tistical and epidemiological methods used to detect 
the association; 
(2) the increased risk of the disease among 
those exposed to toxic substances during active mili-
tary, naval, or air service; and 
(3) whether there exists a plausible biological 
mechanism or other evidence of a causal relationship 
between the exposure and the occurrence of the dis-
ease. 
(e) COOPERATION
OF FEDERAL AGENCIES.—The 
head of each relevant Federal agency, including the Sec-
retary of Defense, shall cooperate fully with the Academies 
in performing the services covered by this section. 
(f) RECOMMENDATIONS
FOR
ADDITIONAL
SCI-
ENTIFIC STUDIES.— 
(1) IN
GENERAL.—Under an agreement be-
tween the Secretary and the Academies under this 
section, the Academies shall make any recommenda-
tions for additional scientific studies to resolve areas 
of continuing scientific uncertainty relating to the 
exposure of humans to toxic substances. 
(2) 
CONSIDERATIONS.—In 
making 
rec-
ommendations under paragraph (1), the Academies 
shall consider— 
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(A) the scientific information that is avail-
able at the time of the recommendation; 
(B) the value and relevance of the informa-
tion that could result from additional studies; 
and 
(C) the cost and feasibility of carrying out 
such additional studies. 
(g) REPORTS.— 
(1) INITIAL REPORT.— 
(A) IN
GENERAL.—Under an agreement 
between the Secretary and the Academies under 
this section, not later than one year after the 
date of the enactment of this Act, the Acad-
emies shall submit to the Secretary, the Com-
mittee on Veterans’ Affairs of the Senate, and 
the Committee on Veterans’ Affairs of the 
House of Representatives an initial report on 
the activities of the Academies under the agree-
ment. 
(B) ELEMENTS.—The report submitted 
under subparagraph (A) shall include the fol-
lowing: 
(i) The determinations described in 
subsection (d). 
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(ii) A full explanation of the scientific 
evidence and reasoning that led to such de-
terminations. 
(iii) Any recommendations of the 
Academies under subsection (f). 
(2) PERIODIC UPDATES.—Under an agreement 
between the Secretary and the Academies under this 
section, not less frequently than once every two 
years after the date on which the initial report is 
submitted under paragraph (1)(A), the Academies 
shall submit to the Secretary, the Committee on Vet-
erans’ Affairs of the Senate, and the Committee on 
Veterans’ Affairs of the House of Representatives an 
updated report on the activities of the Academies 
under the agreement. 
(h) ALTERNATIVE CONTRACT SCIENTIFIC ORGANIZA-
TION.— 
(1) IN GENERAL.—If the Secretary is unable 
within the time period prescribed in subsection 
(b)(2) to enter into an agreement with the Acad-
emies for the purposes of this section on terms ac-
ceptable to the Secretary, the Secretary shall seek to 
enter into an agreement for the purposes of this sec-
tion with another appropriate scientific organization 
that— 
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(A) is not part of the Federal Government; 
(B) operates as a not-for-profit entity; and 
(C) has expertise and objectivity com-
parable to that of the Academies. 
(2) TREATMENT.—If the Secretary enters into 
an agreement with another organization as described 
in paragraph (1), any reference in this section, sec-
tion 547 of title 38, United States Code, as added 
by section 201(a), and section 1119 of such title, as 
added by section 105(a), to the National Academies 
of Sciences, Engineering, and Medicine shall be 
treated as a reference to the other organization. 
SEC. 203. COLLECTION, ANALYSIS, AND REPORT ON TREAT-
MENT OF VETERANS FOR MEDICAL CONDI-
TIONS RELATED TO EXPOSURE TO TOXIC 
SUBSTANCES. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall compile and analyze, on a continuous basis, all clin-
ical data that— 
(1) is obtained by the Department of Veterans 
Affairs in connection with hospital care, medical 
services, and nursing home care furnished under sec-
tion 1710(a)(2)(F) of title 38, United States Code; 
and 
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(2) is likely to be scientifically useful in deter-
mining the association, if any, between the medical 
condition of a veteran and exposure to a toxic sub-
stance. 
(b) CONSENT OF PATIENTS.—Compilation and anal-
ysis by the Secretary of clinical data of a veteran under 
subsection (a) shall be conducted, and such data shall be 
used, consistent with the informed consent of the veteran 
and in compliance with all applicable Federal law. 
(c) ANNUAL REPORT.—Not later than one year after 
the date of the enactment of this Act, and annually there-
after, the Secretary shall submit to the Committee on Vet-
erans’ Affairs of the Senate, the Committee on Veterans’ 
Affairs of the House of Representatives, and the Toxic Ex-
posure Review Commission established by section 547 of 
title 38, United States Code, as added by section 201(a) 
of this Act, a report containing— 
(1) the data compiled under subsection (a); 
(2) an analysis of such data; 
(3) a description of the types and incidences of 
medical conditions identified by the Department 
under such subsection; 
(4) the explanation of the Secretary for the in-
cidence of such medical conditions and other expla-
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nations for the incidence of such conditions as the 
Secretary considers reasonable; and 
(5) the views of the Secretary on the scientific 
validity of drawing conclusions from the incidence of 
such medical conditions, as evidenced by the data 
compiled under subsection (a), regarding any asso-
ciation between such conditions and exposure to a 
toxic substance. 
TITLE 
III—IMPROVEMENT 
OF 
RESOURCES OF DEPARTMENT 
OF VETERANS AFFAIRS RE-
GARDING 
EXPOSURES 
TO 
TOXIC SUBSTANCES 
SEC. 301. PUBLICATION OF LIST OF RESOURCES OF DE-
PARTMENT OF VETERANS AFFAIRS FOR VET-
ERANS EXPOSED TO TOXIC SUBSTANCES AND 
OUTREACH PROGRAM FOR SUCH VETERANS 
AND CAREGIVERS AND SURVIVORS OF SUCH 
VETERANS. 
(a) PUBLICATION OF LIST OF RESOURCES.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, and an-
nually thereafter, the Secretary of Veterans Affairs 
shall publish a list of resources of the Department 
of Veterans Affairs for— 
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(A) veterans provided disability compensa-
tion under chapter 11 of title 38, United States 
Code, relating to exposure to toxic substances; 
(B) veterans eligible for hospital care, 
medical services, and nursing home care under 
section 1710(a)(2)(F) of such title; 
(C) caregivers of veterans described in sub-
paragraph (A) or (B) who are participating in 
the program of comprehensive assistance for 
family caregivers under section 1720G(a) of 
such title; and 
(D) survivors of veterans described in sub-
paragraph (A) or (B) (or who would be de-
scribed in any such subparagraph were the vet-
eran alive) who are receiving death benefits 
under the laws administered by the Secretary. 
(2) UPDATE.—The Secretary shall periodically 
update the list published under paragraph (1). 
(b) OUTREACH.—The Secretary shall develop, with 
input from the community, an informative outreach pro-
gram for veterans on illnesses that may be related to expo-
sure to toxic substances, including outreach with respect 
to benefits and support programs. 
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SEC. 302. INCORPORATION OF TOXIC EXPOSURE QUES-
TIONNAIRE 
DURING 
PRIMARY 
CARE 
AP-
POINTMENTS. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall incorporate a clinical questionnaire to help determine 
potential exposure to toxic substances during active mili-
tary, naval, or air service as part of the initial screening 
conducted for an appointment of a veteran with a primary 
care provider of the Department of Veterans Affairs to 
improve understanding by the Department of exposure of 
veterans to toxic substances while serving in the Armed 
Forces. 
(b) DETERMINATION OF QUESTIONS.—The questions 
included in the questionnaire required under subsection 
(a) shall be determined by the Secretary with input from 
medical professionals. 
SEC. 303. SENSE OF CONGRESS ON PORTAL FOR ACCESS BY 
VETERANS TO INDIVIDUAL LONGITUDINAL 
EXPOSURE RECORD. 
It is the sense of Congress that the Secretary of Vet-
erans Affairs should establish a portal on the internet 
website of the Department of Veterans Affairs through 
which a veteran may access documents and information 
with respect to the veteran contained in the Individual 
Longitudinal Exposure Record of the Department of Vet-
erans Affairs. 
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SEC. 304. TRAINING OF HEALTH CARE PERSONNEL OF DE-
PARTMENT OF VETERANS AFFAIRS ON ILL-
NESSES RELATED TO EXPOSURE TO TOXIC 
SUBSTANCES. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall ensure that health care personnel of the Department 
of Veterans Affairs are appropriately trained to identify, 
treat, and assess the impact of illnesses related to expo-
sure to toxic substances. 
(b) ELEMENTS OF TRAINING.—The training required 
under subsection (a) shall— 
(1) provide health care personnel of the Depart-
ment with specific education with respect to illnesses 
related to exposure to toxic substances; and 
(2) inform such personnel of how to probe for 
additional information from veterans regarding expo-
sures to different toxicants. 
(c) TOXICANT DEFINED.—In this section, the term 
‘‘toxicant’’ has the meaning given that term in subpara-
graph (G)(iv) of section 1710(e)(1) of title 38, United 
States Code, as added by section 101(a). 
Æ 
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