II 

116TH CONGRESS 

1ST SESSION S. 1563 

To amend the Public Health Service Act with respect to the Agency for 

Toxic Substances and Disease Registry’s review and publication of illness 

and conditions relating to veterans stationed at Camp Lejeune, North 

Carolina, and their family members, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 21, 2019 

Mr. BURR (for himself, Mr. TESTER, Mr. TILLIS, Mr. RUBIO, and Mr. 

CARDIN) introduced the following bill; which was read twice and referred 

to the Committee on Veterans’ Affairs 

A BILL 

To amend the Public Health Service Act with respect to 

the Agency for Toxic Substances and Disease Registry’s 

review and publication of illness and conditions relating 

to veterans stationed at Camp Lejeune, North Carolina, 

and their family members, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Janey Ensminger Act 

5 of 2019’’. 


kjohnson on DSK79L0C42 with BILLS
2 

•S 1563 IS

1 SEC. 2. REVIEW OF ILLNESSES AND CONDITIONS RELATING 

2 TO VETERANS STATIONED AT CAMP LE3 JEUNE, NORTH CAROLINA, AND THEIR FAM4 ILY MEMBERS. 

5 (a) REVIEW AND PUBLICATION OF ILLNESS OR CON6 DITION.—Part P of title III of the Public Health Service 

7 Act (42 U.S.C. 280g et seq.) is amended by adding at 

8 the end the following: 

9 ‘‘SEC. 399V–7. REVIEW AND PUBLICATION OF ILLNESSES 

10 AND CONDITIONS. 

11 ‘‘Consistent with section 104(i) of the Comprehensive 

12 Environmental Response, Compensation, and Liability Act 

13 of 1980, not later than 1 year after the date of enactment 

14 of this section, and not less frequently than once every 

15 3 years thereafter, the Secretary, acting through the Ad16 ministrator of the Agency for Toxic Substances and Dis17 ease Registry, shall— 

18 ‘‘(1)(A) review the scientific literature relevant 

19 to the relationship between the employment or resi20 dence of individuals at Camp Lejeune, North Caro21 lina, for not fewer than 30 days during the period 

22 beginning on August 1, 1953, and ending on Decem23 ber 21, 1987, and specific illnesses or conditions in24 curred by those individuals; 

25 ‘‘(B) determine each illness or condition for 

26 which there is evidence that exposure to a toxic subVerDate Sep 11 2014 01:18 May 30, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1563.IS S1563

kjohnson on DSK79L0C42 with BILLS
3 

•S 1563 IS

1 stance at Camp Lejeune, North Carolina, during the 

2 period specific in subparagraph (A) may be a cause 

3 of the illness or condition; and 

4 ‘‘(C) with respect to each illness or condition 

5 for which a determination has been made under sub6 paragraph (B), categorize the evidence of the con7 nection of the illness or condition to exposure de8 scribed in that subparagraph as— 

9 ‘‘(i) sufficient to conclude with reasonable 

10 confidence that the exposure is a cause of the 

11 illness or condition; 

12 ‘‘(ii) modest supporting causation, but not 

13 sufficient to conclude with reasonable con14 fidence that exposure is a cause of the illness 

15 or condition; or 

16 ‘‘(iii) no more than limited supporting cau17 sation; 

18 ‘‘(2) publish in the Federal Register and on the 

19 internet website of the Department of Health and 

20 Human Services— 

21 ‘‘(A) a list of each illness or condition for 

22 which a determination has been made under 

23 paragraph (1)(B), including the categorization 

24 of the evidence of causal connection relating to 


kjohnson on DSK79L0C42 with BILLS
4 

•S 1563 IS

1 the illness or condition under paragraph (1)(C); 

2 and 

3 ‘‘(B) the bibliographic citations for all lit4 erature reviewed under paragraph (1) for each 

5 illness or condition listed under such paragraph; 

6 and 

7 ‘‘(3) update the list under paragraph (2), as ap8 plicable, to add an illness or condition for which a 

9 determination has been made under paragraph 

10 (1)(B), including the categorization of the evidence 

11 of causal connection relating to the illness or condi12 tion under paragraph (1)(C), since such list was last 

13 updated consistent with the requirements of this sec14 tion.’’. 

15 (b) ELIGIBILITY FOR HEALTH CARE FROM DEPART16 MENT OF VETERANS AFFAIRS.— 

17 (1) IN GENERAL.—Section 1710(e)(1)(F) of 

18 title 38, United States Code, is amended— 

19 (A) by redesignating clauses (i) through 

20 (xv) as subclauses (I) through (XV), respec21 tively; 

22 (B) by striking ‘‘(F) Subject to’’ and in23 serting ‘‘(F)(i) Subject to’’; 

24 (C) by striking ‘‘any of the following’’ and 

25 inserting ‘‘any of the illnesses or conditions for 


kjohnson on DSK79L0C42 with BILLS
5 

•S 1563 IS

1 which the evidence of connection of the illness 

2 or condition to exposure to a toxic substance at 

3 Camp Lejeune, North Carolina, during such pe4 riod is categorized as sufficient or modest in the 

5 most recent list published under section 399V– 

6 7(a)(2) of the Public Health Service Act, which 

7 may include any of the following’’; and 

8 (D) by adding at the end the following new 

9 clause: 

10 ‘‘(ii) For the purposes of ensuring continuation of 

11 care, any veteran who has been furnished hospital care 

12 or medical services under this subparagraph for an illness 

13 or condition shall remain eligible for hospital care or med14 ical services for such illness or condition notwithstanding 

15 that the evidence of connection of such illness or condition 

16 to exposure to a toxic substance at Camp Lejeune, North 

17 Carolina, during the period described in clause (i) is not 

18 categorized as sufficient or modest in the most recent list 

19 published under section 399V–7(a)(2) of the Public 

20 Health Service Act.’’. 

21 (2) FAMILY MEMBERS.—Section 1787 of such 

22 title is amended by adding at the end the following 

23 new subsection: 

24 ‘‘(c) CONTINUATION OF CARE.—For the purposes of 

25 ensuring continuation of care, any individual who has been 


kjohnson on DSK79L0C42 with BILLS
6 

•S 1563 IS

1 furnished hospital care or medical services under this sec2 tion for an illness or condition shall remain eligible for 

3 hospital care or medical services for such illness or condi4 tion notwithstanding that the illness or condition is no 

5 longer described in section 1710(e)(1)(F) of this title.’’. 

6 (3) TRANSFER OF AMOUNTS FOR PROGRAM.— 

7 Notwithstanding any other provision of law, for each 

8 of fiscal years 2019 and 2020, the Secretary of Vet9 erans Affairs shall transfer $2,000,000 from 

10 amounts made available to the Department of Vet11 erans Affairs for medical support and compliance to 

12 the Chief Business Office and Financial Services 

13 Center of the Department to be used to continue 

14 building and enhancing the claims processing sys15 tem, eligibility system, and web portal for the Camp 

16 Lejeune Family Member Program of the Depart17 ment. 

Æ 


kjohnson on DSK79L0C42 with BILLS