Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022
PL 117-168 (S.3373), enacted 08/10/2022

[117th Congress Public Law 168]
[From the U.S. Government Publishing Office]



[[Page 136 STAT. 1759]]

Public Law 117-168
117th Congress

                                 An Act


 
 To improve the Iraq and Afghanistan Service Grant and the Children of 
       Fallen Heroes Grant. <<NOTE: Aug. 10, 2022 -  [S. 3373]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Sergeant First 
Class Heath Robinson Honoring our Promise to Address Comprehensive 
Toxics Act of 2022.>> 
SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES 
                              CODE; TABLE OF CONTENTS.

    (a) <<NOTE: 38 USC 101 note.>>  Short Title.--This Act may be cited 
as the ``Sergeant First Class Heath Robinson Honoring our Promise to 
Address Comprehensive Toxics Act of 2022'' or the ``Honoring our PACT 
Act of 2022''.

    (b) Matters Relating to Amendments to Title 38, United States 
Code.--
            (1) References.--Except as otherwise expressly provided, 
        when in this Act an amendment or repeal is expressed in terms of 
        an amendment to, or repeal of, a section or other provision, the 
        reference shall be considered to be made to a section or other 
        provision of title 38, United States Code.
            (2) <<NOTE: 38 USC 101 note prec., 301 prec., 701 
        prec., 1101 prec., 1301 prec., 5100 prec., 7101 prec., 7401 
        prec., 8101 prec.>>  Amendments to tables of contents.--Except 
        as otherwise expressly provided, when an amendment made by this 
        Act to title 38, United States Code, adds a section or larger 
        organizational unit to that title or amends the designation or 
        heading of a section or larger organizational unit in that 
        title, that amendment also shall have the effect of amending any 
        table of sections in that title to alter the table to conform to 
        the changes made by the amendment.

    (c) Table of Contents.--The table of contents for 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.

[[Page 136 STAT. 1760]]

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.
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.

                          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.

[[Page 136 STAT. 1761]]

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.

      TITLE I--E <<NOTE: Conceding Our Veterans' Exposure Now and 
     Necessitating Training Act of 2022.>> XPANSION OF HEALTH CARE 
ELIGIBILITY

                   Subtitle A--Toxic-exposed Veterans

SEC. 101. <<NOTE: 38 USC 101 note.>>  SHORT TITLE.

    This title may be cited as the ``Conceding Our Veterans' Exposure 
Now and Necessitating Training Act of 2022'' or the ``COVENANT Act of 
2022''.
SEC. 102. DEFINITIONS RELATING TO TOXIC-EXPOSED VETERANS.

    (a) In General.--Section 1710(a)(2)(F) <<NOTE: 38 USC 1710.>>  is 
amended by striking ``who was exposed to a toxic substance, radiation, 
or other conditions, as provided in subsection (e)'' and inserting ``who 
is a toxic-exposed veteran, in accordance with subsection (e)''.

    (b) Definitions of Toxic Exposure and Toxic-exposed Veteran.--
Section 101 is amended by adding at the end the following new 
paragraphs:
    ``(37) The term `toxic exposure' includes the following:
            ``(A) A toxic exposure risk activity, as defined in section 
        1710(e)(4) of this title.
            ``(B) An exposure to a substance, chemical, or airborne 
        hazard identified in the list under section 1119(b)(2) of this 
        title.

    ``(38) The term `toxic-exposed veteran' means any veteran described 
in section 1710(e)(1) of this title.''.

[[Page 136 STAT. 1762]]

    (c) Definition of Toxic Exposure Risk Activity.--Section 
1710(e)(4) <<NOTE: 38 USC 1710.>>  is amended by adding at the end the 
following new subparagraph:
            ``(C) The term `toxic exposure risk activity' means any 
        activity--
                    ``(i) that requires a corresponding entry in an 
                exposure tracking record system (as defined in section 
                1119(c) of this title) for the veteran who carried out 
                the activity; or
                    ``(ii) <<NOTE: Determination.>>  that the Secretary 
                determines qualifies for purposes of this subsection 
                when taking into account what is reasonably prudent to 
                protect the health of veterans.''.
SEC. 103. EXPANSION OF HEALTH CARE FOR SPECIFIC CATEGORIES OF 
                        TOXIC-EXPOSED VETERANS AND VETERANS 
                        SUPPORTING CERTAIN OVERSEAS CONTINGENCY 
                        OPERATIONS.

    (a) In General.--
            (1) Expansion.--Subsection (e) of section 1710, as amended 
        by section 102(c), is further amended--
                    (A) <<NOTE: Deadlines.>>  in paragraph (1), by 
                adding at the end the following new subparagraphs:

    ``(G) Beginning not later than the applicable date specified in 
paragraph (6), and subject to paragraph (2), a veteran who participated 
in a toxic exposure risk activity while serving on active duty, active 
duty for training, or inactive duty training is eligible for hospital 
care (including mental health services and counseling), medical 
services, and nursing home care under subsection (a)(2)(F) for any 
illness.
    ``(H) Beginning not later than the applicable date specified in 
paragraph (6), and subject to paragraph (2), a covered veteran (as 
defined in section 1119(c) of this title) is eligible for hospital care 
(including mental health services and counseling), medical services, and 
nursing home care under subsection (a)(2)(F) for any illness.
    ``(I)(i) Beginning not later than the applicable date specified in 
paragraph (6), and subject to paragraph (2), a veteran who deployed in 
support of a contingency operation specified in clause (ii) is eligible 
for hospital care (including mental health services and counseling), 
medical services, and nursing home care under subsection (a)(2)(F) for 
any illness.
    ``(ii) A contingency operation specified in this clause is any of 
the following:
            ``(I) Operation Enduring Freedom.
            ``(II) Operation Freedom's Sentinel.
            ``(III) Operation Iraqi Freedom.
            ``(IV) Operation New Dawn.
            ``(V) Operation Inherent Resolve.
            ``(VI) Resolute Support Mission.''; and
                    (B) in paragraph (2)(B)--
                          (i) by striking ``or (F)'' and inserting 
                      ``(F), (G), (H), or (I)''; and
                          (ii) by striking ``service or testing'' and 
                      inserting ``service, testing, or activity''.
            (2) Phase in.--Such subsection is further amended by adding 
        at the end the following new paragraph:

[[Page 136 STAT. 1763]]

    ``(6)(A) <<NOTE: Determination. Time periods.>>  The Secretary shall 
determine the dates in subparagraphs (G), (H), and (I) of paragraph (1) 
as follows:
            ``(i) October 1, 2024, with respect to a veteran described 
        in such subparagraph (G) or (H) who was discharged or released 
        from the active military, naval, air, or space service during 
        the period beginning on August 2, 1990, and ending on September 
        11, 2001.
            ``(ii) October 1, 2026, with respect to a veteran described 
        in such subparagraph (G) or (H) who was discharged or released 
        from the active military, naval, air, or space service during 
        the period beginning on September 12, 2001, and ending on 
        December 31, 2006.
            ``(iii) October 1, 2028, with respect to a veteran described 
        in such subparagraph (G) or (H) who was discharged or released 
        from the active military, naval, air, or space service during 
        the period beginning on January 1, 2007, and ending on December 
        31, 2012.
            ``(iv) October 1, 2030, with respect to a veteran described 
        in such subparagraph (G) or (H) who was discharged or released 
        from the active military, naval, air, or space service during 
        the period beginning on January 1, 2013, and ending on December 
        31, 2018.
            ``(v) October 1, 2032, with respect to a veteran described 
        in such subparagraph (I).

    ``(B)(i) The Secretary may modify a date specified in subparagraph 
(A) to an earlier date, as the Secretary determines appropriate based on 
the number of veterans receiving hospital care, medical services, and 
nursing home care under subparagraphs (G), (H), and (I) of paragraph (1) 
and the resources available to the Secretary.
    ``(ii) If the Secretary determines to modify a date under clause 
(i), the Secretary shall--
            ``(I) <<NOTE: Notification.>>  notify the Committee on 
        Veterans' Affairs of the Senate and the Committee on Veterans' 
        Affairs of the House of Representatives of the proposed 
        modification; and
            ``(II) <<NOTE: Federal Register, publication.>>  publish 
        such modified date in the Federal Register.''.

    (b) <<NOTE: Deadline. Notification.>>  Outreach Plans.--With respect 
to each of clauses (i) through (v) of section 1710(e)(6)(A) of title 38, 
United States Code (as added by subsection (a)(2)), not later than 180 
days before the date specified in the clause (including a date modified 
pursuant to such section), the Secretary shall submit to the Committee 
on Veterans' Affairs of the Senate and the Committee on Veterans' 
Affairs of the House of Representatives a plan to conduct outreach to 
the veterans described in the clause to notify such veterans of their 
eligibility for hospital care, medical services, or nursing home care 
under subparagraph (G), (H), or (I), of section 1710(e)(1) of such 
title, as the case may be.
SEC. 104. <<NOTE: Deadlines. 38 USC 1710 note.>>  ASSESSMENTS OF 
                        IMPLEMENTATION AND OPERATION.

    (a) <<NOTE: Determinations.>>  Initial Resource Assessment and 
Report.--Not later than 180 days after the date of the enactment of this 
Act, the Secretary of Veterans Affairs shall--
            (1) complete an assessment to determine--
                    (A) the personnel and material resources necessary 
                to implement section 103 (including the amendments made 
                by such section); and

[[Page 136 STAT. 1764]]

                    (B) the total number of covered veterans, as such 
                term is defined in section 1119(c) of title 38, United 
                States Code (as added by section 302), who receive 
                hospital care or medical services furnished by the 
                Secretary under chapter 17 of such title, disaggregated 
                by priority group specified in section 1705(a) of such 
                title; and
            (2) submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report containing the findings of the 
        assessment completed under paragraph (1), including a specific 
        determination as to whether the Department has the personnel and 
        material resources necessary to implement section 103.

    (b) Information Systems.--Not later than October 1, 2024, the 
Secretary shall establish information systems to assess the 
implementation of section 103, including the amendments made by such 
section, and use the results of assessments under such systems to inform 
the reports under subsection (c).
    (c) Annual Reports.--
            (1) Reports.--Not later than October 1, 2025, and on an 
        annual basis thereafter until October 1, 2033, the Secretary 
        shall submit to the Committee on Veterans' Affairs of the Senate 
        and the Committee on Veterans' Affairs of the House of 
        Representatives a report on the following:
                    (A) The effect of the implementation of, and the 
                provision and management of care under, section 103 
                (including the amendments made by such section) on the 
                demand by veterans described in subparagraphs (G), (H), 
                and (I) of section 1710(e)(1) of title 38, United States 
                Code (as added by such section 103) for health care 
                services furnished by the Secretary.
                    (B) Any differing patterns of demand for health care 
                services by such veterans, disaggregated by factors such 
                as the relative distance of the veteran from medical 
                facilities of the Department and whether the veteran had 
                previously received hospital care or medical services 
                furnished by the Secretary under chapter 17 of such 
                title.
                    (C) The extent to which the Secretary has met such 
                demand.
                    (D) Any changes, during the year covered by the 
                report, in the delivery patterns of health care 
                furnished by the Secretary under chapter 17 of such 
                title, and the fiscal impact of such changes.
            (2) Matters.--Each report under paragraph (1) shall include, 
        with respect to the year covered by the report, detailed 
        information on the following:
                    (A) The total number of veterans enrolled in the 
                patient enrollment system who, during such year, 
                received hospital care or medical services furnished by 
                the Secretary under chapter 17 of title 38, United 
                States Code.
                    (B) <<NOTE: Time period.>>  Of the veterans 
                specified in subparagraph (A), the number of such 
                veterans who, during the preceding three fiscal years, 
                had not received such care or services.
                    (C) <<NOTE: Costs.>>  With respect to the veterans 
                specified in subparagraph (B), the cost of providing 
                health care to such veterans during the year covered by 
                the report, shown in total and disaggregated by--
                          (i) the level of care; and

[[Page 136 STAT. 1765]]

                          (ii) whether the care was provided through the 
                      Veterans Community Care Program.
                    (D) With respect to the number of veterans described 
                in subparagraphs (G), (H), and (I) of section 1710(e)(1) 
                of title 38, United States Code (as added by section 
                103), the following (shown in total and disaggregated by 
                medical facility of the Department, as applicable):
                          (i) The number of such veterans who, during 
                      the year covered by the report, enrolled in the 
                      patient enrollment system.
                          (ii) The number of such veterans who applied 
                      for, but were denied, such enrollment.
                          (iii) The number of such veterans who were 
                      denied hospital care or a medical service 
                      furnished by the Secretary that was considered to 
                      be medically necessary but not of an emergency 
                      nature.
                    (E) The numbers and characteristics of, and the type 
                and extent of health care furnished by the Secretary to, 
                veterans enrolled in the patient enrollment system 
                (shown in total and disaggregated by medical facility of 
                the Department).
                    (F) The numbers and characteristics of, and the type 
                and extent of health care furnished by the Secretary to, 
                veterans not enrolled in the patient enrollment system 
                (disaggregated by each class of eligibility for care 
                under section 1710 of title 38, United States Code, and 
                further shown as a total per class and disaggregated by 
                medical facility of the Department).
                    (G) The specific fiscal impact (shown in total and 
                disaggregated by geographic health care delivery areas) 
                of changes in the delivery patterns of health care 
                furnished by the Secretary under chapter 17 of such 
                title as a result of the implementation of section 103 
                (including the amendments made by such section).

    (d) Definitions.--In this section:
            (1) Patient enrollment system.--The term ``patient 
        enrollment system'' means the patient enrollment system of the 
        Department of Veterans Affairs established and operated under 
        section 1705(a) of title 38, United States Code.
            (2) Veterans community care program.--The term ``Veterans 
        Community Care Program'' means the program established under 
        section 1703 of title 38, United States Code.

    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.

    (a) Expanded Period.--Section 1710(e)(3) <<NOTE: 38 USC 1710.>>  is 
amended--
            (1) in subparagraph (A)--
                    (A) by striking ``January 27, 2003'' and inserting 
                ``September 11, 2001''; and
                    (B) by striking ``five-year period'' and inserting 
                ``10-year period'';
            (2) by amending subparagraph (B) to read as follows:

[[Page 136 STAT. 1766]]

            ``(B) With respect to a veteran described in paragraph 
        (1)(D) who was discharged or released from the active military, 
        naval, air, or space service after September 11, 2001, and 
        before October 1, 2013, but did not enroll to receive such 
        hospital care, medical services, or nursing home care under such 
        paragraph pursuant to subparagraph (A) before October 1, 2022, 
        the one-year period beginning on October 1, 2022.''; and
            (3) by striking subparagraph (C).

    (b) Clarification of Coverage.--Section 1710(e)(1)(D) <<NOTE: 38 USC 
1710.>>  is amended by inserting after ``Persian Gulf War'' the 
following: ``(including any veteran who, in connection with service 
during such period, received the Armed Forces Expeditionary Medal, 
Service Specific Expeditionary Medal, Combat Era Specific Expeditionary 
Medal, Campaign Specific Medal, or any other combat theater award 
established by a Federal statute or an Executive order)''.

    (c) <<NOTE: Deadline. Notification.>>  Outreach Plan.--Not later 
than December 1, 2022, the Secretary of Veterans Affairs shall submit to 
the Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a plan to conduct 
outreach to veterans described in subparagraph (B) of section 1710(e)(3) 
of title 38, United States Code, as amended by subsection (a)(2), to 
notify such veterans of their eligibility for hospital care, medical 
services, or nursing home care pursuant to such subparagraph.

    (d) Report on Enrollments.--Not later than January 30, 2024, the 
Secretary shall submit to the Committee on Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report identifying, with respect to the one-year 
period beginning on October 1, 2022, the number of veterans described in 
section 1710(e)(3)(B) of title 38, United States Code, as amended by 
subsection (a)(2), who, during such period, enrolled in the patient 
enrollment system of the Department of Veterans Affairs established and 
operated under section 1705(a) of such title.
    (e) <<NOTE: 38 USC 1710 note.>>  Effective Date.--This section and 
the amendments made by this section shall take effect on October 1, 
2022.

   TITLE II-- <<NOTE: Toxic Exposure in the American Military Act of 
2022.>> TOXIC EXPOSURE PRESUMPTION PROCESS
SEC. 201. <<NOTE: 38 USC 101 note.>>  SHORT TITLE.

    This title may be cited as the ``Toxic Exposure in the American 
Military Act of 2022'' or the ``TEAM Act of 2022''.
SEC. 202. IMPROVEMENTS TO ABILITY OF DEPARTMENT OF VETERANS 
                        AFFAIRS TO ESTABLISH PRESUMPTIONS OF 
                        SERVICE CONNECTION BASED ON TOXIC 
                        EXPOSURE.

    (a) Advisory Committees, Panels, and Boards.--Chapter 11 <<NOTE: 38 
USC 1101 prec.>>  is amended by adding at the end the following new 
subchapter:

[[Page 136 STAT. 1767]]

 ``SUBCHAPTER VII <<NOTE: 38 USC 1171 prec.>> --DETERMINATIONS RELATING 
TO PRESUMPTIONS OF SERVICE CONNECTION BASED ON TOXIC EXPOSURE
``Sec. 1171. <<NOTE: 38 USC 1171.>>  Procedures to determine 
                  presumptions of service connection based on 
                  toxic exposure; definitions

    ``(a) Procedures.--The Secretary shall determine whether to 
establish, or to remove, presumptions of service connection based on 
toxic exposure pursuant to this subchapter, whereby--
            ``(1) under section 1172 of this title--
                    ``(A) the Secretary provides--
                          ``(i) <<NOTE: Notice.>>  public notice 
                      regarding what formal evaluations the Secretary 
                      plans to conduct; and
                          ``(ii) <<NOTE: Public comment.>>  the public 
                      an opportunity to comment on the proposed formal 
                      evaluations;
                    ``(B) <<NOTE: Recommenda- tions.>>  the working 
                group established under subsection (b) of such section 
                provides--
                          ``(i) advice to the Secretary on toxic-exposed 
                      veterans and cases in which veterans who, during 
                      active military, naval, air, or space service, may 
                      have experienced a toxic exposure or their 
                      dependents may have experienced a toxic exposure 
                      while the veterans were serving in the active 
                      military, naval, air, or space service;
                          ``(ii) recommendations to the Secretary on 
                      corrections needed in the Individual Longitudinal 
                      Exposure Record to better reflect veterans and 
                      dependents described in clause (i); and
                          ``(iii) recommendations to the Secretary 
                      regarding which cases of possible toxic exposure 
                      should be reviewed;
            ``(2) <<NOTE: Evaluations.>>  the Secretary provides for 
        formal evaluations of such recommendations under section 1173 of 
        this title and takes into account reports received by the 
        Secretary from the National Academies of Sciences, Engineering, 
        and Medicine under section 1176 of this title; and
            ``(3) <<NOTE: Regulations.>>  the Secretary issues 
        regulations under section 1174 of this title.

    ``(b) Definitions.--In this subchapter:
            ``(1) The term `illness' includes a disease or other 
        condition affecting the health of an individual, including 
        mental and physical health.
            ``(2) The term `Individual Longitudinal Exposure Record' 
        includes--
                    ``(A) service records;
                    ``(B) any database maintained by the Department of 
                Defense and shared with the Department of Veterans 
                Affairs to serve as a central portal for exposure-
                related data that compiles, collates, presents, and 
                provides available occupational and environmental 
                exposure information to support the needs of the 
                Department of Defense and the Department of Veterans 
                Affairs; or
                    ``(C) any successor system to a database described 
                in subparagraph (B).

[[Page 136 STAT. 1768]]

``Sec. 1172. <<NOTE: 38 USC 1172.>>  Annual notice and opportunity 
                  for public comment

    ``(a) <<NOTE: Federal Register, publications.>>  Notice Required.--
(1)(A) Not less frequently than once each year, the Secretary shall 
publish in the Federal Register notice of the formal evaluations that 
the Secretary plans to conduct pursuant to section 1173 of this title.

    ``(B) Each notice published under subparagraph (A) shall include, 
for each formal evaluation referred to in the notice, an explanation as 
to why the military environmental exposures and adverse health outcomes 
that are the subject of the formal evaluation were chosen by the 
Secretary for formal evaluation under section 1173 of this title.
    ``(2)(A) With each notice published under paragraph (1), the 
Secretary shall seek public comment on the military environmental 
exposures and adverse health outcomes that are the subject of the formal 
evaluations referred to in the notice.
    ``(B) The Secretary shall--
            ``(i) consider all public comment received under 
        subparagraph (A); and
            ``(ii) publish in the Federal Register a response to the 
        comments received under subparagraph (A).

    ``(3)(A) For each notice published under paragraph (1), the 
Secretary shall hold an open meeting for members of the public to voice 
their comments in response to the notice.
    ``(B) <<NOTE: Evaluation. Time period.>>  To help evaluate 
presumptions of service connection, the Secretary shall, not less 
frequently than quarterly, collaborate with, partner with, and give 
weight to the advice of veterans service organizations and such other 
stakeholders as the Secretary considers appropriate.

    ``(4) Failure to include a military environmental exposure or 
adverse health effect in a Federal Register notice published pursuant to 
subsection (a) shall not preclude the Secretary from initiating a formal 
evaluation of such exposure or health effect.
    ``(b) <<NOTE: Establishment.>>  Working Group.--(1) The Secretary 
shall establish a working group within the Department (in this section 
referred to as the `Working Group').

    ``(2) The Working Group shall include personnel of the Veterans 
Health Administration and the Veterans Benefits Administration.
    ``(3) <<NOTE: Consultation.>>  The Secretary shall consult with, and 
seek the advice of, the Working Group with respect to cases in which--
            ``(A) a veteran may have, during active military, naval, 
        air, or space service, experienced a toxic exposure; or
            ``(B) a dependent of a veteran may have experienced a toxic 
        exposure during the active military, naval, air, or space 
        service of the veteran.

    ``(c) Assessments.--(1) The Working Group shall assess cases of the 
toxic exposure of veterans and their dependents that occurred during 
active military, naval, air, or space service, including by conducting 
ongoing surveillance and reviewing such exposure described in scientific 
literature, media reports, information from veterans, and information 
from Congress.
    ``(2) The assessments under paragraph (1) shall cover suspected and 
known toxic exposures occurring during active military, naval, air, or 
space service, including by identifying and evaluating new and emerging 
toxic exposures that are not recognized under existing presumptions of 
service connection.

[[Page 136 STAT. 1769]]

    ``(3) The Working Group may conduct an assessment under paragraph 
(1) in response to a comment received under paragraph (2) or (3) of 
subsection (a).
    ``(4) <<NOTE: Consultation.>>  The Working Group shall, in 
consultation with the Secretary of Defense, on a periodic basis, assess 
the Individual Longitudinal Exposure Record to ensure the accuracy of 
data collected.

    ``(d) Development of Recommendations.--(1) <<NOTE: Determination.>>  
Following an assessment of a case of the toxic exposure of veterans that 
occurred during active military, naval, air, or space service under 
subsection (c), or their dependents, the Working Group may develop a 
recommendation for formal evaluation under section 1173 of this title to 
conduct a review of the health effects related to the case of exposure 
if the Working Group determines that the research may change the current 
understanding of the relationship between an exposure to an 
environmental hazard and adverse health outcomes in humans.

    ``(2) Upon receipt of evidence suggesting that previous findings 
regarding the periods and locations of exposure covered by an existing 
presumption of service connection are no longer supported, the Working 
Group may nominate such evidence for formal evaluation under section 
1173 of this title to modify the periods and locations.
    ``(e) <<NOTE: Time period. Public information. Recommenda- tions.>>  
Reports by the Working Group.--Not less frequently than once each year, 
the Working Group shall submit to the Secretary, the Committee on 
Veterans' Affairs of the Senate, and the Committee on Veterans' Affairs 
of the House of Representatives, and make publicly available, a report 
on--
            ``(1) recommendations developed under subsection (d), if 
        any; and
            ``(2) recommendations for such legislative or administrative 
        action as the Working Group considers necessary for the Working 
        Group to be more effective in carrying out the requirements of 
        this section.

    ``(f) <<NOTE: Deadline. Evaluation.>>  Responses by Secretary.--In 
response to each report submitted under subsection (e), the Secretary 
shall, not later than 30 days after receiving the report, initiate a 
formal evaluation pursuant to section 1173 of this title.
``Sec. 1173. <<NOTE: Reviews. Determinations. 38 USC 1173.>>  
                  Formal evaluation of recommendations

    ``(a) Formal Evaluations.--The Secretary shall establish a process 
to conduct a formal evaluation with respect to each recommendation made 
by the Working Group under section 1172 of this title.
    ``(b) Evidence, Data, and Factors.--The Secretary shall ensure that 
each formal evaluation under subsection (a) covers the following:
            ``(1) Scientific evidence, based on the review of available 
        scientific literature, including human, toxicological, animal, 
        and methodological studies, and other factors.
            ``(2) Claims data, based on the review of claim rate, grant 
        rate, and service connection prevalence, and other factors.
            ``(3) Other factors the Secretary determines appropriate, 
        such as--
                    ``(A) the level of disability and mortality caused 
                by the health effects related to the case of toxic 
                exposure being evaluated;

[[Page 136 STAT. 1770]]

                    ``(B) the quantity and quality of the information 
                available and reviewed;
                    ``(C) the feasibility of and period for generating 
                relevant information and evidence;
                    ``(D) whether such health effects are combat- or 
                deployment-related;
                    ``(E) the ubiquity or rarity of the health effects; 
                and
                    ``(F) any time frame during which a health effect 
                must become manifest.

    ``(c) Conduct of Evaluations.--(1) The Secretary shall ensure that 
each formal evaluation under subsection (a)--
            ``(A) reviews scientific evidence in a manner that--
                    ``(i) conforms to principles of scientific and data 
                integrity;
                    ``(ii) is free from suppression or distortion of 
                scientific or technological findings, data, information, 
                conclusions, or technical results; and
            ``(B)(i) evaluates the likelihood that a positive 
        association exists between an illness and a toxic exposure while 
        serving in the active military, naval, air, or space service; 
        and
            ``(ii) <<NOTE: Assessments.>>  assesses the toxic exposures 
        and illnesses and determines whether the evidence supports a 
        finding of a positive association between the toxic exposure and 
        the illness.

    ``(2) <<NOTE: Data.>>  In carrying out paragraph (1)(B)(ii), a 
formal evaluation under subsection (a) shall include reviewing all 
relevant data to determine the strength of evidence for a positive 
association based on the following four categories:
            ``(A) The `sufficient' category, where the evidence is 
        sufficient to conclude that a positive association exists.
            ``(B) The `equipoise and above' category, where the evidence 
        is sufficient to conclude that a positive association is at 
        least as likely as not, but not sufficient to conclude that a 
        positive association exists.
            ``(C) The `below equipoise' category, where the evidence is 
        not sufficient to conclude that a positive association is at 
        least as likely as not, or is not sufficient to make a 
        scientifically informed judgment.
            ``(D) The `against' category, where the evidence suggests 
        the lack of a positive association.

    ``(d) Recommendation for Establishing a Presumption of Service 
Connection.-- <<NOTE: Deadline.>> Not later than 120 days after the date 
on which a formal evaluation is commenced, the element of the Department 
that conducts the evaluation shall submit to the Secretary a 
recommendation with respect to establishing a presumption of service 
connection for the toxic exposure and illness, or modifying an existing 
presumption of service connection, covered by the evaluation.
``Sec. 1174. <<NOTE: 38 USC 1174.>>  Regulations regarding 
                  presumptions of service connection based on 
                  toxic exposure

    ``(a) <<NOTE: Deadline. Determinations.>>  Action Upon 
Recommendation.--Not later than 160 days after the date on which the 
Secretary receives a recommendation to establish or modify a presumption 
of service connection under section 1173 of this title--
            ``(1) if the Secretary determines, in the discretion of the 
        Secretary, that the presumption, or modification, is warranted, 
        the Secretary shall--

[[Page 136 STAT. 1771]]

                    ``(A) commence issuing regulations in accordance 
                with the provisions of subchapter II of chapter 5 of 
                title 5 (commonly referred to as the Administrative 
                Procedures Act) setting forth the presumption or 
                commence revising regulations to carry out such 
                modification; and
                    ``(B) include in such regulations any time frame 
                during which a health effect must become manifest; or
            ``(2) <<NOTE: Federal Register, publication. Notice.>>  if 
        the Secretary determines, in the discretion of the Secretary, 
        that the presumption, or modification, is not warranted, the 
        Secretary shall publish in the Federal Register a notice of the 
        determination, including the reasons supporting the 
        determination.

    ``(b) Removal of Presumption.--(1)(A) The Secretary may--
            ``(i) issue a regulation to remove an illness from a 
        presumption of service connection previously established 
        pursuant to a regulation issued under subsection (a); and
            ``(ii) issue a regulation to remove a presumption of service 
        connection established pursuant to title IV of the Sergeant 
        First Class Heath Robinson Honoring our Promise to Address 
        Comprehensive Toxics Act of 2022 if the Secretary concludes that 
        evidence suggests the lack of a positive association between the 
        disease and the toxic exposure.

    ``(B) Under subparagraph (A)(ii), the Secretary shall not consider 
the lack of evidence as sufficient to support a decision for removal of 
a presumption.
    ``(2) Whenever an illness is removed from regulations pursuant to 
paragraph (1), or the periods and locations of exposure covered by a 
presumption of service connection are modified under subsection (a)--
            ``(A) a veteran who was awarded compensation under chapter 
        11 of this title for such illness on the basis of the 
        presumption provided under such regulations before the effective 
        date of the removal or modification shall continue to be 
        entitled to receive compensation on that basis;
            ``(B) a survivor of a veteran who was awarded dependency and 
        indemnity compensation under chapter 13 of this title for the 
        death of a veteran resulting from such illness on the basis of 
        such presumption shall continue to be entitled to receive 
        dependency and indemnity compensation on such basis; and
            ``(C) no veteran or survivor covered under subparagraph (A) 
        or (B) shall have their compensation reduced solely because of 
        the removal of an illness pursuant to paragraph (1).
``Sec. 1175. <<NOTE: 38 USC 1175.>>  Authority to modify process; 
                  congressional oversight

    ``(a) In General.--The Secretary may modify the process under which 
the working group established under subsection (b) of section 1172 of 
this title conducts assessments under such section, the Secretary 
conducts formal evaluations under section 1173 of this title, and issues 
regulations under section 1174 of this title if--
            ``(1) such evaluations cover the evidence, data, and factors 
        required by subsection (b) of such section 1173; and
            ``(2) <<NOTE: Time period.>>  a period of 180 days has 
        elapsed following the date on which the Secretary submits the 
        notice under subsection (b) regarding the modification.

    ``(b) Notice.--If the Secretary proposes to modify the process under 
which the working group established under subsection (b)

[[Page 136 STAT. 1772]]

of section 1172 of this title conducts assessments under such section, 
the process under which the Secretary conducts formal evaluations under 
section 1173 of this title, or issues regulations under section 1174 of 
this title, the Secretary shall submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of the 
House of Representatives a notice of the proposed modifications 
containing the following:
            ``(1) A description of the proposed modifications.
            ``(2) A description of any exceptions to the requirements of 
        such sections that are proposed because of limited available 
        scientific evidence, and a description of how such evaluations 
        will be conducted.
``Sec. 1176. <<NOTE: 38 USC 1176.>>  Agreement with National 
                  Academies of Sciences, Engineering, and Medicine 
                  concerning toxic exposures

    ``(a) <<NOTE: Reviews. Evaluations.>>  Purpose.--The purpose of this 
section is to provide for the National Academies of Sciences, 
Engineering, and Medicine (in this section referred to as the 
`Academies'), an independent nonprofit scientific organization with 
appropriate expertise that is not part of the Federal Government, to 
review and evaluate the available scientific evidence regarding 
associations between diseases and toxic exposures.

    ``(b) <<NOTE: Time periods.>>  Agreement.--(1) The Secretary shall 
seek to enter into a five-year agreement with the Academies to perform 
the services covered by this section.

    ``(2) <<NOTE: Deadline.>>  The Secretary shall seek to enter into an 
agreement described in paragraph (1) not later than 60 days after the 
date of the enactment of the Sergeant First Class Heath Robinson 
Honoring our Promise to Address Comprehensive Toxics Act of 2022.

    ``(3) <<NOTE: Extension authority.>>  An agreement under this 
section may be extended in five-year increments.

    ``(c) <<NOTE: Summary. Assessment.>>  Review of Scientific 
Evidence.--Under an agreement between the Secretary and the Academies 
under this section, the Academies shall review and summarize the 
scientific evidence, and assess the strength thereof, concerning the 
association between toxic exposures during active military, naval, air, 
or space service and each disease suspected to be associated with such 
exposure in the human population.

    ``(d) Scientific Determinations Concerning Diseases.--For each 
disease reviewed under subsection (c), the Academies shall determine, to 
the extent that available scientific data permit meaningful 
determinations--
            ``(1) whether an association exists between toxic exposures 
        and the occurrence of the disease, taking into account the 
        strength of the scientific evidence and the appropriateness of 
        the statistical and epidemiological methods used to detect the 
        association;
            ``(2) the increased risk of the disease among those 
        reporting toxic exposures during active military, naval, air, or 
        space service;
            ``(3) whether there exists a plausible biological mechanism 
        or other evidence of a positive association between the toxic 
        exposure and the occurrence of the disease; and
            ``(4) determine the strength of evidence for a positive 
        association based on categories furnished under section 1173 of 
        this title.

[[Page 136 STAT. 1773]]

    ``(e) Cooperation of Federal Agencies.--The head of each relevant 
Federal agency, including the Secretary of Defense, shall cooperate 
fully with the Academies in performing the services covered by this 
section.
    ``(f) Recommendations for Additional Scientific Studies.--(1) Under 
an agreement between the Secretary and the Academies under this section, 
the Academies shall make any recommendations for additional scientific 
studies to resolve areas of continuing scientific uncertainty relating 
to toxic exposures.
    ``(2) In making recommendations under paragraph (1), the Academies 
shall consider--
            ``(A) the scientific information that is available at the 
        time of the recommendation;
            ``(B) the value and relevance of the information that could 
        result from additional studies; and
            ``(C) the cost and feasibility of carrying out such 
        additional studies.

    ``(g) Reports.--(1)(A) Under an agreement between the Secretary and 
the Academies under this section, not later than one year after the date 
of the enactment of the Sergeant First Class Heath Robinson Honoring our 
Promise to Address Comprehensive Toxics Act of 2022, the Academies shall 
submit to the Secretary, the Committee 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 agreement.
    ``(B) The report submitted under subparagraph (A) shall include the 
following:
            ``(i) <<NOTE: Determinations.>>  The determinations 
        described in subsection (d).
            ``(ii) A full explanation of the scientific evidence and 
        reasoning that led to such determinations.
            ``(iii) <<NOTE: Recommenda- tions.>>  Any recommendations of 
        the Academies under subsection (f).

    ``(2) <<NOTE: Time period. Update.>>  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 Veterans' 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 Organization.--(1) If the 
Secretary is unable within the time period prescribed in subsection 
(b)(2) to enter into an agreement with the Academies for the purposes of 
this section on terms acceptable to the Secretary, the Secretary shall 
seek to enter into an agreement for the purposes of this section with 
another appropriate scientific organization that--
            ``(A) is not part of the Federal Government;
            ``(B) operates as a not-for-profit entity; and
            ``(C) has expertise and objectivity comparable to that of 
        the Academies.

    ``(2) If the Secretary enters into an agreement with another 
organization as described in paragraph (1), any reference in this 
subchapter to the Academies shall be treated as a reference to the other 
organization.''.
    (b) Reports and Briefings.--

[[Page 136 STAT. 1774]]

            (1) Report.--
                    (A) <<NOTE: Recommenda- tions.>>  In general.--Not 
                later than two years after the date of the enactment of 
                this Act, the Secretary of Veterans Affairs shall submit 
                to the Committee on Veterans' Affairs of the Senate and 
                the Committee on Veterans' Affairs of the House of 
                Representatives a report on the implementation of, and 
                recommendations for, subchapter VII of chapter 11 of 
                title 38, United States Code, as added by subsection 
                (a).
                    (B) Consultation.--The Secretary shall develop the 
                report under subparagraph (A) in consultation with 
                organizations recognized by the Secretary for the 
                representation of veterans under section 5902 of such 
                title and any other entity the Secretary determines 
                appropriate.
            (2) <<NOTE: Time periods.>>  Briefing.--On a quarterly basis 
        during the two-year period beginning on the date of the 
        enactment of this Act, the Secretary shall provide to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a briefing 
        on the implementation of subchapter VII of chapter 11 of such 
        title, as added by subsection (a).

    (c) Independent Assessment.--
            (1) <<NOTE: Deadline.>>  Agreement.--The Secretary shall 
        seek to enter into an agreement with the National Academies of 
        Science, Engineering, and Medicine (in this subsection referred 
        to as the ``Academies'') before the date that is 90 days after 
        the date of the enactment of this Act to perform the services 
        set forth under paragraph (2).
            (2) Assessment.--
                    (A) In general.--Under an agreement between the 
                Secretary and the Academies under paragraph (1), the 
                Academies shall conduct an assessment of the 
                implementation by the Department of Veterans Affairs of 
                the process established under subchapter VII of chapter 
                11 of title 38, United States Code, as added by 
                subsection (a).
                    (B) Elements.--The assessment conducted under 
                subparagraph (A) shall include the following:
                          (i) <<NOTE: Determination.>>  An assessment of 
                      the Department's implementation of the process 
                      established under subsection (a) to determine 
                      whether the process is in accordance with current 
                      scientific standards for assessing the link 
                      between exposure to environmental hazards and the 
                      development of health outcomes,
                          (ii) assess whether the criteria is fair and 
                      consistent, and
                          (iii) <<NOTE: Recommenda- tions.>>  provide 
                      recommendations for improvements to the process.
            (3) Report.--Not later than one year after the date on which 
        the Secretary enters into an agreement under paragraph (1), the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the Senate and the Committee on Veterans' Affairs of the House 
        of Representatives a report on the findings of the Academies 
        pursuant to such agreement.
            (4) Alternative contract scientific organization.--
                    (A) In general.--If the Secretary is unable within 
                the time period prescribed in paragraph (1) to enter 
                into an agreement with the Academies for the purposes of 
                this

[[Page 136 STAT. 1775]]

                subsection on terms acceptable to the Secretary, the 
                Secretary shall seek to enter into an agreement for the 
                purposes of this subsection with another appropriate 
                scientific organization that--
                          (i) is not part of the Federal Government;
                          (ii) operates as a not-for-profit entity; and
                          (iii) has expertise and objectivity comparable 
                      to that of the Academies.
                    (B) Treatment.--If the Secretary enters into an 
                agreement with another organization as described in 
                subparagraph (A), any reference in this subsection to 
                the Academies of Sciences, Engineering, and Medicine 
                shall be treated as a reference to the other 
                organization.

    (d) <<NOTE: Determinations.>>  Conforming Amendments.--Chapter 11 is 
amended--
            (1) <<NOTE: 38 USC 1116.>>  in section 1116--
                    (A) by striking subsections (b), (c), (d), and (e);
                    (B) by inserting after subsection (a) the following 
                new subsection (b):

    ``(b) <<NOTE: Assessments.>>  The Secretary shall ensure that any 
determination made on or after the date of the enactment of the Sergeant 
First Class Heath Robinson Honoring our Promise to Address Comprehensive 
Toxics Act of 2022 regarding a presumption of service connection based 
on exposure to an herbicide agent under this section is made pursuant to 
subchapter VII of this chapter, including with respect to assessing 
reports received by the Secretary from the National Academy of Sciences 
under section 3 of the Agent Orange Act of 1991 (Public Law 102-4).''; 
and
                    (C) by redesignating subsection (f) as subsection 
                (c);
            (2) in section 1116B(b)(2)(A), by inserting ``pursuant to 
        subchapter VII of this chapter,'' before ``the Secretary 
        determines''; and
            (3) in section 1118--
                    (A) by striking subsections (b) through (e); and
                    (B) by inserting after subsection (a) the following 
                new subsection (b):

    ``(b) The Secretary shall ensure that any determination made on or 
after the date of the enactment of the Sergeant First Class Heath 
Robinson Honoring our Promise to Address Comprehensive Toxics Act of 
2022 regarding a presumption of service connection based on a toxic 
exposure under this section is made pursuant to subchapter VII of this 
chapter.''.
SEC. 203. OUTREACH TO CLAIMANTS FOR DISABILITY COMPENSATION 
                        PURSUANT TO CHANGES IN PRESUMPTIONS OF 
                        SERVICE CONNECTION.

    (a) In General.--Subchapter VI of chapter 11 <<NOTE: 38 USC 1101 
prec.>>  is amended by adding at the end the following new section:
``Sec. 1167. <<NOTE: 38 USC 1167.>>  Outreach pursuant to changes 
                  in presumptions of service connection

    ``(a) In General.--Whenever a law, including through a regulation or 
Federal court decision or settlement, establishes or modifies a 
presumption of service connection, the Secretary shall--
            ``(1) identify all claims for compensation under this 
        chapter that--
                    ``(A) were submitted to the Secretary;

[[Page 136 STAT. 1776]]

                    ``(B) were evaluated and denied by the Secretary 
                before the date on which such provision of law went into 
                effect; and
                    ``(C) might have been evaluated differently had the 
                establishment or modification been applicable to the 
                claim; and
            ``(2) pursuant to subsection (b), conduct outreach to the 
        claimants.

    ``(b) Outreach.--(1) The Secretary shall conduct outreach to inform 
claimants identified under subsection (a) that they may submit a 
supplemental claim in light of the establishment or modification of a 
presumption of service connection described in subsection (a).
    ``(2) Outreach under paragraph (1) shall include the following:
            ``(A) <<NOTE: Web posting. Notice.>>  The Secretary shall 
        publish on the internet website of the Department a notice that 
        such veterans may elect to file a supplemental claim.
            ``(B) <<NOTE: Notification.>>  The Secretary shall notify, 
        in writing or by electronic means, veterans service 
        organizations of the ability of such veterans to file a 
        supplemental claim.
            ``(C) The Secretary shall contact each claimant identified 
        under subsection (a) in the same manner that the Department last 
        provided notice of a decision.''.

    (b) <<NOTE: 38 USC 1167 note.>>  Application.--Section 1167 of title 
38, United States Code, as added by subsection (a), shall apply with 
respect to presumptions of service connection established or modified on 
or after the date of the enactment of this Act, including pursuant to 
amendments made by this Act.

    (c) <<NOTE: 38 USC 1167 note.>>  Rule of Construction.--Nothing in 
this section shall be construed as--
            (1) modifying the obligations of the Department of Veterans 
        Affairs under Federal court decisions or settlements in effect 
        as of the date of the enactment of this Act; or
            (2) requiring a retroactively applied effective date of a 
        supplemental claim earlier than the date a presumption of 
        service connection is established or modified.
SEC. 204. REEVALUATION OF CLAIMS FOR DEPENDENCY AND INDEMNITY 
                        COMPENSATION INVOLVING PRESUMPTIONS OF 
                        SERVICE CONNECTION.

    (a) In General.--Subchapter I of chapter 13 <<NOTE: 38 USC 1301 
prec.>>  is amended by adding at the end the following new section:
``Sec. 1305. <<NOTE: 38 USC 1305.>>  Reevaluation of dependency 
                  and indemnity compensation determinations 
                  pursuant to changes in presumptions of service 
                  connection

    ``(a) Reevaluation.--Whenever a law, including through a regulation 
or Federal court decision or settlement, establishes or modifies a 
presumption of service connection, the Secretary shall--
            ``(1) identify all claims for dependency and indemnity 
        compensation under this chapter that--
                    ``(A) were submitted to the Secretary;
                    ``(B) were evaluated and denied by the Secretary 
                before the date on which such provision of law went into 
                effect; and
                    ``(C) might have been evaluated differently had the 
                establishment or modification been applicable to the 
                claim;

[[Page 136 STAT. 1777]]

            ``(2) allow for the reevaluation of such claims at the 
        election of the claimant; and
            ``(3) notwithstanding section 5110 of this title, with 
        respect to claims approved pursuant to such reevaluation, 
        provide compensation under this chapter effective as if the 
        establishment or modification of the presumption of service 
        connection had been in effect on the date of the submission of 
        the original claim described in paragraph (1).

    ``(b) Outreach.--(1) The Secretary shall conduct outreach to inform 
relevant claimants that they may elect to have a claim be reevaluated in 
light of the establishment or modification of a presumption of service 
connection described in subsection (a).
    ``(2) Outreach under paragraph (1) shall include the following:
            ``(A) <<NOTE: Web posting. Notice.>>  The Secretary shall 
        publish on the internet website of the Department a notice that 
        such claimants may elect to have a claim so reevaluated.
            ``(B) <<NOTE: Notification.>>  The Secretary shall notify, 
        in writing or by electronic means, veterans service 
        organizations of the ability of such claimants to elect to have 
        a claim so reevaluated.
            ``(C) The Secretary shall contact each claimant identified 
        under subsection (a) in the same manner that the Department last 
        provided notice of a decision.''.

    (b) <<NOTE: 38 USC 1305 note.>>  Application.--Section 1305 of title 
38, United States Code, as added by subsection (a), shall apply with 
respect to presumptions of service connection established or modified on 
or after the date of the enactment of this Act, including pursuant to 
amendments made by this Act.

    (c) <<NOTE: 38 USC 1305 note.>>  Rule of Construction.--Nothing in 
this section shall be construed as modifying the obligations of the 
Department of Veterans Affairs under Federal court decisions or 
settlements in effect as of the date of the enactment of this Act.

  TITLE III--I <<NOTE: Veterans Burn Pits Exposure Recognition Act of 
  2022.>> MPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS FOR 
TOXIC-EXPOSED VETERANS
SEC. 301. <<NOTE: 38 USC 101 note.>>  SHORT TITLE.

    This title may be cited as the ``Veterans Burn Pits Exposure 
Recognition Act of 2022''.
SEC. 302. PRESUMPTIONS OF TOXIC EXPOSURE.

    Subchapter II of chapter 11 is <<NOTE: 38 USC 1101 prec.>>  amended 
by adding at the end the following new section:
``Sec. 1119. <<NOTE: 38 USC 1119.>>  Presumptions of toxic 
                  exposure

    ``(a) Consideration of Records.--If a veteran submits to the 
Secretary a claim for compensation for a service-connected disability 
under section 1110 of this title with evidence of a disability and a 
toxic exposure that occurred during active military, naval, air, or 
space service, the Secretary may, in adjudicating such claim, consider--
            ``(1) any record of the veteran in an exposure tracking 
        record system; and

[[Page 136 STAT. 1778]]

            ``(2) if no record of the veteran in an exposure tracking 
        record system indicates that the veteran was subject to a toxic 
        exposure during active military, naval, air, or space service, 
        the totality of the circumstances of the service of the veteran.

    ``(b) Presumption of Specific Toxic Exposure for Members Who Served 
in Certain Locations.--(1) The Secretary shall, for purposes of section 
1110 and chapter 17 of this title, presume that any covered veteran was 
exposed to the substances, chemicals, and airborne hazards identified in 
the list under paragraph (2) during the service of the covered veteran 
specified in subsection (c)(1), unless there is affirmative evidence to 
establish that the covered veteran was not exposed to any such 
substances, chemicals, or hazards in connection with such service.
    ``(2) <<NOTE: Determinations.>>  The Secretary shall--
            ``(A) <<NOTE: List.>>  establish and maintain a list that 
        contains an identification of one or more such substances, 
        chemicals, and airborne hazards as the Secretary, in 
        collaboration with the Secretary of Defense, may determine 
        appropriate for purposes of this section; and
            ``(B) <<NOTE: Evaluation.>>  determine, using procedures 
        consistent with section 1172 of this title and through the 
        conduct of a formal evaluation under section 1173 of this title, 
        whether to establish an end date for a covered veteran to 
        qualify for presumptions of exposure under this section, if 
        appropriate, but in no case establish an end date earlier than 
        the last day of the period specified in section 101(33) for the 
        Persian Gulf War.

    ``(3) <<NOTE: Reports. Time period.>>  Beginning not later than two 
years after the date of the enactment of the Sergeant First Class Heath 
Robinson Honoring our Promise to Address Comprehensive Toxics Act of 
2022, and not less frequently than once every two years thereafter, the 
Secretary shall submit to the Committee on Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report identifying any additions or removals to the 
list under paragraph (2) during the period covered by the report.

    ``(c) Definitions.--In this section:
            ``(1) <<NOTE: Effective dates.>>  The term `covered veteran' 
        means any veteran who--
                    ``(A) on or after August 2, 1990, performed active 
                military, naval, air, or space service while assigned to 
                a duty station in, including airspace above--
                          ``(i) Bahrain;
                          ``(ii) Iraq;
                          ``(iii) Kuwait;
                          ``(iv) Oman;
                          ``(v) Qatar;
                          ``(vi) Saudi Arabia;
                          ``(vii) Somalia; or
                          ``(viii) United Arab Emirates; or
                    ``(B) on or after September 11, 2001, performed 
                active military, naval, air, or space service while 
                assigned to a duty station in, including airspace 
                above--
                          ``(i) Afghanistan;
                          ``(ii) Djibouti;
                          ``(iii) Egypt;
                          ``(iv) Jordan;
                          ``(v) Lebanon;
                          ``(vi) Syria;

[[Page 136 STAT. 1779]]

                          ``(vii) Yemen;
                          ``(viii) Uzbekistan; or
                          ``(ix) <<NOTE: Determination.>>  any other 
                      country determined relevant by the Secretary.
            ``(2) The term `exposure tracking record system'--
                    ``(A) means any system, program, or pilot program 
                used by the Secretary of Veterans Affairs or the 
                Secretary of Defense to track how veterans or members of 
                the Armed Forces have been exposed to various 
                occupational or environmental hazards; and
                    ``(B) includes the Individual Longitudinal Exposure 
                Record, or successor system.
            ``(3) The term `toxic exposure risk activity' has the 
        meaning given such term in section 1710(e)(4) of this title.''.
SEC. 303. MEDICAL NEXUS EXAMINATIONS FOR TOXIC EXPOSURE RISK 
                        ACTIVITIES.

    Subchapter VI of chapter 11, as amended by section 203, is further 
amended by adding at the end the following new section:
``Sec. 1168. <<NOTE: 38 USC 1168.>>  Medical nexus examinations 
                  for toxic exposure risk activities

    ``(a) Medical Examinations and Medical Opinions.--(1) Except as 
provided in subsection (b), if a veteran submits to the Secretary a 
claim for compensation for a service-connected disability under section 
1110 of this title with evidence of a disability and evidence of 
participation in a toxic exposure risk activity during active military, 
naval, air, or space service, and such evidence is not sufficient to 
establish a service connection for the disability, the Secretary shall--
            ``(A) provide the veteran with a medical examination under 
        section 5103A(d) of this title; and
            ``(B) obtain a medical opinion (to be requested by the 
        Secretary in connection with the medical examination under 
        subparagraph (A)) as to whether it is at least as likely as not 
        that there is a nexus between the disability and the toxic 
        exposure risk activity.

    ``(2) When providing the Secretary with a medical opinion under 
paragraph (1)(B) for a veteran, the health care provider shall 
consider--
            ``(A) the total potential exposure through all applicable 
        military deployments of the veteran; and
            ``(B) the synergistic, combined effect of all toxic exposure 
        risk activities of the veteran.

    ``(3) The requirement under paragraph (2)(B) shall not be construed 
as requiring a health care provider to consider the synergistic, 
combined effect of each of the substances, chemicals, and airborne 
hazards identified in the list under section 1119(b)(2) of this title.
    ``(b) <<NOTE: Determination.>>  Exception.--Subsection (a) shall not 
apply if the Secretary determines there is no indication of an 
association between the disability claimed by the veteran and the toxic 
exposure risk activity for which the veteran submitted evidence.

    ``(c) Toxic Exposure Risk Activity Defined.--In this section, the 
term `toxic exposure risk activity' has the meaning given that term in 
section 1710(e)(4) of this title.''.

[[Page 136 STAT. 1780]]

              TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION

SEC. 401. <<NOTE: Mark Takai Atomic Veterans Healthcare Parity Act 
                        of 2022.>>  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.

    (a) <<NOTE: 38 USC 101 note.>>  Short Title.--This section may be 
cited as the ``Mark Takai Atomic Veterans Healthcare Parity Act of 
2022''.

    (b) Enewetak Atoll.--Section 1112(c)(3)(B) <<NOTE: 38 USC 1112.>>  
is amended by adding at the end the following new clause:
                    ``(v) <<NOTE: Time period.>>  Cleanup of Enewetak 
                Atoll during the period beginning on January 1, 1977, 
                and ending on December 31, 1980.''.
SEC. 402. <<NOTE: Palomares or Thule Veterans Act of 2022.>>  
                        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.

    (a) <<NOTE: 38 USC 101 note.>>  Short Title.--This section may be 
cited as the ``Palomares or Thule Veterans Act of 2022''.

    (b) <<NOTE: Time periods.>>  Palomares or Thule.--Section 
1112(c)(3)(B), as amended by section 401, is further amended by adding 
at the end the following new clauses:
                    ``(vi) Onsite participation in the response effort 
                following the collision of a United States Air Force B-
                52 bomber and refueling plane that caused the release of 
                four thermonuclear weapons in the vicinity of Palomares, 
                Spain, during the period beginning January 17, 1966, and 
                ending March 31, 1967.
                    ``(vii) Onsite participation in the response effort 
                following the on-board fire and crash of a United States 
                Air Force B-52 bomber that caused the release of four 
                thermonuclear weapons in the vicinity of Thule Air Force 
                Base, Greenland, during the period beginning January 21, 
                1968, and ending September 25, 1968.''.
SEC. 403. <<NOTE: Veterans Agent Orange Exposure Equity Act of 
                        2022.>>  PRESUMPTIONS OF SERVICE 
                        CONNECTION FOR DISEASES ASSOCIATED WITH 
                        EXPOSURES TO CERTAIN HERBICIDE AGENTS FOR 
                        VETERANS WHO SERVED IN CERTAIN LOCATIONS.

    (a) <<NOTE: 38 USC 101 note.>>  Short Title.--This section may be 
cited as the ``Veterans Agent Orange Exposure Equity Act of 2022''.

    (b) <<NOTE: Time periods.>>  In General.--Section 1116, as amended 
by section 202, is further amended--
            (1) by striking ``, during active military, naval, air, or 
        space service, served in the Republic of Vietnam during the 
        period beginning on January 9, 1962, and ending on May 7, 1975'' 
        each place it appears and inserting ``performed covered 
        service'';
            (2) by striking ``performed active military, naval, air, or 
        space service in the Republic of Vietnam during the period 
        beginning on January 9, 1962, and ending on May 7, 1975''

[[Page 136 STAT. 1781]]

        each place it appears and inserting ``performed covered 
        service''; and
            (3) by adding at the end the following new subsection:

    ``(d) <<NOTE: Definition.>>  In this section, the term `covered 
service' means active military, naval, air, or space service--
            ``(1) performed in the Republic of Vietnam during the period 
        beginning on January 9, 1962, and ending on May 7, 1975;
            ``(2) performed in Thailand at any United States or Royal 
        Thai base during the period beginning on January 9, 1962, and 
        ending on June 30, 1976, without regard to where on the base the 
        veteran was located or what military job specialty the veteran 
        performed;
            ``(3) performed in Laos during the period beginning on 
        December 1, 1965, and ending on September 30, 1969;
            ``(4) performed in Cambodia at Mimot or Krek, Kampong Cham 
        Province during the period beginning on April 16, 1969, and 
        ending on April 30, 1969; or
            ``(5) performed on Guam or American Samoa, or in the 
        territorial waters thereof, during the period beginning on 
        January 9, 1962, and ending on July 31, 1980, or served on 
        Johnston Atoll or on a ship that called at Johnston Atoll during 
        the period beginning on January 1, 1972, and ending on September 
        30, 1977.''.

    (c) Eligibility for Hospital Care and Medical Services.--Section 
1710(e)(4), as amended by section 102(c), <<NOTE: 38 USC 1710.>>  is 
further amended by striking subparagraph (A) and inserting the following 
new subparagraph:
            ``(A) <<NOTE: Definition.>>  The term `Vietnam-era 
        herbicide-exposed veteran' means a veteran who--
                    ``(i) performed covered service, as defined in 
                section 1116(d) of this title; or
                    ``(ii) the Secretary finds may have been exposed 
                during active military, naval, air, or space service to 
                dioxin during the Vietnam era, regardless of the 
                geographic area of such service, or was exposed during 
                such service to a toxic substance found in a herbicide 
                or defoliant used for military purposes during such era, 
                regardless of the geographic area of such service.''.

    (d) Conforming Amendment.--The heading for section 1116 <<NOTE: 38 
USC 1101 prec, 1116.>>  is amended by striking ``the Republic of 
Vietnam'' and inserting ``certain locations''.

    (e) <<NOTE: 38 USC 1116 note.>>  Effective Date and Applicability.--
The amendments made by this section shall take effect on the date of the 
enactment of this Act and shall apply as follows:
            (1) <<NOTE: Determination.>>  On the date of the enactment 
        of this Act for claimants for dependency and indemnity 
        compensation under chapter 13 of title 38, United States Code, 
        and for veterans whom the Secretary of Veterans Affairs 
        determines are--
                    (A) terminally ill;
                    (B) homeless;
                    (C) under extreme financial hardship;
                    (D) more than 85 years old; or
                    (E) capable of demonstrating other sufficient cause.
            (2) On October 1, 2022, for everyone not described in 
        paragraph (1).

[[Page 136 STAT. 1782]]

SEC. 404. <<NOTE: Fair Care for Vietnam Veterans Act of 2022.>>  
                        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.

    (a) <<NOTE: 38 USC 101 note.>>  Short Title.--This section may be 
cited as the ``Fair Care for Vietnam Veterans Act of 2022''.

    (b) Monoclonal Gammopathy of Undetermined Significance.--Section 
1116(a)(2) of title 38, United <<NOTE: 38 USC 1116.>> States Code, is 
amended by adding at the end the following new subparagraph:
            ``(L) Monoclonal gammopathy of undetermined significance.''.

    (c) Hypertension.--Such section, as amended by subsection (b), is 
further amended by adding at the end the following new subparagraph:
            ``(M) Hypertension.''.

    (d) <<NOTE: 38 USC 1116 note.>>  Effective Dates and 
Applicability.--
            (1) Monoclonal gammopathy of undetermined significance.--
                    (A) In general.--The amendment made by subsection 
                (b) shall take effect on the date of the enactment of 
                this Act and shall apply as follows:
                          (i) <<NOTE: Determination.>>  On the date of 
                      the enactment of this Act for claimants for 
                      dependency and indemnity compensation under 
                      chapter 13 of title 38, United States Code, and 
                      for veterans whom the Secretary of Veterans 
                      Affairs determines are--
                                    (I) terminally ill;
                                    (II) homeless;
                                    (III) under extreme financial 
                                hardship;
                                    (IV) more than 85 years old; or
                                    (V) capable of demonstrating other 
                                sufficient cause.
                          (ii) On October 1, 2022, for everyone not 
                      described in clause (i).
                    (B) <<NOTE: Claims.>>  Retroactive application.--
                Notwithstanding any Federal court decisions or 
                settlements in effect on the day before the date of the 
                enactment of this Act, the Secretary of Veterans Affairs 
                shall award retroactive claims for a condition under 
                section 1116(a)(2)(L) of title 38, United States Code, 
                as added by subsection (b) of this section, only to 
                claimants for dependency and indemnity compensation 
                under chapter 13 of such title described in subparagraph 
                (A)(i) of this paragraph.
            (2) Hypertension.--
                    (A) In general.--The amendment made by subsection 
                (c) shall take effect on the date of the enactment of 
                this Act and shall apply as follows:
                          (i) <<NOTE: Determination.>>  On the date of 
                      the enactment of this Act for claimants for 
                      dependency and indemnity compensation under 
                      chapter 13 of title 38, United States Code, and 
                      for veterans whom the Secretary of Veterans 
                      Affairs determines are--
                                    (I) terminally ill;
                                    (II) homeless;
                                    (III) under extreme financial 
                                hardship;
                                    (IV) more than 85 years old; or

[[Page 136 STAT. 1783]]

                                    (V) capable of demonstrating other 
                                sufficient cause.
                          (ii) On October 1, 2026, for everyone not 
                      described in subparagraph (A).
                    (B) <<NOTE: Claims.>>  Retroactive application.--
                Notwithstanding any Federal court decisions or 
                settlements in effect on the day before the date of the 
                enactment of this Act, the Secretary of Veterans Affairs 
                shall award retroactive claims for a condition under 
                section 1116(a)(2)(M) of title 38, United States Code, 
                as added by subsection (c) of this section, only to 
                claimants for dependency and indemnity compensation 
                under chapter 13 of such title described in subparagraph 
                (A)(i) of this paragraph.
SEC. 405. IMPROVING COMPENSATION FOR DISABILITIES OCCURRING IN 
                        PERSIAN GULF WAR VETERANS.

    (a) Reduction in Threshold of Eligibility.--Subsection (a)(1) of 
section 1117 <<NOTE: 38 USC 1117.>>  is amended by striking ``became 
manifest--'' and all that follows through the period at the end and 
inserting ``became manifest to any degree at any time.''.

    (b) Permanent Extension of Period of Eligibility.--Such section is 
further amended--
            (1) by striking subsection (b);
            (2) by redesignating subsections (c) and (d) as subsections 
        (b) and (c), respectively; and
            (3) in subsection (a)(2)(C), by striking ``under subsection 
        (d)'' and inserting ``under subsection (c)''.

    (c) Establishing Singular Disability-based Questionnaire.--Such 
section is further amended by inserting after subsection (c) (as 
redesignated by subsection (b)) the following new subsection (d):
    ``(d) If a Persian Gulf veteran at a medical facility of the 
Department presents with any one symptom associated with Gulf War 
Illness, the Secretary shall ensure that health care personnel of the 
Department use a disability benefits questionnaire, or successor 
questionnaire, designed to identify Gulf War Illness, in addition to any 
other diagnostic actions the personnel determine appropriate.''.
    (d) Expansion of Definition of Persian Gulf Veteran.--Subsection (f) 
of such section is amended by inserting ``, Afghanistan, Israel, Egypt, 
Turkey, Syria, or Jordan,'' after ``operations''.
    (e) Training.--Such section is further amended by adding at the end 
the following new subsection:
    ``(i)(1) The Secretary shall take such actions as may be necessary 
to ensure that health care personnel of the Department are appropriately 
trained to effectively carry out this section.
    ``(2) <<NOTE: Reports.>>  Not less frequently than once each year, 
the Secretary shall submit to Congress a report on the actions taken by 
the Secretary to carry out paragraph (1).''.
SEC. 406. <<NOTE: Presumptive Benefits for War Fighters Exposed to 
                        Burn Pits and Other Toxins Act of 2022.>>  
                        PRESUMPTION OF SERVICE CONNECTION FOR 
                        CERTAIN DISEASES ASSOCIATED WITH EXPOSURE 
                        TO BURN PITS AND OTHER TOXINS.

    (a) <<NOTE: 38 USC 101 note.>>  Short Title.--This section may be 
cited as the ``Presumptive Benefits for War Fighters Exposed to Burn 
Pits and Other Toxins Act of 2022''.

[[Page 136 STAT. 1784]]

    (b) In General.--Subchapter II of chapter 11, as amended by section 
302, is further amended by inserting after section 1119 the following 
new section:
``Sec. 1120. <<NOTE: 38 USC 1120.>>  Presumption of service 
                  connection for certain diseases associated with 
                  exposure to burn pits and other toxins

    ``(a) Presumption of Service Connection.--For the purposes of 
section 1110 of this title, and subject to section 1113 of this title, a 
disease specified in subsection (b) becoming manifest in a covered 
veteran shall be considered to have been incurred in or aggravated 
during active military, naval, air, or space service, notwithstanding 
that there is no record of evidence of such disease during the period of 
such service.

    ``(b) Diseases Specified.--The diseases specified in this subsection 
are the following:
            ``(1) Asthma that was diagnosed after service of the covered 
        veteran as specified in subsection (c).
            ``(2) The following types of cancer:
                    ``(A) Head cancer of any type.
                    ``(B) Neck cancer of any type.
                    ``(C) Respiratory cancer of any type.
                    ``(D) Gastrointestinal cancer of any type.
                    ``(E) Reproductive cancer of any type.
                    ``(F) Lymphoma cancer of any type.
                    ``(G) Lymphomatic cancer of any type.
                    ``(H) Kidney cancer.
                    ``(I) Brain cancer.
                    ``(J) Melanoma.
                    ``(K) Pancreatic cancer.
            ``(3) Chronic bronchitis.
            ``(4) Chronic obstructive pulmonary disease.
            ``(5) Constrictive bronchiolitis or obliterative 
        bronchiolitis.
            ``(6) Emphysema.
            ``(7) Granulomatous disease.
            ``(8) Interstitial lung disease.
            ``(9) Pleuritis.
            ``(10) Pulmonary fibrosis.
            ``(11) Sarcoidosis.
            ``(12) Chronic sinusitis.
            ``(13) Chronic rhinitis.
            ``(14) Glioblastoma.
            ``(15) <<NOTE: Determination.>>  Any other disease for which 
        the Secretary determines, pursuant to regulations prescribed 
        under subchapter VII that a presumption of service connection is 
        warranted based on a positive association with a substance, 
        chemical, or airborne hazard identified in the list under 
        section 1119(b)(2) of this title.

    ``(c) Covered Veteran Defined.--In this section, the term `covered 
veteran' has the meaning given that term in section 1119(c) of this 
title.''.
    (c) Conforming Amendment.--Section 1113 <<NOTE: 38 USC 1113.>>  is 
amended by striking ``or 1118'' each place it appears and inserting 
``1118, or 1120''.

    (d) <<NOTE: 38 USC 1120 note.>>  Effective Date and Applicability.--
The amendments made by this section shall take effect on the date of the 
enactment of this Act and shall apply as follows:

[[Page 136 STAT. 1785]]

            (1) <<NOTE: Determination.>>  On the date of the enactment 
        of this Act for claimants for dependency and indemnity 
        compensation under chapter 13 of title 38, United States Code, 
        and veterans whom the Secretary of Veterans Affairs determines 
        are--
                    (A) terminally ill;
                    (B) homeless;
                    (C) under extreme financial hardship;
                    (D) more than 85 years old; or
                    (E) capable of demonstrating other sufficient cause.
            (2) On the date of the enactment of this Act for everyone 
        not described in paragraph (1), with respect to paragraphs (1), 
        (2)(C), (2)(I), (5), (6), (7), (8), (9), (10), (11), (12), (13), 
        and (14), of section 1120(b) of title 38, United States Code, as 
        added by subsection (b).
            (3) On October 1, 2023, for everyone not described in 
        paragraph (1), with respect to paragraphs (3) and (4) of section 
        1120(b) of such title, as so added.
            (4) On October 1, 2024, for everyone not described in 
        paragraph (1), with respect to subparagraphs (A), (B), (D), (E), 
        (F), (G), and (K) of section 1120(b)(2) of such title, as so 
        added.
            (5) On October 1, 2025, for everyone not described in 
        paragraph (1), with respect to subparagraphs (H) and (J) of 
        section 1120(b)(2) of such title, as so added.
SEC. 407. <<NOTE: 38 USC 101 note.>>  RULE OF CONSTRUCTION.

    (a) Generally.--Nothing in this Act shall be construed to prevent 
the Secretary of Veterans Affairs from processing claims for benefits 
under title 38, United States Code, for a condition or disease for which 
this Act establishes a presumption of service connection, as a claim for 
benefits for a condition or disease with direct service connection.
    (b) Effective Dates and Applicability.--The Secretary shall not deny 
a claim for benefits under title 38, United States Code, for a condition 
or disease for which this Act establishes a presumption of service 
connection because the claimant filed the claim prior to the effective 
date or date of applicability for that particular condition or disease.

                        TITLE V--RESEARCH MATTERS

SEC. 501. INTERAGENCY WORKING GROUP ON TOXIC EXPOSURE RESEARCH.

    (a) Establishment.--
            (1) <<NOTE: Deadline.>>  In general.--Not later than one 
        year after the date of the enactment of this Act, the Secretary 
        of Veterans Affairs shall, in collaboration with the heads of 
        the entities described in paragraph (2), establish the Toxic 
        Exposure Research Working Group (in this section referred to as 
        the ``Working Group'').
            (2) Composition.--The Working Group shall consist of 
        employees, selected by the Secretary, of the following:
                    (A) The Department of Veterans Affairs.
                    (B) The Department of Defense.
                    (C) The Department of Health and Human Services.
                    (D) The Environmental Protection Agency.

[[Page 136 STAT. 1786]]

                    (E) Other entities of the Federal Government 
                involved in research activities regarding the health 
                consequences of toxic exposures experienced during 
                active military, naval, air, or space service.

    (b) Functions.--The Working Group shall perform the following 
functions:
            (1) Identify collaborative research activities and resources 
        available among entities represented by members of the Working 
        Group to conduct such collaborative research activities.
            (2) <<NOTE: Time period. Strategic plan.>>  Develop a five-
        year strategic plan for such entities to carry out collaborative 
        research activities.

    (c) Reporting.--The Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives the following:
            (1) Not later than one year after the date of the enactment 
        of this Act, a report on the establishment of the Working Group 
        under subsection (a).
            (2) Not later than two years after the date of the enactment 
        of this Act, a report containing the collaborative research 
        activities identified, and the strategic plan developed, by the 
        Working Group under subsection (b).
            (3) Not less frequently than annually during the five-year 
        period covered by the strategic plan under subsection (b), a 
        progress report on implementation of the strategic plan.

    (d) Termination.--The Working Group shall terminate after submitting 
the final report under subsection (c).
    (e) Definitions.--In this section:
            (1) Active military, naval, air, or space service.--The term 
        ``active military, naval, air, or space service'' has the 
        meaning given that term in section 101 of title 38, United 
        States Code.
            (2) Collaborative research activity.--The term 
        ``collaborative research activity'' means a research activity--
                    (A) agreed upon by the Working Group;
                    (B) conducted by an entity represented by a member 
                of the Working Group;
                    (C) funded by the Federal Government; and
                    (D) regarding the health consequences of toxic 
                exposures experienced during active military, naval, 
                air, or space service.
            (3) Toxic exposure.--The term ``toxic exposure'' has the 
        meaning given such term in section 101 of title 38, United 
        States Code, as amended by section 102(b).
SEC. 502. <<NOTE: 38 USC 527 note.>>  ANALYSIS AND REPORT ON 
                        TREATMENT OF VETERANS FOR MEDICAL 
                        CONDITIONS RELATED TO TOXIC EXPOSURE.

    (a) <<NOTE: Data.>>  In General.--The Secretary of Veterans Affairs 
shall analyze, on a continuous basis, all clinical data that--
            (1) is obtained by the Department of Veterans Affairs in 
        connection with hospital care, medical services, and nursing 
        home care furnished under section 1710(a)(2)(F) of title 38, 
        United States Code; and
            (2) is likely to be scientifically useful in determining the 
        association, if any, between the medical condition of a veteran 
        and a toxic exposure.

    (b) Annual Report.--Not later than one year after the date of the 
enactment of this Act, and annually thereafter, the Secretary

[[Page 136 STAT. 1787]]

shall submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
containing the following:
            (1) The aggregate 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 incidence of 
        such medical conditions and other explanations for the incidence 
        of such conditions as the Secretary considers reasonable.
            (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 association between such conditions and toxic 
        exposures.

    (c) Toxic Exposure Defined.--In this section, the term ``toxic 
exposure'' has the meaning given such term in section 101 of title 38, 
United States Code, as amended by section 102(b).
SEC. 503. ANALYSIS RELATING TO MORTALITY OF VETERANS WHO SERVED IN 
                        SOUTHWEST ASIA.

    (a) Analysis.--
            (1) <<NOTE: Deadline. Coordination. Update.>>  In general.--
        Not later than 270 days after the date of the enactment of this 
        Act, the Secretary of Veterans Affairs, in coordination with the 
        Secretary of Defense, shall conduct an updated analysis of total 
        and respiratory disease mortality in covered veterans.
            (2) Elements.--The analysis required by paragraph (1) shall 
        include, to the extent practicable, the following with respect 
        to each covered veteran:
                    (A) Metrics of airborne exposures.
                    (B) The location and timing of deployments of the 
                veteran.
                    (C) The military occupational specialty of the 
                veteran.
                    (D) The Armed Force in which the veteran served.
                    (E) Pre-existing health status of the veteran, 
                including with respect to asthma.
                    (F) Relevant personal information of the veteran, 
                including cigarette and e-cigarette smoking history, 
                diet, sex, gender, age, race, and ethnicity.

    (b) <<NOTE: Effective dates.>>  Covered Veteran Defined.--In this 
section, the term ``covered veteran'' means any veteran who--
            (1) on or after August 2, 1990, served on active duty in--
                    (A) Bahrain;
                    (B) Iraq;
                    (C) Kuwait;
                    (D) Oman;
                    (E) Qatar;
                    (F) Saudi Arabia;
                    (G) Somalia; or
                    (H) the United Arab Emirates; or
            (2) on or after September 11, 2001, served on active duty 
        in--
                    (A) Afghanistan;
                    (B) Djibouti;
                    (C) Egypt;

[[Page 136 STAT. 1788]]

                    (D) Jordan;
                    (E) Lebanon;
                    (F) Syria; or
                    (G) Yemen.
SEC. 504. <<NOTE: Time period.>>  STUDY ON HEALTH TRENDS OF POST-
                        9/11 VETERANS.

    The Secretary of Veterans Affairs shall conduct an epidemiological 
study on the health trends of veterans who served in the Armed Forces 
after September 11, 2001.
SEC. 505. STUDY ON CANCER RATES AMONG VETERANS.

    (a) <<NOTE: Determination.>>  In General.--The Secretary of Veterans 
Affairs shall conduct a study on the incidence of cancer in veterans to 
determine trends in the rates of the incidence of cancer in veterans.

    (b) Elements.--The study required by subsection (a) shall assess, 
with respect to each veteran included in the study, the following:
            (1) The age of the veteran.
            (2) The period of service and length of service of the 
        veteran in the Armed Forces.
            (3) The military occupational specialty or specialties of 
        the veteran.
            (4) The sex of the veteran.
            (5) The type or types of cancer that the veteran has.
SEC. 506. STUDY ON HEALTH EFFECTS OF WASTE RELATED TO MANHATTAN 
                        PROJECT ON CERTAIN VETERANS.

    (a) <<NOTE: Deadline. Contracts.>>  Study.--Not later than 180 days 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall enter into an agreement with the National Academies of 
Sciences, Engineering, and Medicine for the conduct of a study on the 
health trends of veterans who, while serving in the active military, 
naval, air, or space service--
            (1) participated in activities relating to the Manhattan 
        Project (including activities relating to covered waste) in 
        connection with such service; or
            (2) <<NOTE: Determination.>>  resided at or near, as 
        determined by the Secretary, the locations described in 
        subsection (b).

    (b) <<NOTE: State listing.>>  Covered Locations.--The locations 
described in this subsection are the following locations:
            (1) In the county of St. Louis, Missouri, the following:
                    (A) Coldwater Creek, Missouri.
                    (B) The St. Louis Airport Site, Missouri.
                    (C) The West Lake Landfill.
            (2) Oak Ridge, Tennessee.
            (3) Hanford, Washington.
            (4) <<NOTE: Determination.>>  Any other location that is 
        proximate to covered waste, as determined by the Secretary.

    (c) <<NOTE: Assessments.>>  Elements.--The study under subsection 
(a) shall assess, with respect to each veteran included in the study, 
the following:
            (1) The age, sex, and race of the veteran.
            (2) The period and location of exposure to covered waste.
            (3) Any type of cancer, or other illness associated with 
        toxic exposure, that the veteran has.
            (4) <<NOTE: Determination.>>  A comparison of the overall 
        health condition of the veteran, including any illness of the 
        veteran identified pursuant to paragraph (3), with the overall 
        health condition of past

[[Page 136 STAT. 1789]]

        and present civilian populations residing at the same location 
        of exposure, as determined by the Secretary.

    (d) <<NOTE: Analysis. Data.>>  Report.--Not later than three years 
after the date of the enactment of this Act, the Secretary shall submit 
to the Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a report on the study 
under subsection (a) and include in such report an analysis of the data 
available and data reliability.

    (e) Definitions.--In this section:
            (1) Active military, naval, air, or space service; toxic 
        exposure.--The terms ``active military, naval, air, or space 
        service'' and ``toxic exposure'' have the meanings given those 
        terms in section 101 of title 38, United States Code, as added 
        by section 102(b).
            (2) Covered waste.--The term ``covered waste'' means any 
        waste arising from activities carried out in connection with the 
        Manhattan Project.
            (3) Illness.--The term ``illness'' has the meaning given 
        that term in section 1171 of title 38, United States Code, as 
        added by section 202.
            (4) Toxic exposure.--The term ``toxic exposure'' has the 
        meaning given such term in section 101 of title 38, United 
        States Code, as amended by section 102(b).
SEC. 507. STUDY ON TOXIC EXPOSURE AND MENTAL HEALTH OUTCOMES.

    (a) <<NOTE: Deadline. Contracts. Assessment.>>  Study Required.--Not 
later than 180 days after the date of the enactment of this Act, the 
Secretary of Veterans Affairs shall enter into an agreement with the 
National Academies of Sciences, Engineering, and Medicine for the 
conduct of a study of veterans to assess possible relationships between 
toxic exposures experienced during service in the Armed Forces and 
mental health conditions, including chronic multisymptom illness, 
traumatic brain injury, post-traumatic stress disorder, depression, 
episodes of psychosis, schizophrenia, bipolar disorder, suicide 
attempts, and suicide deaths.

    (b) Elements.--For each veteran included in the study under 
subsection (a), the following information shall be collected and 
assessed:
            (1) Age.
            (2) Sex.
            (3) Race and ethnicity.
            (4) Period and length of service in the Armed Forces.
            (5) The military occupational specialty or specialties of 
        the veteran.
            (6) History of toxic exposure during service in the Armed 
        Forces.
            (7) Any diagnosis of chronic multisymptom illness.
            (8) Any diagnosis of a mental health or cognitive disorder.
            (9) Any history of suicide attempt or suicidality.
            (10) If the veteran died by suicide.
            (11) Any confounding traumatic experiences that could affect 
        a veteran's mental health.

    (c) Report.--Not later than three years after the date of the 
enactment of this Act, the Secretary shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report containing the

[[Page 136 STAT. 1790]]

findings of the National Academies of Sciences, Engineering, and 
Medicine with respect to the study conducted under subsection (a).
SEC. 508. STUDY ON VETERANS IN TERRITORIES OF THE UNITED STATES.

    (a) GAO Study.--
            (1) In general.--The Comptroller General of the United 
        States shall conduct a study on the state of access and barriers 
        to benefits and services furnished by the Veterans Benefits 
        Administration and the Veterans Health Administration under laws 
        administered by the Secretary of Veterans Affairs to veterans in 
        Territories and Freely Associated States of the United States, 
        including deficits in the availability and accessibility of such 
        benefits and services compared to veterans elsewhere in the 
        United States.
            (2) Elements.--The study under paragraph (1) shall include--
                    (A) the number of veterans in each Territory and 
                Freely Associated State of the United States;
                    (B) the number of veterans in each Territory and 
                Freely Associated State who are enrolled in the system 
                of annual patient enrollment of the Department of 
                Veterans Affairs under section 1705(a) of title 38, 
                United States Code;
                    (C) a description of how the Department estimates 
                the number of veterans in each Territory and Freely 
                Associated State who are eligible for services under 
                section 1710 of such title but who are not enrolled as 
                described in subparagraph (B);
                    (D) a detailed description of obstacles facing 
                veterans in each Territory and Freely Associated State 
                in accessing health care services, including those 
                involving the availability of such services to veterans 
                in the Territory or Freely Associated State in which the 
                veterans reside, and any distance impediments to 
                receiving services at a regional medical center of the 
                Veterans Health Administration, a community-based 
                outpatient clinic, another full-service medical facility 
                of the Department, or a Vet Center, respectively;
                    (E) a detailed description of obstacles facing 
                veterans in each Territory and Freely Associated State 
                in accessing readjustment counseling services, including 
                those involving the availability of such services to 
                veterans in the Territory in which the veterans reside, 
                and any distance impediments to receiving services at a 
                readjustment counseling services center of the 
                Department;
                    (F) a detailed description of obstacles facing 
                veterans in each Territory and Freely Associated State 
                in accessing non-health care veterans benefits, 
                including those involving the availability of benefits 
                and services to veterans in the Territory or Freely 
                Associated State in which the veterans reside, and any 
                distance impediments to accessing the nearest office of 
                the Veterans Benefits Administration;
                    (G) <<NOTE: Analysis.>>  an analysis of the staffing 
                and quality of the offices of the Veterans Benefits 
                Administration and Veterans Health Administration 
                charged with serving veterans in the Territories and 
                Freely Associated States, including the

[[Page 136 STAT. 1791]]

                availability of the full- and part-time staff of each 
                office to the veterans they are charged with serving;
                    (H) <<NOTE: Analysis.>>  an analysis of the 
                availability of the Veterans Community Care Program 
                established under section 1703 of title 38, United 
                States Code, to veterans in each Territory and Freely 
                Associated State;
                    (I) <<NOTE: Analysis.>>  an analysis of the economic 
                and health outcomes for veterans in each Territory or 
                Freely Associated State resulting from obstacles to 
                accessing adequate assistance and health care at 
                facilities of the Department;
                    (J) <<NOTE: Analysis. Time period.>>  an analysis of 
                the access to benefit assistance and health care 
                provided to veterans in the aftermath of major disasters 
                declared in each of the Territories and Freely 
                Associated States since September 4, 2017; and
                    (K) <<NOTE: Recommenda- tions.>>  such 
                recommendations as the Comptroller General considers 
                appropriate for improving access of veterans in the 
                Territories and Freely Associated States to benefits and 
                health care services furnished by the Secretary, and 
                reducing barriers and deficits in the availability and 
                accessibility of such benefits and services compared to 
                veterans elsewhere in the United States.

    (b) <<NOTE: Deadline. Recommenda- tions.>>  Briefing.--Not later 
than one year after the date of the enactment of this Act, the 
Comptroller General shall provide to the Committee on Veterans' Affairs 
of the Senate and the Committee on Veterans' Affairs of the House of 
Representatives a briefing setting forth the results of the study 
conducted under subsection (a), including any recommendations developed 
under paragraph (2)(K) of such subsection.

    (c) Definitions.--In this section:
            (1) Freely associated state.--The term ``Freely Associated 
        State'' includes the Federated States of Micronesia, the 
        Republic of the Marshall Islands, and the Republic of Palau.
            (2) Territory.--The term ``Territory'' includes American 
        Samoa, the Commonwealth of the Northern Marianas Islands, Guam, 
        Puerto Rico, and the Virgin Islands.
            (3) Vet center.--The term ``Vet Center'' has the meaning 
        given that term in section 1712A(h) of title 38, United States 
        Code.
SEC. 509. <<NOTE: 38 USC 527 note.>>  DEPARTMENT OF VETERANS 
                        AFFAIRS PUBLIC WEBSITE FOR TOXIC EXPOSURE 
                        RESEARCH.

    (a) <<NOTE: Deadline.>>  Website.--Not later than one year after the 
date of the enactment of this Act, the Secretary of Veterans Affairs 
shall establish, and maintain thereafter, a publicly accessible internet 
website of the Department of Veterans Affairs that serves as a 
clearinghouse for the publication of all toxic exposure research carried 
out or funded by the executive branch of the Federal Government.

    (b) Coordination.--In carrying out subsection (a), the Secretary 
shall coordinate with--
            (1) the heads of each Federal agency carrying out or funding 
        toxic exposure research;
            (2) the War Related Illness and Injury Study Center of the 
        Department of Veterans Affairs, or successor center; and
            (3) any working group of the Department of Veterans Affairs 
        or other similar entity responsible for coordinating toxic 
        exposure research.

    (c) Definitions.--In this section:

[[Page 136 STAT. 1792]]

            (1) Toxic exposure.--The term ``toxic exposure'' has the 
        meaning given that term in section 101 of title 38, United 
        States Code, as added by section 102(b).
            (2) Toxic exposure research.--The term ``toxic exposure 
        research'' means research on the health consequences of toxic 
        exposures experienced during service in the Armed Forces.
SEC. 510. REPORT ON HEALTH EFFECTS OF JET FUELS USED BY ARMED 
                        FORCES.

    (a) <<NOTE: Public information.>>  Initial Report.--Not later than 
one year after the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall submit to the Committee on Veterans' Affairs of 
the Senate and the Committee on Veterans' Affairs of the House of 
Representatives, and make publicly available, a report on health effects 
of jet fuels used by the Armed Forces.

    (b) Contents.--The report submitted under subsection (a) shall 
include the following:
            (1) A discussion of the effect of various different types of 
        jet fuels used by the Armed Forces on the health of individuals 
        by length of exposure.
            (2) An identification of the immediate symptoms of jet fuel 
        exposure that may indicate future health risks.
            (3) A chronology of health safeguards implemented by the 
        Armed Forces intended to reduce the exposure of members of the 
        Armed Forces to jet fuel.
            (4) An identification of any areas relating to jet fuel 
        exposure about which new research needs to be conducted.

    (c) <<NOTE: Update.>>  Follow-up Report.--Not later than five years 
after the date of the submittal of the report under subsection (a), the 
Secretary shall submit to the committees referred to in such subsection 
an update to such report.

    TITLE VI <<NOTE: Fairly Assessing Service-related Toxic Exposure 
  Residuals Presumptions Act of 2022.>> --IMPROVEMENT OF RESOURCES AND 
TRAINING REGARDING TOXIC-EXPOSED VETERANS
SEC. 601. <<NOTE: 38 USC 1101 note prec.>>  SHORT TITLE; 
                        DEFINITIONS.

    (a) Short Title.--This title may be cited as the ``Fairly Assessing 
Service-related Toxic Exposure Residuals Presumptions Act of 2022'' or 
the ``FASTER Presumption Act of 2022''.
    (b) Definitions.--In this title, the terms ``active military, naval, 
air, or space service'', ``toxic exposure'', and ``toxic-exposed 
veteran'' have the meanings given those terms in section 101 of title 
38, United States Code, as amended by section 102.
SEC. 602. <<NOTE: 38 USC 1101 note prec.>>  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.

    (a) Publication of List of Resources.--
            (1) <<NOTE: Deadline. Time period.>>  In general.--Not later 
        than one year after the date of the enactment of this Act, and 
        annually thereafter, the Secretary of Veterans Affairs shall 
        publish a list of resources of the Department of Veterans 
        Affairs for--

[[Page 136 STAT. 1793]]

                    (A) toxic-exposed veterans and veterans who report 
                toxic exposure;
                    (B) families and caregivers of such veterans; and
                    (C) survivors of such veterans 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 program for veterans on illnesses 
that may be related to toxic exposures, including outreach with respect 
to benefits and support programs.
SEC. 603. <<NOTE: 38 USC 1101 note prec.>>  INCORPORATION OF TOXIC 
                        EXPOSURE SCREENING FOR VETERANS.

    (a) <<NOTE: Deadline. Determination.>>  In General.--Beginning not 
later than 90 days after the date of the enactment of this Act, the 
Secretary of Veterans Affairs shall incorporate a screening to help 
determine potential toxic exposures during active military, naval, air, 
or space service as part of a health care screening furnished by the 
Department of Veterans Affairs to veterans enrolled in the system of 
annual patient enrollment of the Department established and operated 
under section 1705 of title 38, United States Code, to improve 
understanding by the Department of toxic exposures while serving in the 
Armed Forces.

    (b) Timing.--The Secretary shall ensure that a veteran described in 
subsection (a) completes the screening required under such subsection 
not less frequently than once every five years.
    (c) Determination of Questions.--
            (1) In general.--The questions included in the screening 
        required under subsection (a) shall be determined by the 
        Secretary with input from medical professionals.
            (2) Specific questions.--At a minimum, the screening 
        required under subsection (a) shall, with respect to a veteran, 
        include--
                    (A) a question about the potential exposure of the 
                veteran to an open burn pit; and
                    (B) a question regarding toxic exposures that are 
                commonly associated with service in the Armed Forces.
            (3) Open burn pit defined.--In this subsection, the term 
        ``open burn pit'' means an area of land that--
                    (A) is designated by the Secretary of Defense to be 
                used for disposing solid waste by burning in the outdoor 
                air; and
                    (B) does not contain a commercially manufactured 
                incinerator or other equipment specifically designed and 
                manufactured for the burning of solid waste.

    (d) Print Material.--In developing the screening established under 
subsection (a), the Secretary shall ensure that print materials 
complementary to such screening that outline related resources for 
veterans are available at each medical center of the Department to 
veterans who may not have access to the internet.
    (e) <<NOTE: Time period.>>  Screening Updates.--The Secretary shall 
consider updates to the content of the screening required under 
subsection (a) not less frequently than biennially to ensure the 
screening contains the most current information.

[[Page 136 STAT. 1794]]

SEC. 604. <<NOTE: 38 USC 1101 note prec.>>  TRAINING FOR PERSONNEL 
                        OF THE DEPARTMENT OF VETERANS AFFAIRS WITH 
                        RESPECT TO VETERANS WHO REPORT TOXIC 
                        EXPOSURES.

    (a) Health Care Personnel.--The Secretary of Veterans Affairs shall 
provide to health care personnel of the Department of Veterans Affairs 
education and training to identify, treat, and assess the impact on 
veterans of illnesses related to toxic exposures and inform such 
personnel of how to ask for additional information from veterans 
regarding different toxic exposures.
    (b) Benefits Personnel.--
            (1) In general.--The Secretary shall incorporate a training 
        program for processors of claims under the laws administered by 
        the Secretary who review claims for disability benefits relating 
        to service-connected disabilities based on toxic exposures.
            (2) Annual training.--Training provided to processors under 
        paragraph (1) shall be provided not less frequently than 
        annually.

                          TITLE VII--RESOURCING

SEC. 701. AUTHORITY TO USE APPROPRIATIONS TO ENHANCE CLAIMS 
                        PROCESSING CAPACITY AND AUTOMATION.

    (a) <<NOTE: 38 USC 324 note.>>  Authority.--The Secretary of 
Veterans Affairs may use, from amounts appropriated to the Cost of War 
Toxic Exposures Fund established by section 324 of title 38, United 
States Code, as added by section 805 of this Act, such amounts as may be 
necessary to continue the modernization, development, and expansion of 
capabilities and capacity of information technology systems and 
infrastructure of the Veterans Benefits Administration, including for 
claims automation, to support expected increased claims processing for 
newly eligible veterans pursuant to this Act.

    (b) Plan for Modernization of Veterans Benefits Administration 
Information Technology Systems.--
            (1) <<NOTE: Deadline.>>  In general.--Not later than 180 
        days after the date of the enactment of this Act, the Secretary 
        of Veterans Affairs shall submit to the appropriate 
        congressional committees a plan for the modernization of the 
        information technology systems of the Veterans Benefits 
        Administration. <<NOTE: Time periods.>> The plan shall cover the 
        first fiscal year that begins after the date of the enactment of 
        this Act and the subsequent four fiscal years and shall include 
        each of the following:
                    (A) An identification of any information system to 
                be modernized or retired, if applicable, during the 
                period covered by the plan.
                    (B) A description of how the Secretary intends to 
                incorporate the following principles into the 
                modernization of such information systems:
                          (i) The purpose of automation should be to 
                      increase the speed and accuracy of claims 
                      processing decisions.
                          (ii) Automation should be conducted in a 
                      manner that enhances the productivity of employees 
                      of the Department of Veterans Affairs.
                          (iii) Automation should be carried out in a 
                      manner that achieves greater consistency in the 
                      processing and

[[Page 136 STAT. 1795]]

                      rating of claims by relying on patterns of similar 
                      evidence in claim files.
                          (iv) To the greatest extent possible, 
                      automation should be carried out by drawing from 
                      information in the possession of the Department, 
                      other Government agencies, and applicants for 
                      benefits.
                          (v) Automation of any claims analysis or 
                      determination process should not be end-to-end or 
                      lack intermediation.
                          (vi) Employees of the Department should 
                      continue to make decisions with respect to the 
                      approval of claims and the granting of benefits.
                          (vii) Automation should not be carried out in 
                      a manner that reduces or infringes upon the due 
                      process rights of applicants for benefits under 
                      the laws administered by the Secretary; or the 
                      duties of the Secretary to assist and notify 
                      claimants.
                          (viii) Automation should be carried out while 
                      taking all necessary measures to protect the 
                      privacy of claimants and their personally 
                      identifiable information.
                          (ix) Automation of claims processing should 
                      not eliminate or reduce the workforce of the 
                      Veterans Benefits Administration.
                    (C) An identification of targets, for each fiscal 
                year, by which the Secretary intends to complete the 
                modernization of each information system or major 
                component or functionality of such system identified 
                under subparagraph (A).
                    (D) <<NOTE: Cost estimates.>>  Cost estimates for 
                the modernization of each information system identified 
                under paragraph (A) for each fiscal year covered by the 
                plan and in total.
            (2) <<NOTE: Definition.>>  Appropriate congressional 
        committees.--In this section, the term ``appropriate 
        congressional committees'' means--
                    (A) the Committee on Veterans' Affairs and the 
                Subcommittee on Military Construction, Veterans Affairs, 
                and Related Agencies of the Committee on Appropriations 
                of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Subcommittee on Military Construction, Veterans Affairs, 
                and Related Agencies of the Committee on Appropriations 
                of the House of Representatives.
SEC. 702. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES OF 
                        DEPARTMENT OF VETERANS AFFAIRS FOR FISCAL 
                        YEAR 2023.

    (a) <<NOTE: State listing.>>  In General.--The Secretary of Veterans 
Affairs may carry out the following major medical facility leases in 
fiscal year 2023:
            (1) Lease for an outpatient clinic in the vicinity of 
        Allentown, Pennsylvania, in an estimated amount of $31,832,000.
            (2) Lease for a facility for member services for the 
        Veterans Health Administration in the vicinity of Atlanta, 
        Georgia, in an estimated amount of $27,134,000.
            (3) Lease for an outpatient clinic in the vicinity of 
        Baltimore, Maryland, in an estimated amount of $43,041,000.
            (4) Lease for an outpatient clinic in the vicinity of Baton 
        Rouge, Louisiana, in an estimated amount of $29,550,000.

[[Page 136 STAT. 1796]]

            (5) Lease for an outpatient clinic in the vicinity of 
        Beaufort, South Carolina, in an estimated amount of $24,254,000.
            (6) Lease for an outpatient clinic in the vicinity of 
        Beaumont, Texas, in an estimated amount of $15,632,000.
            (7) Lease for an outpatient clinic in the vicinity of 
        Brainerd, Minnesota, in an estimated amount of $14,669,000.
            (8) Lease for a facility for research in the vicinity of 
        Buffalo, New York, in an estimated amount of $11,106,000.
            (9) Lease for an outpatient clinic in the vicinity of 
        Clarksville, Tennessee, in an estimated amount of $75,135,000.
            (10) Lease of a facility for research in the vicinity of 
        Columbia, Missouri, in an estimated amount of $20,726,000.
            (11) Lease for an outpatient clinic in the vicinity of 
        Cookeville, Tennessee, in an estimated amount of $10,958,000.
            (12) Lease for a residential treatment facility in the 
        vicinity of Denver, Colorado, in an estimated amount of 
        $9,133,000.
            (13) Lease for an outpatient clinic in the vicinity of 
        Elizabethtown, Kentucky, in an estimated amount of $16,671,000.
            (14) Lease for an outpatient clinic in the vicinity of 
        Farmington, Missouri, in an estimated amount of $17,940,000.
            (15) Lease for an outpatient clinic in the vicinity of 
        Hampton, Virginia, in an estimated amount of $63,085,000.
            (16) Lease for an outpatient clinic in the vicinity of 
        Jacksonville, North Carolina, in an estimated amount of 
        $61,450,000.
            (17) Lease for an outpatient clinic in the vicinity of 
        Killeen, Texas, in an estimated amount of $61,030,000.
            (18) Lease for an outpatient clinic in the vicinity of 
        Lawrence, Indiana, in an estimated amount of $15,811,000.
            (19) Lease for an outpatient clinic in the vicinity of 
        Lecanto, Florida, in an estimated amount of $15,373,000.
            (20) Lease for an outpatient clinic in the vicinity of 
        Nashville, Tennessee, in an estimated amount of $58,038,000.
            (21) Lease for an outpatient clinic in the vicinity of North 
        Kansas City, Missouri, in an estimated amount of $40,027,000.
            (22) Lease for an outpatient clinic in the vicinity of 
        Pflugerville, Texas, in an estimated amount of $16,654,000.
            (23) Lease for an outpatient clinic in the vicinity of 
        Plano, Texas, in an estimated amount of $32,796,000.
            (24) Lease for an outpatient clinic in the vicinity of 
        Prince George's County, Maryland, in an estimated amount of 
        $31,754,000.
            (25) Lease for an outpatient clinic in the vicinity of 
        Rolla, Missouri, in an estimated amount of $21,352,000.
            (26) Lease for an outpatient clinic in the vicinity of Salt 
        Lake City, Utah, in an estimated amount of $29,466,000.
            (27) Lease for an outpatient clinic in the vicinity of 
        Sarasota, Florida, in an estimated amount of $36,517,000.
            (28) Lease for an outpatient clinic in the vicinity of 
        Springfield, Massachusetts, in an estimated amount of 
        $30,918,000.
            (29) Lease for a community living center in the vicinity of 
        Tampa, Florida, in an estimated amount of $51,682,000.
            (30) Lease for an outpatient clinic in the vicinity of The 
        Villages, Florida, in an estimated amount of $48,267,000.
            (31) Lease for an outpatient clinic in the vicinity of Tri-
        Cities, Washington, in an estimated amount of $36,136,000.

[[Page 136 STAT. 1797]]

    (b) Treatment of <<NOTE: Effective date.>> Authorizations.--The 
authorization of leases under subsection (a) shall be considered to be a 
specific authorization by law of the funds for such leases for purposes 
of section 8104(a)(2) of title 38, United States Code, as in effect on 
the day before the date of the enactment of this Act.

    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs for fiscal year 2023, 
or the year in which funds are appropriated for the Medical Facilities 
account, $998,137,000 for the leases authorized in subsection (a).
SEC. 703. TREATMENT OF MAJOR MEDICAL FACILITY LEASES OF THE 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) Congressional Approval of Major Medical Facility Leases.--
Paragraph (2) of subsection (a) of section 8104 of title 38, United 
States Code, is amended--
            (1) by striking ``No funds'' and inserting ``(A) No funds'';
            (2) by striking ``or any major medical facility lease'';
            (3) by striking ``or lease''; and
            (4) by adding at the end the following new subparagraph:
            ``(B) No funds may be appropriated for any fiscal year, and 
        the Secretary may not obligate or expend funds (other than for 
        advance planning and design), for any major medical facility 
        lease unless the Committee on Veterans' Affairs of the Senate 
        and the Committee on Veterans' Affairs of the House of 
        Representatives each adopt a resolution approving the lease.''.

    (b) Modification of Definition of Major Medical Facility Lease.--
Subparagraph (B) of paragraph (3) of such subsection is amended to read 
as follows:
            ``(B) The term `major medical facility lease'--
                    ``(i) means a lease for space for use as a new 
                medical facility approved through the General Services 
                Administration under section 3307(a) of title 40 at an 
                average annual rent equal to or greater than the 
                appropriate dollar threshold described in such section, 
                which shall be subject to annual adjustment in 
                accordance with section 3307(h) of such title; and
                    ``(ii) does not include a lease for space for use as 
                a shared Federal medical facility for which the 
                Department's estimated share of the lease costs does not 
                exceed such dollar threshold.''.

    (c) Separate Prospectus Requirement for Major Medical Facility 
Leases.--Subsection (b) of such section is amended--
            (1) by striking paragraph (7);
            (2) in paragraph (1), by redesignating subparagraphs (A) 
        through (E) as clauses (i) through (v), respectively;
            (3) in paragraph (6), by redesignating subparagraphs (A) 
        through (C) as clauses (i) through (iii), respectively;
            (4) by redesignating paragraphs (1) through (6) as 
        subparagraphs (A) through (F), respectively;
            (5) in the matter preceding subparagraph (A), as 
        redesignated by paragraph (4)--
                    (A) by striking ``Whenever the President'' and 
                inserting ``(1) Whenever the President'';
                    (B) by striking ``the Congress'' and inserting 
                ``Congress''; and

[[Page 136 STAT. 1798]]

                    (C) by striking ``or a major medical facility lease 
                (as defined in subsection (a)(3)(b))'';
            (6) in subparagraph (A), as redesignated by paragraph (4), 
        by striking ``leased,'';
            (7) in subparagraph (E), as redesignated by paragraph (4)--
                    (A) by striking ``or lease'' each place it appears; 
                and
                    (B) by striking ``or leases''; and
            (8) by adding at the end the following new paragraph:

    ``(2) Whenever the President or the Secretary submit to Congress a 
request for the funding of a major medical facility lease (as defined in 
subsection (a)(3)(B)), the Secretary shall submit to each committee, on 
the same day, a prospectus of the proposed medical facility. Any such 
prospectus shall include the following:
            ``(A) A description of the facility to be leased.
            ``(B) <<NOTE: Cost estimate.>>  An estimate of the cost to 
        the Federal Government of the facility to be leased.
            ``(C) <<NOTE: Estimate.>>  An estimate of the energy 
        performance of the proposed lease space, to include a 
        description of anticipated utilization of renewable energy, 
        energy efficient and climate resilient elements, and related 
        matters.
            ``(D) <<NOTE: Data. Time periods.>>  Current and projected 
        workload and utilization data regarding the facility to be 
        leased, including information on projected changes in workload 
        and utilization over a five-year period, a ten-year period, and 
        a twenty-year period.
            ``(E) <<NOTE: Analyses. Compliance.>>  A detailed analysis 
        of how the lease is expected to comply with Office of Management 
        and Budget Circular A-11 and section 1341 of title 31 (commonly 
        referred to as the `Anti-Deficiency Act'). Any such analysis 
        shall include--
                    ``(i) an analysis of the classification of the lease 
                as a `lease purchase', a `capital lease', or an 
                `operating lease' as those terms are defined in Office 
                of Management and Budget Circular A-11;
                    ``(ii) an analysis of the obligation of budgetary 
                resources associated with the lease; and
                    ``(iii) an analysis of the methodology used in 
                determining the asset cost, fair market value, and 
                cancellation costs of the lease.''.

    (d) Interim Leasing Actions.--Such section is further amended by 
adding at the end the following new subsection:
    ``(i)(1) Notwithstanding subsection (a)(2)(B), the Secretary may 
carry out interim leasing actions as the Secretary considers necessary 
for the following leases:
            ``(A) Major medical facility leases (as defined in 
        subsection (a)(3)(B)) approved pursuant to this section and for 
        which a prospectus for a replacement lease has been submitted to 
        Congress pursuant to subsection (b)(2).
            ``(B) Replacement leases that do not require approval under 
        this section and for which a prospectus has been submitted to 
        Congress pursuant to subsection (b)(2).

    ``(2) <<NOTE: Definition.>>  In this subsection, the term `interim 
leasing actions' has the meaning given that term by the Administrator of 
the General Services Administration.''.

    (e) Purchase Options.--Such section is further amended by adding at 
the end the following new subsection:

[[Page 136 STAT. 1799]]

    ``(j) The Secretary may obligate and expend funds to exercise a 
purchase option included in any major medical facility lease (as defined 
in subsection (a)(3)(B)).''.
    (f) <<NOTE: 38 USC 8104 note.>>  Applicability.--The amendments made 
by this section shall apply with respect to any lease that has not been 
specifically authorized by law on or before the date of the enactment of 
this Act.
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.

    Section 8103 of title 38, United States Code, is amended by adding 
at the end the following new subsection:
    ``(h)(1) <<NOTE: Determination.>>  Notwithstanding any other 
provision of law requiring the use of competitive procedures, including 
section 2304 of title 10, when the Secretary determines it to be in the 
best interest of the Department, the Secretary may enter into a lease 
with an academic affiliate or covered entity to acquire space for the 
purpose of providing health-care resources to veterans.

    ``(2) <<NOTE: Definitions.>>  In this subsection:
            ``(A) The term `academic affiliate' means an institution or 
        organization described in section 7302(d) of this title.
            ``(B) The term `covered entity' means a unit or subdivision 
        of a State, local, or municipal government, public or nonprofit 
        agency, institution, or organization, or other institution or 
        organization as the Secretary considers appropriate that owns 
        property controlled by an academic affiliate to be leased under 
        this subsection.
            ``(C) The term `health -care resource' has the meaning given 
        that term in section 8152(1) of this title.
            ``(D) The term `space' means any room, unit, floor, wing, 
        building, parking facility, or other subdivision of a building 
        or facility owned or controlled by an academic affiliate.''.
SEC. 705. MODIFICATIONS TO ENHANCED-USE LEASE AUTHORITY OF 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) Modifications to Authority.--Paragraph (2) of section 8162(a) of 
title 38, United States Code, is amended to read as follows:
    ``(2)(A) <<NOTE: Determination.>>  The Secretary may enter into an 
enhanced-use lease on or after the date of the enactment of this 
paragraph only if the Secretary determines--
            ``(i) that the lease will not be inconsistent with, and will 
        not adversely affect--
                    ``(I) the mission of the Department; or
                    ``(II) the operation of facilities, programs, and 
                services of the Department in the area of the leased 
                property; and
            ``(ii) that--
                    ``(I) the lease will enhance the use of the leased 
                property by directly or indirectly benefitting veterans; 
                or
                    ``(II) the leased property will provide supportive 
                housing.

    ``(B) The Secretary shall give priority to enhanced-use leases that, 
on the leased property--
            ``(i) provide supportive housing for veterans;

[[Page 136 STAT. 1800]]

            ``(ii) provide direct services or benefits targeted to 
        veterans; or
            ``(iii) provide services or benefits that indirectly support 
        veterans.''.

    (b) Extension of Maximum Term of Enhanced-use Lease.--Section 
8162(b)(2) of such title <<NOTE: 38 USC 8162.>>  is amended by striking 
``75 years'' and inserting ``99 years''.

    (c) Modification of Use of Proceeds.--Section 8165(a)(1) of such 
title is amended by striking ``shall be deposited in the Department of 
Veterans Affairs Medical Care Collections Fund established under section 
1729A of this title.'' and inserting ``shall, at the discretion of the 
Secretary, be deposited in--
            ``(A) the Department of Veterans Affairs Medical Care 
        Collections Fund established under section 1729A of this title; 
        or
            ``(B) the Medical Facilities or Construction, Minor Projects 
        account of the Department to be used to defray the costs of 
        administration, maintenance, repair, and related expenses 
        incurred by the Department with respect to property that is 
        owned by or under the jurisdiction or control of the 
        Department.''.

    (d) <<NOTE: 38 USC 8101 prec.>>  Repeal of Sunset.--Section 8169 of 
such title is repealed.

    (e) Appropriation.--In addition to amounts otherwise available, 
there is appropriated for fiscal year 2022, out of any funds in the 
Treasury not otherwise appropriated, $922,000,000 for an additional 
amount for the Department of Veterans Affairs, to remain available until 
expended, to enter into enhanced-use leases pursuant to section 8162 of 
title 38, United States Code, as amended by this section.
SEC. 706. AUTHORITY FOR JOINT LEASING ACTIONS OF DEPARTMENT OF 
                        DEFENSE AND DEPARTMENT OF VETERANS 
                        AFFAIRS.

    (a) Department of Defense.--Section 1104A of title 10, United States 
Code, is amended--
            (1) by inserting ``, or the leasing,'' after ``design, and 
        construction'' each place it appears; and
            (2) in subsection (c)(2), by inserting ``, or the leasing,'' 
        after ``design''.

    (b) Department of Veterans Affairs.--Section 8111B of title 38, 
United States Code, is amended--
            (1) in subsection (a), by inserting ``, or the leasing,'' 
        after ``design, and construction'';
            (2) in subsection (b), by adding at the end the following 
        new paragraph:

    ``(3) <<NOTE: Transfer authority.>>  The Secretary of Veterans 
Affairs may transfer to the Department of Defense amounts appropriated 
to the `Medical Facilities' account of the Department of Veterans 
Affairs for the purpose of leasing space for a shared medical facility 
if the estimated share of the Department of Veterans Affairs for the 
lease costs does not exceed the amount specified in section 
8104(a)(3)(B) of this title.''; and
            (3) in subsection (c), by adding at the end the following 
        new paragraph:

    ``(3) Any amount transferred to the Secretary of Veterans Affairs by 
the Secretary of Defense for the purpose of leasing space for a shared 
medical facility may be credited to the `Medical Facilities'

[[Page 136 STAT. 1801]]

account of the Department of Veterans Affairs and may be used for such 
purpose.''.
SEC. 707. APPROPRIATION OF AMOUNTS FOR MAJOR MEDICAL FACILITY 
                        LEASES.

    (a) Fiscal Year 2023.--In addition to amounts otherwise available, 
there is appropriated for fiscal year 2023, out of any funds in the 
Treasury not otherwise appropriated, $1,880,000,000 for an additional 
amount for the Medical Facilities account of the Department of Veterans 
Affairs, to remain available until expended, for major medical facility 
leases authorized by section 702.
    (b) Additional Years.--In addition to amounts otherwise available, 
there is appropriated, out of any funds in the Treasury not otherwise 
appropriated, for an additional amount for the Medical Facilities 
account of the Department of Veterans Affairs, to remain available until 
expended, for major medical facility leases authorized by section 702 or 
approved pursuant to subchapter I of chapter 81 of title 38, United 
States Code, as amended by section 703--
            (1) $100,000,000 for fiscal year 2024;
            (2) $200,000,000 for fiscal year 2025;
            (3) $400,000,000 for fiscal year 2026;
            (4) $450,000,000 for fiscal year 2027;
            (5) $600,000,000 for fiscal year 2028;
            (6) $610,000,000 for fiscal year 2029;
            (7) $620,000,000 for fiscal year 2030; and
            (8) $650,000,000 for fiscal year 2031.

                  TITLE VIII--RECORDS AND OTHER MATTERS

SEC. 801. EPIDEMIOLOGICAL STUDY ON FORT MCCLELLAN VETERANS.

    The <<NOTE: Time period.>>  Secretary of Veterans Affairs shall 
conduct an epidemiological study on the health trends of veterans who 
served in the Armed Forces at Fort McClellan at any time during the 
period beginning January 1, 1935, and ending on May 20, 1999.
SEC. 802. <<NOTE: 10 USC 1071 note.>>  BIENNIAL BRIEFING ON 
                        INDIVIDUAL LONGITUDINAL EXPOSURE RECORD.

    (a) <<NOTE: Deadline. Determination. Consultation.>>  In General.--
Not later than one year after the date on which the Individual 
Longitudinal Exposure Record achieves full operational capability, as 
determined by the Secretary of Defense, and every two years thereafter, 
the Secretary of Defense, in consultation with the Secretary of Veterans 
Affairs, shall provide the appropriate committees of Congress a briefing 
on--
            (1) the quality of the databases of the Department of 
        Defense that provide the information presented in such 
        Individual Longitudinal Exposure Record; and
            (2) the usefulness of such Individual Longitudinal Exposure 
        Record or system in supporting members of the Armed Forces and 
        veterans in receiving health care and benefits from the 
        Department of Defense and the Department of Veterans Affairs.

    (b) <<NOTE: Recommenda- tions.>>  Elements.--Each briefing required 
by subsection (a) shall include, for the period covered by the report, 
the following:
            (1) An identification of potential exposures to occupational 
        or environmental hazards captured by the current systems of the 
        Department of Defense for environmental, occupational,

[[Page 136 STAT. 1802]]

        and health monitoring, and recommendations for how to improve 
        those systems.
            (2) <<NOTE: Analysis. Determination.>>  An analysis of the 
        quality and accuracy of the location data used by the Department 
        of Defense in determining potential exposures to occupational or 
        environmental hazards by members of the Armed Forces and 
        veterans, and recommendations for how to improve the quality of 
        such data if necessary.

    (c) Definitions.--In this section:
            (1) Appropriate committees of congress.--The term 
        ``appropriate committees of Congress'' means--
                    (A) the Committee on Armed Services and the 
                Committee on Veterans' Affairs of the Senate; and
                    (B) the Committee on Armed Services and the 
                Committee on Veterans' Affairs of the House of 
                Representatives.
            (2) Individual longitudinal exposure record.--The term 
        ``Individual Longitudinal Exposure Record'' has the meaning 
        given such term in section 1171 of title 38, United States Code, 
        as added by section 202.
SEC. 803. <<NOTE: 38 USC 1171 note.>>  CORRECTION OF EXPOSURE 
                        RECORDS BY MEMBERS OF THE ARMED FORCES AND 
                        VETERANS.

    (a) <<NOTE: Coordination. Update.>>  In General.--The Secretary of 
Veterans Affairs shall coordinate with the Secretary of Defense to 
provide a means for veterans to update their records as necessary to 
reflect exposures to occupational or environmental hazards by such 
member or veteran in the Individual Longitudinal Exposure Record.

    (b) Evidence.--
            (1) Provision of evidence.--To update a record under 
        subsection (a), a veteran shall provide such evidence as the 
        Secretary of Veterans Affairs considers necessary.
            (2) Regulations.--The Secretary of Veterans Affairs shall 
        prescribe by regulation the evidence considered necessary under 
        paragraph (1).

    (c) Definitions.--In this section:
            (1) Individual longitudinal exposure record.--The term 
        ``Individual Longitudinal Exposure Record'' has the meaning 
        given such term in section 1171 of title 38, United States Code, 
        as added by section 202.
            (2) Toxic exposure.--The term ``toxic exposure'' has the 
        meaning given such term in section 101 of title 38, United 
        States Code, as amended by section 102(b).
SEC. 804. <<NOTE: Camp Lejeune Justice Act of 2022. 28 USC 2671 
                        note prec.>>  FEDERAL CAUSE OF ACTION 
                        RELATING TO WATER AT CAMP LEJEUNE, NORTH 
                        CAROLINA.

    (a) Short Title.--This section may be cited as the ``Camp Lejeune 
Justice Act of 2022''.
    (b) <<NOTE: Time periods.>>  In General.--An individual, including a 
veteran (as defined in section 101 of title 38, United States Code), or 
the legal representative of such an individual, who resided, worked, or 
was otherwise exposed (including in utero exposure) for not less than 30 
days during the period beginning on August 1, 1953, and ending on 
December 31, 1987, to water at Camp Lejeune, North Carolina, that was 
supplied by, or on behalf of, the United States may bring an action in 
the United States District Court for the Eastern District of North 
Carolina to obtain appropriate relief for harm that was caused by 
exposure to the water at Camp Lejeune.

    (c) Burdens and Standard of Proof.--

[[Page 136 STAT. 1803]]

            (1) In general.--The burden of proof shall be on the party 
        filing the action to show one or more relationships between the 
        water at Camp Lejeune and the harm.
            (2) Standards.--To meet the burden of proof described in 
        paragraph (1), a party shall produce evidence showing that the 
        relationship between exposure to the water at Camp Lejeune and 
        the harm is--
                    (A) sufficient to conclude that a causal 
                relationship exists; or
                    (B) sufficient to conclude that a causal 
                relationship is at least as likely as not.

    (d) Exclusive Jurisdiction and Venue.--The United States District 
Court for the Eastern District of North Carolina shall have exclusive 
jurisdiction over any action filed under subsection (b), and shall be 
the exclusive venue for such an action. Nothing in this subsection shall 
impair the right of any party to a trial by jury.
    (e) Exclusive Remedy.--
            (1) In general.--An individual, or legal representative of 
        an individual, who brings an action under this section for a 
        harm described in subsection (b), including a latent disease, 
        may not thereafter bring a tort action against the United States 
        for such harm pursuant to any other law.
            (2) Health and disability benefits relating to water 
        exposure.--Any award made to an individual, or legal 
        representative of an individual, under this section shall be 
        offset by the amount of any disability award, payment, or 
        benefit provided to the individual, or legal representative--
                    (A) under--
                          (i) any program under the laws administered by 
                      the Secretary of Veterans Affairs;
                          (ii) the Medicare program under title XVIII of 
                      the Social Security Act (42 U.S.C. 1395 et seq.); 
                      or
                          (iii) the Medicaid program under title XIX of 
                      the Social Security Act (42 U.S.C. 1396 et seq.); 
                      and
                    (B) in connection with health care or a disability 
                relating to exposure to the water at Camp Lejeune.

    (f) Immunity Limitation.--The United States may not assert any claim 
to immunity in an action under this section that would otherwise be 
available under section 2680(a) of title 28, United States Code.
    (g) No Punitive Damages.--Punitive damages may not be awarded in any 
action under this section.
    (h) <<NOTE: Compliance.>>  Disposition by Federal Agency Required.--
An individual may not bring an action under this section before 
complying with section 2675 of title 28, United States Code.

    (i) Exception for Combatant Activities.--This section does not apply 
to any claim or action arising out of the combatant activities of the 
Armed Forces.
    (j) <<NOTE: Claims.>>  Applicability; Period for Filing.--
            (1) Applicability.--This section shall apply only to a claim 
        accruing before the date of enactment of this Act.
            (2) Statute of limitations.--A claim in an action under this 
        section may not be commenced after the later of--
                    (A) the date that is two years after the date of 
                enactment of this Act; or

[[Page 136 STAT. 1804]]

                    (B) the date that is 180 days after the date on 
                which the claim is denied under section 2675 of title 
                28, United States Code.
            (3) Inapplicability of other limitations.--Any applicable 
        statute of repose or statute of limitations, other than under 
        paragraph (2), shall not apply to a claim under this section.
SEC. 805. COST OF WAR TOXIC EXPOSURES FUND.

    (a) In General.--Chapter 3 <<NOTE: 38 USC 301 prec.>>  is amended by 
adding at the end the following new section:
``Sec. 324. <<NOTE: 38 USC 324.>> Cost of War Toxic Exposures Fund

    ``(a) Establishment.--There is hereby established in the Treasury of 
the United States an account to be known as the `Cost of War Toxic 
Exposures Fund' (the `Fund'), to be administered by the Secretary.
    ``(b) Deposits.--There shall be deposited in the Fund such amounts 
as may be appropriated to the Fund pursuant to subsection (c).
    ``(c) <<NOTE: Time periods.>>  Authorization of Appropriations.--
There is authorized to be appropriated to the Fund for fiscal year 2023 
and each subsequent fiscal year such sums as are necessary to increase 
funding, over the fiscal year 2021 level, for investment in--
            ``(1) the delivery of veterans' health care associated with 
        exposure to environmental hazards in the active military, naval, 
        air, or space service in programs administered by the Under 
        Secretary for Health;
            ``(2) any expenses incident to the delivery of veterans' 
        health care and benefits associated with exposure to 
        environmental hazards in the active military, naval, air, or 
        space service, including administrative expenses, such as 
        information technology and claims processing and appeals, and 
        excluding leases as authorized or approved under section 8104 of 
        this title; and
            ``(3) medical and other research relating to exposure to 
        environmental hazards.

    ``(d) <<NOTE: Estimates. Time periods.>>  Budget Scorekeeping.--(1) 
Immediately upon enactment of the Sergeant First Class Heath Robinson 
Honoring our Promise to Address Comprehensive Toxics Act of 2022, 
expenses authorized to be appropriated to the Fund in subsection (c) 
shall be estimated for fiscal year 2023 and each subsequent fiscal year 
and treated as budget authority that is considered to be direct 
spending--
            ``(A) in the baseline for purposes of section 257 of the 
        Balanced Budget and Emergency Deficit Control Act of 1985 (2 
        U.S.C. 907);
            ``(B) by the Chairman of the Committee on the Budget of the 
        Senate and the Chair of the Committee on the Budget of the House 
        of Representatives, as appropriate, for purposes of budget 
        enforcement in the Senate and the House of Representatives;
            ``(C) under the Congressional Budget Act of 1974 (2 U.S.C. 
        621 et seq.), including in the reports required by section 
        308(b) of such Act (2 U.S.C. 639); and
            ``(D) for purposes of the Statutory Pay-As-You-Go Act of 
        2010 (2 U.S.C. 931 et seq.).

[[Page 136 STAT. 1805]]

    ``(2) No amount appropriated to the Fund in fiscal year 2023 or any 
subsequent fiscal year pursuant to this section shall be counted as 
discretionary budget authority and outlays or as direct spending for any 
estimate of an appropriation Act under the Congressional Budget and 
Impoundment Control Act of 1974 (2 U.S.C. 621 et seq.) and any other 
Act.
    ``(3) Notwithstanding the Budget Scorekeeping Guidelines and the 
accompanying list of programs and accounts set forth in the joint 
explanatory statement of the committee of conference accompanying 
Conference Report 105-217, and for purposes of the Balanced Budget and 
Emergency Deficit Control Act of 1985 (2 U.S.C. 900 et seq.) and the 
Congressional Budget Act of 1974 (2 U.S.C. 621 et seq.), the Fund shall 
be treated as if it were an account designated as `Appropriated 
Entitlements and Mandatories for Fiscal Year 1997' in the joint 
explanatory statement of the committee of conference accompanying 
Conference Report 105-217.
    ``(e) Estimates for Congressional Consideration.--The Secretary 
shall include in documents submitted to Congress in support of the 
President's budget submitted pursuant to section 1105 of title 31 
detailed estimates of the sums described in subsection (c) for the 
applicable fiscal year.
    ``(f) <<NOTE: Consultation.>>  Procedures for Estimates.--The 
Secretary may, after consultation with the Committee on Appropriations 
of the Senate and the Committee on Appropriations of the House of 
Representatives, establish policies and procedures for developing the 
annual detailed estimates required by subsection (e).''.

    (b) Sequestration.--Section 256(h)(4) of the Balanced Budget and 
Emergency Deficit Control Act of 1985 (2 U.S.C. 906(h)(4)) is amended by 
adding at the end the following new subparagraph:
                    ``(G) Cost of War Toxic Exposures Fund.''.
SEC. 806. APPROPRIATION FOR FISCAL YEAR 2022.

    (a) Appropriation.--In addition to amounts otherwise available, 
there is appropriated for fiscal year 2022, out of any funds in the 
Treasury not otherwise appropriated, $500,000,000 for the Cost of War 
Toxic Exposures Fund, established by section 324 of title 38, United 
States Code, as added by section 805 of this Act, to remain available 
until September 30, 2024.
    (b) <<NOTE: Deadline.>>  Spend Plan.--Not later than 30 days after 
enactment of this Act, the Secretary of Veterans Affairs shall submit a 
plan for expending amounts made available by subsection (a) by program, 
project or activity to the Committee on Appropriations of the Senate and 
the Committee on Appropriations of the House of 
Representatives. <<NOTE: Time period.>>  Funds may not be obligated 
until such Committees issue an approval, or absent a response, a period 
of 30 days has elapsed.
SEC. 807. AUTHORIZATION OF ELECTRONIC NOTICE IN CLAIMS UNDER LAWS 
                        ADMINISTERED BY THE SECRETARY OF VETERANS 
                        AFFAIRS.

    (a) In General.--Title 38, United States Code, is amended as 
follows:
            (1) By striking section 5100 <<NOTE: 38 USC 5100 prec., 
        5100.>>  and inserting the following:
``Sec. 5100. <<NOTE: 38 USC 5100.>> Definitions

    ``In this chapter:
            ``(1) The term `claimant' means any individual applying for, 
        or submitting a claim for, any benefit under the laws 
        administered by the Secretary.

[[Page 136 STAT. 1806]]

            ``(2) The term `notice' means a communication issued through 
        means (including electronic means) prescribed by the 
        Secretary.''.
            (2) In section 5104, <<NOTE: 38 USC 5104.>>  by adding at 
        the end the following new subsection:

    ``(c) The Secretary may provide notice under subsection (a) 
electronically if a claimant (or the claimant's representative) elects 
to receive such notice electronically. A claimant (or the claimant's 
representative) may revoke such an election at any time, by means 
prescribed by the Secretary.
    ``(d) <<NOTE: Time period.>>  The Secretary shall annually--
            ``(1) <<NOTE: Recommenda- tions.>>  solicit recommendations 
        from stakeholders on how to improve notice under this section; 
        and
            ``(2) <<NOTE: Public information. Web posting.>>  publish 
        such recommendations on a publicly available website of the 
        Department.''.
            (3) In section 5104B(c), in the matter preceding paragraph 
        (1) by striking ``in writing'' and inserting ``to the claimant 
        (and any representative of such claimant)''.
            (4) In section 5112(b)(6), by striking ``(at the payee's 
        last address of record)''.
            (5) In section 7104--
                    (A) <<NOTE: 38 USC 7101 prec., 7104.>>  in the 
                heading, by adding ``; decisions; notice'' at the end; 
                and
                    (B) <<NOTE: 38 USC 7104.>>  by striking subsection 
                (e) and inserting the following:

    ``(e) After reaching a decision on an appeal, the Board shall 
promptly issue notice (as that term is defined in section 5100 of this 
title) of such decision to the following:
            ``(1) The appellant.
            ``(2) Any other party with a right to notice of such 
        decision.
            ``(3) Any authorized representative of the appellant or 
        party described in paragraph (2).

    ``(f)(1) The Secretary may provide notice under subsection (e) 
electronically if a claimant (or the claimant's representative) elects 
to receive such notice electronically.
    ``(2) A claimant (or the claimant's representative) may revoke such 
an election at any time, by means prescribed by the Secretary.''.
            (6) In section 7105(b)(1)(A), by striking ``mailing'' and 
        inserting ``issuance''.
            (7) In section 7105A(a), by striking ``mailed'' and 
        inserting ``issued''.
            (8) In section 7266(a), by striking ``mailed'' and inserting 
        ``issued''.

    (b) <<NOTE: 38 USC 5100 note.>>  Rule of Construction.--None of the 
amendments made by this section shall be construed to apply section 
5104(a) of such title to decisions of the Board of Veterans' Appeals 
under chapter 71 of such title.
SEC. 808. <<NOTE: 38 USC 527 note.>> BURN PIT TRANSPARENCY.

    (a) Annual Report on Disability Claims.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, and annually thereafter, the 
        Secretary of Veterans Affairs shall submit to the appropriate 
        congressional committees a report detailing the following:
                    (A) The total number of covered veterans.

[[Page 136 STAT. 1807]]

                    (B) The total number of claimed issues for 
                disability compensation under chapter 11 of title 38, 
                United States Code, approved and the total number denied 
                by the Secretary of Veterans Affairs with respect to a 
                covered veteran, and a breakdown of the reasons for the 
                denials.
                    (C) <<NOTE: List.>>  A comprehensive list of the top 
                10 conditions from each body system for which the 
                Secretary awarded service connection for covered 
                veterans.
                    (D) <<NOTE: Updates.>>  Any updates or trends with 
                respect to the information described in subparagraphs 
                (A), (B), and (C), that the Secretary determines 
                appropriate.
            (2) <<NOTE: Time periods.>>  Covered veteran defined.--In 
        this subsection, the term ``covered veteran'' means a veteran 
        who deployed to the Southwest Asia theater of operations any 
        time after August 1990, or Afghanistan, Syria, Djibouti, or 
        Uzbekistan after September 19, 2001, and who submits a claim for 
        disability compensation under chapter 11 of title 38, United 
        States Code.

    (b) Information Regarding the Airborne Hazards and Open Burn Pit 
Registry.--
            (1) Notice.--The Secretary of Veterans Affairs shall ensure 
        that a medical professional of the Department of Veterans 
        Affairs informs a veteran of the Airborne Hazards and Open Burn 
        Pit Registry if the veteran presents at a medical facility of 
        the Department for treatment that the veteran describes as being 
        related to, or ancillary to, the exposure of the veteran to 
        toxic airborne chemicals and fumes caused by open burn pits.
            (2) Display.--In making information public regarding the 
        number of participants in the Airborne Hazards and Open Burn Pit 
        Registry, the Secretary shall display such numbers by both State 
        and by congressional district.

    (c) Definitions.--In this section:
            (1) Airborne hazards and open burn pit registry.--The term 
        ``Airborne Hazards and Open Burn Pit Registry'' means the 
        registry established by the Secretary of Veterans Affairs under 
        section 201 of the Dignified Burial and Other Veterans' Benefits 
        Improvement Act of 2012 (Public Law 112-260; 38 U.S.C. 527 
        note).
            (2) Appropriate congressional committees.--The term 
        ``appropriate congressional committees'' means--
                    (A) the Committee on Veterans' Affairs and the 
                Committee on Armed Services of the Senate; and
                    (B) The Committee on Veterans' Affairs and the 
                Committee on Armed Services of the House of 
                Representatives.
            (3) Open burn pit.--The term ``open burn pit'' has the 
        meaning given that term in section 201(c) of the Dignified 
        Burial and Other Veterans' Benefits Improvement Act of 2012 
        (Public Law 112-260; 38 U.S.C. 527 note).

[[Page 136 STAT. 1808]]

  TITLE IX--IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS

SEC. 901. <<NOTE: 38 USC 7401 note.>> NATIONAL RURAL RECRUITMENT 
                        AND HIRING PLAN FOR VETERANS HEALTH 
                        ADMINISTRATION.

    (a) <<NOTE: Deadline.>>  In General.--Not later than 18 months after 
the date of the enactment of this Act, the Secretary of Veterans 
Affairs, in collaboration with the directors of each community-based 
outpatient clinic and medical center of the Department of Veterans 
Affairs, shall develop and implement a national rural recruitment and 
hiring plan for the Veterans Health Administration to--
            (1) recruit health care professionals for rural and highly 
        rural community-based outpatient clinics and rural and highly 
        rural medical centers of the Department;
            (2) <<NOTE: Determination.>>  determine which such clinics 
        or centers have a staffing shortage of health care 
        professionals;
            (3) develop best practices and techniques for recruiting 
        health care professionals for such clinics and centers;
            (4) <<NOTE: Time period.>>  not less frequently than 
        annually, provide virtually based, on-demand training to human 
        resources professionals of the Veterans Health Administration on 
        the best practices and techniques developed under paragraph (3); 
        and
            (5) provide recruitment resources, such as pamphlets and 
        marketing material to--
                    (A) Veterans Integrated Service Networks of the 
                Department;
                    (B) rural and highly rural community-based 
                outpatient clinics of the Department; and
                    (C) rural and highly rural medical centers of the 
                Department.

    (b) Annual Report.--Not later than 18 months after the date of the 
enactment of this Act, and annually thereafter, the Secretary shall 
submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
that includes--
            (1) <<NOTE: Plan.>>  the plan developed and implemented 
        under subsection (a); and
            (2) <<NOTE: Assessment.>>  an assessment of the outcomes 
        related to recruitment and retention of employees of the 
        Veterans Health Administration at rural and highly rural 
        facilities of the Department.

    (c) Definitions.--In this section, the terms ``rural'' and ``highly 
rural'' have the meanings given those terms under the rural-urban 
commuting areas coding system of the Department of Agriculture.
SEC. 902. <<NOTE: 38 USC 7401 note.>> 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.

    (a) In General.--For any covered health care professional to whom 
the Secretary of Veterans Affairs has offered employment with the 
Department of Veterans Affairs, the Secretary may buy out the non-
Department service contract of such individual in exchange for such 
individual agreeing to be employed at a rural

[[Page 136 STAT. 1809]]

or highly rural facility of the Department for a period of obligated 
service specified in subsection (c).
    (b) Payment of Amounts.--
            (1) In general.--Payment of any amounts for a buy out of a 
        service contract for a covered health care professional under 
        subsection (a) shall be made directly to the individual or 
        entity with respect to which the covered health care 
        professional has a service obligation under such contract.
            (2) Limitation on total amount.--The total amount paid by 
        the Department under this section shall not exceed $40,000,000 
        per fiscal year.

    (c) <<NOTE: Time period.>>  Obligated Service.--In exchange for a 
contract buy out under subsection (a), a covered health care 
professional shall agree to be employed for not less than four years at 
a rural or highly rural facility of the Department.

    (d) Liability.--
            (1) In general.--Except as provided in paragraph (2), if a 
        covered health care professional fails for any reason to 
        complete the period of obligated service of the individual under 
        subsection (c), the United States shall be entitled to recover 
        from the individual an amount equal to--
                    (A) the total amount paid under subsection (a) to 
                buy out the non-Department service contract of the 
                individual; multiplied by
                    (B) a fraction--
                          (i) the numerator of which is--
                                    (I) the total number of months in 
                                the period of obligated service of the 
                                individual; minus
                                    (II) the number of months served by 
                                the individual; and
                          (ii) the denominator of which is the total 
                      number of months in the period of obligated 
                      service of the individual.
            (2) Exception.--Liability shall not arise under paragraph 
        (1) in the case of an individual covered by that paragraph if 
        the individual does not obtain, or fails to maintain, employment 
        as an employee of the Department due to staffing changes 
        approved by the Under Secretary for Health.

    (e) Annual Report.--
            (1) In general.--Not later than 18 months after the date of 
        the enactment of this Act, and not less frequently than annually 
        thereafter, the Secretary of Veterans Affairs shall submit to 
        the Committee on Veterans' Affairs of the Senate and the 
        Committee on Veterans' Affairs of the House of Representatives a 
        report on the use by the Secretary of the authority under this 
        section.
            (2) Elements.--Each report required by paragraph (1) shall 
        include the following:
                    (A) The number of health care professionals for whom 
                a service contract buyout payment was made under 
                subsection (a) in the previous fiscal year, 
                disaggregated by occupation or specialty.
                    (B) The average, highest, and lowest amount of the 
                service contract buyout payments made under subsection 
                (a) for each occupation or specialty in the previous 
                fiscal year.

[[Page 136 STAT. 1810]]

                    (C) Each location where contract buyout authority 
                under subsection (a) was utilized and the number of 
                covered health care professionals who agreed to be 
                employed at such location in the previous fiscal year.

    (f) Definitions.--In this section:
            (1) Covered health care professional.--The term ``covered 
        health care professional'' means a physician, nurse anesthetist, 
        physician assistant, or nurse practitioner offered employment 
        with the Department regardless of the authority under which such 
        employment is offered.
            (2) Rural; highly rural.--The terms ``rural'' and ``highly 
        rural'' have the meanings given those terms under the rural-
        urban commuting areas coding system of the Department of 
        Agriculture.

    (g) Sunset.--This section shall terminate on September 30, 2027.
SEC. 903. <<NOTE: 38 USC 7401 note.>> QUALIFICATIONS FOR HUMAN 
                        RESOURCES POSITIONS WITHIN DEPARTMENT OF 
                        VETERANS AFFAIRS AND PLAN TO RECRUIT AND 
                        RETAIN HUMAN RESOURCES EMPLOYEES.

    (a) <<NOTE: Deadline.>>  Establishment of Qualifications.--Not later 
than 180 days after the date of the enactment of this Act, the Secretary 
of Veterans Affairs shall--
            (1) <<NOTE: Coordination.>>  establish qualifications for 
        each human resources position within the Department of Veterans 
        Affairs in coordination with the Office of Personnel Management;
            (2) establish standardized performance metrics for each such 
        position; and
            (3) <<NOTE: Reports.>>  submit to the Committee on Veterans' 
        Affairs of the Senate and the Committee on Veterans' Affairs of 
        the House of Representatives a report containing the 
        qualifications and standardized performance metrics established 
        under paragraphs (1) and (2).

    (b) <<NOTE: Deadline.>>  Improvement of Human Resources Actions.--
Not later than 90 days after the date of the enactment of this Act, the 
Secretary shall establish or enhance systems of the Department to 
monitor the hiring and other human resources actions that occur at the 
local, regional, and national levels of the Department to improve the 
performance of those actions.

    (c) <<NOTE: Assessments.>>  Report.--Not later than one year after 
the establishment of the qualifications and performance metrics under 
subsection (a), the Comptroller General of the United States shall 
submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
containing--
            (1) a description of the implementation of such 
        qualifications and performance metrics;
            (2) an assessment of the quality of such qualifications and 
        performance metrics;
            (3) an assessment of performance and outcomes based on such 
        metrics; and
            (4) such other matters as the Comptroller General considers 
        appropriate.

    (d) Plan to Recruit and Retain Human Resources 
Employees. <<NOTE: Deadline.>> --Not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
submit

[[Page 136 STAT. 1811]]

to the Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a plan for the 
recruitment and retention of human resources employees within the 
Department of Veterans Affairs.
SEC. 904. MODIFICATION OF PAY CAP FOR CERTAIN EMPLOYEES OF 
                        VETERANS HEALTH ADMINISTRATION.

    (a) In General.--Section 7455(c) <<NOTE: 38 USC 7455.>>  is 
amended--
            (1) in paragraph (1), by striking ``30 percent'' inserting 
        ``50 percent'';
            (2) in paragraph (2), by striking ``level IV'' inserting 
        ``level II''; and
            (3) by adding at the end the following new paragraph:

    ``(3)(A) Notwithstanding section 5304 of title 5 or any other 
provision of law, but subject to the limitation under paragraph (2), 
pursuant to an increase under subsection (a), the Secretary may pay a 
special rate or an adjusted rate of basic pay in excess of the rate of 
basic pay payable for level IV of the Executive Schedule.
    ``(B) If an employee is in receipt of a special rate of pay under 
subparagraph (A) in excess of the rate of basic pay payable for level IV 
of the Executive Schedule with an established special rate supplement of 
greater value than a supplement based on the applicable locality-based 
comparability payment percentage under section 5304 of title 5, but a 
pay adjustment would cause such established special rate supplement to 
be of lesser value, the special rate supplement shall be converted to a 
supplement based on the applicable locality-based comparability 
percentage unless the Secretary determines that some other action is 
appropriate.''.
    (b) Pay for Critical Positions.--Section 7404(a)(1)(B) is amended by 
inserting ``7306 or'' before ``7401(4)''.
SEC. 905. EXPANSION OF OPPORTUNITIES FOR HOUSEKEEPING AIDES.

    Section 3310 of title 5, United States Code, is amended by inserting 
``(other than for positions of housekeeping aides in the Department of 
Veterans Affairs)'' after ``competitive service''.
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.

    (a) Expansion of Eligibility of Employees for Certain Awards.--
Section 7404(c) is amended--
            (1) by striking ``Notwithstanding'' and inserting ``(1) 
        Notwithstanding'';
            (2) by inserting ``or 7401(4)'' after ``section 7306'';
            (3) by striking ``who is not eligible for pay under 
        subchapter III'' and inserting ``or in a covered executive 
        position under section 7401(1) of this title'';
            (4) by striking ``sections 4507 and 5384'' and inserting 
        ``section 4507''; and
            (5) by adding at the end the following new paragraph:

    ``(2) <<NOTE: Definition.>>  In this subsection, the term `covered 
executive position' means a position that the Secretary has determined 
is of equivalent rank to a Senior Executive Service position (as such 
term is defined in section 3132(a) of title 5) and is subject to an 
agency performance management system.''.

[[Page 136 STAT. 1812]]

    (b) Authority for Awards Programs of Department of Veterans 
Affairs.--
            (1) In general.--Subchapter I of chapter 74 <<NOTE: 38 USC 
        7401 prec.>>  is amended by inserting after section 7404 the 
        following new section:
``Sec. 7404A. <<NOTE: 38 USC 7404A.>>  Awards

    ``(a) Superior Accomplishments and Performance Awards Program.--The 
Secretary may establish an awards program for personnel listed in 
section 7421(b) of this title consistent with chapter 45 of title 5, to 
the extent practicable.
    ``(b) Executive Performance Awards Program.--Notwithstanding section 
7425 of this title or any other provision of law, the Secretary may 
establish a performance awards program consistent with section 5384 of 
title 5 for--
            ``(1) <<NOTE: Determination.>>  personnel appointed under 
        section 7401(1) of this title for a position that the Secretary 
        has determined is of equivalent rank to a Senior Executive 
        Service position (as such term is defined in section 3132(a) of 
        title 5) and is subject to an agency performance management 
        system; and
            ``(2) personnel appointed under section 7306 or 7401(4) of 
        this title.

    ``(c) <<NOTE: Criteria.>>  Payment of Awards.--Awards under this 
section may be paid based on criteria established by the Secretary and 
shall not be considered in calculating the limitation under section 
7431(e)(4) of this title.

    ``(d) Not Considered Basic Pay.--Awards under this section shall not 
be considered basic pay for any purpose.
    ``(e) Regulations.--The Secretary may prescribe regulations for the 
administration of this section.''.
            (2) <<NOTE: Time period. Determination. 38 USC 7404A 
        note.>>  Limitation on past awards.--Notwithstanding any other 
        provision of law, awards made by the Secretary of Veterans 
        Affairs for any period on or after January 1, 2017, and before 
        the date of the enactment of this Act for an employee under 
        section 7306 or 7401(4) of title 38, United States Code, or for 
        a position described in section 7401(1) of such title that the 
        Secretary has determined is of equivalent rank to a Senior 
        Executive Service position (as such term is defined in section 
        3132(a) of title 5, United States Code), may be subject to 
        section 7404A of title 38, United States Code, as added by 
        paragraph (1).

    (c) Modification of Employees Subject to Regulation by Secretary of 
Veterans Affairs of Hours and Conditions of Employment and Leaves of 
Absence.--
            (1) In general.--Section 7421 <<NOTE: 38 USC 7421.>>  is 
        amended--
                    (A) in subsection (a), by striking ``chapter'' and 
                inserting ``title''; and
                    (B) in subsection (b), by adding at the end the 
                following new paragraph:
            ``(9) Any position for which the employee is appointed under 
        section 7306 or 7401(4) of this title.''.
            (2) Administration of full-time employees.--Section 7423 is 
        amended--
                    (A) in subsection (a)(2), by adding at the end the 
                following new subparagraph:

    ``(D) <<NOTE: Determination.>>  The Secretary may exclude from the 
requirements of paragraph (1) employees hired under section 7306 or 
7401(4) of this title or for a position described in section 7401(1) of 
this title

[[Page 136 STAT. 1813]]

that the Secretary has determined is of equivalent rank to a Senior 
Executive Service position (as such term is defined in section 3132(a) 
of title 5).''; and
                    (B) in subsection (e)(1), by striking ``7401(1)'' 
                and inserting ``7421(b)''.
            (3) Additional pay authorities.--Section 7410(a) <<NOTE: 38 
        USC 7410.>>  is amended--
                    (A) by striking ``The Secretary'' and inserting 
                ``(1) The Secretary'';
                    (B) by striking ``the personnel described in 
                paragraph (1) of section 7401 of this title'' and 
                inserting ``personnel appointed under section 7306 of 
                this title or section 7401(4) of this title, or 
                personnel described in section 7401(1) of this title,''; 
                and
                    (C) by striking ``in the same manner, and subject to 
                the same limitations, as in the case of'' and inserting 
                ``in a manner consistent with''; and
                    (D) by adding at the end the following new 
                paragraph:

    ``(2) Payments under paragraph (1) shall not be considered in 
calculating the limitation under section 7431(e)(4) of this title.''.
            (4) <<NOTE: Time period. Determination. 38 USC 7410 note.>>  
        Treatment of pay authority changes.--For the purposes of the 
        amendments made by paragraph (3), the Secretary of Veterans 
        Affairs shall treat any award or payment made by the Secretary 
        between January 1, 2017, and the date of the enactment of this 
        Act to employees appointed under sections 7306, 7401(1), and 
        7401(4) of title 38, United States Code, that the Secretary has 
        determined are of equivalent rank to a Senior Executive Service 
        position (as such term is defined in section 3132(a) of title 5, 
        United States Code), as if such amendments had been in effect at 
        the time of such award or payment.
            (5) <<NOTE: Time period. 38 USC 7421 note.>>  Treatment of 
        prior leave balances.--Notwithstanding any other provision of 
        law, the Secretary may adjust the leave balance and carryover 
        leave balance of any employee described in section 7421(b)(9) of 
        title 38, United States Code, as amended by paragraph (1)(B), to 
        ensure any leave accrued or carried over before the date of the 
        enactment of this Act remains available to such employee.

    (d) Treatment of Certain Employees as Appointed Under Section 
7306.--Section 7306 is amended--
            (1) in subsection (a), by redesignating the second paragraph 
        (11) as paragraph (12); and
            (2) by adding at the end the following new subsection:

    ``(g) For purposes of applying any provision of chapter 74 of this 
title, including sections 7404, 7410, and 7421, or any other provision 
of law, the Secretary may treat any appointment for a position under 
this chapter to be an appointment under this section.''.
    (e) Conforming Amendment.--Section 7431(e)(4) is amended by striking 
``In no case'' and inserting ``Except as provided in sections 7404A(c) 
and 7410(a)(2) of this title, in no case''.
SEC. 907. WAIVER OF PAY LIMITATION FOR CERTAIN EMPLOYEES OF 
                        DEPARTMENT OF VETERANS AFFAIRS.

    Subchapter I of chapter 7 <<NOTE: 38 USC 701 prec.>>  is amended by 
inserting after section 703 the following new section:

[[Page 136 STAT. 1814]]

``Sec. 704. <<NOTE: 38 USC 704.>> Waiver of pay limitation for 
                certain employees

    ``(a) Employees of Veterans Health Administration Impacted by 
Closure or Realignment.--Notwithstanding any other provision of law, the 
Secretary may waive any annual premium or aggregate limitation on pay 
for an employee of the Veterans Health Administration for the calendar 
year during which--
            ``(1) the official duty station of the employee is closed; 
        or
            ``(2) the office, facility, activity, or organization of the 
        employee is realigned.

    ``(b) Employees Providing Care to Veterans Exposed to Open Burn 
Pits.--
            ``(1) In general.--Notwithstanding any other provision of 
        law, the Secretary may waive any annual premium or aggregate 
        limitation on pay for an employee of the Department whose 
        primary duties include providing expanded care for veterans 
        exposed to open burn pits.
            ``(2) Open burn pit defined.--In this subsection, the term 
        `open burn pit' has the meaning given that term in section 
        201(c) of the Dignified Burial and Other Veterans' Benefits 
        Improvement Act of 2012 (Public Law 112-260; 38 U.S.C. 527 
        note).

    ``(c) Coordination With Office of Personnel Management.--In 
implementing this section, the Secretary shall coordinate with the 
Director of the Office of Personnel Management.
    ``(d) Reports.--
            ``(1) <<NOTE: Time period.>>  In general.--For each quarter 
        that the Secretary waives a limitation under this section, the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the Senate, the Committee on Veterans' Affairs of the House of 
        Representatives, and the Office of Personnel Management a report 
        on the waiver or waivers.
            ``(2) Contents.--Each report submitted under paragraph (1) 
        with respect to a waiver or waivers shall include the following:
                    ``(A) Where the waiver or waivers were used, 
                including in which component of the Department and, as 
                the case may be, which medical center of the Department.
                    ``(B) For how many employees the waiver or waivers 
                were used, disaggregated by component of the Department 
                and, if applicable, medical center of the Department.
                    ``(C) The average amount by which each payment 
                exceeded the pay limitation that was waived, 
                disaggregated by component of the Department and, if 
                applicable, medical center of the Department.

    ``(e) Employee Defined.--In this section, the term `employee' means 
any employee regardless of the authority under which the employee was 
hired.
    ``(f) Termination.--This section shall terminate on September 30, 
2027.''.
SEC. 908. ELIMINATION OF LIMITATION ON AWARDS AND BONUS FOR 
                        EMPLOYEES OF DEPARTMENT OF VETERANS 
                        AFFAIRS.

    (a) In General.--Section 705(a) of the Veterans Access, Choice, and 
Accountability Act of 2014 (Public Law 113-146; 38 U.S.C. 703 note) is 
amended by striking paragraph (3).

[[Page 136 STAT. 1815]]

    (b) <<NOTE: 38 USC 703 note.>>  Applicability.--Subsection (a) shall 
take effect on the date of the enactment of this Act and apply as if 
such subsection had been enacted on September 30, 2021.
SEC. 909. ADDITIONAL AUTHORITY OF THE SECRETARY OF VETERANS 
                        AFFAIRS RELATING TO RECRUITMENT AND 
                        RETENTION OF PERSONNEL.

    Subchapter I of chapter 7 <<NOTE: 38 USC 701 prec.>>  is amended by 
inserting after section 705 the following new section:
``Sec. 706. <<NOTE: 38 USC 706.>>  Additional authority relating 
                to recruitment and retention of personnel

    ``(a) Recruitment and Relocation Bonuses.--The Secretary may pay a 
recruitment or relocation bonus under section 5753(e) of title 5 without 
regard to any requirements for certification or approval under that 
section.
    ``(b) Retention Bonuses.--(1) The Secretary may pay a retention 
bonus under section 5754(f) of title 5 without regard to any requirement 
for certification or approval under that subsection.
    ``(2) The Secretary may pay a retention bonus as specified in 
subsection (e)(2) of section 5754 of title 5 and may pay the bonus as a 
single lump-sum payment at the beginning of the full period of service 
required by an agreement under subsection (d) of such section.
    ``(c) Merit Awards.--The Secretary may grant a cash award under 
section 4502(b) of title 5 without regard to any requirement for 
certification or approval under that section.
    ``(d) <<NOTE: Determination.>>  Incentives for Critical Skills.--(1) 
Subject to the provisions of this paragraph, the Secretary may provide a 
critical skill incentive to an employee in a case in which the Secretary 
determines--
            ``(A) the employee possesses a high-demand skill or skill 
        that is at a shortage;
            ``(B) such skill is directly related to the duties and 
        responsibilities of the employee's position; and
            ``(C) employment of an individual with such skill in such 
        position serves a critical mission-related need of the 
        Department.

    ``(2) An incentive provided to an employee under paragraph (1) may 
not to exceed 25 percent of the basic pay of the employee.
    ``(3) <<NOTE: Contracts.>>  Provision of an incentive under 
paragraph (1) shall be contingent on the employee entering into a 
written agreement to complete a period of employment with the 
Department.

    ``(4) An incentive provided under paragraph (1) shall not be 
considered basic pay for any purpose.
    ``(5) The Secretary may prescribe conditions, including with respect 
to eligibility, and limitations on provision of incentive under 
paragraph (1).
    ``(6) Incentive provided under paragraph (1) shall not be included 
in the calculation of total amount of compensation under section 
7431(e)(4) of this title.
    ``(e) Student Loan Repayments.--(1) Subject to the provisions of 
this subsection, the Secretary may repay a student loan pursuant to 
section 5379(b) of title 5.
    ``(2) Paragraph (2) of such section shall not apply to payment under 
this subsection.

[[Page 136 STAT. 1816]]

    ``(3) Payment under this subsection shall be made subject to such 
terms, limitations, or conditions as may be mutually agreed to by the 
Secretary and the employee concerned, except that the amount paid by the 
Secretary under this subsection may not exceed--
            ``(A) $40,000 for any employee in any calendar year; or
            ``(B) a total of $100,000 in the case of any employee.

    ``(f) Expedited Hiring Authority for College Graduates; Competitive 
Service.--(1) Subject to paragraph (2) of this subsection, the Secretary 
may expedite hiring for college graduates under section 3115 of title 5 
without regard to subsection (e) of such section or any regulations 
prescribed by the Office of Personnel Management for administration of 
such subsection.
    ``(2) The number of employees the Secretary may appoint under 
section 3115 of title 5 may not exceed the number equal to 25 percent of 
individuals that the Secretary appointed during the previous fiscal year 
to a position in the competitive service classified in a professional or 
administrative occupational category, at the GS-11 level, or an 
equivalent level, or below, under a competitive examining procedure.
    ``(g) Expedited Hiring Authority for Post-secondary Students; 
Competitive Service.--(1) Subject to paragraph (2) of this subsection, 
the Secretary may expedite hiring of post-secondary students under 
section 3116 of title 5, without regard to subsection (d) of such 
section or any regulations prescribed by the Office of Personnel 
Management for administration of such subsection.
    ``(2) The number of employees the Secretary may appoint under 
section 3116 of title 5 may not exceed the number equal to 25 percent of 
the number of students that the Secretary appointed during the previous 
fiscal year to a position at the GS-11 level, or an equivalent level, or 
below.
    ``(h) Pay Authority for Critical Positions.--(1) Subject to the 
provisions of this subsection, the Secretary may authorize the fixing of 
the rate of pay for a critical position in the Department consistent 
with the authorities and requirements of section 5377 of title 5 that 
apply to the Office of Personnel Management.
    ``(2) The Secretary may fix the rate of pay for a critical position 
under this subsection in excess of the limitation set forth by section 
5377(d)(2) of such title.
    ``(3) <<NOTE: President.>>  Basic pay may not be fixed under this 
subsection at a rate greater than the rate payable for the Vice 
President of the United States established under section 104 of title 3, 
except upon written approval of the President.

    ``(4) Notwithstanding section 5377(f) of title 5, the Secretary may 
authorize the exercise of authority under this subsection with respect 
to up to 200 positions at any time.
    ``(i) <<NOTE: Applicability.>>  Rates of Special Pay.--(1) The 
Secretary may establish a rate for special pay under section 5305(a)(1) 
of title 5.

    ``(2) In applying such section to the Secretary's authority under 
paragraph (1)--
            ``(A) `50 percent' shall be substituted for `30 percent'; 
        and
            ``(B) `level II of the Executive Schedule' shall be 
        substituted for `level IV of the Executive Schedule'.

[[Page 136 STAT. 1817]]

    ``(j) Waiver of Limitations on Certain Payments Under Pay 
Comparability System.--The Secretary may waive the limitation in section 
5307 of title 5 for an employee or a payment.
    ``(k) Termination.--The authorities under this section shall 
terminate on September 30, 2027.''.

    Approved August 10, 2022.

LEGISLATIVE HISTORY--S. 3373:
---------------------------------------------------------------------------

CONGRESSIONAL RECORD, Vol. 168 (2022):
            Feb. 17, considered and passed Senate.
            July 13, considered and passed House, amended.
            July 21, 25-27, Aug. 2, Senate considered and concurred in
              House amendment.
DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2022):
            Aug. 10, Presidential remarks.

                                  <all>