IIB 
113TH CONGRESS 
2D SESSION 
H. R. 4261 
IN THE SENATE OF THE UNITED STATES 
JUNE 2, 2014 
Received; read twice and referred to the Committee on Veterans’ Affairs 
AN ACT 
To improve the research of Gulf War Illness, the Research 
Advisory Committee on Gulf War Veterans’ Illnesses, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Gulf War Health Re-
search Reform Act of 2014’’. 
SEC. 2. IMPROVEMENTS TO RESEARCH ADVISORY COM-
MITTEE 
ON 
GULF 
WAR 
VETERANS’ 
ILL-
NESSES. 
(a) INDEPENDENCE OF COMMITTEE.—Subsection (b) 
of section 707 of the Veterans Health Care Act of 1992 
(Public Law 102–585; 38 U.S.C. 527 note) is amended— 
(1) by striking ‘‘Not later than’’ and inserting 
‘‘(1) ESTABLISHMENT.—Not later than’’; and 
(2) by adding at the end the following new 
paragraphs: 
‘‘(2) INDEPENDENCE.—(A) The Committee estab-
lished under paragraph (1) shall be an independent advi-
sory committee which shall provide advice and counsel to 
the congressional veterans committees and to the Sec-
retary of Veterans Affairs (as the head of the department 
designated under subsection (a) that established the Com-
mittee under paragraph (1)). 
‘‘(B) In carrying out the functions, powers, and du-
ties of the Committee, the Committee shall be independent 
of the Secretary of Veterans Affairs. The Committee shall 
exert independent control of the budget allocations, staff-
ing levels and expenditures, personnel decisions and proc-
esses, procurements, and other administrative and man-
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agement functions of the Committee. The administration 
and management of the Committee shall be subject to the 
usual and customary Federal audit procedures. 
‘‘(3) DUTIES.—(A) The Committee shall provide to 
Congress, the Secretary of Veterans Affairs, and the heads 
of other departments and agencies of the Federal Govern-
ment that conduct research on illnesses in Gulf War vet-
erans advice with respect to proposed research studies, re-
search plans, or research strategies relating to the health 
consequences of military service in the Southwest Asia 
theater of operations during the Gulf War. 
‘‘(B) The Committee may not conduct scientific re-
search or review research proposals submitted to the Sec-
retary of Veterans Affairs prior to funding. The Secretary 
shall appoint three members from the Committee who 
have appropriate scientific expertise to the committee des-
ignated to review such research proposals relating to ill-
nesses in Gulf War veterans. 
‘‘(C) The guiding principle for the Committee shall 
be the premise that the fundamental goal of Gulf War 
health-related research, either basic or applied, conducted 
by the Federal Government is to ultimately improve the 
health of ill Gulf War veterans, and that the choice and 
success of research efforts shall be judged accordingly. 
The Committee shall assess the overall effectiveness of 
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such research conducted by the Federal Government to 
answer central questions on the nature, causes, and treat-
ments for health consequences of military service in the 
Southwest Asia theater of operations during the Gulf War. 
‘‘(D) The Committee shall meet in public session to 
review research funded by the Department of Veterans Af-
fairs relevant to understanding and treating the health 
consequences of military service in the Gulf War, and the 
processes conducted to solicit, review, and select such 
funded research to assess methods, results, and implica-
tions of such research. The Committee may review re-
search plans, initiatives, and activities from other depart-
ments and agencies of the Federal Government supporting 
research relating to the health consequences of military 
service in the Southwest Asia theater of operations during 
the Gulf War. 
‘‘(4) REPORTS AND RECOMMENDATIONS.—(A) Not 
later than December 1 of each year, the Committee shall 
submit to the congressional veterans committees and the 
Secretary of Veterans Affairs an annual report summa-
rizing the activities of the Committee during the period 
covered by the report. 
‘‘(B) The Committee shall submit to the congres-
sional veterans committees, the Secretary of Veterans Af-
fairs, and the head of any other department or agency of 
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the Federal Government that conducts research on ill-
nesses in Gulf War veterans any other reports and rec-
ommendations of the Committee regarding Gulf War-re-
lated research. 
‘‘(C) Reports, recommendations, publications, and 
other documents of the Committee shall not be subject to 
review or approval by the Secretary of Veterans Affairs. 
‘‘(D) The Committee may submit to the Secretary of 
Veterans Affairs proposed recommendations of the Com-
mittee for comment for a period not to exceed 30 days. 
‘‘(E) Each report submitted by the Committee shall 
be approved by the Committee meeting in public session 
prior to such submission. 
‘‘(5) MEMBERSHIP.—(A) The Committee shall be 
composed of 12 members appointed as follows: 
‘‘(i) One member appointed jointly by the chair-
man of the congressional veterans committees, who 
shall serve as chairman of the Committee. 
‘‘(ii) Two members appointed by the chairman 
of the Committee on Veterans’ Affairs of the House 
of Representatives. 
‘‘(iii) Two members appointed by the chairman 
of the Committee on Veterans’ Affairs of the Senate. 
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‘‘(iv) Two members appointed by the ranking 
member of the Committee on Veterans’ Affairs of 
the House of Representatives. 
‘‘(v) Two members appointed by the ranking 
member of the Committee on Veterans’ Affairs of 
the Senate. 
‘‘(vi) Three members appointed by the Sec-
retary of Veterans Affairs, of whom not less than 
one shall be a veteran. 
‘‘(B)(i) The first 11 vacancies from among the mem-
bers of the Committee (not including a member serving 
as chairman of the Committee) occurring on or after the 
date of the enactment of the Gulf War Health Research 
Reform Act of 2014 shall be filled by— 
‘‘(I) the chairman of the Committee on Vet-
erans’ Affairs of the House of Representatives ap-
pointing a member for the first and sixth vacancy; 
‘‘(II) the chairman of the Committee on Vet-
erans’ Affairs of the Senate appointing a member 
for the second and seventh vacancy; 
‘‘(III) the ranking member of the Committee on 
Veterans’ Affairs of the House of Representatives 
appointing a member for the third and eighth va-
cancy; 
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‘‘(IV) the ranking member of the Committee on 
Veterans’ Affairs of the Senate appointing a member 
for the fourth and ninth vacancy; and 
‘‘(V) the Secretary of Veterans Affairs appoint-
ing a member for the fifth, tenth, and eleventh va-
cancy. 
‘‘(ii) A vacancy in the Committee of a member serv-
ing as chairman shall be filled jointly by the chairmen of 
the congressional veterans committees. 
‘‘(iii) Except as provided by clause (i) or (ii), a va-
cancy in the Committee of a member shall be filled in the 
manner in which the appointment of such member was 
made. A member appointed to fill a vacancy occurring be-
fore the expiration of the term for which the member’s 
predecessor was appointed shall be appointed only for the 
remainder of that term. 
‘‘(C) Of the members of the Committee who are ap-
pointed on or after the date of the enactment of the Gulf 
War Health Research Reform Act of 2014— 
‘‘(i) not fewer than three members shall be vet-
erans; 
‘‘(ii) not fewer than eight members shall be sci-
entists or physicians who have experience in bio-
medicine, epidemiology, immunology, environmental 
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health, neurology, toxicology, or other appropriate 
disciplines; and 
‘‘(iii) the chairman shall be a veteran or an ex-
pert described in clause (ii), or both. 
‘‘(D) Each member of the Committee who is ap-
pointed on or after the date of the enactment of the Gulf 
War Health Research Reform Act of 2014 shall be ap-
pointed for a three-year term. Except as provided by sec-
tion 2(c)(3) of such Act, a member may be reappointed 
once (not including the initial appointment of a member 
made before the date of the enactment of such Act). 
‘‘(6) MEETINGS.—(A) The Committee shall meet at 
the call of the chairman, but not less than twice annually. 
‘‘(B) A majority of the members of the Committee 
shall constitute a quorum, but a lesser number of members 
may hold hearings. 
‘‘(C)(i) The Secretary of Veterans Affairs, the head 
of the Office of Research and Development of the Depart-
ment of Veterans Affairs, and the head of the Office of 
Public Health of the Department shall attend each meet-
ing of the Committee. 
‘‘(ii) The Secretary of Veterans Affairs may delegate 
the attendance of the Secretary under clause (i) to a level 
not below the Deputy Under Secretary for Health of the 
Department of Veterans Affairs, but the Secretary shall 
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attend at least one meeting each year without making such 
delegation. 
‘‘(D) Each meeting of the Committee shall be open 
to the public. 
‘‘(7) COMPENSATION AND STAFF.—(A) Except with 
respect to a member who serves a scientific director under 
subparagraph (C)(ii) and is treated as staff for purposes 
of compensation, each member of the Committee shall be 
paid at the daily rate provided for temporary and intermit-
tent services under section 3109(b) of title 5, United 
States Code, for each day during which the member at-
tends meetings of the Committee. 
‘‘(B) The members of the Committee shall be allowed 
travel expenses, including per diem in lieu of subsistence, 
at rates authorized for employees of agencies under sub-
chapter I of chapter 57 of title 5, United States Code, 
while away from their homes or regular places of business 
in the performance of service of the Committee. 
‘‘(C)(i) The chairman of the Committee may appoint 
a staff of not more than four employees to provide the 
Committee scientific and administrative support. Such 
employees may be— 
‘‘(I) detailees of the Department of Veterans 
Affairs or other departments or agencies of the Fed-
eral Government; 
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‘‘(II) individuals employed as temporary em-
ployees of the Federal Government; or 
‘‘(III) at the request of the chairman of the 
Committee, provided under a contract entered into 
by the Secretary of Veterans Affairs and a medical 
school or other medical research institution selected 
by the chairman of the Committee. 
‘‘(ii) The chairman of the Committee may appoint, 
from the members of the Committee, a scientific director 
to supervise the operations of the Committee. Such direc-
tor shall count as one of the four employees authorized 
under clause (i). 
‘‘(iii) At the request of the chairman of the Com-
mittee, the Secretary of Veterans Affairs shall procure 
services from nongovernmental consultants to assist the 
Committee in preparing reports, background papers, and 
other material for consideration by the Committee. Such 
services may be procured under the contract described in 
clause (i)(III). 
‘‘(8) APPLICATION
OF FEDERAL ADVISORY COM-
MITTEE ACT.—(A) Except as otherwise provided by this 
subsection, the Committee shall be subject to the Federal 
Advisory Committee Act (5 U.S.C. App.). 
‘‘(B) The Secretary of Veterans Affairs shall consult 
with the chairman of the congressional veterans commit-
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tees in designating an officer or employee of the Depart-
ment under section 10 of the Federal Advisory Committee 
Act (5 U.S.C. App.). 
‘‘(C) Notwithstanding such section 10, such des-
ignated officer or employee may not have authority— 
‘‘(i) over the agenda or conduct of a meeting; 
‘‘(ii) to adjourn a meeting of the Committee; or 
‘‘(iii) to take any other action that is incon-
sistent with the independence of the Committee 
under paragraph (2). 
‘‘(9) FUNDING.—Amounts for the activities of the 
Committee shall be derived from amounts appropriated to 
the Department of Veterans Affairs for purposes of this 
subsection. 
‘‘(10) TERMINATION.—(A) Except as provided by 
subparagraph (B), the Committee shall terminate on the 
date that is two years after the date on which the Com-
mittee submits to the congressional veterans committees, 
the Secretary of Defense, and the Secretary of Veterans 
Affairs a report (signed by not less than nine concurring 
members) explaining that each Secretary is carrying out 
an effective research program relating to the health con-
sequences of military service in the Southwest Asia theater 
of operations during the Gulf War. 
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‘‘(B) If during the two-year period described in sub-
paragraph (A) the Committee notifies the congressional 
veterans committees, the Secretary of Defense, and the 
Secretary of Veterans Affairs that the information con-
tained in the report submitted under subparagraph (A) 
is no longer applicable, the two-year period shall toll until 
the date on which the Committee submits a new report 
described in subparagraph (A).’’. 
(b) DEFINITIONS; REDESIGNATION; CONFORMING 
AMENDMENTS.— 
(1) DEFINITIONS.—Such section 707 is further 
amended by adding at the end the following new 
subsection: 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘congressional veterans commit-
tees’ means the Committees on Veterans’ Affairs of 
the House of Representatives and the Senate. 
‘‘(2) The term ‘Gulf War’ means the Southwest 
Asia theater of operations from August 2, 1990, to 
July 31, 1991. 
‘‘(3) The term ‘Gulf War veteran’ means an in-
dividual who served as a member of the Armed 
Forces in the Gulf War.’’. 
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(c) MEMBERS CURRENTLY SERVING.— 
(1) MEMBERSHIP.—Notwithstanding paragraph 
(5)(A) of subsection (b) of such section 707, as 
amended by subsection (a)(2), the chairmen and 
ranking members of the congressional veterans com-
mittees shall jointly designate 10 members of the 
Research Advisory Committee on Gulf War Vet-
erans’ Illnesses established pursuant to such sub-
section (b) who are serving as members as of the 
date of the enactment of this Act to continue to 
serve as members for periods determined pursuant 
to paragraph (2) rather than for the term for which 
the members were appointed before such date of en-
actment. 
(2) PERIOD OF SERVICE.—The chairmen and 
ranking members of the congressional veterans com-
mittees shall jointly determine the period of service 
of each member specified in paragraph (1) in a man-
ner that staggers the periods of such members in pe-
riods of one, two, or three years beginning on the 
date of the enactment of this Act. In determining 
such staggered periods, the chairmen and ranking 
members shall take into account the order of filling 
vacancies pursuant to subsection (b)(5)(B) of such 
section 707, as amended by subsection (a)(2). Any 
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vacancies occurring of such members shall be filled 
in accordance with such subsection. 
(3) NEW MEMBERS.—Upon designating mem-
bers under paragraph (1), the chairmen of the con-
gressional veterans committees shall each appoint 
one additional member to the committee from among 
individuals who have not served on the Research Ad-
visory Committee on Gulf War Veterans’ Illnesses. 
Such appointments shall be treated as the first and 
second vacancies described in subclauses (I) and (II) 
of subsection (b)(5)(B)(i) of such section 707, as 
amended by subsection (a)(2), respectively. 
(4) REAPPOINTMENT.—A member of the Com-
mittee specified in paragraph (1) who has served 
more than three years may not be reappointed after 
the period for the member specified in paragraph (2) 
expires. 
SEC. 3. RESEARCH CASE DEFINITION OF GULF WAR ILL-
NESS. 
(a) STANDARD DEFINITION.—Except as provided by 
subsection (b), the Secretary of Veterans Affairs shall en-
sure that any research conducted or funded by the Sec-
retary on the chronic multisymptom illness that afflicts 
approximately 25 percent of Gulf War veterans— 
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(1) refers to the illness as ‘‘Gulf War Illness’’; 
and 
(2) uses the research case definition of such ill-
ness that is recommended from time to time by the 
Research Advisory Committee on Gulf War Vet-
erans’ Illnesses established by section 707 of the 
Veterans Health Care Act of 1992 (Public Law 
102–585; 38 U.S.C. 527 note). 
(b) ALTERNATIVE DEFINITION.—During any period 
in which the Research Advisory Committee on Gulf War 
Veterans’ Illnesses has not recommended a research case 
definition for Gulf War Illness, the Secretary of Veterans 
Affairs shall ensure that any research on such illness con-
ducted or funded by the Secretary uses a research case 
definition that is consistent with the definition of the term 
‘‘chronic multisymptom illness in Persian Gulf War vet-
erans’’ provided by section 805(e) of the Veterans’ Bene-
fits Act of 2010 (Public Law 111–275; 124 Stat. 2890). 
(c) ADVICE.—The Research Advisory Committee on 
Gulf War Veterans’ Illnesses shall submit to the Secretary 
of Defense advice regarding the best type of organization 
and process for the Gulf War Illness Research Program 
of the Congressionally Directed Medical Research Pro-
gram to use to develop a research case definition of ‘‘Gulf 
War Illness’’. 
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SEC. 4. STUDIES AND REPORTS ON GULF WAR ILLNESS. 
(a) CONDUCT OF NEW STUDIES.— 
(1) EVALUATION OF ANIMAL STUDIES.—In con-
ducting or funding any study relating to illnesses of 
Gulf War veterans on or after the date of the enact-
ment of this Act, the Secretary of Veterans Affairs 
shall ensure that such study is conducted in a man-
ner such that animal studies are considered to the 
same extent in all respects as human studies. 
(2) SUFFICIENT EVIDENCE OF ASSOCIATION.— 
In conducting or funding any study relating to ill-
nesses of Gulf War veterans, or other health matters 
of veterans, on or after the date of the enactment 
of this Act, the Institute of Medicine of the National 
Academies shall ensure that such study is conducted 
in a manner that defines ‘‘sufficient evidence of an 
association’’ in the ‘‘categories of association’’ used 
in the study as the following: ‘‘Evidence is sufficient 
to conclude that there is a positive association. That 
is, a positive association has been observed between 
an exposure to a specific agent and a health outcome 
in human or animal studies in which chance, bias, 
and confounding could be ruled out with reasonable 
confidence.’’. 
(b) SENSE OF CONGRESS ON NATIONAL COHORT 
STUDY.—It is the sense of Congress that the Secretary 
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of Veterans Affairs should conduct an additional follow- 
up study of a national cohort of Gulf War and Gulf-War- 
Era veterans that includes questions described in the 
‘‘Symptom Inventory Required to Ascertain Case Status 
for Gulf War Multisymptom Illness, as Defined by both 
the Fukuda and Kansas criteria’’ published by the Re-
search Advisory Committee on Gulf War Veterans’ Ill-
nesses on June 9, 2012, in appendix F of the document 
titled ‘‘Research Advisory Committee on Gulf War Vet-
erans’ Illnesses Findings and Recommendations’’. 
(c) SENSE OF CONGRESS ON STUDY ON RISK OF DE-
VELOPING MULTIPLE SCLEROSIS, MULTIPLE SCLEROSIS, 
PARKINSON’S DISEASE, BRAIN CANCERS, AND OTHER 
CONDITIONS.—It is the sense of Congress that the Sec-
retary of Veterans Affairs should submit to the congres-
sional veterans committees each report required by section 
804 of the Veterans’ Benefits Improvement Act of 2008 
(Public Law 110–389; 122 Stat. 4187). 
(d) SENSE
OF CONGRESS
ON PREVIOUSLY CON-
DUCTED STUDIES.—It is the sense of Congress that the 
Secretary of Veterans Affairs should— 
(1) seek to enter into an agreement with the In-
stitute of Medicine of the National Academies to 
carry out the review described in section 805 of the 
Veterans’ Benefits Act of 2010 (Public Law 111– 
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275; 124 Stat. 2890), regardless of any previous re-
view conducted under such section, in a manner that 
ensures that the Institute of Medicine convenes to 
conduct the review a group of medical professionals 
who are experienced in treating individuals who 
served as members of the Armed Forces in the 
Southwest Asia Theater of Operations of the Persian 
Gulf War during 1990 or 1991 and who have been 
diagnosed with Gulf War illness, chronic multisymp-
tom illness, or another health condition related to 
chemical and environmental exposure that may have 
occurred during such service; 
(2) seek to enter into an agreement with the In-
stitute of Medicine to carry out the review described 
in section 1603 of the Persian Gulf War Veterans 
Act of 1998 (Public Law 105–277; 38 U.S.C. 1117 
note), regardless of any previous review conducted 
under such section, addressing the matters originally 
reviewed by the Institute of Medicine in the reports 
titled ‘‘Gulf War and Health: Volume 1. Depleted 
Uranium, Sarin, Pyridostigmine Bromide, and Vac-
cines’’, ‘‘Gulf War and Health: Volume 2. Insecti-
cides and Solvents’’, and ‘‘Gulf War and Health: 
Volume 3. Fuels, Combustion Products, and Propel-
lants’’; and 
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(3) not disseminate or use for research, clinical 
care, benefits, or any other purpose the results of 
the report of the Institute of Medicine titled ‘‘Gulf 
War and Health Report: Volume 9. Treatment for 
Chronic Multisymptom Illness’’. 
(e) SENSE OF CONGRESS ON CONSULTATION.—It is 
the sense of Congress that the Secretary of Veterans Af-
fairs should, prior to entering into a contract or agreement 
with the Institute of Medicine of the National Academies 
with respect to research or studies on the health of Gulf 
War veterans, obtain the advice of the Research Advisory 
Committee on Gulf War Veterans’ Illnesses established by 
section 707 of the Veterans Health Care Act of 1992 
(Public Law 102–585; 38 U.S.C. 527 note) regarding the 
scope of work and the charge to be given to the Institute 
of Medicine. 
(f) SENSE OF CONGRESS ON INCLUSION OF CERTAIN 
PROFESSIONALS IN SCIENTIFIC OR MEDICAL GROUPS.— 
It is the sense of Congress that, in any contract requiring 
the Institute of Medicine of the National Academies to 
convene a committee to study the health of Gulf War vet-
erans, the Secretary of Veterans Affairs should ensure 
that any such committee convened should contain not less 
than three members of the Research Advisory Committee 
on Gulf War Veterans’ Illnesses established by section 707 
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of the Veterans Health Care Act of 1992 (Public Law 
102–585; 38 U.S.C. 527 note). 
(g) SENSE
OF CONGRESS
ON NOTIFICATION
OF 
UNDUE INFLUENCE.—It is the sense of Congress that the 
Secretary of Veterans Affairs should promptly notify the 
congressional veterans committees of any employee or con-
tractor of the Federal Government whom the Secretary 
believes influenced, or attempted to influence, the outcome 
of a report or study on the health of Gulf War veterans 
conducted by the Department of Veterans Affairs or the 
Institute of Medicine of the National Academies if such 
influence was not related to a scientifically objective out-
come. 
SEC. 5. DEFINITIONS. 
In this Act: 
(1) The term ‘‘congressional veterans commit-
tees’’ means the Committees on Veterans’ Affairs of 
the House of Representatives and the Senate. 
(2) The term ‘‘Gulf War’’ means the Southwest 
Asia theater of operations from August 2, 1990, to 
July 31, 1991. 
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(3) The term ‘‘Gulf War veteran’’ means an in-
dividual who served as a member of the Armed 
Forces in the Gulf War. 
Passed the House of Representatives May 28, 2014. 
Attest: 
KAREN L. HAAS, 
Clerk. 
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