Title: K2 Veterans Toxic Exposure Accountability Act of 2020
Policy area: Armed Forces and National Security

Summary:
K2 Veterans Toxic Exposure Accountability Act of 2020
This bill addresses toxic exposure of members of the Armed Forces deployed to Karshi-Khanabad (K-2) Air Base in Uzbekistan between October 1, 2001, and December 31, 2005.
Specifically, the bill requires the Department of Defense (DOD) to conduct a study and report on such exposure. Based on the results of the study, the Department of Veterans Affairs (VA) must determine (1) whether a positive association exists between such exposure and the occurrence of a diagnosed illness in humans, and (2) whether a presumption of service-connection is warranted. Under a presumption of service-connection, specific conditions diagnosed in certain veterans are presumed to have been caused by the circumstances of their military service. Health care benefits and disability compensation may then be awarded.
If the VA determines a presumption of service-connection is not warranted, notice must be published and include an explanation of the basis for the determination. The bill also requires the VA to remove previous presumptions if evidence indicates such presumption is not warranted.
The bill requires the VA to establish and maintain a registry for individuals who were deployed to K-2 during the specified time frame.
Finally, DOD must provide access to information upon request by the National Academies of Sciences, Engineering, and Medicine for purposes of a study regarding the effects of exposure to toxic substances at K-2.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5957 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 5957

 To direct the Secretary of Defense to conduct a study regarding toxic 
exposure by members of the Armed Forces deployed to Karshi Khanabad Air 
   Base, Uzbekistan, to direct the Secretary of Veterans Affairs to 
 establish a registry regarding such exposure, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 25, 2020

   Mr. Green of Tennessee (for himself and Mr. Lynch) introduced the 
   following bill; which was referred to the Committee on Veterans' 
  Affairs, and in addition to the Committee on Armed Services, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
 To direct the Secretary of Defense to conduct a study regarding toxic 
exposure by members of the Armed Forces deployed to Karshi Khanabad Air 
   Base, Uzbekistan, to direct the Secretary of Veterans Affairs to 
 establish a registry regarding such exposure, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``K2 Veterans Toxic Exposure 
Accountability Act of 2020''.

SEC. 2. STUDY ON TOXIC EXPOSURE AT KARSHI KHANABAD AIR BASE, 
              UZBEKISTAN.

    (a) Study.--
            (1) In general.--The Secretary of Defense shall conduct a 
        study on toxic exposure by members of the Armed Forces deployed 
        to Karshi Khanabad Air Base, Uzbekistan, at any time during the 
        period beginning October 1, 2001, and ending December 31, 2005.
            (2) Matters included.--The study under paragraph (1) shall 
        include the following:
                    (A) An assessment regarding the conditions of 
                Karshi Khanabad Air Base, Uzbekistan, during the period 
                beginning October 1, 2001, and ending December 31, 
                2005, including an identification of toxic substances 
                contaminating the Air Base during such period.
                    (B) An epidemiological study of the health 
                consequences of a member of the Armed Forces deployed 
                to the Air Base during such period.
                    (C) An assessment of any association between 
                exposure to toxic substances identified under 
                subparagraph (A) and the health consequences studied 
                under subparagraph (B).
    (b) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense and the Secretary of 
Veterans Affairs shall jointly submit to the appropriate congressional 
committees a report containing--
            (1) the study under subsection (a); and
            (2) a description of--
                    (A) the benefits administered by the Secretary of 
                Veterans Affairs that a veteran may be eligible to 
                receive by reason of being exposed to toxic substances 
                at Karshi Khanabad Air Base, Uzbekistan, while serving 
                in the Armed Forces; and
                    (B) the outreach conducted by the Secretary to 
                inform such veterans of such benefits.

SEC. 3. ESTABLISHMENT OF K2 TOXIC EXPOSURE REGISTRY.

    (a) Establishment of Registry.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall--
                    (A) establish and maintain a registry for eligible 
                individuals who may have been exposed to toxic 
                substances at Karshi Khanabad Air Base, Uzbekistan, at 
                any time during the period beginning October 1, 2001, 
                and ending December 31, 2005;
                    (B) include any information in such registry that 
                the Secretary of Veterans Affairs determines necessary 
                to ascertain and monitor the health effects of the 
                exposure of members to such substances;
                    (C) develop a public information campaign to inform 
                eligible individuals about the registry, including how 
                to register and the benefits of registering; and
                    (D) periodically notify eligible individuals of 
                significant developments in the study and treatment of 
                conditions associated with such exposure.
            (2) Updates.--The Secretary shall take actions necessary to 
        ensure that the registry may be updated with the cause of death 
        of a deceased registered individual by--
                    (A) an individual designated by such deceased 
                registered individual; or
                    (B) if no such individual is designated, an 
                immediate family member of such deceased registered 
                individual.
            (3) Coordination.--The Secretary of Veterans Affairs shall 
        coordinate with the Secretary of Defense in carrying out 
        paragraph (1).
    (b) Report to Congress.--
            (1) Reports by independent scientific organization.--The 
        Secretary of Veterans Affairs shall enter into an agreement 
        with an independent scientific organization to prepare reports 
        as follows:
                    (A) Not later than two years after the date on 
                which the registry under subsection (a) is established, 
                an initial report containing the following:
                            (i) An assessment of the effectiveness of 
                        actions taken by the Secretaries to collect and 
                        maintain information on the health effects of 
                        exposure to toxic substances at Karshi Khanabad 
                        Air Base, Uzbekistan.
                            (ii) Recommendations to improve the 
                        collection and maintenance of such information.
                            (iii) Using established and previously 
                        published epidemiological studies, 
                        recommendations regarding the most effective 
                        and prudent means of addressing the medical 
                        needs of eligible individuals with respect to 
                        conditions that are likely to result from such 
                        exposure.
                    (B) Not later than five years after completing the 
                initial report described in subparagraph (A), a follow-
                up report containing the following:
                            (i) An update to the initial report 
                        described in subparagraph (A).
                            (ii) An assessment of whether and to what 
                        degree the content of the registry established 
                        under subsection (a) is current and 
                        scientifically up-to-date.
            (2) Submittal to congress.--
                    (A) Initial report.--Not later than two years after 
                the date on which the registry under subsection (a) is 
                established, the Secretary of Veterans Affairs shall 
                submit to Congress the initial report prepared under 
                paragraph (1)(A).
                    (B) Follow-up report.--Not later than five years 
                after submitting the report under subparagraph (A), the 
                Secretary of Veterans Affairs shall submit to Congress 
                the follow-up report prepared under paragraph (1)(B).
    (c) Definitions.--In this section:
            (1) The term ``eligible individual'' means any individual 
        who was deployed as a member of the Armed Forces to Karshi 
        Khanabad Air Base, Uzbekistan, at any time during the period 
        beginning October 1, 2001, and ending December 31, 2005.
            (2) The term ``immediate family member'', with respect to a 
        deceased individual, means--
                    (A) the spouse, parent, brother, sister, or adult 
                child of the individual;
                    (B) an adult person to whom the individual stands 
                in loco parentis; or
                    (C) any other adult person--
                            (i) living in the household of the 
                        individual at the time of the death of the 
                        individual; and
                            (ii) related to the individual by blood or 
                        marriage.
            (3) The term ``registered individual'' means an individual 
        registered with the registry under subsection (a).

SEC. 4. DETERMINATION OF PRESUMPTIONS OF SERVICE CONNECTION FOR 
              ILLNESSES ASSOCIATED WITH K2 EXPOSURE.

    (a) In General.--
            (1) Determination required.--Not later than 60 days after 
        the date on which the Secretary of Veterans Affairs receives 
        the results of a covered study, the Secretary shall make a 
        determination whether a positive association exists between--
                    (A) the exposure of humans to toxic substances at 
                Karshi Khanabad Air Base, Uzbekistan, at any time 
                during the period beginning October 1, 2001, and ending 
                December 31, 2005; and
                    (B) the occurrence of a diagnosed illness in 
                humans.
            (2) Bases of determination.--In making a determination 
        under paragraph (1), the Secretary shall consider--
                    (A) whether the evidence is statistically 
                significant, capable of replication, and able to 
                withstand peer review demonstrating that there is 
                positive association between the exposure and the 
                occurrence of a diagnosed illness;
                    (B) the results of a covered study; and
                    (C) all other sound medical and scientific evidence 
                available to the Secretary.
            (3) Presumption.--If the Secretary determines that a 
        positive association exists between exposure and a diagnosed 
        illness pursuant to paragraph (1), the Secretary shall 
        prescribe regulations providing that--
                    (A) a presumption of service connection is 
                warranted for the illness covered by that determination 
                if the illness first becomes manifest within the 
                period, if any, prescribed in such regulations in a 
                covered veteran; and
                    (B) such covered veteran shall be presumed to have 
                been exposed to toxic substances at Karshi Khanabad Air 
                Base, Uzbekistan, at any time during the period 
                beginning October 1, 2001, and ending December 31, 
                2005, unless there is conclusive evidence to establish 
                that--
                            (i) the covered veteran was not exposed to 
                        toxic substances in the course of such service 
                        in the Armed Forces; or
                            (ii) the illness first became manifest 
                        prior to the covered veteran's exposure.
            (4) Submission.--Upon the date on which the Secretary makes 
        the determination under paragraph (1), the Secretary shall 
        submit to the Committees on Veterans' Affairs of the House of 
        Representatives and the Senate an explanation of such 
        determination.
    (b) Regulations.--
            (1) Proposed regulations.--
                    (A) Timing.--If the Secretary determines under 
                subsection (a)(1) that a presumption of service 
                connection is warranted for an illness, the Secretary 
                shall, not later than 180 days after making such 
                determination--
                            (i) issue proposed regulations setting 
                        forth the determination; or
                            (ii) submit the initial report under 
                        subparagraph (B).
                    (B) Reports.--If the Secretary does not issue 
                proposed regulations by the deadline established in 
                subparagraph (A), the Secretary shall submit to the 
                Committees on Veterans' Affairs of the House of 
                Representatives and the Senate a report on the status 
                of such proposed regulations. On a quarterly basis 
                thereafter until the date on which the Secretary issues 
                such proposed regulations, the Secretary shall submit 
                to such committees an update on such status.
            (2) Final regulations.--Not later than 180 days after the 
        date on which the Secretary issues any proposed regulations 
        under this subsection, the Secretary shall prescribe final 
        regulations. Such regulations shall be effective on the date of 
        issuance.
            (3) Presumption not warranted.--
                    (A) Publication.--If the Secretary determines under 
                subsection (a) that a presumption of service connection 
                is not warranted for an illness, or proposes to remove 
                a previously established presumption, the Secretary 
                shall publish in the Federal Register a notice of that 
                determination not later than 180 days after making the 
                determination. The notice shall include an explanation 
                of the evidence and scientific basis for that 
                determination.
                    (B) Removal of previous presumption.--If an illness 
                already presumed to be service connected under this 
                section is subject to a notice published under 
                subparagraph (A), the Secretary shall issue proposed 
                regulations removing the presumption for the illness 
                not later than 180 days after publication of such 
                notice.
            (4) Effect of removal.--Whenever the presumption of service 
        connection for an illness under this section is removed under 
        this subsection--
                    (A) a veteran who was awarded compensation for the 
                illness on the basis of the presumption before the 
                effective date of the removal of the presumption shall 
                continue to be entitled to receive compensation on that 
                basis; and
                    (B) a survivor of a veteran who was awarded 
                dependency and indemnity compensation for the death of 
                a veteran resulting from the illness on the basis of 
                the presumption before that date shall continue to be 
                entitled to receive dependency and indemnity 
                compensation on that basis.
    (c) Effective Date of Benefit Awards.--The effective date of any 
benefit awarded by reason of this section shall be determined in 
accordance with section 5110 of title 38, United States Code, but shall 
in no case be earlier than the effective date of the final regulations 
prescribed pursuant to subsection (b)(2).
    (d) Definitions.--In this section:
            (1) The term ``covered study'' includes--
                    (A) the study conducted under section 2; and
                    (B) any subsequent study or any study conducted by 
                the National Academies of Sciences, Engineering, and 
                Medicine regarding the effects of exposure of humans to 
                toxic substances at Karshi Khanabad Air Base, 
                Uzbekistan, at any time during the period beginning 
                October 1, 2001, and ending December 31, 2005.
            (2) The term ``covered veteran'' means a veteran who was 
        deployed as a member of the Armed Forces to Karshi Khanabad Air 
        Base, Uzbekistan, at any time during the period beginning 
        October 1, 2001, and ending December 31, 2005.

SEC. 5. ACCESS OF THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND 
              MEDICINE TO INFORMATION FROM THE DEPARTMENT OF DEFENSE.

    Upon request by the National Academies of Sciences, Engineering, 
and Medicine (in this section referred to as the ``Academies''), the 
Secretary of Defense shall provide to the Academies information in the 
possession of the Department of Defense that the Academies determine 
useful in performing a covered study, as that term is defined in 
section 4(d). Such information includes, at a minimum, all 
environmental sampling data relative to any location included in the 
study.
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