I 118th CONGRESS 1st Session H. R. 4061 IN THE HOUSE OF REPRESENTATIVES June 13, 2023 Mr. Case (for himself and Ms. Tokuda ) introduced the following bill; which was referred to the Committee on Energy and Commerce , 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 require the Secretary of Health and Human Services to establish an exposure registry and conduct epidemiological studies to assess health outcomes associated with the Red Hill Incident.

1. Registry for impacted individuals of the Red Hill Incident (a) Establishment of registry The Secretary of Health and Human Services (referred to in this section as the Secretary ) shall establish within the Agency for Toxic Substances and Disease Registry or the Centers for Disease Control and Prevention or through an award of a grant or contract, as the Secretary determines appropriate, a Red Hill Incident exposure registry to collect data on health implications of petroleum-contaminated water for impacted individuals on a voluntary basis. Such registry shall be complementary to, and not duplicative of, the Red Hill Incident Report of the Defense Occupational and Environmental Health Readiness System. (b) Other responsibilities (1) In general The Secretary, in coordination with the Director of the Centers for Disease Control and Prevention, and in consultation with the Secretary of Defense, the Secretary of Veterans Affairs, and such State and local authorities or other partners as the Secretary of Health and Human Services considers appropriate, shall— (A) review the Federal programs and services available to individuals exposed to petroleum; (B) review current research on petroleum exposure in order to identify additional research needs; (C) identify effective services, individuals and communities affected by petroleum-contaminated water; and (D) undertake any other review or activities that the Secretary determines to be appropriate. (2) Report Not later than 1 year after the date of enactment of this Act, and annually thereafter for 6 additional years, the Secretary shall submit to the appropriate congressional committees a report on the review and activities undertaken under paragraph (1) that includes— (A) strategies for communicating and engaging with stakeholders on the Red Hill Incident; (B) the number of impacted and potentially impacted individuals enrolled in the registry established under subsection (a); (C) processes for referring such registry enrollees to comprehensive, coordinated services to mitigate the effects of petroleum exposure; (D) measures and frequency of follow-up to collect data and specimens related to exposure, health, and developmental milestones as appropriate; and (E) a summary of data and analyses on exposure, health, and developmental milestones for impacted individuals. (3) Consultation In carrying out paragraphs (1) and (2), the Secretary shall consult with— (A) non-Federal experts, including persons with certification in epidemiology, toxicology, mental health, pediatrics, and environmental health; and (B) members of the impacted community. (c) Funding Without regard to section 2215 of title 10, United States Code, the Secretary of Defense is authorized to provide, from amounts made available to such Secretary, such sums as may be necessary for each of fiscal years 2024 through 2030 for the Secretary of Health and Human Services to carry out this section. 2. Red Hill epidemiological health outcomes study (a) In general The Secretary of Health and Human Services, in consultation with the Secretary of Defense, the Secretary of Veterans Affairs, and such State and local health authorities or other partners as the Secretary of Health and Human Services considers appropriate, shall conduct an epidemiological study or studies for a period of not less than 20 years to assess health outcomes for impacted individuals of the Red Hill Incident. (b) Additional contracts The Secretary of Health and Human Services may contract with independent research institutes or consultants, nonprofit or public entities, laboratories, or medical schools, as the Secretary considers appropriate, that are not part of the Federal Government to assist with the feasibility assessment required by subsection (d) and the study or studies under subsection (a). (c) Funding Without regard to section 2215 of title 10, United States Code, the Secretary of Defense is authorized to provide, from amounts made available to such Secretary, no less than $4,000,000 for fiscal year 2024 for the Secretary of Health and Human Services to carry out the assessment under subsection (d), and such sums as may be necessary to complete the study or studies under subsection (a). (d) Feasibility assessment Not later than one year after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to the appropriate congressional committees the results of a feasibility assessment to inform the design of the epidemiological study or studies to assess health outcomes for impacted individuals and a plan for such study or studies under subsection (a), which may include— (1) a strategy to recruit impacted individuals to participate in the study or studies, including incentives for participation; (2) a description of protocols and methodologies to assess health outcomes from the Red Hill Incident, including data management protocols to secure the privacy and security of the personal information of impacted individuals; and (3) the periodicity for data collection that takes into account the differences between health care practices among impacted individuals who are— (A) members of the Armed Forces on active duty or spouses or dependents of such members; (B) members of the Armed Forces separating from active duty or spouses or dependents of such members; (C) veterans and other individuals with access to health care from the Department of Veterans Affairs; and (D) individuals without access to health care from the Department of Defense or the Department of Veterans Affairs; (4) a description of methodologies to analyze data received from the study or studies to determine possible connections between exposure to water contaminated during the Red Hill Incident and adverse impacts to the health of impacted individuals; (5) an identification of exposures resulting from the Red Hill Incident that may qualify individuals to be eligible for participation in the study or studies as a result of those exposures; and (6) steps that will be taken to provide individuals impacted by the Red Hill Incident with information on available resources and services. (e) Potentially impacted individuals (1) In general The Secretary of Health and Human Services may enlarge the scope of the study or studies under subsection (a) to include potentially impacted individuals based on— (A) the request of a potentially impacted individual, as applicable; (B) the recommendation of the Secretary of Defense, the Secretary of Veterans Affairs, or any contracted party under subsection (b); (C) the exposures identified in subsection (d)(5); or (D) other exigent circumstances. (2) Treatment of potentially impacted individuals If, under paragraph (1), the Secretary enlarges the scope of the study or studies under subsection (a), potentially impacted individuals shall be treated as impacted individuals for purposes of this section. (f) Notifications; briefings (1) In general Not later than 1 year after the completion of the feasibility assessment under subsection (d), and annually thereafter, the Secretary of Health and Human Services shall— (A) notify impacted individuals on the interim findings of the study or studies; and (B) brief the appropriate congressional committees on the interim findings of the study or studies. (2) Final notification Upon completion of the study or studies under subsection (a), the Secretary of Health and Human Services shall notify the appropriate congressional committees and all impacted individuals of the completion of the study or studies and the publication of the final report under subsection (g)(2). (g) Reports (1) Annual reports Not later than 1 year after the date of the commencement of the study or studies under subsection (a), and annually thereafter, the Secretary of Health and Human Services shall publish on the website of the Department of Health and Human Services a report on the interim findings of the study or studies. (2) Final report Upon completion of the study or studies under subsection (a), the Secretary of Health and Human Services— (A) shall publish on a publicly available internet website of the Department of Health and Human Services a report on the findings of the study or studies; and (B) may publish such report in a scientific publication. 3. Definitions In this Act: (1) Appropriate congressional committees The term appropriate congressional committees means— (A) the Committee on Health, Education, Labor, and Pensions of the Senate; (B) the Committee on Armed Services and the Subcommittee on Defense of the Committee on Appropriations of the Senate; (C) the Committee on Veterans’ Affairs of the Senate; (D) the Committee on Energy and Commerce of the House of Representatives; (E) the Committee on Armed Services and the Subcommittee on Defense of the Committee on Appropriations of the House of Representatives; and (F) the Committee on Veterans’ Affairs of the House of Representatives. (2) Impacted individual The term impacted individual means an individual who, at the time of the Red Hill Incident, lived or worked in a building or residence served by the community water system at Joint Base Pearl Harbor-Hickam, Oahu, Hawaii. (3) Red Hill Incident The term Red Hill Incident means the release of fuel from the Red Hill Bulk Fuel Storage Facility, Oahu, Hawaii, into the sole-source basal aquifer located 100 feet below the facility, contaminating the community water system at Joint Base Pearl Harbor-Hickam on November 20, 2021.