; (2) 
at least quarterly, meet with the director or another 
representative of the National Center on the Center's work, 
including its research efforts; (3) review the annual report 
submitted by the National Center to Congress and the Advisory 
Board under Section 3(e)(1); and (4) advise the Secretary on: 
issues related to conduct at the National Center; health 
conditions of descendants of individuals exposed to toxic 
substances while serving as members of the Armed Forces that 
are related to the exposure of such individual to toxic 
substances; health care services that are needed by the 
descendants of individuals exposed to toxic substances while 
serving as members of the Armed Forces for health conditions 
that are related to exposure of such individual to such toxic 
substance; and any determinations or recommendations that the 
Advisory Board may have with respect to the feasibility and 
advisability of the Department providing health care services 
described in this Section to descendants described in such 
paragraph, including a description of changes to existing 
policy.
    Section 4(d)(1) of the bill would require that, no later 
than one year after the establishment of the Advisory Board 
under subsection (a), and no less frequently than once a year 
thereafter, the Advisory Board submit to the Committees on 
Veterans' Affairs of the Senate and House and to the Secretary 
a report on the Advisory Board's recommendations.
    Section 4(d)(2) of the bill would require that each report 
submitted under paragraph (1) include recommendations for 
administrative or legislative action, including recommendations 
for further research by the National Center, with respect to 
each health condition of a descendant of an individual exposed 
to a toxic substance while serving as a member of the Armed 
Forces for which the National Center has made one of the 
following determinations in conducting research under Section 
3(b): the health condition is related to the exposure of such 
individual to such toxic substance; it is unclear whether the 
health condition is related to the exposure of such individual 
to such toxic substance; or the health condition is not related 
to the exposure of such individual to such toxic substance.
    Section 4(e) of the bill would require the Advisory Board 
to meet at the call of the Chairperson, but no less frequently 
than once per quarter.
    Section 4(f) of the bill would require the members of the 
Advisory Board to serve without compensation.
    Section 4(g) of the bill would require the Secretary to 
determine the appropriate expenses of the Advisory Board.
    Section 4(h)(1) of the bill would allow the Chairperson, 
without any regard to the civil service laws and regulations, 
to appoint an executive director of the Advisory Board, who 
shall be a civilian employee of VA, and such personnel as may 
be necessary to enable the Advisory Board to perform its 
duties.
    Section 4(h)(2) of the bill would require that the 
appointment of an executive director under paragraph (1) be 
subject to approval by the Advisory Board.
    Section 4(h) (3) of the bill would allow the Chairperson to 
fix the compensation of the executive director and other 
personnel without regard to the provisions of chapter 51 and 
subchapter III of chapter 53 of title 5, U.S.C., except that 
the rate of pay for the executive director and other personnel 
may not exceed the rate payable for level V of the Executive 
Schedule under section 5316 of such title.

Section 5. Declassification review by Department of Defense of certain 
        incidents of exposure of Members of the Armed Forces to toxic 
        substances

    Section 5(a) of this bill would require the Secretary to 
conduct a declassification review to determine what information 
may be made publicly available relating to any known incident 
in which no less than 100 members of the Armed Forces were 
exposed to a toxic substance that resulted in at least one case 
of a disability that a specialist in the field of occupational 
medicine has determined to be credibly associated with that 
toxic substance.
    Section 5(b) of this bill would require that, to the extent 
possible subject to subsection (c) and consistent with national 
security, the Secretary of DOD make publicly available 
information declassified following the review by subsection 
(a).
    Section 5(c) of the bill would require that information 
made publicly available pursuant to subsection (b) be limited 
to information necessary for an individual who was potentially 
exposed to a toxic substance to determine the following: (1) 
whether that individual was exposed to that toxic substance; 
(2) the potential severity of the exposure of that individual 
to that toxic substance; and (3) any potential health 
conditions that may have resulted from exposure to that toxic 
substance.

Section 6. National outreach campaign on potential long-term health 
        effects of exposure to toxic substances by Members of the Armed 
        Forces and their descendants

    Section 6(a) of the bill would require the Secretary of VA, 
in consultation with the Secretary of HHS and the Secretary of 
DOD, to conduct a national outreach and education campaign 
directed toward members of the Armed Forces, veterans, and 
their family members to communicate the following information: 
(1) information on incidents of exposure of members of the 
Armed Forces to toxic substances, health conditions resulting 
from such exposure, and the potential long-term effects of such 
exposure on the individuals exposed to those substances and the 
descendants of those individuals; and (2) information on the 
National Center established under Section 3 for individuals 
eligible to participate in studies conducted at the National 
Center.
    Section 6(b) of the bill would require the Secretary to 
design and implement the national outreach and education 
campaign conducted under subsection (a), including: (1) by 
distributing printed materials containing information described 
in subsection (a) to veterans; (2) by publishing such 
information on a publicly available VA website; (3) by 
presenting such information in person at facilities that serve 
a large number of veterans or members of the Armed Forces; and 
(4) by educating employees of all VA medical facilities with 
respect to such information and providing such employees with 
printed materials containing such information.
    Section 6(c) of the bill would require the Secretary of DOD 
to assist the Secretary of VA in implementing the national 
outreach and education campaign conducted under subsection (a) 
by making the information described in subsection (a) available 
to all members of the Armed Forces and their families, by 
notifying all members of the Armed Forces of such information, 
and by publishing such information on a publicly available DOD 
website.
    Section 6(d) of the bill would require the Secretary of HHS 
to assist the Secretary of VA in implementing the national 
outreach and education campaign conducted under subsection (a) 
by making the information described in subsection (a) available 
to members of the health care profession, by notifying such 
members of such information, and by publishing such information 
on a publicly available HHS website.

Section 7. Prohibition of new appropriations

    Section 7 of the bill would prohibit the additional 
authorization of appropriated funds to carry out this Act and 
would instead require that this Act be carried out using 
amounts otherwise made available for the purpose of this Act.

         CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

    If enacted, this bill would make no changes in existing 
law.

                                  [all]