In the House of Representatives, U. S., 

July 13, 2022. 

Resolved, That the bill from the Senate (S. 3373) entitled ‘‘An Act to improve the Iraq and Afghanistan Service 

Grant and the Children of Fallen Heroes Grant.’’, do pass 

with the following 

AMENDMENT: 

Strike out all after the enacting clause and insert: 

1 SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, 

2 UNITED STATES CODE; TABLE OF CONTENTS. 

3 (a) SHORT TITLE.—This Act may be cited as the ‘‘Ser4 geant First Class Heath Robinson Honoring our Promise 

5 to Address Comprehensive Toxics Act of 2022’’ or the ‘‘Hon6 oring our PACT Act of 2022’’. 

7 (b) MATTERS RELATING TO AMENDMENTS TO TITLE

8 38, UNITED STATES CODE.— 

9 (1) REFERENCES.—Except as otherwise expressly 

10 provided, when in this Act an amendment or repeal 

11 is expressed in terms of an amendment to, or repeal 

12 of, a section or other provision, the reference shall be 

13 considered to be made to a section or other provision 

14 of title 38, United States Code. 
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1 (2) AMENDMENTS TO TABLES OF CONTENTS.— 

2 Except as otherwise expressly provided, when an 

3 amendment made by this Act to title 38, United 

4 States Code, adds a section or larger organizational 

5 unit to that title or amends the designation or head6 ing of a section or larger organizational unit in that 

7 title, that amendment also shall have the effect of 

8 amending any table of sections in that title to alter 

9 the table to conform to the changes made by the 

10 amendment. 

11 (c) TABLE OF CONTENTS.—The table of contents for 

12 this Act is as follows: 

Sec. 1. Short title; references to title 38, United States Code; table of contents. 

TITLE I—EXPANSION OF HEALTH CARE ELIGIBILITY 

Subtitle A—Toxic-exposed Veterans 

Sec. 101. Short title. 

Sec. 102. Definitions relating to toxic-exposed veterans. 

Sec. 103. Expansion of health care for specific categories of toxic-exposed veterans 

and veterans supporting certain overseas contingency operations. 

Sec. 104. Assessments of implementation and operation. 

Subtitle B—Certain Veterans of Combat Service and Other Matters 

Sec. 111. Expansion of period of eligibility for health care for certain veterans 

of combat service. 

TITLE II—TOXIC EXPOSURE PRESUMPTION PROCESS 

Sec. 201. Short title. 

Sec. 202. Improvements to ability of Department of Veterans Affairs to establish 

presumptions of service connection based on toxic exposure. 

Sec. 203. Outreach to claimants for disability compensation pursuant to changes 

in presumptions of service connection. 

Sec. 204. Reevaluation of claims for dependency and indemnity compensation involving presumptions of service connection. 

TITLE III—IMPROVING THE ESTABLISHMENT OF SERVICE 

CONNECTION PROCESS FOR TOXIC-EXPOSED VETERANS 

Sec. 301. Short title. 
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Sec. 302. Presumptions of toxic exposure. 

Sec. 303. Medical nexus examinations for toxic exposure risk activities. 

TITLE IV—PRESUMPTIONS OF SERVICE CONNECTION 

Sec. 401. Treatment of veterans who participated in cleanup of Enewetak Atoll 

as radiation-exposed veterans for purposes of presumption of 

service connection of certain disabilities by Department of Veterans Affairs. 

Sec. 402. Treatment of veterans who participated in nuclear response near 

Palomares, Spain, or Thule, Greenland, as radiation-exposed 

veterans for purposes of presumption of service connection of certain disabilities by Department of Veterans Affairs. 

Sec. 403. Presumptions of service connection for diseases associated with exposures to certain herbicide agents for veterans who served in certain locations. 

Sec. 404. Addition of additional diseases associated with exposure to certain herbicide agents for which there is a presumption of service connection for veterans who served in certain locations. 

Sec. 405. Improving compensation for disabilities occurring in Persian Gulf War 

veterans. 

Sec. 406. Presumption of service connection for certain diseases associated with 

exposure to burn pits and other toxins. 

Sec. 407. Rule of construction. 

TITLE V—RESEARCH MATTERS 

Sec. 501. Interagency working group on toxic exposure research. 

Sec. 502. Analysis and report on treatment of veterans for medical conditions related to toxic exposure. 

Sec. 503. Analysis relating to mortality of veterans who served in Southwest 

Asia. 

Sec. 504. Study on health trends of post–9/11 veterans. 

Sec. 505. Study on cancer rates among veterans. 

Sec. 506. Study on health effects of waste related to Manhattan Project on certain 

veterans. 

Sec. 507. Study on toxic exposure and mental health outcomes. 

Sec. 508. Study on veterans in Territories of the United States. 

Sec. 509. Department of Veterans Affairs public website for toxic exposure research. 

Sec. 510. Report on health effects of jet fuels used by Armed Forces. 

TITLE VI—IMPROVEMENT OF RESOURCES AND TRAINING 

REGARDING TOXIC-EXPOSED VETERANS 

Sec. 601. Short title; definitions. 

Sec. 602. Publication of list of resources of Department of Veterans Affairs for 

toxic-exposed veterans and veterans who report toxic exposures 

and outreach program for such veterans and caregivers and survivors of such veterans. 

Sec. 603. Incorporation of toxic exposure screening for veterans. 

Sec. 604. Training for personnel of the Department of Veterans Affairs with respect to veterans who report toxic exposures. 
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TITLE VII—RESOURCING 

Sec. 701. Authority to use appropriations to enhance claims processing capacity 

and automation. 

Sec. 702. Authorization of major medical facility leases of Department of Veterans Affairs for fiscal year 2023. 

Sec. 703. Treatment of major medical facility leases of the Department of Veterans Affairs. 

Sec. 704. Authority to enter into agreements with academic affiliates and other 

entities to acquire space for the purpose of providing health-care 

resources to veterans. 

Sec. 705. Modifications to enhanced-use lease authority of Department of Veterans 

Affairs. 

Sec. 706. Authority for joint leasing actions of Department of Defense and Department of Veterans Affairs. 

Sec. 707. Appropriation of amounts for major medical facility leases. 

TITLE VIII—RECORDS AND OTHER MATTERS 

Sec. 801. Epidemiological study on Fort McClellan veterans. 

Sec. 802. Biennial briefing on Individual Longitudinal Exposure Record. 

Sec. 803. Correction of exposure records by members of the Armed Forces and veterans. 

Sec. 804. Federal cause of action relating to water at Camp Lejeune, North Carolina. 

Sec. 805. Cost of War Toxic Exposures Fund. 

Sec. 806. Appropriation for fiscal year 2022. 

Sec. 807. Authorization of electronic notice in claims under laws administered by 

the Secretary of Veterans Affairs. 

Sec. 808. Burn pit transparency. 

TITLE IX—IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF 

VETERANS AFFAIRS 

Sec. 901. National rural recruitment and hiring plan for Veterans Health Administration. 

Sec. 902. Authority to buy out service contracts for certain health care professionals in exchange for employment at rural or highly rural facilities of Department of Veterans Affairs. 

Sec. 903. Qualifications for human resources positions within Department of Veterans Affairs and plan to recruit and retain human resources 

employees. 

Sec. 904. Modification of pay cap for certain employees of Veterans Health Administration. 

Sec. 905. Expansion of opportunities for housekeeping aides. 

Sec. 906. Modification of authority of the Secretary of Veterans Affairs relating 

to hours, conditions of employment, and pay for certain employees of Veterans Health Administration. 

Sec. 907. Waiver of pay limitation for certain employees of Department of Veterans Affairs. 

Sec. 908. Elimination of limitation on awards and bonus for employees of Department of Veterans Affairs. 

Sec. 909. Additional authority of the Secretary of Veterans Affairs relating to recruitment and retention of personnel. 
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1 TITLE I—EXPANSION OF HEALTH 

2 CARE ELIGIBILITY 

3 Subtitle A—Toxic-exposed Veterans 

4 SEC. 101. SHORT TITLE. 

5 This title may be cited as the ‘‘Conceding Our Vet6 erans’ Exposure Now and Necessitating Training Act of 

7 2022’’ or the ‘‘COVENANT Act of 2022’’. 

8 SEC. 102. DEFINITIONS RELATING TO TOXIC-EXPOSED VET9 ERANS. 

10 (a) IN GENERAL.—Section 1710(a)(2)(F) is amended 

11 by striking ‘‘who was exposed to a toxic substance, radi12 ation, or other conditions, as provided in subsection (e)’’ 

13 and inserting ‘‘who is a toxic-exposed veteran, in accord14 ance with subsection (e)’’. 

15 (b) DEFINITIONS OF TOXIC EXPOSURE AND TOXIC-EX16 POSED VETERAN.—Section 101 is amended by adding at 

17 the end the following new paragraphs: 

18 ‘‘(37) The term ‘toxic exposure’ includes the following: 

19 ‘‘(A) A toxic exposure risk activity, as defined in 

20 section 1710(e)(4) of this title. 

21 ‘‘(B) An exposure to a substance, chemical, or 

22 airborne hazard identified in the list under section 

23 1119(b)(2) of this title. 

24 ‘‘(38) The term ‘toxic-exposed veteran’ means any vet25 eran described in section 1710(e)(1) of this title.’’. 
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1 (c) DEFINITION OF TOXIC EXPOSURE RISK ACTIV2 ITY.—Section 1710(e)(4) is amended by adding at the end 

3 the following new subparagraph: 

4 ‘‘(C) The term ‘toxic exposure risk activity’ 

5 means any activity— 

6 ‘‘(i) that requires a corresponding entry in 

7 an exposure tracking record system (as defined 

8 in section 1119(c) of this title) for the veteran 

9 who carried out the activity; or 

10 ‘‘(ii) that the Secretary determines qualifies 

11 for purposes of this subsection when taking into 

12 account what is reasonably prudent to protect 

13 the health of veterans.’’. 

14 SEC. 103. EXPANSION OF HEALTH CARE FOR SPECIFIC CAT15 EGORIES OF TOXIC-EXPOSED VETERANS AND 

16 VETERANS SUPPORTING CERTAIN OVERSEAS 

17 CONTINGENCY OPERATIONS. 

18 (a) IN GENERAL.— 

19 (1) EXPANSION.—Subsection (e) of section 1710, 

20 as amended by section 102(c), is further amended— 

21 (A) in paragraph (1), by adding at the end 

22 the following new subparagraphs: 

23 ‘‘(G) Beginning not later than the applicable date 

24 specified in paragraph (6), and subject to paragraph (2), 

25 a veteran who participated in a toxic exposure risk activity 
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1 while serving on active duty, active duty for training, or 

2 inactive duty training is eligible for hospital care (includ3 ing mental health services and counseling), medical services, 

4 and nursing home care under subsection (a)(2)(F) for any 

5 illness. 

6 ‘‘(H) Beginning not later than the applicable date 

7 specified in paragraph (6), and subject to paragraph (2), 

8 a covered veteran (as defined in section 1119(c) of this title) 

9 is eligible for hospital care (including mental health services 

10 and counseling), medical services, and nursing home care 

11 under subsection (a)(2)(F) for any illness. 

12 ‘‘(I)(i) Beginning not later than the applicable date 

13 specified in paragraph (6), and subject to paragraph (2), 

14 a veteran who deployed in support of a contingency oper15 ation specified in clause (ii) is eligible for hospital care (in16 cluding mental health services and counseling), medical 

17 services, and nursing home care under subsection (a)(2)(F) 

18 for any illness. 

19 ‘‘(ii) A contingency operation specified in this clause 

20 is any of the following: 

21 ‘‘(I) Operation Enduring Freedom. 

22 ‘‘(II) Operation Freedom’s Sentinel. 

23 ‘‘(III) Operation Iraqi Freedom. 

24 ‘‘(IV) Operation New Dawn. 

25 ‘‘(V) Operation Inherent Resolve. 
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1 ‘‘(VI) Resolute Support Mission.’’; and 

2 (B) in paragraph (2)(B)— 

3 (i) by striking ‘‘or (F)’’ and inserting 

4 ‘‘(F), (G), (H), or (I)’’; and 

5 (ii) by striking ‘‘service or testing’’ and 

6 inserting ‘‘service, testing, or activity’’. 

7 (2) PHASE IN.—Such subsection is further 

8 amended by adding at the end the following new 

9 paragraph: 

10 ‘‘(6)(A) The Secretary shall determine the dates in sub11 paragraphs (G), (H), and (I) of paragraph (1) as follows: 

12 ‘‘(i) October 1, 2024, with respect to a veteran 

13 described in such subparagraph (G) or (H) who was 

14 discharged or released from the active military, naval, 

15 air, or space service during the period beginning on 

16 August 2, 1990, and ending on September 11, 2001. 

17 ‘‘(ii) October 1, 2026, with respect to a veteran 

18 described in such subparagraph (G) or (H) who was 

19 discharged or released from the active military, naval, 

20 air, or space service during the period beginning on 

21 September 12, 2001, and ending on December 31, 

22 2006. 

23 ‘‘(iii) October 1, 2028, with respect to a veteran 

24 described in such subparagraph (G) or (H) who was 

25 discharged or released from the active military, naval, 
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1 air, or space service during the period beginning on 

2 January 1, 2007, and ending on December 31, 2012. 

3 ‘‘(iv) October 1, 2030, with respect to a veteran 

4 described in such subparagraph (G) or (H) who was 

5 discharged or released from the active military, naval, 

6 air, or space service during the period beginning on 

7 January 1, 2013, and ending on December 31, 2018. 

8 ‘‘(v) October 1, 2032, with respect to a veteran 

9 described in such subparagraph (I). 

10 ‘‘(B)(i) The Secretary may modify a date specified in 

11 subparagraph (A) to an earlier date, as the Secretary deter12 mines appropriate based on the number of veterans receiv13 ing hospital care, medical services, and nursing home care 

14 under subparagraphs (G), (H), and (I) of paragraph (1) 

15 and the resources available to the Secretary. 

16 ‘‘(ii) If the Secretary determines to modify a date 

17 under clause (i), the Secretary shall— 

18 ‘‘(I) notify the Committee on Veterans’ Affairs of 

19 the Senate and the Committee on Veterans’ Affairs of 

20 the House of Representatives of the proposed modi21 fication; and 

22 ‘‘(II) publish such modified date in the Federal 

23 Register.’’. 

24 (b) OUTREACH PLANS.—With respect to each of clauses 

25 (i) through (v) of section 1710(e)(6)(A) of title 38, United 
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1 States Code (as added by subsection (a)(2)), not later than 

2 180 days before the date specified in the clause (including 

3 a date modified pursuant to such section), the Secretary 

4 shall submit to the Committee on Veterans’ Affairs of the 

5 Senate and the Committee on Veterans’ Affairs of the House 

6 of Representatives a plan to conduct outreach to the vet7 erans described in the clause to notify such veterans of their 

8 eligibility for hospital care, medical services, or nursing 

9 home care under subparagraph (G), (H), or (I), of section 

10 1710(e)(1) of such title, as the case may be. 

11 SEC. 104. ASSESSMENTS OF IMPLEMENTATION AND OPER12 ATION. 

13 (a) INITIAL RESOURCE ASSESSMENT AND REPORT.— 

14 Not later than 180 days after the date of the enactment of 

15 this Act, the Secretary of Veterans Affairs shall— 

16 (1) complete an assessment to determine— 

17 (A) the personnel and material resources 

18 necessary to implement section 103 (including 

19 the amendments made by such section); and 

20 (B) the total number of covered veterans, as 

21 such term is defined in section 1119(c) of title 

22 38, United States Code (as added by section 

23 302), who receive hospital care or medical serv24 ices furnished by the Secretary under chapter 17 
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1 of such title, disaggregated by priority group 

2 specified in section 1705(a) of such title; and 

3 (2) submit to the Committee on Veterans’ Affairs 

4 of the Senate and the Committee on Veterans’ Affairs 

5 of the House of Representatives a report containing 

6 the findings of the assessment completed under para7 graph (1), including a specific determination as to 

8 whether the Department has the personnel and mate9 rial resources necessary to implement section 103. 

10 (b) INFORMATION SYSTEMS.—Not later than October 

11 1, 2024, the Secretary shall establish information systems 

12 to assess the implementation of section 103, including the 

13 amendments made by such section, and use the results of 

14 assessments under such systems to inform the reports under 

15 subsection (c). 

16 (c) ANNUAL REPORTS.— 

17 (1) REPORTS.—Not later than October 1, 2025, 

18 and on an annual basis thereafter until October 1, 

19 2033, the Secretary shall submit to the Committee on 

20 Veterans’ Affairs of the Senate and the Committee on 

21 Veterans’ Affairs of the House of Representatives a re22 port on the following: 

23 (A) The effect of the implementation of, and 

24 the provision and management of care under, 

25 section 103 (including the amendments made by 
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1 such section) on the demand by veterans de2 scribed in subparagraphs (G), (H), and (I) of 

3 section 1710(e)(1) of title 38, United States Code 

4 (as added by such section 103) for health care 

5 services furnished by the Secretary. 

6 (B) Any differing patterns of demand for 

7 health care services by such veterans, 

8 disaggregated by factors such as the relative dis9 tance of the veteran from medical facilities of the 

10 Department and whether the veteran had pre11 viously received hospital care or medical services 

12 furnished by the Secretary under chapter 17 of 

13 such title. 

14 (C) The extent to which the Secretary has 

15 met such demand. 

16 (D) Any changes, during the year covered 

17 by the report, in the delivery patterns of health 

18 care furnished by the Secretary under chapter 17 

19 of such title, and the fiscal impact of such 

20 changes. 

21 (2) MATTERS.—Each report under paragraph 

22 (1) shall include, with respect to the year covered by 

23 the report, detailed information on the following: 

24 (A) The total number of veterans enrolled in 

25 the patient enrollment system who, during such 
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1 year, received hospital care or medical services 

2 furnished by the Secretary under chapter 17 of 

3 title 38, United States Code. 

4 (B) Of the veterans specified in subpara5 graph (A), the number of such veterans who, dur6 ing the preceding three fiscal years, had not re7 ceived such care or services. 

8 (C) With respect to the veterans specified in 

9 subparagraph (B), the cost of providing health 

10 care to such veterans during the year covered by 

11 the report, shown in total and disaggregated 

12 by— 

13 (i) the level of care; and 

14 (ii) whether the care was provided 

15 through the Veterans Community Care Pro16 gram. 

17 (D) With respect to the number of veterans 

18 described in subparagraphs (G), (H), and (I) of 

19 section 1710(e)(1) of title 38, United States Code 

20 (as added by section 103), the following (shown 

21 in total and disaggregated by medical facility of 

22 the Department, as applicable): 

23 (i) The number of such veterans who, 

24 during the year covered by the report, en25 rolled in the patient enrollment system. 
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1 (ii) The number of such veterans who 

2 applied for, but were denied, such enroll3 ment. 

4 (iii) The number of such veterans who 

5 were denied hospital care or a medical serv6 ice furnished by the Secretary that was con7 sidered to be medically necessary but not of 

8 an emergency nature. 

9 (E) The numbers and characteristics of, and 

10 the type and extent of health care furnished by 

11 the Secretary to, veterans enrolled in the patient 

12 enrollment system (shown in total and 

13 disaggregated by medical facility of the Depart14 ment). 

15 (F) The numbers and characteristics of, and 

16 the type and extent of health care furnished by 

17 the Secretary to, veterans not enrolled in the pa18 tient enrollment system (disaggregated by each 

19 class of eligibility for care under section 1710 of 

20 title 38, United States Code, and further shown 

21 as a total per class and disaggregated by medical 

22 facility of the Department). 

23 (G) The specific fiscal impact (shown in 

24 total and disaggregated by geographic health 

25 care delivery areas) of changes in the delivery 
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1 patterns of health care furnished by the Sec2 retary under chapter 17 of such title as a result 

3 of the implementation of section 103 (including 

4 the amendments made by such section). 

5 (d) DEFINITIONS.—In this section: 

6 (1) PATIENT ENROLLMENT SYSTEM.—The term 

7 ‘‘patient enrollment system’’ means the patient enroll8 ment system of the Department of Veterans Affairs es9 tablished and operated under section 1705(a) of title 

10 38, United States Code. 

11 (2) VETERANS COMMUNITY CARE PROGRAM.—The 

12 term ‘‘Veterans Community Care Program’’ means 

13 the program established under section 1703 of title 38, 

14 United States Code. 

15 Subtitle B—Certain Veterans of 

16 Combat Service and Other Matters 

17 SEC. 111. EXPANSION OF PERIOD OF ELIGIBILITY FOR 

18 HEALTH CARE FOR CERTAIN VETERANS OF 

19 COMBAT SERVICE. 

20 (a) EXPANDED PERIOD.—Section 1710(e)(3) is 

21 amended— 

22 (1) in subparagraph (A)— 

23 (A) by striking ‘‘January 27, 2003’’ and in24 serting ‘‘September 11, 2001’’; and 
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1 (B) by striking ‘‘five-year period’’ and in2 serting ‘‘10-year period’’; 

3 (2) by amending subparagraph (B) to read as 

4 follows: 

5 ‘‘(B) With respect to a veteran described in 

6 paragraph (1)(D) who was discharged or released 

7 from the active military, naval, air, or space service 

8 after September 11, 2001, and before October 1, 2013, 

9 but did not enroll to receive such hospital care, med10 ical services, or nursing home care under such para11 graph pursuant to subparagraph (A) before October 1, 

12 2022, the one-year period beginning on October 1, 

13 2022.’’; and 

14 (3) by striking subparagraph (C). 

15 (b) CLARIFICATION OF COVERAGE.—Section 

16 1710(e)(1)(D) is amended by inserting after ‘‘Persian Gulf 

17 War’’ the following: ‘‘(including any veteran who, in con18 nection with service during such period, received the Armed 

19 Forces Expeditionary Medal, Service Specific Expedi20 tionary Medal, Combat Era Specific Expeditionary Medal, 

21 Campaign Specific Medal, or any other combat theater 

22 award established by a Federal statute or an Executive 

23 order)’’. 

24 (c) OUTREACH PLAN.—Not later than December 1, 

25 2022, the Secretary of Veterans Affairs shall submit to the 
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1 Committee on Veterans’ Affairs of the Senate and the Com2 mittee on Veterans’ Affairs of the House of Representatives 

3 a plan to conduct outreach to veterans described in sub4 paragraph (B) of section 1710(e)(3) of title 38, United 

5 States Code, as amended by subsection (a)(2), to notify such 

6 veterans of their eligibility for hospital care, medical serv7 ices, or nursing home care pursuant to such subparagraph. 

8 (d) REPORT ON ENROLLMENTS.—Not later than Janu9 ary 30, 2024, the Secretary shall submit to the Committee 

10 on Veterans’ Affairs of the Senate and the Committee on 

11 Veterans’ Affairs of the House of Representatives a report 

12 identifying, with respect to the one-year period beginning 

13 on October 1, 2022, the number of veterans described in sec14 tion 1710(e)(3)(B) of title 38, United States Code, as 

15 amended by subsection (a)(2), who, during such period, en16 rolled in the patient enrollment system of the Department 

17 of Veterans Affairs established and operated under section 

18 1705(a) of such title. 

19 (e) EFFECTIVE DATE.—This section and the amend20 ments made by this section shall take effect on October 1, 

21 2022. 
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1 TITLE II—TOXIC EXPOSURE 

2 PRESUMPTION PROCESS 

3 SEC. 201. SHORT TITLE. 

4 This title may be cited as the ‘‘Toxic Exposure in the 

5 American Military Act of 2022’’ or the ‘‘TEAM Act of 

6 2022’’. 

7 SEC. 202. IMPROVEMENTS TO ABILITY OF DEPARTMENT OF 

8 VETERANS AFFAIRS TO ESTABLISH PRESUMP9 TIONS OF SERVICE CONNECTION BASED ON 

10 TOXIC EXPOSURE. 

11 (a) ADVISORY COMMITTEES, PANELS, AND BOARDS.— 

12 Chapter 11 is amended by adding at the end the following 

13 new subchapter: 

14 ‘‘SUBCHAPTER VII—DETERMINATIONS RELATING 

15 TO PRESUMPTIONS OF SERVICE CONNEC16 TION BASED ON TOXIC EXPOSURE 

17 ‘‘§ 1171. Procedures to determine presumptions of 

18 service connection based on toxic expo19 sure; definitions 

20 ‘‘(a) PROCEDURES.—The Secretary shall determine 

21 whether to establish, or to remove, presumptions of service 

22 connection based on toxic exposure pursuant to this sub23 chapter, whereby— 

24 ‘‘(1) under section 1172 of this title— 

25 ‘‘(A) the Secretary provides— 
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1 ‘‘(i) public notice regarding what for2 mal evaluations the Secretary plans to con3 duct; and 

4 ‘‘(ii) the public an opportunity to com5 ment on the proposed formal evaluations; 

6 ‘‘(B) the working group established under 

7 subsection (b) of such section provides— 

8 ‘‘(i) advice to the Secretary on toxic9 exposed veterans and cases in which vet10 erans who, during active military, naval, 

11 air, or space service, may have experienced 

12 a toxic exposure or their dependents may 

13 have experienced a toxic exposure while the 

14 veterans were serving in the active military, 

15 naval, air, or space service; 

16 ‘‘(ii) recommendations to the Secretary 

17 on corrections needed in the Individual 

18 Longitudinal Exposure Record to better re19 flect veterans and dependents described in 

20 clause (i); and 

21 ‘‘(iii) recommendations to the Sec22 retary regarding which cases of possible 

23 toxic exposure should be reviewed; 

24 ‘‘(2) the Secretary provides for formal evalua25 tions of such recommendations under section 1173 of 
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1 this title and takes into account reports received by 

2 the Secretary from the National Academies of 

3 Sciences, Engineering, and Medicine under section 

4 1176 of this title; and 

5 ‘‘(3) the Secretary issues regulations under sec6 tion 1174 of this title. 

7 ‘‘(b) DEFINITIONS.—In this subchapter: 

8 ‘‘(1) The term ‘illness’ includes a disease or other 

9 condition affecting the health of an individual, in10 cluding mental and physical health. 

11 ‘‘(2) The term ‘Individual Longitudinal Expo12 sure Record’ includes— 

13 ‘‘(A) service records; 

14 ‘‘(B) any database maintained by the De15 partment of Defense and shared with the Depart16 ment of Veterans Affairs to serve as a central 

17 portal for exposure-related data that compiles, 

18 collates, presents, and provides available occupa19 tional and environmental exposure information 

20 to support the needs of the Department of De21 fense and the Department of Veterans Affairs; or 

22 ‘‘(C) any successor system to a database de23 scribed in subparagraph (B). 
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1 ‘‘§ 1172. Annual notice and opportunity for public 

2 comment 

3 ‘‘(a) NOTICE REQUIRED.—(1)(A) Not less frequently 

4 than once each year, the Secretary shall publish in the Fed5 eral Register notice of the formal evaluations that the Sec6 retary plans to conduct pursuant to section 1173 of this 

7 title. 

8 ‘‘(B) Each notice published under subparagraph (A) 

9 shall include, for each formal evaluation referred to in the 

10 notice, an explanation as to why the military environ11 mental exposures and adverse health outcomes that are the 

12 subject of the formal evaluation were chosen by the Sec13 retary for formal evaluation under section 1173 of this title. 

14 ‘‘(2)(A) With each notice published under paragraph 

15 (1), the Secretary shall seek public comment on the military 

16 environmental exposures and adverse health outcomes that 

17 are the subject of the formal evaluations referred to in the 

18 notice. 

19 ‘‘(B) The Secretary shall— 

20 ‘‘(i) consider all public comment received under 

21 subparagraph (A); and 

22 ‘‘(ii) publish in the Federal Register a response 

23 to the comments received under subparagraph (A). 

24 ‘‘(3)(A) For each notice published under paragraph 

25 (1), the Secretary shall hold an open meeting for members 
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1 of the public to voice their comments in response to the no2 tice. 

3 ‘‘(B) To help evaluate presumptions of service connec4 tion, the Secretary shall, not less frequently than quarterly, 

5 collaborate with, partner with, and give weight to the advice 

6 of veterans service organizations and such other stakeholders 

7 as the Secretary considers appropriate. 

8 ‘‘(4) Failure to include a military environmental expo9 sure or adverse health effect in a Federal Register notice 

10 published pursuant to subsection (a) shall not preclude the 

11 Secretary from initiating a formal evaluation of such expo12 sure or health effect. 

13 ‘‘(b) WORKING GROUP.—(1) The Secretary shall estab14 lish a working group within the Department (in this section 

15 referred to as the ‘Working Group’). 

16 ‘‘(2) The Working Group shall include personnel of the 

17 Veterans Health Administration and the Veterans Benefits 

18 Administration. 

19 ‘‘(3) The Secretary shall consult with, and seek the ad20 vice of, the Working Group with respect to cases in which— 

21 ‘‘(A) a veteran may have, during active mili22 tary, naval, air, or space service, experienced a toxic 

23 exposure; or 
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1 ‘‘(B) a dependent of a veteran may have experi2 enced a toxic exposure during the active military, 

3 naval, air, or space service of the veteran. 

4 ‘‘(c) ASSESSMENTS.—(1) The Working Group shall as5 sess cases of the toxic exposure of veterans and their depend6 ents that occurred during active military, naval, air, or 

7 space service, including by conducting ongoing surveillance 

8 and reviewing such exposure described in scientific lit9 erature, media reports, information from veterans, and in10 formation from Congress. 

11 ‘‘(2) The assessments under paragraph (1) shall cover 

12 suspected and known toxic exposures occurring during ac13 tive military, naval, air, or space service, including by 

14 identifying and evaluating new and emerging toxic expo15 sures that are not recognized under existing presumptions 

16 of service connection. 

17 ‘‘(3) The Working Group may conduct an assessment 

18 under paragraph (1) in response to a comment received 

19 under paragraph (2) or (3) of subsection (a). 

20 ‘‘(4) The Working Group shall, in consultation with 

21 the Secretary of Defense, on a periodic basis, assess the In22 dividual Longitudinal Exposure Record to ensure the accu23 racy of data collected. 

24 ‘‘(d) DEVELOPMENT OF RECOMMENDATIONS.—(1) Fol25 lowing an assessment of a case of the toxic exposure of vet-
24 

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1 erans that occurred during active military, naval, air, or 

2 space service under subsection (c), or their dependents, the 

3 Working Group may develop a recommendation for formal 

4 evaluation under section 1173 of this title to conduct a re5 view of the health effects related to the case of exposure if 

6 the Working Group determines that the research may 

7 change the current understanding of the relationship be8 tween an exposure to an environmental hazard and adverse 

9 health outcomes in humans. 

10 ‘‘(2) Upon receipt of evidence suggesting that previous 

11 findings regarding the periods and locations of exposure 

12 covered by an existing presumption of service connection 

13 are no longer supported, the Working Group may nominate 

14 such evidence for formal evaluation under section 1173 of 

15 this title to modify the periods and locations. 

16 ‘‘(e) REPORTS BY THE WORKING GROUP.—Not less fre17 quently than once each year, the Working Group shall sub18 mit to the Secretary, the Committee on Veterans’ Affairs 

19 of the Senate, and the Committee on Veterans’ Affairs of 

20 the House of Representatives, and make publicly available, 

21 a report on— 

22 ‘‘(1) recommendations developed under sub23 section (d), if any; and 

24 ‘‘(2) recommendations for such legislative or ad25 ministrative action as the Working Group considers 
25 

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1 necessary for the Working Group to be more effective 

2 in carrying out the requirements of this section. 

3 ‘‘(f) RESPONSES BY SECRETARY.—In response to each 

4 report submitted under subsection (e), the Secretary shall, 

5 not later than 30 days after receiving the report, initiate 

6 a formal evaluation pursuant to section 1173 of this title. 

7 ‘‘§ 1173. Formal evaluation of recommendations 

8 ‘‘(a) FORMAL EVALUATIONS.—The Secretary shall es9 tablish a process to conduct a formal evaluation with re10 spect to each recommendation made by the Working Group 

11 under section 1172 of this title. 

12 ‘‘(b) EVIDENCE, DATA, AND FACTORS.—The Secretary 

13 shall ensure that each formal evaluation under subsection 

14 (a) covers the following: 

15 ‘‘(1) Scientific evidence, based on the review of 

16 available scientific literature, including human, toxi17 cological, animal, and methodological studies, and 

18 other factors. 

19 ‘‘(2) Claims data, based on the review of claim 

20 rate, grant rate, and service connection prevalence, 

21 and other factors. 

22 ‘‘(3) Other factors the Secretary determines ap23 propriate, such as— 
26 

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1 ‘‘(A) the level of disability and mortality 

2 caused by the health effects related to the case of 

3 toxic exposure being evaluated; 

4 ‘‘(B) the quantity and quality of the infor5 mation available and reviewed; 

6 ‘‘(C) the feasibility of and period for gener7 ating relevant information and evidence; 

8 ‘‘(D) whether such health effects are combat9 or deployment-related; 

10 ‘‘(E) the ubiquity or rarity of the health ef11 fects; and 

12 ‘‘(F) any time frame during which a health 

13 effect must become manifest. 

14 ‘‘(c) CONDUCT OF EVALUATIONS.—(1) The Secretary 

15 shall ensure that each formal evaluation under subsection 

16 (a)— 

17 ‘‘(A) reviews scientific evidence in a manner 

18 that— 

19 ‘‘(i) conforms to principles of scientific and 

20 data integrity; 

21 ‘‘(ii) is free from suppression or distortion 

22 of scientific or technological findings, data, in23 formation, conclusions, or technical results; and 

24 ‘‘(B)(i) evaluates the likelihood that a positive 

25 association exists between an illness and a toxic expo-
27 

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1 sure while serving in the active military, naval, air, 

2 or space service; and 

3 ‘‘(ii) assesses the toxic exposures and illnesses 

4 and determines whether the evidence supports a find5 ing of a positive association between the toxic expo6 sure and the illness. 

7 ‘‘(2) In carrying out paragraph (1)(B)(ii), a formal 

8 evaluation under subsection (a) shall include reviewing all 

9 relevant data to determine the strength of evidence for a 

10 positive association based on the following four categories: 

11 ‘‘(A) The ‘sufficient’ category, where the evidence 

12 is sufficient to conclude that a positive association ex13 ists. 

14 ‘‘(B) The ‘equipoise and above’ category, where 

15 the evidence is sufficient to conclude that a positive 

16 association is at least as likely as not, but not suffi17 cient to conclude that a positive association exists. 

18 ‘‘(C) The ‘below equipoise’ category, where the 

19 evidence is not sufficient to conclude that a positive 

20 association is at least as likely as not, or is not suffi21 cient to make a scientifically informed judgment. 

22 ‘‘(D) The ‘against’ category, where the evidence 

23 suggests the lack of a positive association. 

24 ‘‘(d) RECOMMENDATION FOR ESTABLISHING A PRE25 SUMPTION OF SERVICE CONNECTION.—Not later than 120 
28 

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1 days after the date on which a formal evaluation is com2 menced, the element of the Department that conducts the 

3 evaluation shall submit to the Secretary a recommendation 

4 with respect to establishing a presumption of service connec5 tion for the toxic exposure and illness, or modifying an ex6 isting presumption of service connection, covered by the 

7 evaluation. 

8 ‘‘§ 1174. Regulations regarding presumptions of serv9 ice connection based on toxic exposure 

10 ‘‘(a) ACTION UPON RECOMMENDATION.—Not later 

11 than 160 days after the date on which the Secretary receives 

12 a recommendation to establish or modify a presumption of 

13 service connection under section 1173 of this title— 

14 ‘‘(1) if the Secretary determines, in the discre15 tion of the Secretary, that the presumption, or modi16 fication, is warranted, the Secretary shall— 

17 ‘‘(A) commence issuing regulations in ac18 cordance with the provisions of subchapter II of 

19 chapter 5 of title 5 (commonly referred to as the 

20 Administrative Procedures Act) setting forth the 

21 presumption or commence revising regulations to 

22 carry out such modification; and 

23 ‘‘(B) include in such regulations any time 

24 frame during which a health effect must become 

25 manifest; or 
29 

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1 ‘‘(2) if the Secretary determines, in the discre2 tion of the Secretary, that the presumption, or modi3 fication, is not warranted, the Secretary shall publish 

4 in the Federal Register a notice of the determination, 

5 including the reasons supporting the determination. 

6 ‘‘(b) REMOVAL OF PRESUMPTION.—(1)(A) The Sec7 retary may— 

8 ‘‘(i) issue a regulation to remove an illness from 

9 a presumption of service connection previously estab10 lished pursuant to a regulation issued under sub11 section (a); and 

12 ‘‘(ii) issue a regulation to remove a presumption 

13 of service connection established pursuant to title IV 

14 of the Sergeant First Class Heath Robinson Honoring 

15 our Promise to Address Comprehensive Toxics Act of 

16 2022 if the Secretary concludes that evidence suggests 

17 the lack of a positive association between the disease 

18 and the toxic exposure. 

19 ‘‘(B) Under subparagraph (A)(ii), the Secretary shall 

20 not consider the lack of evidence as sufficient to support 

21 a decision for removal of a presumption. 

22 ‘‘(2) Whenever an illness is removed from regulations 

23 pursuant to paragraph (1), or the periods and locations of 

24 exposure covered by a presumption of service connection are 

25 modified under subsection (a)— 
30 

•S 3373 EAH 

1 ‘‘(A) a veteran who was awarded compensation 

2 under chapter 11 of this title for such illness on the 

3 basis of the presumption provided under such regula4 tions before the effective date of the removal or modi5 fication shall continue to be entitled to receive com6 pensation on that basis; 

7 ‘‘(B) a survivor of a veteran who was awarded 

8 dependency and indemnity compensation under chap9 ter 13 of this title for the death of a veteran resulting 

10 from such illness on the basis of such presumption 

11 shall continue to be entitled to receive dependency and 

12 indemnity compensation on such basis; and 

13 ‘‘(C) no veteran or survivor covered under sub14 paragraph (A) or (B) shall have their compensation 

15 reduced solely because of the removal of an illness 

16 pursuant to paragraph (1). 

17 ‘‘§ 1175. Authority to modify process; congressional 

18 oversight 

19 ‘‘(a) IN GENERAL.—The Secretary may modify the 

20 process under which the working group established under 

21 subsection (b) of section 1172 of this title conducts assess22 ments under such section, the Secretary conducts formal 

23 evaluations under section 1173 of this title, and issues regu24 lations under section 1174 of this title if— 
31 

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1 ‘‘(1) such evaluations cover the evidence, data, 

2 and factors required by subsection (b) of such section 

3 1173; and 

4 ‘‘(2) a period of 180 days has elapsed following 

5 the date on which the Secretary submits the notice 

6 under subsection (b) regarding the modification. 

7 ‘‘(b) NOTICE.—If the Secretary proposes to modify the 

8 process under which the working group established under 

9 subsection (b) of section 1172 of this title conducts assess10 ments under such section, the process under which the Sec11 retary conducts formal evaluations under section 1173 of 

12 this title, or issues regulations under section 1174 of this 

13 title, the Secretary shall submit to the Committee on Vet14 erans’ Affairs of the Senate and the Committee on Veterans’ 

15 Affairs of the House of Representatives a notice of the pro16 posed modifications containing the following: 

17 ‘‘(1) A description of the proposed modifications. 

18 ‘‘(2) A description of any exceptions to the re19 quirements of such sections that are proposed because 

20 of limited available scientific evidence, and a descrip21 tion of how such evaluations will be conducted. 
32 

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1 ‘‘§ 1176. Agreement with National Academies of 

2 Sciences, Engineering, and Medicine con3 cerning toxic exposures 

4 ‘‘(a) PURPOSE.—The purpose of this section is to pro5 vide for the National Academies of Sciences, Engineering, 

6 and Medicine (in this section referred to as the ‘Acad7 emies’), an independent nonprofit scientific organization 

8 with appropriate expertise that is not part of the Federal 

9 Government, to review and evaluate the available scientific 

10 evidence regarding associations between diseases and toxic 

11 exposures. 

12 ‘‘(b) AGREEMENT.—(1) The Secretary shall seek to 

13 enter into a five-year agreement with the Academies to per14 form the services covered by this section. 

15 ‘‘(2) The Secretary shall seek to enter into an agree16 ment described in paragraph (1) not later than 60 days 

17 after the date of the enactment of the Sergeant First Class 

18 Heath Robinson Honoring our Promise to Address Com19 prehensive Toxics Act of 2022. 

20 ‘‘(3) An agreement under this section may be extended 

21 in five-year increments. 

22 ‘‘(c) REVIEW OF SCIENTIFIC EVIDENCE.—Under an 

23 agreement between the Secretary and the Academies under 

24 this section, the Academies shall review and summarize the 

25 scientific evidence, and assess the strength thereof, con26 cerning the association between toxic exposures during ac-
33 

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1 tive military, naval, air, or space service and each disease 

2 suspected to be associated with such exposure in the human 

3 population. 

4 ‘‘(d) SCIENTIFIC DETERMINATIONS CONCERNING DIS5 EASES.—For each disease reviewed under subsection (c), the 

6 Academies shall determine, to the extent that available sci7 entific data permit meaningful determinations— 

8 ‘‘(1) whether an association exists between toxic 

9 exposures and the occurrence of the disease, taking 

10 into account the strength of the scientific evidence and 

11 the appropriateness of the statistical and epidemiolog12 ical methods used to detect the association; 

13 ‘‘(2) the increased risk of the disease among those 

14 reporting toxic exposures during active military, 

15 naval, air, or space service; 

16 ‘‘(3) whether there exists a plausible biological 

17 mechanism or other evidence of a positive association 

18 between the toxic exposure and the occurrence of the 

19 disease; and 

20 ‘‘(4) determine the strength of evidence for a 

21 positive association based on categories furnished 

22 under section 1173 of this title. 

23 ‘‘(e) COOPERATION OF FEDERAL AGENCIES.—The 

24 head of each relevant Federal agency, including the Sec-
34 

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1 retary of Defense, shall cooperate fully with the Academies 

2 in performing the services covered by this section. 

3 ‘‘(f) RECOMMENDATIONS FOR ADDITIONAL SCIENTIFIC

4 STUDIES.—(1) Under an agreement between the Secretary 

5 and the Academies under this section, the Academies shall 

6 make any recommendations for additional scientific studies 

7 to resolve areas of continuing scientific uncertainty relating 

8 to toxic exposures. 

9 ‘‘(2) In making recommendations under paragraph 

10 (1), the Academies shall consider— 

11 ‘‘(A) the scientific information that is available 

12 at the time of the recommendation; 

13 ‘‘(B) the value and relevance of the information 

14 that could result from additional studies; and 

15 ‘‘(C) the cost and feasibility of carrying out such 

16 additional studies. 

17 ‘‘(g) REPORTS.—(1)(A) Under an agreement between 

18 the Secretary and the Academies under this section, not 

19 later than one year after the date of the enactment of the 

20 Sergeant First Class Heath Robinson Honoring our Prom21 ise to Address Comprehensive Toxics Act of 2022, the Acad22 emies shall submit to the Secretary, the Committee on Vet23 erans’ Affairs of the Senate, and the Committee on Veterans’ 

24 Affairs of the House of Representatives an initial report on 

25 the activities of the Academies under the agreement. 
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1 ‘‘(B) The report submitted under subparagraph (A) 

2 shall include the following: 

3 ‘‘(i) The determinations described in subsection 

4 (d). 

5 ‘‘(ii) A full explanation of the scientific evidence 

6 and reasoning that led to such determinations. 

7 ‘‘(iii) Any recommendations of the Academies 

8 under subsection (f). 

9 ‘‘(2) Under an agreement between the Secretary and 

10 the Academies under this section, not less frequently than 

11 once every two years after the date on which the initial re12 port is submitted under paragraph (1)(A), the Academies 

13 shall submit to the Secretary, the Committee on Veterans’ 

14 Affairs of the Senate, and the Committee on Veterans’ Af15 fairs of the House of Representatives an updated report on 

16 the activities of the Academies under the agreement. 

17 ‘‘(h) ALTERNATIVE CONTRACT SCIENTIFIC ORGANIZA18 TION.—(1) If the Secretary is unable within the time period 

19 prescribed in subsection (b)(2) to enter into an agreement 

20 with the Academies for the purposes of this section on terms 

21 acceptable to the Secretary, the Secretary shall seek to enter 

22 into an agreement for the purposes of this section with an23 other appropriate scientific organization that— 

24 ‘‘(A) is not part of the Federal Government; 

25 ‘‘(B) operates as a not-for-profit entity; and 
36 

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1 ‘‘(C) has expertise and objectivity comparable to 

2 that of the Academies. 

3 ‘‘(2) If the Secretary enters into an agreement with 

4 another organization as described in paragraph (1), any 

5 reference in this subchapter to the Academies shall be treat6 ed as a reference to the other organization.’’. 

7 (b) REPORTS AND BRIEFINGS.— 

8 (1) REPORT.— 

9 (A) IN GENERAL.—Not later than two years 

10 after the date of the enactment of this Act, the 

11 Secretary of Veterans Affairs shall submit to the 

12 Committee on Veterans’ Affairs of the Senate 

13 and the Committee on Veterans’ Affairs of the 

14 House of Representatives a report on the imple15 mentation of, and recommendations for, sub16 chapter VII of chapter 11 of title 38, United 

17 States Code, as added by subsection (a). 

18 (B) CONSULTATION.—The Secretary shall 

19 develop the report under subparagraph (A) in 

20 consultation with organizations recognized by 

21 the Secretary for the representation of veterans 

22 under section 5902 of such title and any other 

23 entity the Secretary determines appropriate. 

24 (2) BRIEFING.—On a quarterly basis during the 

25 two-year period beginning on the date of the enact-
37 

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1 ment of this Act, the Secretary shall provide to the 

2 Committee on Veterans’ Affairs of the Senate and the 

3 Committee on Veterans’ Affairs of the House of Rep4 resentatives a briefing on the implementation of sub5 chapter VII of chapter 11 of such title, as added by 

6 subsection (a). 

7 (c) INDEPENDENT ASSESSMENT.— 

8 (1) AGREEMENT.—The Secretary shall seek to 

9 enter into an agreement with the National Academies 

10 of Science, Engineering, and Medicine (in this sub11 section referred to as the ‘‘Academies’’) before the date 

12 that is 90 days after the date of the enactment of this 

13 Act to perform the services set forth under paragraph 

14 (2). 

15 (2) ASSESSMENT.— 

16 (A) IN GENERAL.—Under an agreement be17 tween the Secretary and the Academies under 

18 paragraph (1), the Academies shall conduct an 

19 assessment of the implementation by the Depart20 ment of Veterans Affairs of the process estab21 lished under subchapter VII of chapter 11 of title 

22 38, United States Code, as added by subsection 

23 (a). 
38 

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1 (B) ELEMENTS.—The assessment conducted 

2 under subparagraph (A) shall include the fol3 lowing: 

4 (i) An assessment of the Department’s 

5 implementation of the process established 

6 under subsection (a) to determine whether 

7 the process is in accordance with current 

8 scientific standards for assessing the link 

9 between exposure to environmental hazards 

10 and the development of health outcomes, 

11 (ii) assess whether the criteria is fair 

12 and consistent, and 

13 (iii) provide recommendations for im14 provements to the process. 

15 (3) REPORT.—Not later than one year after the 

16 date on which the Secretary enters into an agreement 

17 under paragraph (1), the Secretary shall submit to 

18 the Committee on Veterans’ Affairs of the Senate and 

19 the Committee on Veterans’ Affairs of the House of 

20 Representatives a report on the findings of the Acad21 emies pursuant to such agreement. 

22 (4) ALTERNATIVE CONTRACT SCIENTIFIC ORGANI23 ZATION.— 

24 (A) IN GENERAL.—If the Secretary is un25 able within the time period prescribed in para-
39 

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1 graph (1) to enter into an agreement with the 

2 Academies for the purposes of this subsection on 

3 terms acceptable to the Secretary, the Secretary 

4 shall seek to enter into an agreement for the pur5 poses of this subsection with another appropriate 

6 scientific organization that— 

7 (i) is not part of the Federal Govern8 ment; 

9 (ii) operates as a not-for-profit entity; 

10 and 

11 (iii) has expertise and objectivity com12 parable to that of the Academies. 

13 (B) TREATMENT.—If the Secretary enters 

14 into an agreement with another organization as 

15 described in subparagraph (A), any reference in 

16 this subsection to the Academies of Sciences, En17 gineering, and Medicine shall be treated as a ref18 erence to the other organization. 

19 (d) CONFORMING AMENDMENTS.—Chapter 11 is 

20 amended— 

21 (1) in section 1116— 

22 (A) by striking subsections (b), (c), (d), and 

23 (e); 

24 (B) by inserting after subsection (a) the fol25 lowing new subsection (b): 
40 

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1 ‘‘(b) The Secretary shall ensure that any determina2 tion made on or after the date of the enactment of the Ser3 geant First Class Heath Robinson Honoring our Promise 

4 to Address Comprehensive Toxics Act of 2022 regarding a 

5 presumption of service connection based on exposure to an 

6 herbicide agent under this section is made pursuant to sub7 chapter VII of this chapter, including with respect to assess8 ing reports received by the Secretary from the National 

9 Academy of Sciences under section 3 of the Agent Orange 

10 Act of 1991 (Public Law 102–4).’’; and 

11 (C) by redesignating subsection (f) as sub12 section (c); 

13 (2) in section 1116B(b)(2)(A), by inserting ‘‘pur14 suant to subchapter VII of this chapter,’’ before ‘‘the 

15 Secretary determines’’; and 

16 (3) in section 1118— 

17 (A) by striking subsections (b) through (e); 

18 and 

19 (B) by inserting after subsection (a) the fol20 lowing new subsection (b): 

21 ‘‘(b) The Secretary shall ensure that any determina22 tion made on or after the date of the enactment of the Ser23 geant First Class Heath Robinson Honoring our Promise 

24 to Address Comprehensive Toxics Act of 2022 regarding a 

25 presumption of service connection based on a toxic exposure 
41 

•S 3373 EAH 

1 under this section is made pursuant to subchapter VII of 

2 this chapter.’’. 

3 SEC. 203. OUTREACH TO CLAIMANTS FOR DISABILITY COM4 PENSATION PURSUANT TO CHANGES IN PRE5 SUMPTIONS OF SERVICE CONNECTION. 

6 (a) IN GENERAL.—Subchapter VI of chapter 11 is 

7 amended by adding at the end the following new section: 

8 ‘‘§ 1167. Outreach pursuant to changes in presump9 tions of service connection 

10 ‘‘(a) IN GENERAL.—Whenever a law, including 

11 through a regulation or Federal court decision or settlement, 

12 establishes or modifies a presumption of service connection, 

13 the Secretary shall— 

14 ‘‘(1) identify all claims for compensation under 

15 this chapter that— 

16 ‘‘(A) were submitted to the Secretary; 

17 ‘‘(B) were evaluated and denied by the Sec18 retary before the date on which such provision of 

19 law went into effect; and 

20 ‘‘(C) might have been evaluated differently 

21 had the establishment or modification been ap22 plicable to the claim; and 

23 ‘‘(2) pursuant to subsection (b), conduct outreach 

24 to the claimants. 
42 

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1 ‘‘(b) OUTREACH.—(1) The Secretary shall conduct out2 reach to inform claimants identified under subsection (a) 

3 that they may submit a supplemental claim in light of the 

4 establishment or modification of a presumption of service 

5 connection described in subsection (a). 

6 ‘‘(2) Outreach under paragraph (1) shall include the 

7 following: 

8 ‘‘(A) The Secretary shall publish on the internet 

9 website of the Department a notice that such veterans 

10 may elect to file a supplemental claim. 

11 ‘‘(B) The Secretary shall notify, in writing or by 

12 electronic means, veterans service organizations of the 

13 ability of such veterans to file a supplemental claim. 

14 ‘‘(C) The Secretary shall contact each claimant 

15 identified under subsection (a) in the same manner 

16 that the Department last provided notice of a deci17 sion.’’. 

18 (b) APPLICATION.—Section 1167 of title 38, United 

19 States Code, as added by subsection (a), shall apply with 

20 respect to presumptions of service connection established or 

21 modified on or after the date of the enactment of this Act, 

22 including pursuant to amendments made by this Act. 

23 (c) RULE OF CONSTRUCTION.—Nothing in this section 

24 shall be construed as— 
43 

•S 3373 EAH 

1 (1) modifying the obligations of the Department 

2 of Veterans Affairs under Federal court decisions or 

3 settlements in effect as of the date of the enactment of 

4 this Act; or 

5 (2) requiring a retroactively applied effective 

6 date of a supplemental claim earlier than the date a 

7 presumption of service connection is established or 

8 modified. 

9 SEC. 204. REEVALUATION OF CLAIMS FOR DEPENDENCY 

10 AND INDEMNITY COMPENSATION INVOLVING 

11 PRESUMPTIONS OF SERVICE CONNECTION. 

12 (a) IN GENERAL.—Subchapter I of chapter 13 is 

13 amended by adding at the end the following new section: 

14 ‘‘§ 1305. Reevaluation of dependency and indemnity 

15 compensation determinations pursuant to 

16 changes in presumptions of service con17 nection 

18 ‘‘(a) REEVALUATION.—Whenever a law, including 

19 through a regulation or Federal court decision or settlement, 

20 establishes or modifies a presumption of service connection, 

21 the Secretary shall— 

22 ‘‘(1) identify all claims for dependency and in23 demnity compensation under this chapter that— 

24 ‘‘(A) were submitted to the Secretary; 
44 

•S 3373 EAH 

1 ‘‘(B) were evaluated and denied by the Sec2 retary before the date on which such provision of 

3 law went into effect; and 

4 ‘‘(C) might have been evaluated differently 

5 had the establishment or modification been ap6 plicable to the claim; 

7 ‘‘(2) allow for the reevaluation of such claims at 

8 the election of the claimant; and 

9 ‘‘(3) notwithstanding section 5110 of this title, 

10 with respect to claims approved pursuant to such re11 evaluation, provide compensation under this chapter 

12 effective as if the establishment or modification of the 

13 presumption of service connection had been in effect 

14 on the date of the submission of the original claim de15 scribed in paragraph (1). 

16 ‘‘(b) OUTREACH.—(1) The Secretary shall conduct out17 reach to inform relevant claimants that they may elect to 

18 have a claim be reevaluated in light of the establishment 

19 or modification of a presumption of service connection de20 scribed in subsection (a). 

21 ‘‘(2) Outreach under paragraph (1) shall include the 

22 following: 

23 ‘‘(A) The Secretary shall publish on the internet 

24 website of the Department a notice that such claim25 ants may elect to have a claim so reevaluated. 
45 

•S 3373 EAH 

1 ‘‘(B) The Secretary shall notify, in writing or by 

2 electronic means, veterans service organizations of the 

3 ability of such claimants to elect to have a claim so 

4 reevaluated. 

5 ‘‘(C) The Secretary shall contact each claimant 

6 identified under subsection (a) in the same manner 

7 that the Department last provided notice of a deci8 sion.’’. 

9 (b) APPLICATION.—Section 1305 of title 38, United 

10 States Code, as added by subsection (a), shall apply with 

11 respect to presumptions of service connection established or 

12 modified on or after the date of the enactment of this Act, 

13 including pursuant to amendments made by this Act. 

14 (c) RULE OF CONSTRUCTION.—Nothing in this section 

15 shall be construed as modifying the obligations of the De16 partment of Veterans Affairs under Federal court decisions 

17 or settlements in effect as of the date of the enactment of 

18 this Act. 

19 TITLE III—IMPROVING THE ES20 TABLISHMENT OF SERVICE 

21 CONNECTION PROCESS FOR 

22 TOXIC-EXPOSED VETERANS 

23 SEC. 301. SHORT TITLE. 

24 This title may be cited as the ‘‘Veterans Burn Pits Ex25 posure Recognition Act of 2022’’. 
46 

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1 SEC. 302. PRESUMPTIONS OF TOXIC EXPOSURE. 

2 Subchapter II of chapter 11 is amended by adding at 

3 the end the following new section: 

4 ‘‘§ 1119. Presumptions of toxic exposure 

5 ‘‘(a) CONSIDERATION OF RECORDS.—If a veteran sub6 mits to the Secretary a claim for compensation for a serv7 ice-connected disability under section 1110 of this title with 

8 evidence of a disability and a toxic exposure that occurred 

9 during active military, naval, air, or space service, the Sec10 retary may, in adjudicating such claim, consider— 

11 ‘‘(1) any record of the veteran in an exposure 

12 tracking record system; and 

13 ‘‘(2) if no record of the veteran in an exposure 

14 tracking record system indicates that the veteran was 

15 subject to a toxic exposure during active military, 

16 naval, air, or space service, the totality of the cir17 cumstances of the service of the veteran. 

18 ‘‘(b) PRESUMPTION OF SPECIFIC TOXIC EXPOSURE

19 FOR MEMBERS WHO SERVED IN CERTAIN LOCATIONS.— 

20 (1) The Secretary shall, for purposes of section 1110 and 

21 chapter 17 of this title, presume that any covered veteran 

22 was exposed to the substances, chemicals, and airborne haz23 ards identified in the list under paragraph (2) during the 

24 service of the covered veteran specified in subsection (c)(1), 

25 unless there is affirmative evidence to establish that the cov-
47 

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1 ered veteran was not exposed to any such substances, chemi2 cals, or hazards in connection with such service. 

3 ‘‘(2) The Secretary shall— 

4 ‘‘(A) establish and maintain a list that contains 

5 an identification of one or more such substances, 

6 chemicals, and airborne hazards as the Secretary, in 

7 collaboration with the Secretary of Defense, may de8 termine appropriate for purposes of this section; and 

9 ‘‘(B) determine, using procedures consistent with 

10 section 1172 of this title and through the conduct of 

11 a formal evaluation under section 1173 of this title, 

12 whether to establish an end date for a covered veteran 

13 to qualify for presumptions of exposure under this 

14 section, if appropriate, but in no case establish an 

15 end date earlier than the last day of the period speci16 fied in section 101(33) for the Persian Gulf War. 

17 ‘‘(3) Beginning not later than two years after the date 

18 of the enactment of the Sergeant First Class Heath Robin19 son Honoring our Promise to Address Comprehensive 

20 Toxics Act of 2022, and not less frequently than once every 

21 two years thereafter, the Secretary shall submit to the Com22 mittee on Veterans’ Affairs of the Senate and the Committee 

23 on Veterans’ Affairs of the House of Representatives a report 

24 identifying any additions or removals to the list under 

25 paragraph (2) during the period covered by the report. 
48 

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1 ‘‘(c) DEFINITIONS.—In this section: 

2 ‘‘(1) The term ‘covered veteran’ means any vet3 eran who— 

4 ‘‘(A) on or after August 2, 1990, performed 

5 active military, naval, air, or space service while 

6 assigned to a duty station in, including airspace 

7 above— 

8 ‘‘(i) Bahrain; 

9 ‘‘(ii) Iraq; 

10 ‘‘(iii) Kuwait; 

11 ‘‘(iv) Oman; 

12 ‘‘(v) Qatar; 

13 ‘‘(vi) Saudi Arabia; 

14 ‘‘(vii) Somalia; or 

15 ‘‘(viii) United Arab Emirates; or 

16 ‘‘(B) on or after September 11, 2001, per17 formed active military, naval, air, or space serv18 ice while assigned to a duty station in, including 

19 airspace above— 

20 ‘‘(i) Afghanistan; 

21 ‘‘(ii) Djibouti; 

22 ‘‘(iii) Egypt; 

23 ‘‘(iv) Jordan; 

24 ‘‘(v) Lebanon; 

25 ‘‘(vi) Syria; 
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1 ‘‘(vii) Yemen; 

2 ‘‘(viii) Uzbekistan; or 

3 ‘‘(ix) any other country determined rel4 evant by the Secretary. 

5 ‘‘(2) The term ‘exposure tracking record sys6 tem’— 

7 ‘‘(A) means any system, program, or pilot 

8 program used by the Secretary of Veterans Af9 fairs or the Secretary of Defense to track how 

10 veterans or members of the Armed Forces have 

11 been exposed to various occupational or environ12 mental hazards; and 

13 ‘‘(B) includes the Individual Longitudinal 

14 Exposure Record, or successor system. 

15 ‘‘(3) The term ‘toxic exposure risk activity’ has 

16 the meaning given such term in section 1710(e)(4) of 

17 this title.’’. 

18 SEC. 303. MEDICAL NEXUS EXAMINATIONS FOR TOXIC EX19 POSURE RISK ACTIVITIES. 

20 Subchapter VI of chapter 11, as amended by section 

21 203, is further amended by adding at the end the following 

22 new section: 
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1 ‘‘§ 1168. Medical nexus examinations for toxic expo2 sure risk activities 

3 ‘‘(a) MEDICAL EXAMINATIONS AND MEDICAL OPIN4 IONS.—(1) Except as provided in subsection (b), if a vet5 eran submits to the Secretary a claim for compensation for 

6 a service-connected disability under section 1110 of this 

7 title with evidence of a disability and evidence of participa8 tion in a toxic exposure risk activity during active mili9 tary, naval, air, or space service, and such evidence is not 

10 sufficient to establish a service connection for the disability, 

11 the Secretary shall— 

12 ‘‘(A) provide the veteran with a medical exam13 ination under section 5103A(d) of this title; and 

14 ‘‘(B) obtain a medical opinion (to be requested 

15 by the Secretary in connection with the medical ex16 amination under subparagraph (A)) as to whether it 

17 is at least as likely as not that there is a nexus be18 tween the disability and the toxic exposure risk activ19 ity. 

20 ‘‘(2) When providing the Secretary with a medical 

21 opinion under paragraph (1)(B) for a veteran, the health 

22 care provider shall consider— 

23 ‘‘(A) the total potential exposure through all ap24 plicable military deployments of the veteran; and 

25 ‘‘(B) the synergistic, combined effect of all toxic 

26 exposure risk activities of the veteran. 
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1 ‘‘(3) The requirement under paragraph (2)(B) shall 

2 not be construed as requiring a health care provider to con3 sider the synergistic, combined effect of each of the sub4 stances, chemicals, and airborne hazards identified in the 

5 list under section 1119(b)(2) of this title. 

6 ‘‘(b) EXCEPTION.—Subsection (a) shall not apply if 

7 the Secretary determines there is no indication of an asso8 ciation between the disability claimed by the veteran and 

9 the toxic exposure risk activity for which the veteran sub10 mitted evidence. 

11 ‘‘(c) TOXIC EXPOSURE RISK ACTIVITY DEFINED.—In 

12 this section, the term ‘toxic exposure risk activity’ has the 

13 meaning given that term in section 1710(e)(4) of this title.’’. 

14 TITLE IV—PRESUMPTIONS OF 

15 SERVICE CONNECTION 

16 SEC. 401. TREATMENT OF VETERANS WHO PARTICIPATED 

17 IN CLEANUP OF ENEWETAK ATOLL AS RADI18 ATION-EXPOSED VETERANS FOR PURPOSES 

19 OF PRESUMPTION OF SERVICE CONNECTION 

20 OF CERTAIN DISABILITIES BY DEPARTMENT 

21 OF VETERANS AFFAIRS. 

22 (a) SHORT TITLE.—This section may be cited as the 

23 ‘‘Mark Takai Atomic Veterans Healthcare Parity Act of 

24 2022’’. 
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1 (b) ENEWETAK ATOLL.—Section 1112(c)(3)(B) is 

2 amended by adding at the end the following new clause: 

3 ‘‘(v) Cleanup of Enewetak Atoll during the 

4 period beginning on January 1, 1977, and end5 ing on December 31, 1980.’’. 

6 SEC. 402. TREATMENT OF VETERANS WHO PARTICIPATED 

7 IN NUCLEAR RESPONSE NEAR PALOMARES, 

8 SPAIN, OR THULE, GREENLAND, AS RADI9 ATION-EXPOSED VETERANS FOR PURPOSES 

10 OF PRESUMPTION OF SERVICE CONNECTION 

11 OF CERTAIN DISABILITIES BY DEPARTMENT 

12 OF VETERANS AFFAIRS. 

13 (a) SHORT TITLE.—This section may be cited as the 

14 ‘‘Palomares or Thule Veterans Act of 2022’’. 

15 (b) PALOMARES OR THULE.—Section 1112(c)(3)(B), 

16 as amended by section 401, is further amended by adding 

17 at the end the following new clauses: 

18 ‘‘(vi) Onsite participation in the response 

19 effort following the collision of a United States 

20 Air Force B–52 bomber and refueling plane that 

21 caused the release of four thermonuclear weapons 

22 in the vicinity of Palomares, Spain, during the 

23 period beginning January 17, 1966, and ending 

24 March 31, 1967. 
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1 ‘‘(vii) Onsite participation in the response 

2 effort following the on-board fire and crash of a 

3 United States Air Force B–52 bomber that 

4 caused the release of four thermonuclear weapons 

5 in the vicinity of Thule Air Force Base, Green6 land, during the period beginning January 21, 

7 1968, and ending September 25, 1968.’’. 

8 SEC. 403. PRESUMPTIONS OF SERVICE CONNECTION FOR 

9 DISEASES ASSOCIATED WITH EXPOSURES TO 

10 CERTAIN HERBICIDE AGENTS FOR VETERANS 

11 WHO SERVED IN CERTAIN LOCATIONS. 

12 (a) SHORT TITLE.—This section may be cited as the 

13 ‘‘Veterans Agent Orange Exposure Equity Act of 2022’’. 

14 (b) IN GENERAL.—Section 1116, as amended by sec15 tion 202, is further amended— 

16 (1) by striking ‘‘, during active military, naval, 

17 air, or space service, served in the Republic of Viet18 nam during the period beginning on January 9, 

19 1962, and ending on May 7, 1975’’ each place it ap20 pears and inserting ‘‘performed covered service’’; 

21 (2) by striking ‘‘performed active military, 

22 naval, air, or space service in the Republic of Viet23 nam during the period beginning on January 9, 

24 1962, and ending on May 7, 1975’’ each place it ap25 pears and inserting ‘‘performed covered service’’; and 
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1 (3) by adding at the end the following new sub2 section: 

3 ‘‘(d) In this section, the term ‘covered service’ means 

4 active military, naval, air, or space service— 

5 ‘‘(1) performed in the Republic of Vietnam dur6 ing the period beginning on January 9, 1962, and 

7 ending on May 7, 1975; 

8 ‘‘(2) performed in Thailand at any United 

9 States or Royal Thai base during the period begin10 ning on January 9, 1962, and ending on June 30, 

11 1976, without regard to where on the base the veteran 

12 was located or what military job specialty the veteran 

13 performed; 

14 ‘‘(3) performed in Laos during the period begin15 ning on December 1, 1965, and ending on September 

16 30, 1969; 

17 ‘‘(4) performed in Cambodia at Mimot or Krek, 

18 Kampong Cham Province during the period begin19 ning on April 16, 1969, and ending on April 30, 

20 1969; or 

21 ‘‘(5) performed on Guam or American Samoa, or 

22 in the territorial waters thereof, during the period be23 ginning on January 9, 1962, and ending on July 31, 

24 1980, or served on Johnston Atoll or on a ship that 

25 called at Johnston Atoll during the period beginning 
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1 on January 1, 1972, and ending on September 30, 

2 1977.’’. 

3 (c) ELIGIBILITY FOR HOSPITAL CARE AND MEDICAL

4 SERVICES.—Section 1710(e)(4), as amended by section 

5 102(c), is further amended by striking subparagraph (A) 

6 and inserting the following new subparagraph: 

7 ‘‘(A) The term ‘Vietnam-era herbicide-exposed 

8 veteran’ means a veteran who— 

9 ‘‘(i) performed covered service, as defined in 

10 section 1116(d) of this title; or 

11 ‘‘(ii) the Secretary finds may have been ex12 posed during active military, naval, air, or 

13 space service to dioxin during the Vietnam era, 

14 regardless of the geographic area of such service, 

15 or was exposed during such service to a toxic 

16 substance found in a herbicide or defoliant used 

17 for military purposes during such era, regardless 

18 of the geographic area of such service.’’. 

19 (d) CONFORMING AMENDMENT.—The heading for sec20 tion 1116 is amended by striking ‘‘the Republic of 

21 Vietnam’’ and inserting ‘‘certain locations’’. 

22 (e) EFFECTIVE DATE AND APPLICABILITY.—The 

23 amendments made by this section shall take effect on the 

24 date of the enactment of this Act and shall apply as follows: 
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1 (1) On the date of the enactment of this Act for 

2 claimants for dependency and indemnity compensa3 tion under chapter 13 of title 38, United States Code, 

4 and for veterans whom the Secretary of Veterans Af5 fairs determines are— 

6 (A) terminally ill; 

7 (B) homeless; 

8 (C) under extreme financial hardship; 

9 (D) more than 85 years old; or 

10 (E) capable of demonstrating other suffi11 cient cause. 

12 (2) On October 1, 2022, for everyone not de13 scribed in paragraph (1). 

14 SEC. 404. ADDITION OF ADDITIONAL DISEASES ASSOCIATED 

15 WITH EXPOSURE TO CERTAIN HERBICIDE 

16 AGENTS FOR WHICH THERE IS A PRESUMP17 TION OF SERVICE CONNECTION FOR VET18 ERANS WHO SERVED IN CERTAIN LOCATIONS. 

19 (a) SHORT TITLE.—This section may be cited as the 

20 ‘‘Fair Care for Vietnam Veterans Act of 2022’’. 

21 (b) MONOCLONAL GAMMOPATHY OF UNDETERMINED

22 SIGNIFICANCE.—Section 1116(a)(2) of title 38, United 

23 States Code, is amended by adding at the end the following 

24 new subparagraph: 
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1 ‘‘(L) Monoclonal gammopathy of undetermined 

2 significance.’’. 

3 (c) HYPERTENSION.—Such section, as amended by 

4 subsection (b), is further amended by adding at the end the 

5 following new subparagraph: 

6 ‘‘(M) Hypertension.’’. 

7 (d) EFFECTIVE DATES AND APPLICABILITY.— 

8 (1) MONOCLONAL GAMMOPATHY OF UNDETER9 MINED SIGNIFICANCE.— 

10 (A) IN GENERAL.—The amendment made 

11 by subsection (b) shall take effect on the date of 

12 the enactment of this Act and shall apply as fol13 lows: 

14 (i) On the date of the enactment of this 

15 Act for claimants for dependency and in16 demnity compensation under chapter 13 of 

17 title 38, United States Code, and for vet18 erans whom the Secretary of Veterans Af19 fairs determines are— 

20 (I) terminally ill; 

21 (II) homeless; 

22 (III) under extreme financial 

23 hardship; 

24 (IV) more than 85 years old; or 
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1 (V) capable of demonstrating 

2 other sufficient cause. 

3 (ii) On October 1, 2022, for everyone 

4 not described in clause (i). 

5 (B) RETROACTIVE APPLICATION.—Notwith6 standing any Federal court decisions or settle7 ments in effect on the day before the date of the 

8 enactment of this Act, the Secretary of Veterans 

9 Affairs shall award retroactive claims for a con10 dition under section 1116(a)(2)(L) of title 38, 

11 United States Code, as added by subsection (b) 

12 of this section, only to claimants for dependency 

13 and indemnity compensation under chapter 13 

14 of such title described in subparagraph (A)(i) of 

15 this paragraph. 

16 (2) HYPERTENSION.— 

17 (A) IN GENERAL.—The amendment made 

18 by subsection (c) shall take effect on the date of 

19 the enactment of this Act and shall apply as fol20 lows: 

21 (i) On the date of the enactment of this 

22 Act for claimants for dependency and in23 demnity compensation under chapter 13 of 

24 title 38, United States Code, and for vet-
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1 erans whom the Secretary of Veterans Af2 fairs determines are— 

3 (I) terminally ill; 

4 (II) homeless; 

5 (III) under extreme financial 

6 hardship; 

7 (IV) more than 85 years old; or 

8 (V) capable of demonstrating 

9 other sufficient cause. 

10 (ii) On October 1, 2026, for everyone 

11 not described in subparagraph (A). 

12 (B) RETROACTIVE APPLICATION.—Notwith13 standing any Federal court decisions or settle14 ments in effect on the day before the date of the 

15 enactment of this Act, the Secretary of Veterans 

16 Affairs shall award retroactive claims for a con17 dition under section 1116(a)(2)(M) of title 38, 

18 United States Code, as added by subsection (c) 

19 of this section, only to claimants for dependency 

20 and indemnity compensation under chapter 13 

21 of such title described in subparagraph (A)(i) of 

22 this paragraph. 
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1 SEC. 405. IMPROVING COMPENSATION FOR DISABILITIES 

2 OCCURRING IN PERSIAN GULF WAR VET3 ERANS. 

4 (a) REDUCTION IN THRESHOLD OF ELIGIBILITY.— 

5 Subsection (a)(1) of section 1117 is amended by striking 

6 ‘‘became manifest—’’ and all that follows through the pe7 riod at the end and inserting ‘‘became manifest to any de8 gree at any time.’’. 

9 (b) PERMANENT EXTENSION OF PERIOD OF ELIGI10 BILITY.—Such section is further amended— 

11 (1) by striking subsection (b); 

12 (2) by redesignating subsections (c) and (d) as 

13 subsections (b) and (c), respectively; and 

14 (3) in subsection (a)(2)(C), by striking ‘‘under 

15 subsection (d)’’ and inserting ‘‘under subsection (c)’’. 

16 (c) ESTABLISHING SINGULAR DISABILITY-BASED

17 QUESTIONNAIRE.—Such section is further amended by in18 serting after subsection (c) (as redesignated by subsection 

19 (b)) the following new subsection (d): 

20 ‘‘(d) If a Persian Gulf veteran at a medical facility 

21 of the Department presents with any one symptom associ22 ated with Gulf War Illness, the Secretary shall ensure that 

23 health care personnel of the Department use a disability 

24 benefits questionnaire, or successor questionnaire, designed 

25 to identify Gulf War Illness, in addition to any other diag26 nostic actions the personnel determine appropriate.’’. 
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1 (d) EXPANSION OF DEFINITION OF PERSIAN GULF

2 VETERAN.—Subsection (f) of such section is amended by in3 serting ‘‘, Afghanistan, Israel, Egypt, Turkey, Syria, or 

4 Jordan,’’ after ‘‘operations’’. 

5 (e) TRAINING.—Such section is further amended by 

6 adding at the end the following new subsection: 

7 ‘‘(i)(1) The Secretary shall take such actions as may 

8 be necessary to ensure that health care personnel of the De9 partment are appropriately trained to effectively carry out 

10 this section. 

11 ‘‘(2) Not less frequently than once each year, the Sec12 retary shall submit to Congress a report on the actions 

13 taken by the Secretary to carry out paragraph (1).’’. 

14 SEC. 406. PRESUMPTION OF SERVICE CONNECTION FOR 

15 CERTAIN DISEASES ASSOCIATED WITH EXPO16 SURE TO BURN PITS AND OTHER TOXINS. 

17 (a) SHORT TITLE.—This section may be cited as the 

18 ‘‘Presumptive Benefits for War Fighters Exposed to Burn 

19 Pits and Other Toxins Act of 2022’’. 

20 (b) IN GENERAL.—Subchapter II of chapter 11, as 

21 amended by section 302, is further amended by inserting 

22 after section 1119 the following new section: 
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1 ‘‘§ 1120. Presumption of service connection for certain 

2 diseases associated with exposure to burn 

3 pits and other toxins 

4 ‘‘(a) PRESUMPTION OF SERVICE CONNECTION.—For 

5 the purposes of section 1110 of this title, and subject to sec6 tion 1113 of this title, a disease specified in subsection (b) 

7 becoming manifest in a covered veteran shall be considered 

8 to have been incurred in or aggravated during active mili9 tary, naval, air, or space service, notwithstanding that 

10 there is no record of evidence of such disease during the 

11 period of such service. 

12 ‘‘(b) DISEASES SPECIFIED.—The diseases specified in 

13 this subsection are the following: 

14 ‘‘(1) Asthma that was diagnosed after service of 

15 the covered veteran as specified in subsection (c). 

16 ‘‘(2) The following types of cancer: 

17 ‘‘(A) Head cancer of any type. 

18 ‘‘(B) Neck cancer of any type. 

19 ‘‘(C) Respiratory cancer of any type. 

20 ‘‘(D) Gastrointestinal cancer of any type. 

21 ‘‘(E) Reproductive cancer of any type. 

22 ‘‘(F) Lymphoma cancer of any type. 

23 ‘‘(G) Lymphomatic cancer of any type. 

24 ‘‘(H) Kidney cancer. 

25 ‘‘(I) Brain cancer. 

26 ‘‘(J) Melanoma. 
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1 ‘‘(K) Pancreatic cancer. 

2 ‘‘(3) Chronic bronchitis. 

3 ‘‘(4) Chronic obstructive pulmonary disease. 

4 ‘‘(5) Constrictive bronchiolitis or obliterative 

5 bronchiolitis. 

6 ‘‘(6) Emphysema. 

7 ‘‘(7) Granulomatous disease. 

8 ‘‘(8) Interstitial lung disease. 

9 ‘‘(9) Pleuritis. 

10 ‘‘(10) Pulmonary fibrosis. 

11 ‘‘(11) Sarcoidosis. 

12 ‘‘(12) Chronic sinusitis. 

13 ‘‘(13) Chronic rhinitis. 

14 ‘‘(14) Glioblastoma. 

15 ‘‘(15) Any other disease for which the Secretary 

16 determines, pursuant to regulations prescribed under 

17 subchapter VII that a presumption of service connec18 tion is warranted based on a positive association with 

19 a substance, chemical, or airborne hazard identified 

20 in the list under section 1119(b)(2) of this title. 

21 ‘‘(c) COVERED VETERAN DEFINED.—In this section, 

22 the term ‘covered veteran’ has the meaning given that term 

23 in section 1119(c) of this title.’’. 
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1 (c) CONFORMING AMENDMENT.—Section 1113 is 

2 amended by striking ‘‘or 1118’’ each place it appears and 

3 inserting ‘‘1118, or 1120’’. 

4 (d) EFFECTIVE DATE AND APPLICABILITY.—The 

5 amendments made by this section shall take effect on the 

6 date of the enactment of this Act and shall apply as follows: 

7 (1) On the date of the enactment of this Act for 

8 claimants for dependency and indemnity compensa9 tion under chapter 13 of title 38, United States Code, 

10 and veterans whom the Secretary of Veterans Affairs 

11 determines are— 

12 (A) terminally ill; 

13 (B) homeless; 

14 (C) under extreme financial hardship; 

15 (D) more than 85 years old; or 

16 (E) capable of demonstrating other suffi17 cient cause. 

18 (2) On the date of the enactment of this Act for 

19 everyone not described in paragraph (1), with respect 

20 to paragraphs (1), (2)(C), (2)(I), (5), (6), (7), (8), 

21 (9), (10), (11), (12), (13), and (14), of section 1120(b) 

22 of title 38, United States Code, as added by subsection 

23 (b). 

24 (3) On October 1, 2023, for everyone not de25 scribed in paragraph (1), with respect to paragraphs 
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1 (3) and (4) of section 1120(b) of such title, as so 

2 added. 

3 (4) On October 1, 2024, for everyone not de4 scribed in paragraph (1), with respect to subpara5 graphs (A), (B), (D), (E), (F), (G), and (K) of section 

6 1120(b)(2) of such title, as so added. 

7 (5) On October 1, 2025, for everyone not de8 scribed in paragraph (1), with respect to subpara9 graphs (H) and (J) of section 1120(b)(2) of such title, 

10 as so added. 

11 SEC. 407. RULE OF CONSTRUCTION. 

12 (a) GENERALLY.—Nothing in this Act shall be con13 strued to prevent the Secretary of Veterans Affairs from 

14 processing claims for benefits under title 38, United States 

15 Code, for a condition or disease for which this Act estab16 lishes a presumption of service connection, as a claim for 

17 benefits for a condition or disease with direct service con18 nection. 

19 (b) EFFECTIVE DATES AND APPLICABILITY.—The Sec20 retary shall not deny a claim for benefits under title 38, 

21 United States Code, for a condition or disease for which 

22 this Act establishes a presumption of service connection be23 cause the claimant filed the claim prior to the effective date 

24 or date of applicability for that particular condition or dis25 ease. 
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1 TITLE V—RESEARCH MATTERS 

2 SEC. 501. INTERAGENCY WORKING GROUP ON TOXIC EXPO3 SURE RESEARCH. 

4 (a) ESTABLISHMENT.— 

5 (1) IN GENERAL.—Not later than one year after 

6 the date of the enactment of this Act, the Secretary of 

7 Veterans Affairs shall, in collaboration with the heads 

8 of the entities described in paragraph (2), establish 

9 the Toxic Exposure Research Working Group (in this 

10 section referred to as the ‘‘Working Group’’). 

11 (2) COMPOSITION.—The Working Group shall 

12 consist of employees, selected by the Secretary, of the 

13 following: 

14 (A) The Department of Veterans Affairs. 

15 (B) The Department of Defense. 

16 (C) The Department of Health and Human 

17 Services. 

18 (D) The Environmental Protection Agency. 

19 (E) Other entities of the Federal Govern20 ment involved in research activities regarding 

21 the health consequences of toxic exposures experi22 enced during active military, naval, air, or 

23 space service. 

24 (b) FUNCTIONS.—The Working Group shall perform 

25 the following functions: 
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1 (1) Identify collaborative research activities and 

2 resources available among entities represented by 

3 members of the Working Group to conduct such col4 laborative research activities. 

5 (2) Develop a five-year strategic plan for such 

6 entities to carry out collaborative research activities. 

7 (c) REPORTING.—The Secretary shall submit to the 

8 Committee on Veterans’ Affairs of the Senate and the Com9 mittee on Veterans’ Affairs of the House of Representatives 

10 the following: 

11 (1) Not later than one year after the date of the 

12 enactment of this Act, a report on the establishment 

13 of the Working Group under subsection (a). 

14 (2) Not later than two years after the date of the 

15 enactment of this Act, a report containing the collabo16 rative research activities identified, and the strategic 

17 plan developed, by the Working Group under sub18 section (b). 

19 (3) Not less frequently than annually during the 

20 five-year period covered by the strategic plan under 

21 subsection (b), a progress report on implementation of 

22 the strategic plan. 

23 (d) TERMINATION.—The Working Group shall termi24 nate after submitting the final report under subsection (c). 

25 (e) DEFINITIONS.—In this section: 
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1 (1) ACTIVE MILITARY, NAVAL, AIR, OR SPACE

2 SERVICE.—The term ‘‘active military, naval, air, or 

3 space service’’ has the meaning given that term in 

4 section 101 of title 38, United States Code. 

5 (2) COLLABORATIVE RESEARCH ACTIVITY.—The 

6 term ‘‘collaborative research activity’’ means a re7 search activity— 

8 (A) agreed upon by the Working Group; 

9 (B) conducted by an entity represented by 

10 a member of the Working Group; 

11 (C) funded by the Federal Government; and 

12 (D) regarding the health consequences of 

13 toxic exposures experienced during active mili14 tary, naval, air, or space service. 

15 (3) TOXIC EXPOSURE.—The term ‘‘toxic expo16 sure’’ has the meaning given such term in section 101 

17 of title 38, United States Code, as amended by section 

18 102(b). 

19 SEC. 502. ANALYSIS AND REPORT ON TREATMENT OF VET20 ERANS FOR MEDICAL CONDITIONS RELATED 

21 TO TOXIC EXPOSURE. 

22 (a) IN GENERAL.—The Secretary of Veterans Affairs 

23 shall analyze, on a continuous basis, all clinical data 

24 that— 
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1 (1) is obtained by the Department of Veterans 

2 Affairs in connection with hospital care, medical serv3 ices, and nursing home care furnished under section 

4 1710(a)(2)(F) of title 38, United States Code; and 

5 (2) is likely to be scientifically useful in deter6 mining the association, if any, between the medical 

7 condition of a veteran and a toxic exposure. 

8 (b) ANNUAL REPORT.—Not later than one year after 

9 the date of the enactment of this Act, and annually there10 after, the Secretary shall submit to the Committee on Vet11 erans’ Affairs of the Senate and the Committee on Veterans’ 

12 Affairs of the House of Representatives a report containing 

13 the following: 

14 (1) The aggregate data compiled under sub15 section (a). 

16 (2) An analysis of such data. 

17 (3) A description of the types and incidences of 

18 medical conditions identified by the Department 

19 under such subsection. 

20 (4) The explanation of the Secretary for the inci21 dence of such medical conditions and other expla22 nations for the incidence of such conditions as the 

23 Secretary considers reasonable. 

24 (5) The views of the Secretary on the scientific 

25 validity of drawing conclusions from the incidence of 
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1 such medical conditions, as evidenced by the data 

2 compiled under subsection (a), regarding any associa3 tion between such conditions and toxic exposures. 

4 (c) TOXIC EXPOSURE DEFINED.—In this section, the 

5 term ‘‘toxic exposure’’ has the meaning given such term in 

6 section 101 of title 38, United States Code, as amended by 

7 section 102(b). 

8 SEC. 503. ANALYSIS RELATING TO MORTALITY OF VET9 ERANS WHO SERVED IN SOUTHWEST ASIA. 

10 (a) ANALYSIS.— 

11 (1) IN GENERAL.—Not later than 270 days after 

12 the date of the enactment of this Act, the Secretary of 

13 Veterans Affairs, in coordination with the Secretary 

14 of Defense, shall conduct an updated analysis of total 

15 and respiratory disease mortality in covered veterans. 

16 (2) ELEMENTS.—The analysis required by para17 graph (1) shall include, to the extent practicable, the 

18 following with respect to each covered veteran: 

19 (A) Metrics of airborne exposures. 

20 (B) The location and timing of deployments 

21 of the veteran. 

22 (C) The military occupational specialty of 

23 the veteran. 

24 (D) The Armed Force in which the veteran 

25 served. 
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1 (E) Pre-existing health status of the veteran, 

2 including with respect to asthma. 

3 (F) Relevant personal information of the 

4 veteran, including cigarette and e-cigarette smok5 ing history, diet, sex, gender, age, race, and eth6 nicity. 

7 (b) COVERED VETERAN DEFINED.—In this section, the 

8 term ‘‘covered veteran’’ means any veteran who— 

9 (1) on or after August 2, 1990, served on active 

10 duty in— 

11 (A) Bahrain; 

12 (B) Iraq; 

13 (C) Kuwait; 

14 (D) Oman; 

15 (E) Qatar; 

16 (F) Saudi Arabia; 

17 (G) Somalia; or 

18 (H) the United Arab Emirates; or 

19 (2) on or after September 11, 2001, served on ac20 tive duty in— 

21 (A) Afghanistan; 

22 (B) Djibouti; 

23 (C) Egypt; 

24 (D) Jordan; 

25 (E) Lebanon; 
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1 (F) Syria; or 

2 (G) Yemen. 

3 SEC. 504. STUDY ON HEALTH TRENDS OF POST–9/11 VET4 ERANS. 

5 The Secretary of Veterans Affairs shall conduct an epi6 demiological study on the health trends of veterans who 

7 served in the Armed Forces after September 11, 2001. 

8 SEC. 505. STUDY ON CANCER RATES AMONG VETERANS. 

9 (a) IN GENERAL.—The Secretary of Veterans Affairs 

10 shall conduct a study on the incidence of cancer in veterans 

11 to determine trends in the rates of the incidence of cancer 

12 in veterans. 

13 (b) ELEMENTS.—The study required by subsection (a) 

14 shall assess, with respect to each veteran included in the 

15 study, the following: 

16 (1) The age of the veteran. 

17 (2) The period of service and length of service of 

18 the veteran in the Armed Forces. 

19 (3) The military occupational specialty or spe20 cialties of the veteran. 

21 (4) The sex of the veteran. 

22 (5) The type or types of cancer that the veteran 

23 has. 
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1 SEC. 506. STUDY ON HEALTH EFFECTS OF WASTE RELATED 

2 TO MANHATTAN PROJECT ON CERTAIN VET3 ERANS. 

4 (a) STUDY.—Not later than 180 days after the date 

5 of the enactment of this Act, the Secretary of Veterans Af6 fairs shall enter into an agreement with the National Acad7 emies of Sciences, Engineering, and Medicine for the con8 duct of a study on the health trends of veterans who, while 

9 serving in the active military, naval, air, or space service— 

10 (1) participated in activities relating to the 

11 Manhattan Project (including activities relating to 

12 covered waste) in connection with such service; or 

13 (2) resided at or near, as determined by the Sec14 retary, the locations described in subsection (b). 

15 (b) COVERED LOCATIONS.—The locations described in 

16 this subsection are the following locations: 

17 (1) In the county of St. Louis, Missouri, the fol18 lowing: 

19 (A) Coldwater Creek, Missouri. 

20 (B) The St. Louis Airport Site, Missouri. 

21 (C) The West Lake Landfill. 

22 (2) Oak Ridge, Tennessee. 

23 (3) Hanford, Washington. 

24 (4) Any other location that is proximate to cov25 ered waste, as determined by the Secretary. 
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1 (c) ELEMENTS.—The study under subsection (a) shall 

2 assess, with respect to each veteran included in the study, 

3 the following: 

4 (1) The age, sex, and race of the veteran. 

5 (2) The period and location of exposure to cov6 ered waste. 

7 (3) Any type of cancer, or other illness associated 

8 with toxic exposure, that the veteran has. 

9 (4) A comparison of the overall health condition 

10 of the veteran, including any illness of the veteran 

11 identified pursuant to paragraph (3), with the overall 

12 health condition of past and present civilian popu13 lations residing at the same location of exposure, as 

14 determined by the Secretary. 

15 (d) REPORT.—Not later than three years after the date 

16 of the enactment of this Act, the Secretary shall submit to 

17 the Committee on Veterans’ Affairs of the Senate and the 

18 Committee on Veterans’ Affairs of the House of Representa19 tives a report on the study under subsection (a) and include 

20 in such report an analysis of the data available and data 

21 reliability. 

22 (e) DEFINITIONS.—In this section: 

23 (1) ACTIVE MILITARY, NAVAL, AIR, OR SPACE

24 SERVICE; TOXIC EXPOSURE.—The terms ‘‘active mili25 tary, naval, air, or space service’’ and ‘‘toxic expo-
75 

•S 3373 EAH 

1 sure’’ have the meanings given those terms in section 

2 101 of title 38, United States Code, as added by sec3 tion 102(b). 

4 (2) COVERED WASTE.—The term ‘‘covered waste’’ 

5 means any waste arising from activities carried out 

6 in connection with the Manhattan Project. 

7 (3) ILLNESS.—The term ‘‘illness’’ has the mean8 ing given that term in section 1171 of title 38, United 

9 States Code, as added by section 202. 

10 (4) TOXIC EXPOSURE.—The term ‘‘toxic expo11 sure’’ has the meaning given such term in section 101 

12 of title 38, United States Code, as amended by section 

13 102(b). 

14 SEC. 507. STUDY ON TOXIC EXPOSURE AND MENTAL 

15 HEALTH OUTCOMES. 

16 (a) STUDY REQUIRED.—Not later than 180 days after 

17 the date of the enactment of this Act, the Secretary of Vet18 erans Affairs shall enter into an agreement with the Na19 tional Academies of Sciences, Engineering, and Medicine 

20 for the conduct of a study of veterans to assess possible rela21 tionships between toxic exposures experienced during service 

22 in the Armed Forces and mental health conditions, includ23 ing chronic multisymptom illness, traumatic brain injury, 

24 post-traumatic stress disorder, depression, episodes of psy-
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•S 3373 EAH 

1 chosis, schizophrenia, bipolar disorder, suicide attempts, 

2 and suicide deaths. 

3 (b) ELEMENTS.—For each veteran included in the 

4 study under subsection (a), the following information shall 

5 be collected and assessed: 

6 (1) Age. 

7 (2) Sex. 

8 (3) Race and ethnicity. 

9 (4) Period and length of service in the Armed 

10 Forces. 

11 (5) The military occupational specialty or spe12 cialties of the veteran. 

13 (6) History of toxic exposure during service in 

14 the Armed Forces. 

15 (7) Any diagnosis of chronic multisymptom ill16 ness. 

17 (8) Any diagnosis of a mental health or cognitive 

18 disorder. 

19 (9) Any history of suicide attempt or suicidality. 

20 (10) If the veteran died by suicide. 

21 (11) Any confounding traumatic experiences that 

22 could affect a veteran’s mental health. 

23 (c) REPORT.—Not later than three years after the date 

24 of the enactment of this Act, the Secretary shall submit to 

25 the Committee on Veterans’ Affairs of the Senate and the 
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1 Committee on Veterans’ Affairs of the House of Representa2 tives a report containing the findings of the National Acad3 emies of Sciences, Engineering, and Medicine with respect 

4 to the study conducted under subsection (a). 

5 SEC. 508. STUDY ON VETERANS IN TERRITORIES OF THE 

6 UNITED STATES. 

7 (a) GAO STUDY.— 

8 (1) IN GENERAL.—The Comptroller General of 

9 the United States shall conduct a study on the state 

10 of access and barriers to benefits and services fur11 nished by the Veterans Benefits Administration and 

12 the Veterans Health Administration under laws ad13 ministered by the Secretary of Veterans Affairs to vet14 erans in Territories and Freely Associated States of 

15 the United States, including deficits in the avail16 ability and accessibility of such benefits and services 

17 compared to veterans elsewhere in the United States. 

18 (2) ELEMENTS.—The study under paragraph (1) 

19 shall include— 

20 (A) the number of veterans in each Terri21 tory and Freely Associated State of the United 

22 States; 

23 (B) the number of veterans in each Terri24 tory and Freely Associated State who are en25 rolled in the system of annual patient enrollment 
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1 of the Department of Veterans Affairs under sec2 tion 1705(a) of title 38, United States Code; 

3 (C) a description of how the Department es4 timates the number of veterans in each Territory 

5 and Freely Associated State who are eligible for 

6 services under section 1710 of such title but who 

7 are not enrolled as described in subparagraph 

8 (B); 

9 (D) a detailed description of obstacles fac10 ing veterans in each Territory and Freely Asso11 ciated State in accessing health care services, in12 cluding those involving the availability of such 

13 services to veterans in the Territory or Freely 

14 Associated State in which the veterans reside, 

15 and any distance impediments to receiving serv16 ices at a regional medical center of the Veterans 

17 Health Administration, a community-based out18 patient clinic, another full-service medical facil19 ity of the Department, or a Vet Center, respec20 tively; 

21 (E) a detailed description of obstacles facing 

22 veterans in each Territory and Freely Associated 

23 State in accessing readjustment counseling serv24 ices, including those involving the availability of 

25 such services to veterans in the Territory in 
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1 which the veterans reside, and any distance im2 pediments to receiving services at a readjustment 

3 counseling services center of the Department; 

4 (F) a detailed description of obstacles facing 

5 veterans in each Territory and Freely Associated 

6 State in accessing non-health care veterans bene7 fits, including those involving the availability of 

8 benefits and services to veterans in the Territory 

9 or Freely Associated State in which the veterans 

10 reside, and any distance impediments to access11 ing the nearest office of the Veterans Benefits Ad12 ministration; 

13 (G) an analysis of the staffing and quality 

14 of the offices of the Veterans Benefits Adminis15 tration and Veterans Health Administration 

16 charged with serving veterans in the Territories 

17 and Freely Associated States, including the 

18 availability of the full- and part-time staff of 

19 each office to the veterans they are charged with 

20 serving; 

21 (H) an analysis of the availability of the 

22 Veterans Community Care Program established 

23 under section 1703 of title 38, United States 

24 Code, to veterans in each Territory and Freely 

25 Associated State; 
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•S 3373 EAH 

1 (I) an analysis of the economic and health 

2 outcomes for veterans in each Territory or Freely 

3 Associated State resulting from obstacles to ac4 cessing adequate assistance and health care at 

5 facilities of the Department; 

6 (J) an analysis of the access to benefit as7 sistance and health care provided to veterans in 

8 the aftermath of major disasters declared in each 

9 of the Territories and Freely Associated States 

10 since September 4, 2017; and 

11 (K) such recommendations as the Comp12 troller General considers appropriate for improv13 ing access of veterans in the Territories and 

14 Freely Associated States to benefits and health 

15 care services furnished by the Secretary, and re16 ducing barriers and deficits in the availability 

17 and accessibility of such benefits and services 

18 compared to veterans elsewhere in the United 

19 States. 

20 (b) BRIEFING.—Not later than one year after the date 

21 of the enactment of this Act, the Comptroller General shall 

22 provide to the Committee on Veterans’ Affairs of the Senate 

23 and the Committee on Veterans’ Affairs of the House of Rep24 resentatives a briefing setting forth the results of the study 

25 conducted under subsection (a), including any rec-
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•S 3373 EAH 

1 ommendations developed under paragraph (2)(K) of such 

2 subsection. 

3 (c) DEFINITIONS.—In this section: 

4 (1) FREELY ASSOCIATED STATE.—The term 

5 ‘‘Freely Associated State’’ includes the Federated 

6 States of Micronesia, the Republic of the Marshall Is7 lands, and the Republic of Palau. 

8 (2) TERRITORY.—The term ‘‘Territory’’ includes 

9 American Samoa, the Commonwealth of the Northern 

10 Marianas Islands, Guam, Puerto Rico, and the Vir11 gin Islands. 

12 (3) VET CENTER.—The term ‘‘Vet Center’’ has 

13 the meaning given that term in section 1712A(h) of 

14 title 38, United States Code. 

15 SEC. 509. DEPARTMENT OF VETERANS AFFAIRS PUBLIC 

16 WEBSITE FOR TOXIC EXPOSURE RESEARCH. 

17 (a) WEBSITE.—Not later than one year after the date 

18 of the enactment of this Act, the Secretary of Veterans Af19 fairs shall establish, and maintain thereafter, a publicly ac20 cessible internet website of the Department of Veterans Af21 fairs that serves as a clearinghouse for the publication of 

22 all toxic exposure research carried out or funded by the exec23 utive branch of the Federal Government. 

24 (b) COORDINATION.—In carrying out subsection (a), 

25 the Secretary shall coordinate with— 
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1 (1) the heads of each Federal agency carrying 

2 out or funding toxic exposure research; 

3 (2) the War Related Illness and Injury Study 

4 Center of the Department of Veterans Affairs, or suc5 cessor center; and 

6 (3) any working group of the Department of Vet7 erans Affairs or other similar entity responsible for 

8 coordinating toxic exposure research. 

9 (c) DEFINITIONS.—In this section: 

10 (1) TOXIC EXPOSURE.—The term ‘‘toxic expo11 sure’’ has the meaning given that term in section 101 

12 of title 38, United States Code, as added by section 

13 102(b). 

14 (2) TOXIC EXPOSURE RESEARCH.—The term 

15 ‘‘toxic exposure research’’ means research on the 

16 health consequences of toxic exposures experienced 

17 during service in the Armed Forces. 

18 SEC. 510. REPORT ON HEALTH EFFECTS OF JET FUELS 

19 USED BY ARMED FORCES. 

20 (a) INITIAL REPORT.—Not later than one year after 

21 the date of the enactment of this Act, the Secretary of Vet22 erans Affairs shall submit to the Committee on Veterans’ 

23 Affairs of the Senate and the Committee on Veterans’ Af24 fairs of the House of Representatives, and make publicly 
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1 available, a report on health effects of jet fuels used by the 

2 Armed Forces. 

3 (b) CONTENTS.—The report submitted under sub4 section (a) shall include the following: 

5 (1) A discussion of the effect of various different 

6 types of jet fuels used by the Armed Forces on the 

7 health of individuals by length of exposure. 

8 (2) An identification of the immediate symptoms 

9 of jet fuel exposure that may indicate future health 

10 risks. 

11 (3) A chronology of health safeguards imple12 mented by the Armed Forces intended to reduce the 

13 exposure of members of the Armed Forces to jet fuel. 

14 (4) An identification of any areas relating to jet 

15 fuel exposure about which new research needs to be 

16 conducted. 

17 (c) FOLLOW-UP REPORT.—Not later than five years 

18 after the date of the submittal of the report under subsection 

19 (a), the Secretary shall submit to the committees referred 

20 to in such subsection an update to such report. 
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1 TITLE VI—IMPROVEMENT OF RE2 SOURCES AND TRAINING RE3 GARDING TOXIC-EXPOSED 

4 VETERANS 

5 SEC. 601. SHORT TITLE; DEFINITIONS. 

6 (a) SHORT TITLE.—This title may be cited as the 

7 ‘‘Fairly Assessing Service-related Toxic Exposure Residuals 

8 Presumptions Act of 2022’’ or the ‘‘FASTER Presumption 

9 Act of 2022’’. 

10 (b) DEFINITIONS.—In this title, the terms ‘‘active mili11 tary, naval, air, or space service’’, ‘‘toxic exposure’’, and 

12 ‘‘toxic-exposed veteran’’ have the meanings given those 

13 terms in section 101 of title 38, United States Code, as 

14 amended by section 102. 

15 SEC. 602. PUBLICATION OF LIST OF RESOURCES OF DE16 PARTMENT OF VETERANS AFFAIRS FOR 

17 TOXIC-EXPOSED VETERANS AND VETERANS 

18 WHO REPORT TOXIC EXPOSURES AND OUT19 REACH PROGRAM FOR SUCH VETERANS AND 

20 CAREGIVERS AND SURVIVORS OF SUCH VET21 ERANS. 

22 (a) PUBLICATION OF LIST OF RESOURCES.— 

23 (1) IN GENERAL.—Not later than one year after 

24 the date of the enactment of this Act, and annually 

25 thereafter, the Secretary of Veterans Affairs shall pub-
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1 lish a list of resources of the Department of Veterans 

2 Affairs for— 

3 (A) toxic-exposed veterans and veterans who 

4 report toxic exposure; 

5 (B) families and caregivers of such veterans; 

6 and 

7 (C) survivors of such veterans who are re8 ceiving death benefits under the laws adminis9 tered by the Secretary. 

10 (2) UPDATE.—The Secretary shall periodically 

11 update the list published under paragraph (1). 

12 (b) OUTREACH.—The Secretary shall develop, with 

13 input from the community, an informative outreach pro14 gram for veterans on illnesses that may be related to toxic 

15 exposures, including outreach with respect to benefits and 

16 support programs. 

17 SEC. 603. INCORPORATION OF TOXIC EXPOSURE SCREEN18 ING FOR VETERANS. 

19 (a) IN GENERAL.—Beginning not later than 90 days 

20 after the date of the enactment of this Act, the Secretary 

21 of Veterans Affairs shall incorporate a screening to help de22 termine potential toxic exposures during active military, 

23 naval, air, or space service as part of a health care screen24 ing furnished by the Department of Veterans Affairs to vet25 erans enrolled in the system of annual patient enrollment 
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•S 3373 EAH 

1 of the Department established and operated under section 

2 1705 of title 38, United States Code, to improve under3 standing by the Department of toxic exposures while serving 

4 in the Armed Forces. 

5 (b) TIMING.—The Secretary shall ensure that a veteran 

6 described in subsection (a) completes the screening required 

7 under such subsection not less frequently than once every 

8 five years. 

9 (c) DETERMINATION OF QUESTIONS.— 

10 (1) IN GENERAL.—The questions included in the 

11 screening required under subsection (a) shall be deter12 mined by the Secretary with input from medical pro13 fessionals. 

14 (2) SPECIFIC QUESTIONS.—At a minimum, the 

15 screening required under subsection (a) shall, with re16 spect to a veteran, include— 

17 (A) a question about the potential exposure 

18 of the veteran to an open burn pit; and 

19 (B) a question regarding toxic exposures 

20 that are commonly associated with service in the 

21 Armed Forces. 

22 (3) OPEN BURN PIT DEFINED.—In this sub23 section, the term ‘‘open burn pit’’ means an area of 

24 land that— 
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1 (A) is designated by the Secretary of De2 fense to be used for disposing solid waste by 

3 burning in the outdoor air; and 

4 (B) does not contain a commercially manu5 factured incinerator or other equipment specifi6 cally designed and manufactured for the burning 

7 of solid waste. 

8 (d) PRINT MATERIAL.—In developing the screening es9 tablished under subsection (a), the Secretary shall ensure 

10 that print materials complementary to such screening that 

11 outline related resources for veterans are available at each 

12 medical center of the Department to veterans who may not 

13 have access to the internet. 

14 (e) SCREENING UPDATES.—The Secretary shall con15 sider updates to the content of the screening required under 

16 subsection (a) not less frequently than biennially to ensure 

17 the screening contains the most current information. 

18 SEC. 604. TRAINING FOR PERSONNEL OF THE DEPARTMENT 

19 OF VETERANS AFFAIRS WITH RESPECT TO 

20 VETERANS WHO REPORT TOXIC EXPOSURES. 

21 (a) HEALTH CARE PERSONNEL.—The Secretary of 

22 Veterans Affairs shall provide to health care personnel of 

23 the Department of Veterans Affairs education and training 

24 to identify, treat, and assess the impact on veterans of ill25 nesses related to toxic exposures and inform such personnel 
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1 of how to ask for additional information from veterans re2 garding different toxic exposures. 

3 (b) BENEFITS PERSONNEL.— 

4 (1) IN GENERAL.—The Secretary shall incor5 porate a training program for processors of claims 

6 under the laws administered by the Secretary who re7 view claims for disability benefits relating to service8 connected disabilities based on toxic exposures. 

9 (2) ANNUAL TRAINING.—Training provided to 

10 processors under paragraph (1) shall be provided not 

11 less frequently than annually. 

12 TITLE VII—RESOURCING 

13 SEC. 701. AUTHORITY TO USE APPROPRIATIONS TO EN14 HANCE CLAIMS PROCESSING CAPACITY AND 

15 AUTOMATION. 

16 (a) AUTHORITY.—The Secretary of Veterans Affairs 

17 may use, from amounts appropriated to the Cost of War 

18 Toxic Exposures Fund established by section 324 of title 

19 38, United States Code, as added by section 805 of this Act, 

20 such amounts as may be necessary to continue the mod21 ernization, development, and expansion of capabilities and 

22 capacity of information technology systems and infrastruc23 ture of the Veterans Benefits Administration, including for 

24 claims automation, to support expected increased claims 

25 processing for newly eligible veterans pursuant to this Act. 
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•S 3373 EAH 

1 (b) PLAN FOR MODERNIZATION OF VETERANS BENE2 FITS ADMINISTRATION INFORMATION TECHNOLOGY SYS3 TEMS.— 

4 (1) IN GENERAL.—Not later than 180 days after 

5 the date of the enactment of this Act, the Secretary of 

6 Veterans Affairs shall submit to the appropriate con7 gressional committees a plan for the modernization of 

8 the information technology systems of the Veterans 

9 Benefits Administration. The plan shall cover the 

10 first fiscal year that begins after the date of the enact11 ment of this Act and the subsequent four fiscal years 

12 and shall include each of the following: 

13 (A) An identification of any information 

14 system to be modernized or retired, if applicable, 

15 during the period covered by the plan. 

16 (B) A description of how the Secretary in17 tends to incorporate the following principles into 

18 the modernization of such information systems: 

19 (i) The purpose of automation should 

20 be to increase the speed and accuracy of 

21 claims processing decisions. 

22 (ii) Automation should be conducted in 

23 a manner that enhances the productivity of 

24 employees of the Department of Veterans Af25 fairs. 
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1 (iii) Automation should be carried out 

2 in a manner that achieves greater consist3 ency in the processing and rating of claims 

4 by relying on patterns of similar evidence 

5 in claim files. 

6 (iv) To the greatest extent possible, au7 tomation should be carried out by drawing 

8 from information in the possession of the 

9 Department, other Government agencies, 

10 and applicants for benefits. 

11 (v) Automation of any claims analysis 

12 or determination process should not be end13 to-end or lack intermediation. 

14 (vi) Employees of the Department 

15 should continue to make decisions with re16 spect to the approval of claims and the 

17 granting of benefits. 

18 (vii) Automation should not be carried 

19 out in a manner that reduces or infringes 

20 upon the due process rights of applicants for 

21 benefits under the laws administered by the 

22 Secretary; or the duties of the Secretary to 

23 assist and notify claimants. 

24 (viii) Automation should be carried 

25 out while taking all necessary measures to 
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•S 3373 EAH 

1 protect the privacy of claimants and their 

2 personally identifiable information. 

3 (ix) Automation of claims processing 

4 should not eliminate or reduce the workforce 

5 of the Veterans Benefits Administration. 

6 (C) An identification of targets, for each fis7 cal year, by which the Secretary intends to com8 plete the modernization of each information sys9 tem or major component or functionality of such 

10 system identified under subparagraph (A). 

11 (D) Cost estimates for the modernization of 

12 each information system identified under para13 graph (A) for each fiscal year covered by the 

14 plan and in total. 

15 (2) APPROPRIATE CONGRESSIONAL COMMIT16 TEES.—In this section, the term ‘‘appropriate con17 gressional committees’’ means— 

18 (A) the Committee on Veterans’ Affairs and 

19 the Subcommittee on Military Construction, Vet20 erans Affairs, and Related Agencies of the Com21 mittee on Appropriations of the Senate; and 

22 (B) the Committee on Veterans’ Affairs and 

23 the Subcommittee on Military Construction, Vet24 erans Affairs, and Related Agencies of the Com-
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1 mittee on Appropriations of the House of Rep2 resentatives. 

3 SEC. 702. AUTHORIZATION OF MAJOR MEDICAL FACILITY 

4 LEASES OF DEPARTMENT OF VETERANS AF5 FAIRS FOR FISCAL YEAR 2023. 

6 (a) IN GENERAL.—The Secretary of Veterans Affairs 

7 may carry out the following major medical facility leases 

8 in fiscal year 2023: 

9 (1) Lease for an outpatient clinic in the vicinity 

10 of Allentown, Pennsylvania, in an estimated amount 

11 of $31,832,000. 

12 (2) Lease for a facility for member services for 

13 the Veterans Health Administration in the vicinity of 

14 Atlanta, Georgia, in an estimated amount of 

15 $27,134,000. 

16 (3) Lease for an outpatient clinic in the vicinity 

17 of Baltimore, Maryland, in an estimated amount of 

18 $43,041,000. 

19 (4) Lease for an outpatient clinic in the vicinity 

20 of Baton Rouge, Louisiana, in an estimated amount 

21 of $29,550,000. 

22 (5) Lease for an outpatient clinic in the vicinity 

23 of Beaufort, South Carolina, in an estimated amount 

24 of $24,254,000. 
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•S 3373 EAH 

1 (6) Lease for an outpatient clinic in the vicinity 

2 of Beaumont, Texas, in an estimated amount of 

3 $15,632,000. 

4 (7) Lease for an outpatient clinic in the vicinity 

5 of Brainerd, Minnesota, in an estimated amount of 

6 $14,669,000. 

7 (8) Lease for a facility for research in the vicin8 ity of Buffalo, New York, in an estimated amount of 

9 $11,106,000. 

10 (9) Lease for an outpatient clinic in the vicinity 

11 of Clarksville, Tennessee, in an estimated amount of 

12 $75,135,000. 

13 (10) Lease of a facility for research in the vicin14 ity of Columbia, Missouri, in an estimated amount of 

15 $20,726,000. 

16 (11) Lease for an outpatient clinic in the vicin17 ity of Cookeville, Tennessee, in an estimated amount 

18 of $10,958,000. 

19 (12) Lease for a residential treatment facility in 

20 the vicinity of Denver, Colorado, in an estimated 

21 amount of $9,133,000. 

22 (13) Lease for an outpatient clinic in the vicin23 ity of Elizabethtown, Kentucky, in an estimated 

24 amount of $16,671,000. 
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•S 3373 EAH 

1 (14) Lease for an outpatient clinic in the vicin2 ity of Farmington, Missouri, in an estimated amount 

3 of $17,940,000. 

4 (15) Lease for an outpatient clinic in the vicin5 ity of Hampton, Virginia, in an estimated amount of 

6 $63,085,000. 

7 (16) Lease for an outpatient clinic in the vicin8 ity of Jacksonville, North Carolina, in an estimated 

9 amount of $61,450,000. 

10 (17) Lease for an outpatient clinic in the vicin11 ity of Killeen, Texas, in an estimated amount of 

12 $61,030,000. 

13 (18) Lease for an outpatient clinic in the vicin14 ity of Lawrence, Indiana, in an estimated amount of 

15 $15,811,000. 

16 (19) Lease for an outpatient clinic in the vicin17 ity of Lecanto, Florida, in an estimated amount of 

18 $15,373,000. 

19 (20) Lease for an outpatient clinic in the vicin20 ity of Nashville, Tennessee, in an estimated amount 

21 of $58,038,000. 

22 (21) Lease for an outpatient clinic in the vicin23 ity of North Kansas City, Missouri, in an estimated 

24 amount of $40,027,000. 
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•S 3373 EAH 

1 (22) Lease for an outpatient clinic in the vicin2 ity of Pflugerville, Texas, in an estimated amount of 

3 $16,654,000. 

4 (23) Lease for an outpatient clinic in the vicin5 ity of Plano, Texas, in an estimated amount of 

6 $32,796,000. 

7 (24) Lease for an outpatient clinic in the vicin8 ity of Prince George’s County, Maryland, in an esti9 mated amount of $31,754,000. 

10 (25) Lease for an outpatient clinic in the vicin11 ity of Rolla, Missouri, in an estimated amount of 

12 $21,352,000. 

13 (26) Lease for an outpatient clinic in the vicin14 ity of Salt Lake City, Utah, in an estimated amount 

15 of $29,466,000. 

16 (27) Lease for an outpatient clinic in the vicin17 ity of Sarasota, Florida, in an estimated amount of 

18 $36,517,000. 

19 (28) Lease for an outpatient clinic in the vicin20 ity of Springfield, Massachusetts, in an estimated 

21 amount of $30,918,000. 

22 (29) Lease for a community living center in the 

23 vicinity of Tampa, Florida, in an estimated amount 

24 of $51,682,000. 
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1 (30) Lease for an outpatient clinic in the vicin2 ity of The Villages, Florida, in an estimated amount 

3 of $48,267,000. 

4 (31) Lease for an outpatient clinic in the vicin5 ity of Tri-Cities, Washington, in an estimated 

6 amount of $36,136,000. 

7 (b) TREATMENT OF AUTHORIZATIONS.—The author8 ization of leases under subsection (a) shall be considered to 

9 be a specific authorization by law of the funds for such 

10 leases for purposes of section 8104(a)(2) of title 38, United 

11 States Code, as in effect on the day before the date of the 

12 enactment of this Act. 

13 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

14 authorized to be appropriated to the Secretary of Veterans 

15 Affairs for fiscal year 2023, or the year in which funds are 

16 appropriated for the Medical Facilities account, 

17 $998,137,000 for the leases authorized in subsection (a). 

18 SEC. 703. TREATMENT OF MAJOR MEDICAL FACILITY 

19 LEASES OF THE DEPARTMENT OF VETERANS 

20 AFFAIRS. 

21 (a) CONGRESSIONAL APPROVAL OF MAJOR MEDICAL

22 FACILITY LEASES.—Paragraph (2) of subsection (a) of sec23 tion 8104 of title 38, United States Code, is amended— 

24 (1) by striking ‘‘No funds’’ and inserting ‘‘(A) 

25 No funds’’; 
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1 (2) by striking ‘‘or any major medical facility 

2 lease’’; 

3 (3) by striking ‘‘or lease’’; and 

4 (4) by adding at the end the following new sub5 paragraph: 

6 ‘‘(B) No funds may be appropriated for any fis7 cal year, and the Secretary may not obligate or ex8 pend funds (other than for advance planning and de9 sign), for any major medical facility lease unless the 

10 Committee on Veterans’ Affairs of the Senate and the 

11 Committee on Veterans’ Affairs of the House of Rep12 resentatives each adopt a resolution approving the 

13 lease.’’. 

14 (b) MODIFICATION OF DEFINITION OF MAJOR MED15 ICAL FACILITY LEASE.—Subparagraph (B) of paragraph 

16 (3) of such subsection is amended to read as follows: 

17 ‘‘(B) The term ‘major medical facility lease’— 

18 ‘‘(i) means a lease for space for use as a 

19 new medical facility approved through the Gen20 eral Services Administration under section 

21 3307(a) of title 40 at an average annual rent 

22 equal to or greater than the appropriate dollar 

23 threshold described in such section, which shall 

24 be subject to annual adjustment in accordance 

25 with section 3307(h) of such title; and 
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1 ‘‘(ii) does not include a lease for space for 

2 use as a shared Federal medical facility for 

3 which the Department’s estimated share of the 

4 lease costs does not exceed such dollar threshold.’’. 

5 (c) SEPARATE PROSPECTUS REQUIREMENT FOR

6 MAJOR MEDICAL FACILITY LEASES.—Subsection (b) of 

7 such section is amended— 

8 (1) by striking paragraph (7); 

9 (2) in paragraph (1), by redesignating subpara10 graphs (A) through (E) as clauses (i) through (v), re11 spectively; 

12 (3) in paragraph (6), by redesignating subpara13 graphs (A) through (C) as clauses (i) through (iii), re14 spectively; 

15 (4) by redesignating paragraphs (1) through (6) 

16 as subparagraphs (A) through (F), respectively; 

17 (5) in the matter preceding subparagraph (A), as 

18 redesignated by paragraph (4)— 

19 (A) by striking ‘‘Whenever the President’’ 

20 and inserting ‘‘(1) Whenever the President’’; 

21 (B) by striking ‘‘the Congress’’ and insert22 ing ‘‘Congress’’; and 

23 (C) by striking ‘‘or a major medical facility 

24 lease (as defined in subsection (a)(3)(b))’’; 
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1 (6) in subparagraph (A), as redesignated by 

2 paragraph (4), by striking ‘‘leased,’’; 

3 (7) in subparagraph (E), as redesignated by 

4 paragraph (4)— 

5 (A) by striking ‘‘or lease’’ each place it ap6 pears; and 

7 (B) by striking ‘‘or leases’’; and 

8 (8) by adding at the end the following new para9 graph: 

10 ‘‘(2) Whenever the President or the Secretary submit 

11 to Congress a request for the funding of a major medical 

12 facility lease (as defined in subsection (a)(3)(B)), the Sec13 retary shall submit to each committee, on the same day, 

14 a prospectus of the proposed medical facility. Any such pro15 spectus shall include the following: 

16 ‘‘(A) A description of the facility to be leased. 

17 ‘‘(B) An estimate of the cost to the Federal Gov18 ernment of the facility to be leased. 

19 ‘‘(C) An estimate of the energy performance of 

20 the proposed lease space, to include a description of 

21 anticipated utilization of renewable energy, energy ef22 ficient and climate resilient elements, and related 

23 matters. 

24 ‘‘(D) Current and projected workload and utili25 zation data regarding the facility to be leased, includ-
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1 ing information on projected changes in workload and 

2 utilization over a five-year period, a ten-year period, 

3 and a twenty-year period. 

4 ‘‘(E) A detailed analysis of how the lease is ex5 pected to comply with Office of Management and 

6 Budget Circular A–11 and section 1341 of title 31 

7 (commonly referred to as the ‘Anti-Deficiency Act’). 

8 Any such analysis shall include— 

9 ‘‘(i) an analysis of the classification of the 

10 lease as a ‘lease purchase’, a ‘capital lease’, or an 

11 ‘operating lease’ as those terms are defined in 

12 Office of Management and Budget Circular A– 

13 11; 

14 ‘‘(ii) an analysis of the obligation of budg15 etary resources associated with the lease; and 

16 ‘‘(iii) an analysis of the methodology used 

17 in determining the asset cost, fair market value, 

18 and cancellation costs of the lease.’’. 

19 (d) INTERIM LEASING ACTIONS.—Such section is fur20 ther amended by adding at the end the following new sub21 section: 

22 ‘‘(i)(1) Notwithstanding subsection (a)(2)(B), the Sec23 retary may carry out interim leasing actions as the Sec24 retary considers necessary for the following leases: 
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1 ‘‘(A) Major medical facility leases (as defined in 

2 subsection (a)(3)(B)) approved pursuant to this sec3 tion and for which a prospectus for a replacement 

4 lease has been submitted to Congress pursuant to sub5 section (b)(2). 

6 ‘‘(B) Replacement leases that do not require ap7 proval under this section and for which a prospectus 

8 has been submitted to Congress pursuant to subsection 

9 (b)(2). 

10 ‘‘(2) In this subsection, the term ‘interim leasing ac11 tions’ has the meaning given that term by the Adminis12 trator of the General Services Administration.’’. 

13 (e) PURCHASE OPTIONS.—Such section is further 

14 amended by adding at the end the following new subsection: 

15 ‘‘(j) The Secretary may obligate and expend funds to 

16 exercise a purchase option included in any major medical 

17 facility lease (as defined in subsection (a)(3)(B)).’’. 

18 (f) APPLICABILITY.—The amendments made by this 

19 section shall apply with respect to any lease that has not 

20 been specifically authorized by law on or before the date 

21 of the enactment of this Act. 
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1 SEC. 704. AUTHORITY TO ENTER INTO AGREEMENTS WITH 

2 ACADEMIC AFFILIATES AND OTHER ENTITIES 

3 TO ACQUIRE SPACE FOR THE PURPOSE OF 

4 PROVIDING HEALTH-CARE RESOURCES TO 

5 VETERANS. 

6 Section 8103 of title 38, United States Code, is amend7 ed by adding at the end the following new subsection: 

8 ‘‘(h)(1) Notwithstanding any other provision of law re9 quiring the use of competitive procedures, including section 

10 2304 of title 10, when the Secretary determines it to be in 

11 the best interest of the Department, the Secretary may enter 

12 into a lease with an academic affiliate or covered entity 

13 to acquire space for the purpose of providing health-care 

14 resources to veterans. 

15 ‘‘(2) In this subsection: 

16 ‘‘(A) The term ‘academic affiliate’ means an in17 stitution or organization described in section 7302(d) 

18 of this title. 

19 ‘‘(B) The term ‘covered entity’ means a unit or 

20 subdivision of a State, local, or municipal govern21 ment, public or nonprofit agency, institution, or orga22 nization, or other institution or organization as the 

23 Secretary considers appropriate that owns property 

24 controlled by an academic affiliate to be leased under 

25 this subsection. 
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1 ‘‘(C) The term ‘health -care resource’ has the 

2 meaning given that term in section 8152(1) of this 

3 title. 

4 ‘‘(D) The term ‘space’ means any room, unit, 

5 floor, wing, building, parking facility, or other sub6 division of a building or facility owned or controlled 

7 by an academic affiliate.’’. 

8 SEC. 705. MODIFICATIONS TO ENHANCED-USE LEASE AU9 THORITY OF DEPARTMENT OF VETERANS AF10 FAIRS. 

11 (a) MODIFICATIONS TO AUTHORITY.—Paragraph (2) 

12 of section 8162(a) of title 38, United States Code, is amend13 ed to read as follows: 

14 ‘‘(2)(A) The Secretary may enter into an enhanced15 use lease on or after the date of the enactment of this para16 graph only if the Secretary determines— 

17 ‘‘(i) that the lease will not be inconsistent with, 

18 and will not adversely affect— 

19 ‘‘(I) the mission of the Department; or 

20 ‘‘(II) the operation of facilities, programs, 

21 and services of the Department in the area of the 

22 leased property; and 

23 ‘‘(ii) that— 
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1 ‘‘(I) the lease will enhance the use of the 

2 leased property by directly or indirectly benefit3 ting veterans; or 

4 ‘‘(II) the leased property will provide sup5 portive housing. 

6 ‘‘(B) The Secretary shall give priority to enhanced-use 

7 leases that, on the leased property— 

8 ‘‘(i) provide supportive housing for veterans; 

9 ‘‘(ii) provide direct services or benefits targeted 

10 to veterans; or 

11 ‘‘(iii) provide services or benefits that indirectly 

12 support veterans.’’. 

13 (b) EXTENSION OF MAXIMUM TERM OF ENHANCED14 USE LEASE.—Section 8162(b)(2) of such title is amended 

15 by striking ‘‘75 years’’ and inserting ‘‘99 years’’. 

16 (c) MODIFICATION OF USE OF PROCEEDS.—Section 

17 8165(a)(1) of such title is amended by striking ‘‘shall be 

18 deposited in the Department of Veterans Affairs Medical 

19 Care Collections Fund established under section 1729A of 

20 this title.’’ and inserting ‘‘shall, at the discretion of the Sec21 retary, be deposited in— 

22 ‘‘(A) the Department of Veterans Affairs Medical 

23 Care Collections Fund established under section 

24 1729A of this title; or 
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1 ‘‘(B) the Medical Facilities or Construction, 

2 Minor Projects account of the Department to be used 

3 to defray the costs of administration, maintenance, 

4 repair, and related expenses incurred by the Depart5 ment with respect to property that is owned by or 

6 under the jurisdiction or control of the Department.’’. 

7 (d) REPEAL OF SUNSET.—Section 8169 of such title 

8 is repealed. 

9 (e) APPROPRIATION.—In addition to amounts other10 wise available, there is appropriated for fiscal year 2022, 

11 out of any funds in the Treasury not otherwise appro12 priated, $922,000,000 for an additional amount for the De13 partment of Veterans Affairs, to remain available until ex14 pended, to enter into enhanced-use leases pursuant to sec15 tion 8162 of title 38, United States Code, as amended by 

16 this section. 

17 SEC. 706. AUTHORITY FOR JOINT LEASING ACTIONS OF DE18 PARTMENT OF DEFENSE AND DEPARTMENT 

19 OF VETERANS AFFAIRS. 

20 (a) DEPARTMENT OF DEFENSE.—Section 1104A of 

21 title 10, United States Code, is amended— 

22 (1) by inserting ‘‘, or the leasing,’’ after ‘‘design, 

23 and construction’’ each place it appears; and 

24 (2) in subsection (c)(2), by inserting ‘‘, or the 

25 leasing,’’ after ‘‘design’’. 
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1 (b) DEPARTMENT OF VETERANS AFFAIRS.—Section 

2 8111B of title 38, United States Code, is amended— 

3 (1) in subsection (a), by inserting ‘‘, or the leas4 ing,’’ after ‘‘design, and construction’’; 

5 (2) in subsection (b), by adding at the end the 

6 following new paragraph: 

7 ‘‘(3) The Secretary of Veterans Affairs may transfer 

8 to the Department of Defense amounts appropriated to the 

9 ‘Medical Facilities’ account of the Department of Veterans 

10 Affairs for the purpose of leasing space for a shared medical 

11 facility if the estimated share of the Department of Veterans 

12 Affairs for the lease costs does not exceed the amount speci13 fied in section 8104(a)(3)(B) of this title.’’; and 

14 (3) in subsection (c), by adding at the end the 

15 following new paragraph: 

16 ‘‘(3) Any amount transferred to the Secretary of Vet17 erans Affairs by the Secretary of Defense for the purpose 

18 of leasing space for a shared medical facility may be cred19 ited to the ‘Medical Facilities’ account of the Department 

20 of Veterans Affairs and may be used for such purpose.’’. 

21 SEC. 707. APPROPRIATION OF AMOUNTS FOR MAJOR MED22 ICAL FACILITY LEASES. 

23 (a) FISCAL YEAR 2023.—In addition to amounts oth24 erwise available, there is appropriated for fiscal year 2023, 

25 out of any funds in the Treasury not otherwise appro-
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1 priated, $1,880,000,000 for an additional amount for the 

2 Medical Facilities account of the Department of Veterans 

3 Affairs, to remain available until expended, for major med4 ical facility leases authorized by section 702. 

5 (b) ADDITIONAL YEARS.—In addition to amounts oth6 erwise available, there is appropriated, out of any funds 

7 in the Treasury not otherwise appropriated, for an addi8 tional amount for the Medical Facilities account of the De9 partment of Veterans Affairs, to remain available until ex10 pended, for major medical facility leases authorized by sec11 tion 702 or approved pursuant to subchapter I of chapter 

12 81 of title 38, United States Code, as amended by section 

13 703— 

14 (1) $100,000,000 for fiscal year 2024; 

15 (2) $200,000,000 for fiscal year 2025; 

16 (3) $400,000,000 for fiscal year 2026; 

17 (4) $450,000,000 for fiscal year 2027; 

18 (5) $600,000,000 for fiscal year 2028; 

19 (6) $610,000,000 for fiscal year 2029; 

20 (7) $620,000,000 for fiscal year 2030; and 

21 (8) $650,000,000 for fiscal year 2031. 
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1 TITLE VIII—RECORDS AND 

2 OTHER MATTERS 

3 SEC. 801. EPIDEMIOLOGICAL STUDY ON FORT MCCLELLAN 

4 VETERANS. 

5 The Secretary of Veterans Affairs shall conduct an epi6 demiological study on the health trends of veterans who 

7 served in the Armed Forces at Fort McClellan at any time 

8 during the period beginning January 1, 1935, and ending 

9 on May 20, 1999. 

10 SEC. 802. BIENNIAL BRIEFING ON INDIVIDUAL LONGITU11 DINAL EXPOSURE RECORD. 

12 (a) IN GENERAL.—Not later than one year after the 

13 date on which the Individual Longitudinal Exposure 

14 Record achieves full operational capability, as determined 

15 by the Secretary of Defense, and every two years thereafter, 

16 the Secretary of Defense, in consultation with the Secretary 

17 of Veterans Affairs, shall provide the appropriate commit18 tees of Congress a briefing on— 

19 (1) the quality of the databases of the Depart20 ment of Defense that provide the information pre21 sented in such Individual Longitudinal Exposure 

22 Record; and 

23 (2) the usefulness of such Individual Longitu24 dinal Exposure Record or system in supporting mem25 bers of the Armed Forces and veterans in receiving 
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1 health care and benefits from the Department of De2 fense and the Department of Veterans Affairs. 

3 (b) ELEMENTS.—Each briefing required by subsection 

4 (a) shall include, for the period covered by the report, the 

5 following: 

6 (1) An identification of potential exposures to oc7 cupational or environmental hazards captured by the 

8 current systems of the Department of Defense for envi9 ronmental, occupational, and health monitoring, and 

10 recommendations for how to improve those systems. 

11 (2) An analysis of the quality and accuracy of 

12 the location data used by the Department of Defense 

13 in determining potential exposures to occupational or 

14 environmental hazards by members of the Armed 

15 Forces and veterans, and recommendations for how to 

16 improve the quality of such data if necessary. 

17 (c) DEFINITIONS.—In this section: 

18 (1) APPROPRIATE COMMITTEES OF CONGRESS.— 

19 The term ‘‘appropriate committees of Congress’’ 

20 means— 

21 (A) the Committee on Armed Services and 

22 the Committee on Veterans’ Affairs of the Senate; 

23 and 
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1 (B) the Committee on Armed Services and 

2 the Committee on Veterans’ Affairs of the House 

3 of Representatives. 

4 (2) INDIVIDUAL LONGITUDINAL EXPOSURE

5 RECORD.—The term ‘‘Individual Longitudinal Expo6 sure Record’’ has the meaning given such term in sec7 tion 1171 of title 38, United States Code, as added 

8 by section 202. 

9 SEC. 803. CORRECTION OF EXPOSURE RECORDS BY MEM10 BERS OF THE ARMED FORCES AND VET11 ERANS. 

12 (a) IN GENERAL.—The Secretary of Veterans Affairs 

13 shall coordinate with the Secretary of Defense to provide 

14 a means for veterans to update their records as necessary 

15 to reflect exposures to occupational or environmental haz16 ards by such member or veteran in the Individual Longitu17 dinal Exposure Record. 

18 (b) EVIDENCE.— 

19 (1) PROVISION OF EVIDENCE.—To update a 

20 record under subsection (a), a veteran shall provide 

21 such evidence as the Secretary of Veterans Affairs con22 siders necessary. 

23 (2) REGULATIONS.—The Secretary of Veterans 

24 Affairs shall prescribe by regulation the evidence con25 sidered necessary under paragraph (1). 
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1 (c) DEFINITIONS.—In this section: 

2 (1) INDIVIDUAL LONGITUDINAL EXPOSURE

3 RECORD.—The term ‘‘Individual Longitudinal Expo4 sure Record’’ has the meaning given such term in sec5 tion 1171 of title 38, United States Code, as added 

6 by section 202. 

7 (2) TOXIC EXPOSURE.—The term ‘‘toxic expo8 sure’’ has the meaning given such term in section 101 

9 of title 38, United States Code, as amended by section 

10 102(b). 

11 SEC. 804. FEDERAL CAUSE OF ACTION RELATING TO WATER 

12 AT CAMP LEJEUNE, NORTH CAROLINA. 

13 (a) SHORT TITLE.—This section may be cited as the 

14 ‘‘Camp Lejeune Justice Act of 2022’’. 

15 (b) IN GENERAL.—An individual, including a veteran 

16 (as defined in section 101 of title 38, United States Code), 

17 or the legal representative of such an individual, who re18 sided, worked, or was otherwise exposed (including in utero 

19 exposure) for not less than 30 days during the period begin20 ning on August 1, 1953, and ending on December 31, 1987, 

21 to water at Camp Lejeune, North Carolina, that was sup22 plied by, or on behalf of, the United States may bring an 

23 action in the United States District Court for the Eastern 

24 District of North Carolina to obtain appropriate relief for 
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1 harm that was caused by exposure to the water at Camp 

2 Lejeune. 

3 (c) BURDENS AND STANDARD OF PROOF.— 

4 (1) IN GENERAL.—The burden of proof shall be 

5 on the party filing the action to show one or more re6 lationships between the water at Camp Lejeune and 

7 the harm. 

8 (2) STANDARDS.—To meet the burden of proof 

9 described in paragraph (1), a party shall produce evi10 dence showing that the relationship between exposure 

11 to the water at Camp Lejeune and the harm is— 

12 (A) sufficient to conclude that a causal rela13 tionship exists; or 

14 (B) sufficient to conclude that a causal rela15 tionship is at least as likely as not. 

16 (d) EXCLUSIVE JURISDICTION AND VENUE.—The 

17 United States District Court for the Eastern District of 

18 North Carolina shall have exclusive jurisdiction over any 

19 action filed under subsection (b), and shall be the exclusive 

20 venue for such an action. Nothing in this subsection shall 

21 impair the right of any party to a trial by jury. 

22 (e) EXCLUSIVE REMEDY.— 

23 (1) IN GENERAL.—An individual, or legal rep24 resentative of an individual, who brings an action 

25 under this section for a harm described in subsection 
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1 (b), including a latent disease, may not thereafter 

2 bring a tort action against the United States for such 

3 harm pursuant to any other law. 

4 (2) HEALTH AND DISABILITY BENEFITS RELAT5 ING TO WATER EXPOSURE.—Any award made to an 

6 individual, or legal representative of an individual, 

7 under this section shall be offset by the amount of any 

8 disability award, payment, or benefit provided to the 

9 individual, or legal representative— 

10 (A) under— 

11 (i) any program under the laws ad12 ministered by the Secretary of Veterans Af13 fairs; 

14 (ii) the Medicare program under title 

15 XVIII of the Social Security Act (42 U.S.C. 

16 1395 et seq.); or 

17 (iii) the Medicaid program under title 

18 XIX of the Social Security Act (42 U.S.C. 

19 1396 et seq.); and 

20 (B) in connection with health care or a dis21 ability relating to exposure to the water at Camp 

22 Lejeune. 

23 (f) IMMUNITY LIMITATION.—The United States may 

24 not assert any claim to immunity in an action under this 
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1 section that would otherwise be available under section 

2 2680(a) of title 28, United States Code. 

3 (g) NO PUNITIVE DAMAGES.—Punitive damages may 

4 not be awarded in any action under this section. 

5 (h) DISPOSITION BY FEDERAL AGENCY REQUIRED.— 

6 An individual may not bring an action under this section 

7 before complying with section 2675 of title 28, United 

8 States Code. 

9 (i) EXCEPTION FOR COMBATANT ACTIVITIES.—This 

10 section does not apply to any claim or action arising out 

11 of the combatant activities of the Armed Forces. 

12 (j) APPLICABILITY; PERIOD FOR FILING.— 

13 (1) APPLICABILITY.—This section shall apply 

14 only to a claim accruing before the date of enactment 

15 of this Act. 

16 (2) STATUTE OF LIMITATIONS.—A claim in an 

17 action under this section may not be commenced after 

18 the later of— 

19 (A) the date that is two years after the date 

20 of enactment of this Act; or 

21 (B) the date that is 180 days after the date 

22 on which the claim is denied under section 2675 

23 of title 28, United States Code. 

24 (3) INAPPLICABILITY OF OTHER LIMITATIONS.— 

25 Any applicable statute of repose or statute of limita-
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1 tions, other than under paragraph (2), shall not 

2 apply to a claim under this section. 

3 SEC. 805. COST OF WAR TOXIC EXPOSURES FUND. 

4 (a) IN GENERAL.—Chapter 3 is amended by adding 

5 at the end the following new section: 

6 ‘‘§ 324. Cost of War Toxic Exposures Fund 

7 ‘‘(a) ESTABLISHMENT.—There is hereby established in 

8 the Treasury of the United States an account to be known 

9 as the ‘Cost of War Toxic Exposures Fund’ (the ‘Fund’), 

10 to be administered by the Secretary. 

11 ‘‘(b) DEPOSITS.—There shall be deposited in the Fund 

12 such amounts as may be appropriated to the Fund pursu13 ant to subsection (c). 

14 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There is 

15 authorized to be appropriated to the Fund for fiscal year 

16 2023 and each subsequent fiscal year such sums as are nec17 essary to increase funding, over the fiscal year 2021 level, 

18 for investment in— 

19 ‘‘(1) the delivery of veterans’ health care associ20 ated with exposure to environmental hazards in the 

21 active military, naval, air, or space service in pro22 grams administered by the Under Secretary for 

23 Health; 

24 ‘‘(2) any expenses incident to the delivery of vet25 erans’ health care and benefits associated with expo-
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1 sure to environmental hazards in the active military, 

2 naval, air, or space service, including administrative 

3 expenses, such as information technology and claims 

4 processing and appeals, and excluding leases as au5 thorized or approved under section 8104 of this title; 

6 and 

7 ‘‘(3) medical and other research relating to expo8 sure to environmental hazards. 

9 ‘‘(d) BUDGET SCOREKEEPING.—(1) Immediately upon 

10 enactment of the Sergeant First Class Heath Robinson Hon11 oring our Promise to Address Comprehensive Toxics Act of 

12 2022, expenses authorized to be appropriated to the Fund 

13 in subsection (c) shall be estimated for fiscal year 2023 and 

14 each subsequent fiscal year and treated as budget authority 

15 that is considered to be direct spending— 

16 ‘‘(A) in the baseline for purposes of section 257 

17 of the Balanced Budget and Emergency Deficit Con18 trol Act of 1985 (2 U.S.C. 907); 

19 ‘‘(B) by the Chairman of the Committee on the 

20 Budget of the Senate and the Chair of the Committee 

21 on the Budget of the House of Representatives, as ap22 propriate, for purposes of budget enforcement in the 

23 Senate and the House of Representatives; 

24 ‘‘(C) under the Congressional Budget Act of 1974 

25 (2 U.S.C. 621 et seq.), including in the reports re-
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1 quired by section 308(b) of such Act (2 U.S.C. 639); 

2 and 

3 ‘‘(D) for purposes of the Statutory Pay-As-You4 Go Act of 2010 (2 U.S.C. 931 et seq.). 

5 ‘‘(2) No amount appropriated to the Fund in fiscal 

6 year 2023 or any subsequent fiscal year pursuant to this 

7 section shall be counted as discretionary budget authority 

8 and outlays or as direct spending for any estimate of an 

9 appropriation Act under the Congressional Budget and Im10 poundment Control Act of 1974 (2 U.S.C. 621 et seq.) and 

11 any other Act. 

12 ‘‘(3) Notwithstanding the Budget Scorekeeping Guide13 lines and the accompanying list of programs and accounts 

14 set forth in the joint explanatory statement of the committee 

15 of conference accompanying Conference Report 105–217, 

16 and for purposes of the Balanced Budget and Emergency 

17 Deficit Control Act of 1985 (2 U.S.C. 900 et seq.) and the 

18 Congressional Budget Act of 1974 (2 U.S.C. 621 et seq.), 

19 the Fund shall be treated as if it were an account designated 

20 as ‘Appropriated Entitlements and Mandatories for Fiscal 

21 Year 1997’ in the joint explanatory statement of the com22 mittee of conference accompanying Conference Report 105– 

23 217. 

24 ‘‘(e) ESTIMATES FOR CONGRESSIONAL CONSIDER25 ATION.—The Secretary shall include in documents sub-
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1 mitted to Congress in support of the President’s budget sub2 mitted pursuant to section 1105 of title 31 detailed esti3 mates of the sums described in subsection (c) for the appli4 cable fiscal year. 

5 ‘‘(f) PROCEDURES FOR ESTIMATES.—The Secretary 

6 may, after consultation with the Committee on Appropria7 tions of the Senate and the Committee on Appropriations 

8 of the House of Representatives, establish policies and proce9 dures for developing the annual detailed estimates required 

10 by subsection (e).’’. 

11 (b) SEQUESTRATION.—Section 256(h)(4) of the Bal12 anced Budget and Emergency Deficit Control Act of 1985 

13 (2 U.S.C. 906(h)(4)) is amended by adding at the end the 

14 following new subparagraph: 

15 ‘‘(G) Cost of War Toxic Exposures Fund.’’. 

16 SEC. 806. APPROPRIATION FOR FISCAL YEAR 2022. 

17 (a) APPROPRIATION.—In addition to amounts other18 wise available, there is appropriated for fiscal year 2022, 

19 out of any funds in the Treasury not otherwise appro20 priated, $500,000,000 for the Cost of War Toxic Exposures 

21 Fund, established by section 324 of title 38, United States 

22 Code, as added by section 805 of this Act, to remain avail23 able until September 30, 2024. 

24 (b) SPEND PLAN.—Not later than 30 days after enact25 ment of this Act, the Secretary of Veterans Affairs shall sub-
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1 mit a plan for expending amounts made available by sub2 section (a) by program, project or activity to the Committee 

3 on Appropriations of the Senate and the Committee on Ap4 propriations of the House of Representatives. Funds may 

5 not be obligated until such Committees issue an approval, 

6 or absent a response, a period of 30 days has elapsed. 

7 SEC. 807. AUTHORIZATION OF ELECTRONIC NOTICE IN 

8 CLAIMS UNDER LAWS ADMINISTERED BY THE 

9 SECRETARY OF VETERANS AFFAIRS. 

10 (a) IN GENERAL.—Title 38, United States Code, is 

11 amended as follows: 

12 (1) By striking section 5100 and inserting the 

13 following: 

14 ‘‘§ 5100. Definitions 

15 ‘‘In this chapter: 

16 ‘‘(1) The term ‘claimant’ means any individual 

17 applying for, or submitting a claim for, any benefit 

18 under the laws administered by the Secretary. 

19 ‘‘(2) The term ‘notice’ means a communication 

20 issued through means (including electronic means) 

21 prescribed by the Secretary.’’. 

22 (2) In section 5104, by adding at the end the fol23 lowing new subsection: 

24 ‘‘(c) The Secretary may provide notice under sub25 section (a) electronically if a claimant (or the claimant’s 
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1 representative) elects to receive such notice electronically. A 

2 claimant (or the claimant’s representative) may revoke such 

3 an election at any time, by means prescribed by the Sec4 retary. 

5 ‘‘(d) The Secretary shall annually— 

6 ‘‘(1) solicit recommendations from stakeholders 

7 on how to improve notice under this section; and 

8 ‘‘(2) publish such recommendations on a publicly 

9 available website of the Department.’’. 

10 (3) In section 5104B(c), in the matter preceding 

11 paragraph (1) by striking ‘‘in writing’’ and inserting 

12 ‘‘to the claimant (and any representative of such 

13 claimant)’’. 

14 (4) In section 5112(b)(6), by striking ‘‘(at the 

15 payee’s last address of record)’’. 

16 (5) In section 7104— 

17 (A) in the heading, by adding ‘‘; deci18 sions; notice’’ at the end; and 

19 (B) by striking subsection (e) and inserting 

20 the following: 

21 ‘‘(e) After reaching a decision on an appeal, the Board 

22 shall promptly issue notice (as that term is defined in sec23 tion 5100 of this title) of such decision to the following: 

24 ‘‘(1) The appellant. 
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1 ‘‘(2) Any other party with a right to notice of 

2 such decision. 

3 ‘‘(3) Any authorized representative of the appel4 lant or party described in paragraph (2). 

5 ‘‘(f)(1) The Secretary may provide notice under sub6 section (e) electronically if a claimant (or the claimant’s 

7 representative) elects to receive such notice electronically. 

8 ‘‘(2) A claimant (or the claimant’s representative) 

9 may revoke such an election at any time, by means pre10 scribed by the Secretary.’’. 

11 (6) In section 7105(b)(1)(A), by striking ‘‘mail12 ing’’ and inserting ‘‘issuance’’. 

13 (7) In section 7105A(a), by striking ‘‘mailed’’ 

14 and inserting ‘‘issued’’. 

15 (8) In section 7266(a), by striking ‘‘mailed’’ and 

16 inserting ‘‘issued’’. 

17 (b) RULE OF CONSTRUCTION.—None of the amend18 ments made by this section shall be construed to apply sec19 tion 5104(a) of such title to decisions of the Board of Vet20 erans’ Appeals under chapter 71 of such title. 

21 SEC. 808. BURN PIT TRANSPARENCY. 

22 (a) ANNUAL REPORT ON DISABILITY CLAIMS.— 

23 (1) IN GENERAL.—Not later than 180 days after 

24 the date of the enactment of this Act, and annually 

25 thereafter, the Secretary of Veterans Affairs shall sub-
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1 mit to the appropriate congressional committees a re2 port detailing the following: 

3 (A) The total number of covered veterans. 

4 (B) The total number of claimed issues for 

5 disability compensation under chapter 11 of title 

6 38, United States Code, approved and the total 

7 number denied by the Secretary of Veterans Af8 fairs with respect to a covered veteran, and a 

9 breakdown of the reasons for the denials. 

10 (C) A comprehensive list of the top 10 con11 ditions from each body system for which the Sec12 retary awarded service connection for covered 

13 veterans. 

14 (D) Any updates or trends with respect to 

15 the information described in subparagraphs (A), 

16 (B), and (C), that the Secretary determines ap17 propriate. 

18 (2) COVERED VETERAN DEFINED.—In this sub19 section, the term ‘‘covered veteran’’ means a veteran 

20 who deployed to the Southwest Asia theater of oper21 ations any time after August 1990, or Afghanistan, 

22 Syria, Djibouti, or Uzbekistan after September 19, 

23 2001, and who submits a claim for disability com24 pensation under chapter 11 of title 38, United States 

25 Code. 
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1 (b) INFORMATION REGARDING THE AIRBORNE HAZ2 ARDS AND OPEN BURN PIT REGISTRY.— 

3 (1) NOTICE.—The Secretary of Veterans Affairs 

4 shall ensure that a medical professional of the Depart5 ment of Veterans Affairs informs a veteran of the Air6 borne Hazards and Open Burn Pit Registry if the 

7 veteran presents at a medical facility of the Depart8 ment for treatment that the veteran describes as being 

9 related to, or ancillary to, the exposure of the veteran 

10 to toxic airborne chemicals and fumes caused by open 

11 burn pits. 

12 (2) DISPLAY.—In making information public re13 garding the number of participants in the Airborne 

14 Hazards and Open Burn Pit Registry, the Secretary 

15 shall display such numbers by both State and by con16 gressional district. 

17 (c) DEFINITIONS.—In this section: 

18 (1) AIRBORNE HAZARDS AND OPEN BURN PIT

19 REGISTRY.—The term ‘‘Airborne Hazards and Open 

20 Burn Pit Registry’’ means the registry established by 

21 the Secretary of Veterans Affairs under section 201 of 

22 the Dignified Burial and Other Veterans’ Benefits 

23 Improvement Act of 2012 (Public Law 112–260; 38 

24 U.S.C. 527 note). 
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1 (2) APPROPRIATE CONGRESSIONAL COMMIT2 TEES.—The term ‘‘appropriate congressional commit3 tees’’ means— 

4 (A) the Committee on Veterans’ Affairs and 

5 the Committee on Armed Services of the Senate; 

6 and 

7 (B) The Committee on Veterans’ Affairs and 

8 the Committee on Armed Services of the House 

9 of Representatives. 

10 (3) OPEN BURN PIT.—The term ‘‘open burn pit’’ 

11 has the meaning given that term in section 201(c) of 

12 the Dignified Burial and Other Veterans’ Benefits 

13 Improvement Act of 2012 (Public Law 112–260; 38 

14 U.S.C. 527 note). 

15 TITLE IX—IMPROVEMENT OF 

16 WORKFORCE OF DEPART17 MENT OF VETERANS AFFAIRS 

18 SEC. 901. NATIONAL RURAL RECRUITMENT AND HIRING 

19 PLAN FOR VETERANS HEALTH ADMINISTRA20 TION. 

21 (a) IN GENERAL.—Not later than 18 months after the 

22 date of the enactment of this Act, the Secretary of Veterans 

23 Affairs, in collaboration with the directors of each commu24 nity-based outpatient clinic and medical center of the De25 partment of Veterans Affairs, shall develop and implement 
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1 a national rural recruitment and hiring plan for the Vet2 erans Health Administration to— 

3 (1) recruit health care professionals for rural 

4 and highly rural community-based outpatient clinics 

5 and rural and highly rural medical centers of the De6 partment; 

7 (2) determine which such clinics or centers have 

8 a staffing shortage of health care professionals; 

9 (3) develop best practices and techniques for re10 cruiting health care professionals for such clinics and 

11 centers; 

12 (4) not less frequently than annually, provide 

13 virtually based, on-demand training to human re14 sources professionals of the Veterans Health Adminis15 tration on the best practices and techniques developed 

16 under paragraph (3); and 

17 (5) provide recruitment resources, such as pam18 phlets and marketing material to— 

19 (A) Veterans Integrated Service Networks of 

20 the Department; 

21 (B) rural and highly rural community22 based outpatient clinics of the Department; and 

23 (C) rural and highly rural medical centers 

24 of the Department. 
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1 (b) ANNUAL REPORT.—Not later than 18 months after 

2 the date of the enactment of this Act, and annually there3 after, the Secretary shall submit to the Committee on Vet4 erans’ Affairs of the Senate and the Committee on Veterans’ 

5 Affairs of the House of Representatives a report that in6 cludes— 

7 (1) the plan developed and implemented under 

8 subsection (a); and 

9 (2) an assessment of the outcomes related to re10 cruitment and retention of employees of the Veterans 

11 Health Administration at rural and highly rural fa12 cilities of the Department. 

13 (c) DEFINITIONS.—In this section, the terms ‘‘rural’’ 

14 and ‘‘highly rural’’ have the meanings given those terms 

15 under the rural-urban commuting areas coding system of 

16 the Department of Agriculture. 

17 SEC. 902. AUTHORITY TO BUY OUT SERVICE CONTRACTS 

18 FOR CERTAIN HEALTH CARE PROFESSIONALS 

19 IN EXCHANGE FOR EMPLOYMENT AT RURAL 

20 OR HIGHLY RURAL FACILITIES OF DEPART21 MENT OF VETERANS AFFAIRS. 

22 (a) IN GENERAL.—For any covered health care profes23 sional to whom the Secretary of Veterans Affairs has offered 

24 employment with the Department of Veterans Affairs, the 

25 Secretary may buy out the non-Department service contract 
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1 of such individual in exchange for such individual agreeing 

2 to be employed at a rural or highly rural facility of the 

3 Department for a period of obligated service specified in 

4 subsection (c). 

5 (b) PAYMENT OF AMOUNTS.— 

6 (1) IN GENERAL.—Payment of any amounts for 

7 a buy out of a service contract for a covered health 

8 care professional under subsection (a) shall be made 

9 directly to the individual or entity with respect to 

10 which the covered health care professional has a serv11 ice obligation under such contract. 

12 (2) LIMITATION ON TOTAL AMOUNT.—The total 

13 amount paid by the Department under this section 

14 shall not exceed $40,000,000 per fiscal year. 

15 (c) OBLIGATED SERVICE.—In exchange for a contract 

16 buy out under subsection (a), a covered health care profes17 sional shall agree to be employed for not less than four years 

18 at a rural or highly rural facility of the Department. 

19 (d) LIABILITY.— 

20 (1) IN GENERAL.—Except as provided in para21 graph (2), if a covered health care professional fails 

22 for any reason to complete the period of obligated 

23 service of the individual under subsection (c), the 

24 United States shall be entitled to recover from the in25 dividual an amount equal to— 
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1 (A) the total amount paid under subsection 

2 (a) to buy out the non-Department service con3 tract of the individual; multiplied by 

4 (B) a fraction— 

5 (i) the numerator of which is— 

6 (I) the total number of months in 

7 the period of obligated service of the in8 dividual; minus 

9 (II) the number of months served 

10 by the individual; and 

11 (ii) the denominator of which is the 

12 total number of months in the period of ob13 ligated service of the individual. 

14 (2) EXCEPTION.—Liability shall not arise under 

15 paragraph (1) in the case of an individual covered by 

16 that paragraph if the individual does not obtain, or 

17 fails to maintain, employment as an employee of the 

18 Department due to staffing changes approved by the 

19 Under Secretary for Health. 

20 (e) ANNUAL REPORT.— 

21 (1) IN GENERAL.—Not later than 18 months 

22 after the date of the enactment of this Act, and not 

23 less frequently than annually thereafter, the Secretary 

24 of Veterans Affairs shall submit to the Committee on 

25 Veterans’ Affairs of the Senate and the Committee on 
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1 Veterans’ Affairs of the House of Representatives a re2 port on the use by the Secretary of the authority 

3 under this section. 

4 (2) ELEMENTS.—Each report required by para5 graph (1) shall include the following: 

6 (A) The number of health care professionals 

7 for whom a service contract buyout payment was 

8 made under subsection (a) in the previous fiscal 

9 year, disaggregated by occupation or specialty. 

10 (B) The average, highest, and lowest 

11 amount of the service contract buyout payments 

12 made under subsection (a) for each occupation or 

13 specialty in the previous fiscal year. 

14 (C) Each location where contract buyout 

15 authority under subsection (a) was utilized and 

16 the number of covered health care professionals 

17 who agreed to be employed at such location in 

18 the previous fiscal year. 

19 (f) DEFINITIONS.—In this section: 

20 (1) COVERED HEALTH CARE PROFESSIONAL.— 

21 The term ‘‘covered health care professional’’ means a 

22 physician, nurse anesthetist, physician assistant, or 

23 nurse practitioner offered employment with the De24 partment regardless of the authority under which 

25 such employment is offered. 
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1 (2) RURAL; HIGHLY RURAL.—The terms ‘‘rural’’ 

2 and ‘‘highly rural’’ have the meanings given those 

3 terms under the rural-urban commuting areas coding 

4 system of the Department of Agriculture. 

5 (g) SUNSET.—This section shall terminate on Sep6 tember 30, 2027. 

7 SEC. 903. QUALIFICATIONS FOR HUMAN RESOURCES POSI8 TIONS WITHIN DEPARTMENT OF VETERANS 

9 AFFAIRS AND PLAN TO RECRUIT AND RETAIN 

10 HUMAN RESOURCES EMPLOYEES. 

11 (a) ESTABLISHMENT OF QUALIFICATIONS.—Not later 

12 than 180 days after the date of the enactment of this Act, 

13 the Secretary of Veterans Affairs shall— 

14 (1) establish qualifications for each human re15 sources position within the Department of Veterans 

16 Affairs in coordination with the Office of Personnel 

17 Management; 

18 (2) establish standardized performance metrics 

19 for each such position; and 

20 (3) submit to the Committee on Veterans’ Affairs 

21 of the Senate and the Committee on Veterans’ Affairs 

22 of the House of Representatives a report containing 

23 the qualifications and standardized performance 

24 metrics established under paragraphs (1) and (2). 
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1 (b) IMPROVEMENT OF HUMAN RESOURCES ACTIONS.— 

2 Not later than 90 days after the date of the enactment of 

3 this Act, the Secretary shall establish or enhance systems 

4 of the Department to monitor the hiring and other human 

5 resources actions that occur at the local, regional, and na6 tional levels of the Department to improve the performance 

7 of those actions. 

8 (c) REPORT.—Not later than one year after the estab9 lishment of the qualifications and performance metrics 

10 under subsection (a), the Comptroller General of the United 

11 States shall submit to the Committee on Veterans’ Affairs 

12 of the Senate and the Committee on Veterans’ Affairs of 

13 the House of Representatives a report containing— 

14 (1) a description of the implementation of such 

15 qualifications and performance metrics; 

16 (2) an assessment of the quality of such quali17 fications and performance metrics; 

18 (3) an assessment of performance and outcomes 

19 based on such metrics; and 

20 (4) such other matters as the Comptroller Gen21 eral considers appropriate. 

22 (d) PLAN TO RECRUIT AND RETAIN HUMAN RE23 SOURCES EMPLOYEES.—Not later than one year after the 

24 date of the enactment of this Act, the Secretary of Veterans 

25 Affairs shall submit to the Committee on Veterans’ Affairs 
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1 of the Senate and the Committee on Veterans’ Affairs of 

2 the House of Representatives a plan for the recruitment and 

3 retention of human resources employees within the Depart4 ment of Veterans Affairs. 

5 SEC. 904. MODIFICATION OF PAY CAP FOR CERTAIN EM6 PLOYEES OF VETERANS HEALTH ADMINIS7 TRATION. 

8 (a) IN GENERAL.—Section 7455(c) is amended— 

9 (1) in paragraph (1), by striking ‘‘30 percent’’ 

10 inserting ‘‘50 percent’’; 

11 (2) in paragraph (2), by striking ‘‘level IV’’ in12 serting ‘‘level II’’; and 

13 (3) by adding at the end the following new para14 graph: 

15 ‘‘(3)(A) Notwithstanding section 5304 of title 5 or any 

16 other provision of law, but subject to the limitation under 

17 paragraph (2), pursuant to an increase under subsection 

18 (a), the Secretary may pay a special rate or an adjusted 

19 rate of basic pay in excess of the rate of basic pay payable 

20 for level IV of the Executive Schedule. 

21 ‘‘(B) If an employee is in receipt of a special rate of 

22 pay under subparagraph (A) in excess of the rate of basic 

23 pay payable for level IV of the Executive Schedule with an 

24 established special rate supplement of greater value than a 

25 supplement based on the applicable locality-based com-
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1 parability payment percentage under section 5304 of title 

2 5, but a pay adjustment would cause such established spe3 cial rate supplement to be of lesser value, the special rate 

4 supplement shall be converted to a supplement based on the 

5 applicable locality-based comparability percentage unless 

6 the Secretary determines that some other action is appro7 priate.’’. 

8 (b) PAY FOR CRITICAL POSITIONS.—Section 

9 7404(a)(1)(B) is amended by inserting ‘‘7306 or’’ before 

10 ‘‘7401(4)’’. 

11 SEC. 905. EXPANSION OF OPPORTUNITIES FOR HOUSE12 KEEPING AIDES. 

13 Section 3310 of title 5, United States Code, is amended 

14 by inserting ‘‘(other than for positions of housekeeping aides 

15 in the Department of Veterans Affairs)’’ after ‘‘competitive 

16 service’’. 

17 SEC. 906. MODIFICATION OF AUTHORITY OF THE SEC18 RETARY OF VETERANS AFFAIRS RELATING TO 

19 HOURS, CONDITIONS OF EMPLOYMENT, AND 

20 PAY FOR CERTAIN EMPLOYEES OF VETERANS 

21 HEALTH ADMINISTRATION. 

22 (a) EXPANSION OF ELIGIBILITY OF EMPLOYEES FOR

23 CERTAIN AWARDS.—Section 7404(c) is amended— 

24 (1) by striking ‘‘Notwithstanding’’ and inserting 

25 ‘‘(1) Notwithstanding’’; 
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1 (2) by inserting ‘‘or 7401(4)’’ after ‘‘section 

2 7306’’; 

3 (3) by striking ‘‘who is not eligible for pay under 

4 subchapter III’’ and inserting ‘‘or in a covered execu5 tive position under section 7401(1) of this title’’; 

6 (4) by striking ‘‘sections 4507 and 5384’’ and in7 serting ‘‘section 4507’’; and 

8 (5) by adding at the end the following new para9 graph: 

10 ‘‘(2) In this subsection, the term ‘covered executive po11 sition’ means a position that the Secretary has determined 

12 is of equivalent rank to a Senior Executive Service position 

13 (as such term is defined in section 3132(a) of title 5) and 

14 is subject to an agency performance management system.’’. 

15 (b) AUTHORITY FOR AWARDS PROGRAMS OF DEPART16 MENT OF VETERANS AFFAIRS.— 

17 (1) IN GENERAL.—Subchapter I of chapter 74 is 

18 amended by inserting after section 7404 the following 

19 new section: 

20 ‘‘§ 7404A. Awards 

21 ‘‘(a) SUPERIOR ACCOMPLISHMENTS AND PERFORM22 ANCE AWARDS PROGRAM.—The Secretary may establish an 

23 awards program for personnel listed in section 7421(b) of 

24 this title consistent with chapter 45 of title 5, to the extent 

25 practicable. 
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1 ‘‘(b) EXECUTIVE PERFORMANCE AWARDS PROGRAM.— 

2 Notwithstanding section 7425 of this title or any other pro3 vision of law, the Secretary may establish a performance 

4 awards program consistent with section 5384 of title 5 

5 for— 

6 ‘‘(1) personnel appointed under section 7401(1) 

7 of this title for a position that the Secretary has de8 termined is of equivalent rank to a Senior Executive 

9 Service position (as such term is defined in section 

10 3132(a) of title 5) and is subject to an agency per11 formance management system; and 

12 ‘‘(2) personnel appointed under section 7306 or 

13 7401(4) of this title. 

14 ‘‘(c) PAYMENT OF AWARDS.—Awards under this sec15 tion may be paid based on criteria established by the Sec16 retary and shall not be considered in calculating the limita17 tion under section 7431(e)(4) of this title. 

18 ‘‘(d) NOT CONSIDERED BASIC PAY.—Awards under 

19 this section shall not be considered basic pay for any pur20 pose. 

21 ‘‘(e) REGULATIONS.—The Secretary may prescribe reg22 ulations for the administration of this section.’’. 

23 (2) LIMITATION ON PAST AWARDS.—Notwith24 standing any other provision of law, awards made by 

25 the Secretary of Veterans Affairs for any period on or 
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1 after January 1, 2017, and before the date of the en2 actment of this Act for an employee under section 

3 7306 or 7401(4) of title 38, United States Code, or for 

4 a position described in section 7401(1) of such title 

5 that the Secretary has determined is of equivalent 

6 rank to a Senior Executive Service position (as such 

7 term is defined in section 3132(a) of title 5, United 

8 States Code), may be subject to section 7404A of title 

9 38, United States Code, as added by paragraph (1). 

10 (c) MODIFICATION OF EMPLOYEES SUBJECT TO REGU11 LATION BY SECRETARY OF VETERANS AFFAIRS OF HOURS

12 AND CONDITIONS OF EMPLOYMENT AND LEAVES OF AB13 SENCE.— 

14 (1) IN GENERAL.—Section 7421 is amended— 

15 (A) in subsection (a), by striking ‘‘chapter’’ 

16 and inserting ‘‘title’’; and 

17 (B) in subsection (b), by adding at the end 

18 the following new paragraph: 

19 ‘‘(9) Any position for which the employee is ap20 pointed under section 7306 or 7401(4) of this title.’’. 

21 (2) ADMINISTRATION OF FULL-TIME EMPLOY22 EES.—Section 7423 is amended— 

23 (A) in subsection (a)(2), by adding at the 

24 end the following new subparagraph: 
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1 ‘‘(D) The Secretary may exclude from the requirements 

2 of paragraph (1) employees hired under section 7306 or 

3 7401(4) of this title or for a position described in section 

4 7401(1) of this title that the Secretary has determined is 

5 of equivalent rank to a Senior Executive Service position 

6 (as such term is defined in section 3132(a) of title 5).’’; 

7 and 

8 (B) in subsection (e)(1), by striking 

9 ‘‘7401(1)’’ and inserting ‘‘7421(b)’’. 

10 (3) ADDITIONAL PAY AUTHORITIES.—Section 

11 7410(a) is amended— 

12 (A) by striking ‘‘The Secretary’’ and insert13 ing ‘‘(1) The Secretary’’; 

14 (B) by striking ‘‘the personnel described in 

15 paragraph (1) of section 7401 of this title’’ and 

16 inserting ‘‘personnel appointed under section 

17 7306 of this title or section 7401(4) of this title, 

18 or personnel described in section 7401(1) of this 

19 title,’’; and 

20 (C) by striking ‘‘in the same manner, and 

21 subject to the same limitations, as in the case of’’ 

22 and inserting ‘‘in a manner consistent with’’; 

23 and 

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

25 paragraph: 
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1 ‘‘(2) Payments under paragraph (1) shall not be con2 sidered in calculating the limitation under section 

3 7431(e)(4) of this title.’’. 

4 (4) TREATMENT OF PAY AUTHORITY CHANGES.— 

5 For the purposes of the amendments made by para6 graph (3), the Secretary of Veterans Affairs shall treat 

7 any award or payment made by the Secretary be8 tween January 1, 2017, and the date of the enactment 

9 of this Act to employees appointed under sections 

10 7306, 7401(1), and 7401(4) of title 38, United States 

11 Code, that the Secretary has determined are of equiv12 alent rank to a Senior Executive Service position (as 

13 such term is defined in section 3132(a) of title 5, 

14 United States Code), as if such amendments had been 

15 in effect at the time of such award or payment. 

16 (5) TREATMENT OF PRIOR LEAVE BALANCES.— 

17 Notwithstanding any other provision of law, the Sec18 retary may adjust the leave balance and carryover 

19 leave balance of any employee described in section 

20 7421(b)(9) of title 38, United States Code, as amend21 ed by paragraph (1)(B), to ensure any leave accrued 

22 or carried over before the date of the enactment of this 

23 Act remains available to such employee. 
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1 (d) TREATMENT OF CERTAIN EMPLOYEES AS AP2 POINTED UNDER SECTION 7306.—Section 7306 is amend3 ed— 

4 (1) in subsection (a), by redesignating the second 

5 paragraph (11) as paragraph (12); and 

6 (2) by adding at the end the following new sub7 section: 

8 ‘‘(g) For purposes of applying any provision of chapter 

9 74 of this title, including sections 7404, 7410, and 7421, 

10 or any other provision of law, the Secretary may treat any 

11 appointment for a position under this chapter to be an ap12 pointment under this section.’’. 

13 (e) CONFORMING AMENDMENT.—Section 7431(e)(4) is 

14 amended by striking ‘‘In no case’’ and inserting ‘‘Except 

15 as provided in sections 7404A(c) and 7410(a)(2) of this 

16 title, in no case’’. 

17 SEC. 907. WAIVER OF PAY LIMITATION FOR CERTAIN EM18 PLOYEES OF DEPARTMENT OF VETERANS AF19 FAIRS. 

20 Subchapter I of chapter 7 is amended by inserting 

21 after section 703 the following new section: 

22 ‘‘§ 704. Waiver of pay limitation for certain employees 

23 ‘‘(a) EMPLOYEES OF VETERANS HEALTH ADMINISTRA24 TION IMPACTED BY CLOSURE OR REALIGNMENT.—Notwith25 standing any other provision of law, the Secretary may 
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1 waive any annual premium or aggregate limitation on pay 

2 for an employee of the Veterans Health Administration for 

3 the calendar year during which— 

4 ‘‘(1) the official duty station of the employee is 

5 closed; or 

6 ‘‘(2) the office, facility, activity, or organization 

7 of the employee is realigned. 

8 ‘‘(b) EMPLOYEES PROVIDING CARE TO VETERANS EX9 POSED TO OPEN BURN PITS.— 

10 ‘‘(1) IN GENERAL.—Notwithstanding any other 

11 provision of law, the Secretary may waive any an12 nual premium or aggregate limitation on pay for an 

13 employee of the Department whose primary duties in14 clude providing expanded care for veterans exposed to 

15 open burn pits. 

16 ‘‘(2) OPEN BURN PIT DEFINED.—In this sub17 section, the term ‘open burn pit’ has the meaning 

18 given that term in section 201(c) of the Dignified 

19 Burial and Other Veterans’ Benefits Improvement Act 

20 of 2012 (Public Law 112–260; 38 U.S.C. 527 note). 

21 ‘‘(c) COORDINATION WITH OFFICE OF PERSONNEL

22 MANAGEMENT.—In implementing this section, the Sec23 retary shall coordinate with the Director of the Office of 

24 Personnel Management. 

25 ‘‘(d) REPORTS.— 
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1 ‘‘(1) IN GENERAL.—For each quarter that the 

2 Secretary waives a limitation under this section, the 

3 Secretary shall submit to the Committee on Veterans’ 

4 Affairs of the Senate, the Committee on Veterans’ Af5 fairs of the House of Representatives, and the Office 

6 of Personnel Management a report on the waiver or 

7 waivers. 

8 ‘‘(2) CONTENTS.—Each report submitted under 

9 paragraph (1) with respect to a waiver or waivers 

10 shall include the following: 

11 ‘‘(A) Where the waiver or waivers were 

12 used, including in which component of the De13 partment and, as the case may be, which medical 

14 center of the Department. 

15 ‘‘(B) For how many employees the waiver 

16 or waivers were used, disaggregated by compo17 nent of the Department and, if applicable, med18 ical center of the Department. 

19 ‘‘(C) The average amount by which each 

20 payment exceeded the pay limitation that was 

21 waived, disaggregated by component of the De22 partment and, if applicable, medical center of 

23 the Department. 
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1 ‘‘(e) EMPLOYEE DEFINED.—In this section, the term 

2 ‘employee’ means any employee regardless of the authority 

3 under which the employee was hired. 

4 ‘‘(f) TERMINATION.—This section shall terminate on 

5 September 30, 2027.’’. 

6 SEC. 908. ELIMINATION OF LIMITATION ON AWARDS AND 

7 BONUS FOR EMPLOYEES OF DEPARTMENT OF 

8 VETERANS AFFAIRS. 

9 (a) IN GENERAL.—Section 705(a) of the Veterans Ac10 cess, Choice, and Accountability Act of 2014 (Public Law 

11 113–146; 38 U.S.C. 703 note) is amended by striking para12 graph (3). 

13 (b) APPLICABILITY.—Subsection (a) shall take effect on 

14 the date of the enactment of this Act and apply as if such 

15 subsection had been enacted on September 30, 2021. 

16 SEC. 909. ADDITIONAL AUTHORITY OF THE SECRETARY OF 

17 VETERANS AFFAIRS RELATING TO RECRUIT18 MENT AND RETENTION OF PERSONNEL. 

19 Subchapter I of chapter 7 is amended by inserting 

20 after section 705 the following new section: 

21 ‘‘§ 706. Additional authority relating to recruitment 

22 and retention of personnel 

23 ‘‘(a) RECRUITMENT AND RELOCATION BONUSES.—The 

24 Secretary may pay a recruitment or relocation bonus under 
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1 section 5753(e) of title 5 without regard to any require2 ments for certification or approval under that section. 

3 ‘‘(b) RETENTION BONUSES.—(1) The Secretary may 

4 pay a retention bonus under section 5754(f) of title 5 with5 out regard to any requirement for certification or approval 

6 under that subsection. 

7 ‘‘(2) The Secretary may pay a retention bonus as spec8 ified in subsection (e)(2) of section 5754 of title 5 and may 

9 pay the bonus as a single lump-sum payment at the begin10 ning of the full period of service required by an agreement 

11 under subsection (d) of such section. 

12 ‘‘(c) MERIT AWARDS.—The Secretary may grant a 

13 cash award under section 4502(b) of title 5 without regard 

14 to any requirement for certification or approval under that 

15 section. 

16 ‘‘(d) INCENTIVES FOR CRITICAL SKILLS.—(1) Subject 

17 to the provisions of this paragraph, the Secretary may pro18 vide a critical skill incentive to an employee in a case in 

19 which the Secretary determines— 

20 ‘‘(A) the employee possesses a high-demand skill 

21 or skill that is at a shortage; 

22 ‘‘(B) such skill is directly related to the duties 

23 and responsibilities of the employee’s position; and 
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1 ‘‘(C) employment of an individual with such 

2 skill in such position serves a critical mission-related 

3 need of the Department. 

4 ‘‘(2) An incentive provided to an employee under 

5 paragraph (1) may not to exceed 25 percent of the basic 

6 pay of the employee. 

7 ‘‘(3) Provision of an incentive under paragraph (1) 

8 shall be contingent on the employee entering into a written 

9 agreement to complete a period of employment with the De10 partment. 

11 ‘‘(4) An incentive provided under paragraph (1) shall 

12 not be considered basic pay for any purpose. 

13 ‘‘(5) The Secretary may prescribe conditions, includ14 ing with respect to eligibility, and limitations on provision 

15 of incentive under paragraph (1). 

16 ‘‘(6) Incentive provided under paragraph (1) shall not 

17 be included in the calculation of total amount of compensa18 tion under section 7431(e)(4) of this title. 

19 ‘‘(e) STUDENT LOAN REPAYMENTS.—(1) Subject to the 

20 provisions of this subsection, the Secretary may repay a 

21 student loan pursuant to section 5379(b) of title 5. 

22 ‘‘(2) Paragraph (2) of such section shall not apply to 

23 payment under this subsection. 

24 ‘‘(3) Payment under this subsection shall be made sub25 ject to such terms, limitations, or conditions as may be mu-
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1 tually agreed to by the Secretary and the employee con2 cerned, except that the amount paid by the Secretary under 

3 this subsection may not exceed— 

4 ‘‘(A) $40,000 for any employee in any calendar 

5 year; or 

6 ‘‘(B) a total of $100,000 in the case of any em7 ployee. 

8 ‘‘(f) EXPEDITED HIRING AUTHORITY FOR COLLEGE

9 GRADUATES; COMPETITIVE SERVICE.—(1) Subject to para10 graph (2) of this subsection, the Secretary may expedite hir11 ing for college graduates under section 3115 of title 5 with12 out regard to subsection (e) of such section or any regula13 tions prescribed by the Office of Personnel Management for 

14 administration of such subsection. 

15 ‘‘(2) The number of employees the Secretary may ap16 point under section 3115 of title 5 may not exceed the num17 ber equal to 25 percent of individuals that the Secretary 

18 appointed during the previous fiscal year to a position in 

19 the competitive service classified in a professional or ad20 ministrative occupational category, at the GS–11 level, or 

21 an equivalent level, or below, under a competitive exam22 ining procedure. 

23 ‘‘(g) EXPEDITED HIRING AUTHORITY FOR POST-SEC24 ONDARY STUDENTS; COMPETITIVE SERVICE.—(1) Subject 

25 to paragraph (2) of this subsection, the Secretary may expe-
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1 dite hiring of post-secondary students under section 3116 

2 of title 5, without regard to subsection (d) of such section 

3 or any regulations prescribed by the Office of Personnel 

4 Management for administration of such subsection. 

5 ‘‘(2) The number of employees the Secretary may ap6 point under section 3116 of title 5 may not exceed the num7 ber equal to 25 percent of the number of students that the 

8 Secretary appointed during the previous fiscal year to a 

9 position at the GS–11 level, or an equivalent level, or below. 

10 ‘‘(h) PAY AUTHORITY FOR CRITICAL POSITIONS.—(1) 

11 Subject to the provisions of this subsection, the Secretary 

12 may authorize the fixing of the rate of pay for a critical 

13 position in the Department consistent with the authorities 

14 and requirements of section 5377 of title 5 that apply to 

15 the Office of Personnel Management. 

16 ‘‘(2) The Secretary may fix the rate of pay for a crit17 ical position under this subsection in excess of the limita18 tion set forth by section 5377(d)(2) of such title. 

19 ‘‘(3) Basic pay may not be fixed under this subsection 

20 at a rate greater than the rate payable for the Vice Presi21 dent of the United States established under section 104 of 

22 title 3, except upon written approval of the President. 

23 ‘‘(4) Notwithstanding section 5377(f) of title 5, the Sec24 retary may authorize the exercise of authority under this 

25 subsection with respect to up to 200 positions at any time. 
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1 ‘‘(i) RATES OF SPECIAL PAY.—(1) The Secretary may 

2 establish a rate for special pay under section 5305(a)(1) 

3 of title 5. 

4 ‘‘(2) In applying such section to the Secretary’s au5 thority under paragraph (1)— 

6 ‘‘(A) ‘50 percent’ shall be substituted for ‘30 per7 cent’; and 

8 ‘‘(B) ‘level II of the Executive Schedule’ shall be 

9 substituted for ‘level IV of the Executive Schedule’. 

10 ‘‘(j) WAIVER OF LIMITATIONS ON CERTAIN PAYMENTS

11 UNDER PAY COMPARABILITY SYSTEM.—The Secretary may 

12 waive the limitation in section 5307 of title 5 for an em13 ployee or a payment. 

14 ‘‘(k) TERMINATION.—The authorities under this sec15 tion shall terminate on September 30, 2027.’’. 

Attest: 

Clerk. 
117TH CONGRESS 

2D SESSION S. 3373 

AMENDMENT