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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4261 Referred in Senate (RFS)]

113th CONGRESS
  2d Session
                                H. R. 4261

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              June 2, 2014

Received; read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 AN ACT

 
  To improve the research of Gulf War Illness, the Research Advisory 
   Committee on Gulf War Veterans' Illnesses, 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 ``Gulf War Health Research Reform Act 
of 2014''.

SEC. 2. IMPROVEMENTS TO RESEARCH ADVISORY COMMITTEE ON GULF WAR 
              VETERANS' ILLNESSES.

    (a) Independence of Committee.--Subsection (b) of section 707 of 
the Veterans Health Care Act of 1992 (Public Law 102-585; 38 U.S.C. 527 
note) is amended--
            (1) by striking ``Not later than'' and inserting ``(1) 
        Establishment.--Not later than''; and
            (2) by adding at the end the following new paragraphs:
    ``(2) Independence.--(A) The Committee established under paragraph 
(1) shall be an independent advisory committee which shall provide 
advice and counsel to the congressional veterans committees and to the 
Secretary of Veterans Affairs (as the head of the department designated 
under subsection (a) that established the Committee under paragraph 
(1)).
    ``(B) In carrying out the functions, powers, and duties of the 
Committee, the Committee shall be independent of the Secretary of 
Veterans Affairs. The Committee shall exert independent control of the 
budget allocations, staffing levels and expenditures, personnel 
decisions and processes, procurements, and other administrative and 
management functions of the Committee. The administration and 
management of the Committee shall be subject to the usual and customary 
Federal audit procedures.
    ``(3) Duties.--(A) The Committee shall provide to Congress, the 
Secretary of Veterans Affairs, and the heads of other departments and 
agencies of the Federal Government that conduct research on illnesses 
in Gulf War veterans advice with respect to proposed research studies, 
research plans, or research strategies relating to the health 
consequences of military service in the Southwest Asia theater of 
operations during the Gulf War.
    ``(B) The Committee may not conduct scientific research or review 
research proposals submitted to the Secretary of Veterans Affairs prior 
to funding. The Secretary shall appoint three members from the 
Committee who have appropriate scientific expertise to the committee 
designated to review such research proposals relating to illnesses in 
Gulf War veterans.
    ``(C) The guiding principle for the Committee shall be the premise 
that the fundamental goal of Gulf War health-related research, either 
basic or applied, conducted by the Federal Government is to ultimately 
improve the health of ill Gulf War veterans, and that the choice and 
success of research efforts shall be judged accordingly. The Committee 
shall assess the overall effectiveness of such research conducted by 
the Federal Government to answer central questions on the nature, 
causes, and treatments for health consequences of military service in 
the Southwest Asia theater of operations during the Gulf War.
    ``(D) The Committee shall meet in public session to review research 
funded by the Department of Veterans Affairs relevant to understanding 
and treating the health consequences of military service in the Gulf 
War, and the processes conducted to solicit, review, and select such 
funded research to assess methods, results, and implications of such 
research. The Committee may review research plans, initiatives, and 
activities from other departments and agencies of the Federal 
Government supporting research relating to the health consequences of 
military service in the Southwest Asia theater of operations during the 
Gulf War.
    ``(4) Reports and Recommendations.--(A) Not later than December 1 
of each year, the Committee shall submit to the congressional veterans 
committees and the Secretary of Veterans Affairs an annual report 
summarizing the activities of the Committee during the period covered 
by the report.
    ``(B) The Committee shall submit to the congressional veterans 
committees, the Secretary of Veterans Affairs, and the head of any 
other department or agency of the Federal Government that conducts 
research on illnesses in Gulf War veterans any other reports and 
recommendations of the Committee regarding Gulf War-related research.
    ``(C) Reports, recommendations, publications, and other documents 
of the Committee shall not be subject to review or approval by the 
Secretary of Veterans Affairs.
    ``(D) The Committee may submit to the Secretary of Veterans Affairs 
proposed recommendations of the Committee for comment for a period not 
to exceed 30 days.
    ``(E) Each report submitted by the Committee shall be approved by 
the Committee meeting in public session prior to such submission.
    ``(5) Membership.--(A) The Committee shall be composed of 12 
members appointed as follows:
            ``(i) One member appointed jointly by the chairman of the 
        congressional veterans committees, who shall serve as chairman 
        of the Committee.
            ``(ii) Two members appointed by the chairman of the 
        Committee on Veterans' Affairs of the House of Representatives.
            ``(iii) Two members appointed by the chairman of the 
        Committee on Veterans' Affairs of the Senate.
            ``(iv) Two members appointed by the ranking member of the 
        Committee on Veterans' Affairs of the House of Representatives.
            ``(v) Two members appointed by the ranking member of the 
        Committee on Veterans' Affairs of the Senate.
            ``(vi) Three members appointed by the Secretary of Veterans 
        Affairs, of whom not less than one shall be a veteran.
    ``(B)(i) The first 11 vacancies from among the members of the 
Committee (not including a member serving as chairman of the Committee) 
occurring on or after the date of the enactment of the Gulf War Health 
Research Reform Act of 2014 shall be filled by--
            ``(I) the chairman of the Committee on Veterans' Affairs of 
        the House of Representatives appointing a member for the first 
        and sixth vacancy;
            ``(II) the chairman of the Committee on Veterans' Affairs 
        of the Senate appointing a member for the second and seventh 
        vacancy;
            ``(III) the ranking member of the Committee on Veterans' 
        Affairs of the House of Representatives appointing a member for 
        the third and eighth vacancy;
            ``(IV) the ranking member of the Committee on Veterans' 
        Affairs of the Senate appointing a member for the fourth and 
        ninth vacancy; and
            ``(V) the Secretary of Veterans Affairs appointing a member 
        for the fifth, tenth, and eleventh vacancy.
    ``(ii) A vacancy in the Committee of a member serving as chairman 
shall be filled jointly by the chairmen of the congressional veterans 
committees.
    ``(iii) Except as provided by clause (i) or (ii), a vacancy in the 
Committee of a member shall be filled in the manner in which the 
appointment of such member was made. A member appointed to fill a 
vacancy occurring before the expiration of the term for which the 
member's predecessor was appointed shall be appointed only for the 
remainder of that term.
    ``(C) Of the members of the Committee who are appointed on or after 
the date of the enactment of the Gulf War Health Research Reform Act of 
2014--
            ``(i) not fewer than three members shall be veterans;
            ``(ii) not fewer than eight members shall be scientists or 
        physicians who have experience in biomedicine, epidemiology, 
        immunology, environmental health, neurology, toxicology, or 
        other appropriate disciplines; and
            ``(iii) the chairman shall be a veteran or an expert 
        described in clause (ii), or both.
    ``(D) Each member of the Committee who is appointed on or after the 
date of the enactment of the Gulf War Health Research Reform Act of 
2014 shall be appointed for a three-year term. Except as provided by 
section 2(c)(3) of such Act, a member may be reappointed once (not 
including the initial appointment of a member made before the date of 
the enactment of such Act).
    ``(6) Meetings.--(A) The Committee shall meet at the call of the 
chairman, but not less than twice annually.
    ``(B) A majority of the members of the Committee shall constitute a 
quorum, but a lesser number of members may hold hearings.
    ``(C)(i) The Secretary of Veterans Affairs, the head of the Office 
of Research and Development of the Department of Veterans Affairs, and 
the head of the Office of Public Health of the Department shall attend 
each meeting of the Committee.
    ``(ii) The Secretary of Veterans Affairs may delegate the 
attendance of the Secretary under clause (i) to a level not below the 
Deputy Under Secretary for Health of the Department of Veterans 
Affairs, but the Secretary shall attend at least one meeting each year 
without making such delegation.
    ``(D) Each meeting of the Committee shall be open to the public.
    ``(7) Compensation and Staff.--(A) Except with respect to a member 
who serves a scientific director under subparagraph (C)(ii) and is 
treated as staff for purposes of compensation, each member of the 
Committee shall be paid at the daily rate provided for temporary and 
intermittent services under section 3109(b) of title 5, United States 
Code, for each day during which the member attends meetings of the 
Committee.
    ``(B) The members of the Committee shall be allowed travel 
expenses, including per diem in lieu of subsistence, at rates 
authorized for employees of agencies under subchapter I of chapter 57 
of title 5, United States Code, while away from their homes or regular 
places of business in the performance of service of the Committee.
    ``(C)(i) The chairman of the Committee may appoint a staff of not 
more than four employees to provide the Committee scientific and 
administrative support. Such employees may be--
            ``(I) detailees of the Department of Veterans Affairs or 
        other departments or agencies of the Federal Government;
            ``(II) individuals employed as temporary employees of the 
        Federal Government; or
            ``(III) at the request of the chairman of the Committee, 
        provided under a contract entered into by the Secretary of 
        Veterans Affairs and a medical school or other medical research 
        institution selected by the chairman of the Committee.
    ``(ii) The chairman of the Committee may appoint, from the members 
of the Committee, a scientific director to supervise the operations of 
the Committee. Such director shall count as one of the four employees 
authorized under clause (i).
    ``(iii) At the request of the chairman of the Committee, the 
Secretary of Veterans Affairs shall procure services from 
nongovernmental consultants to assist the Committee in preparing 
reports, background papers, and other material for consideration by the 
Committee. Such services may be procured under the contract described 
in clause (i)(III).
    ``(8) Application of Federal Advisory Committee Act.--(A) Except as 
otherwise provided by this subsection, the Committee shall be subject 
to the Federal Advisory Committee Act (5 U.S.C. App.).
    ``(B) The Secretary of Veterans Affairs shall consult with the 
chairman of the congressional veterans committees in designating an 
officer or employee of the Department under section 10 of the Federal 
Advisory Committee Act (5 U.S.C. App.).
    ``(C) Notwithstanding such section 10, such designated officer or 
employee may not have authority--
            ``(i) over the agenda or conduct of a meeting;
            ``(ii) to adjourn a meeting of the Committee; or
            ``(iii) to take any other action that is inconsistent with 
        the independence of the Committee under paragraph (2).
    ``(9) Funding.--Amounts for the activities of the Committee shall 
be derived from amounts appropriated to the Department of Veterans 
Affairs for purposes of this subsection.
    ``(10) Termination.--(A) Except as provided by subparagraph (B), 
the Committee shall terminate on the date that is two years after the 
date on which the Committee submits to the congressional veterans 
committees, the Secretary of Defense, and the Secretary of Veterans 
Affairs a report (signed by not less than nine concurring members) 
explaining that each Secretary is carrying out an effective research 
program relating to the health consequences of military service in the 
Southwest Asia theater of operations during the Gulf War.
    ``(B) If during the two-year period described in subparagraph (A) 
the Committee notifies the congressional veterans committees, the 
Secretary of Defense, and the Secretary of Veterans Affairs that the 
information contained in the report submitted under subparagraph (A) is 
no longer applicable, the two-year period shall toll until the date on 
which the Committee submits a new report described in subparagraph 
(A).''.
    (b) Definitions; Redesignation; Conforming Amendments.--
            (1) Definitions.--Such section 707 is further amended by 
        adding at the end the following new subsection:
    ``(f) Definitions.--In this section:
            ``(1) The term `congressional veterans committees' means 
        the Committees on Veterans' Affairs of the House of 
        Representatives and the Senate.
            ``(2) The term `Gulf War' means the Southwest Asia theater 
        of operations from August 2, 1990, to July 31, 1991.
            ``(3) The term `Gulf War veteran' means an individual who 
        served as a member of the Armed Forces in the Gulf War.''.
            (2) Redesignation.--Subsection (a) of such section 707 is 
        amended by striking ``, and may redesignate from time to 
        time,''.
            (3) Conforming amendments.--Such section 707 is further 
        amended--
                    (A) in paragraph (1) of subsection (b), as 
                designated by subsection (a)(1) and amended by 
                paragraph (2)--
                            (i) by inserting ``(in this subsection 
                        referred to as the `Committee')'' after ``an 
                        advisory committee''; and
                            (ii) by striking ``and representatives of 
                        such veterans'' and inserting ``representatives 
                        of such veterans, and individuals from the 
                        scientific and medical community'';
                    (B) by striking ``Persian Gulf theater of 
                operations during the Persian Gulf War'' each place it 
                appears and inserting ``Gulf War'';
                    (C) by striking ``Persian Gulf War veterans'' each 
                place it appears and inserting ``Gulf War veterans''; 
                and
                    (D) by striking ``during the Persian Gulf War'' 
                each place it appears and inserting ``during the Gulf 
                War''.
    (c) Members Currently Serving.--
            (1) Membership.--Notwithstanding paragraph (5)(A) of 
        subsection (b) of such section 707, as amended by subsection 
        (a)(2), the chairmen and ranking members of the congressional 
        veterans committees shall jointly designate 10 members of the 
        Research Advisory Committee on Gulf War Veterans' Illnesses 
        established pursuant to such subsection (b) who are serving as 
        members as of the date of the enactment of this Act to continue 
        to serve as members for periods determined pursuant to 
        paragraph (2) rather than for the term for which the members 
        were appointed before such date of enactment.
            (2) Period of service.--The chairmen and ranking members of 
        the congressional veterans committees shall jointly determine 
        the period of service of each member specified in paragraph (1) 
        in a manner that staggers the periods of such members in 
        periods of one, two, or three years beginning on the date of 
        the enactment of this Act. In determining such staggered 
        periods, the chairmen and ranking members shall take into 
        account the order of filling vacancies pursuant to subsection 
        (b)(5)(B) of such section 707, as amended by subsection (a)(2). 
        Any vacancies occurring of such members shall be filled in 
        accordance with such subsection.
            (3) New members.--Upon designating members under paragraph 
        (1), the chairmen of the congressional veterans committees 
        shall each appoint one additional member to the committee from 
        among individuals who have not served on the Research Advisory 
        Committee on Gulf War Veterans' Illnesses. Such appointments 
        shall be treated as the first and second vacancies described in 
        subclauses (I) and (II) of subsection (b)(5)(B)(i) of such 
        section 707, as amended by subsection (a)(2), respectively.
            (4) Reappointment.--A member of the Committee specified in 
        paragraph (1) who has served more than three years may not be 
        reappointed after the period for the member specified in 
        paragraph (2) expires.

SEC. 3. RESEARCH CASE DEFINITION OF GULF WAR ILLNESS.

    (a) Standard Definition.--Except as provided by subsection (b), the 
Secretary of Veterans Affairs shall ensure that any research conducted 
or funded by the Secretary on the chronic multisymptom illness that 
afflicts approximately 25 percent of Gulf War veterans--
            (1) refers to the illness as ``Gulf War Illness''; and
            (2) uses the research case definition of such illness that 
        is recommended from time to time by the Research Advisory 
        Committee on Gulf War Veterans' Illnesses established by 
        section 707 of the Veterans Health Care Act of 1992 (Public Law 
        102-585; 38 U.S.C. 527 note).
    (b) Alternative Definition.--During any period in which the 
Research Advisory Committee on Gulf War Veterans' Illnesses has not 
recommended a research case definition for Gulf War Illness, the 
Secretary of Veterans Affairs shall ensure that any research on such 
illness conducted or funded by the Secretary uses a research case 
definition that is consistent with the definition of the term ``chronic 
multisymptom illness in Persian Gulf War veterans'' provided by section 
805(e) of the Veterans' Benefits Act of 2010 (Public Law 111-275; 124 
Stat. 2890).
    (c) Advice.--The Research Advisory Committee on Gulf War Veterans' 
Illnesses shall submit to the Secretary of Defense advice regarding the 
best type of organization and process for the Gulf War Illness Research 
Program of the Congressionally Directed Medical Research Program to use 
to develop a research case definition of ``Gulf War Illness''.

SEC. 4. STUDIES AND REPORTS ON GULF WAR ILLNESS.

    (a) Conduct of New Studies.--
            (1) Evaluation of animal studies.--In conducting or funding 
        any study relating to illnesses of Gulf War veterans on or 
        after the date of the enactment of this Act, the Secretary of 
        Veterans Affairs shall ensure that such study is conducted in a 
        manner such that animal studies are considered to the same 
        extent in all respects as human studies.
            (2) Sufficient evidence of association.--In conducting or 
        funding any study relating to illnesses of Gulf War veterans, 
        or other health matters of veterans, on or after the date of 
        the enactment of this Act, the Institute of Medicine of the 
        National Academies shall ensure that such study is conducted in 
        a manner that defines ``sufficient evidence of an association'' 
        in the ``categories of association'' used in the study as the 
        following: ``Evidence is sufficient to conclude that there is a 
        positive association. That is, a positive association has been 
        observed between an exposure to a specific agent and a health 
        outcome in human or animal studies in which chance, bias, and 
        confounding could be ruled out with reasonable confidence.''.
    (b) Sense of Congress on National Cohort Study.--It is the sense of 
Congress that the Secretary of Veterans Affairs should conduct an 
additional follow-up study of a national cohort of Gulf War and Gulf-
War-Era veterans that includes questions described in the ``Symptom 
Inventory Required to Ascertain Case Status for Gulf War Multisymptom 
Illness, as Defined by both the Fukuda and Kansas criteria'' published 
by the Research Advisory Committee on Gulf War Veterans' Illnesses on 
June 9, 2012, in appendix F of the document titled ``Research Advisory 
Committee on Gulf War Veterans' Illnesses Findings and 
Recommendations''.
    (c) Sense of Congress on Study on Risk of Developing Multiple 
Sclerosis, Multiple Sclerosis, Parkinson's Disease, Brain Cancers, and 
Other Conditions.--It is the sense of Congress that the Secretary of 
Veterans Affairs should submit to the congressional veterans committees 
each report required by section 804 of the Veterans' Benefits 
Improvement Act of 2008 (Public Law 110-389; 122 Stat. 4187).
    (d) Sense of Congress on Previously Conducted Studies.--It is the 
sense of Congress that the Secretary of Veterans Affairs should--
            (1) seek to enter into an agreement with the Institute of 
        Medicine of the National Academies to carry out the review 
        described in section 805 of the Veterans' Benefits Act of 2010 
        (Public Law 111-275; 124 Stat. 2890), regardless of any 
        previous review conducted under such section, in a manner that 
        ensures that the Institute of Medicine convenes to conduct the 
        review a group of medical professionals who are experienced in 
        treating individuals who served as members of the Armed Forces 
        in the Southwest Asia Theater of Operations of the Persian Gulf 
        War during 1990 or 1991 and who have been diagnosed with Gulf 
        War illness, chronic multisymptom illness, or another health 
        condition related to chemical and environmental exposure that 
        may have occurred during such service;
            (2) seek to enter into an agreement with the Institute of 
        Medicine to carry out the review described in section 1603 of 
        the Persian Gulf War Veterans Act of 1998 (Public Law 105-277; 
        38 U.S.C. 1117 note), regardless of any previous review 
        conducted under such section, addressing the matters originally 
        reviewed by the Institute of Medicine in the reports titled 
        ``Gulf War and Health: Volume 1. Depleted Uranium, Sarin, 
        Pyridostigmine Bromide, and Vaccines'', ``Gulf War and Health: 
        Volume 2. Insecticides and Solvents'', and ``Gulf War and 
        Health: Volume 3. Fuels, Combustion Products, and 
        Propellants''; and
            (3) not disseminate or use for research, clinical care, 
        benefits, or any other purpose the results of the report of the 
        Institute of Medicine titled ``Gulf War and Health Report: 
        Volume 9. Treatment for Chronic Multisymptom Illness''.
    (e) Sense of Congress on Consultation.--It is the sense of Congress 
that the Secretary of Veterans Affairs should, prior to entering into a 
contract or agreement with the Institute of Medicine of the National 
Academies with respect to research or studies on the health of Gulf War 
veterans, obtain the advice of the Research Advisory Committee on Gulf 
War Veterans' Illnesses established by section 707 of the Veterans 
Health Care Act of 1992 (Public Law 102-585; 38 U.S.C. 527 note) 
regarding the scope of work and the charge to be given to the Institute 
of Medicine.
    (f) Sense of Congress on Inclusion of Certain Professionals in 
Scientific or Medical Groups.--It is the sense of Congress that, in any 
contract requiring the Institute of Medicine of the National Academies 
to convene a committee to study the health of Gulf War veterans, the 
Secretary of Veterans Affairs should ensure that any such committee 
convened should contain not less than three members of the Research 
Advisory Committee on Gulf War Veterans' Illnesses established by 
section 707 of the Veterans Health Care Act of 1992 (Public Law 102-
585; 38 U.S.C. 527 note).
    (g) Sense of Congress on Notification of Undue Influence.--It is 
the sense of Congress that the Secretary of Veterans Affairs should 
promptly notify the congressional veterans committees of any employee 
or contractor of the Federal Government whom the Secretary believes 
influenced, or attempted to influence, the outcome of a report or study 
on the health of Gulf War veterans conducted by the Department of 
Veterans Affairs or the Institute of Medicine of the National Academies 
if such influence was not related to a scientifically objective 
outcome.

SEC. 5. DEFINITIONS.

    In this Act:
            (1) The term ``congressional veterans committees'' means 
        the Committees on Veterans' Affairs of the House of 
        Representatives and the Senate.
            (2) The term ``Gulf War'' means the Southwest Asia theater 
        of operations from August 2, 1990, to July 31, 1991.
            (3) The term ``Gulf War veteran'' means an individual who 
        served as a member of the Armed Forces in the Gulf War.

            Passed the House of Representatives May 28, 2014.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.
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