[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2389 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2389

To require the Secretary of Defense to establish registries of members 
 and former members of the Armed Forces exposed in the line of duty to 
occupational and environmental health chemical hazards, to amend title 
 38, United States Code, to provide health care to veterans exposed to 
                 such hazards, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 13, 2009

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

_______________________________________________________________________

                                 A BILL


 
To require the Secretary of Defense to establish registries of members 
 and former members of the Armed Forces exposed in the line of duty to 
occupational and environmental health chemical hazards, to amend title 
 38, United States Code, to provide health care to veterans exposed to 
                 such hazards, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care for Members of the Armed 
Forces Exposed to Chemical Hazards Act of 2009''.

SEC. 2. ESTABLISHMENT OF REGISTRIES OF MEMBERS AND FORMER MEMBERS OF 
              THE ARMED FORCES EXPOSED IN LINE OF DUTY TO OCCUPATIONAL 
              AND ENVIRONMENTAL HEALTH CHEMICAL HAZARDS.

    (a) Establishment.--For each occupational and environmental health 
chemical hazard of particular concern, the Secretary of Defense shall 
establish and administer a registry of members and former members of 
the Armed Forces who were exposed in the line of duty to such hazard on 
or after September 11, 2001.
    (b) Registration.--For every member and former member of the Armed 
Forces who was exposed in the line of duty to a hazard described in 
subsection (a), the Secretary shall--
            (1) register such member or former member in such registry; 
        and
            (2) collect such information about such member or former 
        member as the Secretary considers appropriate for purposes of 
        establishing and administering such registry.
    (c) Notification.--In the case that the Secretary learns that a 
member or former member of the Armed Forces may have been exposed in 
the line of duty to a hazard described in subsection (a), the Secretary 
shall--
            (1) notify of such exposure--
                    (A) such member or former member;
                    (B) the commanding officer of the unit to which 
                such member or former member belonged at the time of 
                such exposure; and
                    (C) in the case of a member of the National Guard, 
                the Adjutant General of the State concerned; and
            (2) inform such member or former member that such member or 
        former member may be included in the registry required by 
        subsection (a) for such hazard.
    (d) Examination.--Not later than 30 days after the date on which 
the Secretary becomes aware of an exposure of a member or former member 
of the Armed Forces to a hazard described in subsection (a) and 
annually thereafter, the Secretary shall provide such member or former 
member--
            (1) a complete physical and medical examination;
            (2) consultation and counseling with respect to the results 
        of such physical and examination; and
            (3) a copy of the documentation of such exposure in the 
        member's or former member's medical record maintained by the 
        Department of Defense.
    (e) Occupational and Environmental Health Chemical Hazard of 
Particular Concern Defined.--In this section, the term ``occupational 
and environmental health chemical hazard of particular concern'' means 
an occupational and environmental health chemical hazard that the 
Secretary of Defense determines is of particular concern after 
considering appropriate guidelines and standards for exposure, 
including the following:
            (1) The military exposure guidelines specified in the 
        January 2002 Chemical Exposure Guidelines for Deployed Military 
        Personnel, United States Army Center for Health Promotion and 
        Preventive Medicine Technical Guide 230 (or any successor 
        technical guide that establishes military exposure guidelines 
        for the assessment of the significance of field exposures to 
        occupational and environmental health chemical hazards during 
        deployments).
            (2) Occupational and environmental health chemical exposure 
        standards promulgated by the Occupational Safety and Health 
        Administration.

SEC. 3. SCIENTIFIC REVIEW OF ASSOCIATION OF INCIDENTS OF EXPOSURE TO 
              OCCUPATIONAL AND ENVIRONMENTAL HEALTH CHEMICAL HAZARDS 
              WITH HEALTH CONSEQUENCES.

    (a) Agreement.--
            (1) In general.--The Secretary of Defense shall seek to 
        enter into an agreement with the Institute of Medicine of the 
        National Academies for the Institute of Medicine to perform the 
        services covered by this section.
            (2) Timing.--The Secretary shall seek to enter into the 
        agreement described in paragraph (1) not later than 2 months 
        after the date of the enactment of this Act.
    (b) Review of Scientific Evidence.--Under an agreement between the 
Secretary of Defense and the Institute of Medicine under this section, 
the Institute of Medicine shall, for each incident of exposure 
involving one or more members of the Armed Forces reported in a 
registry established under section 2(a) to an occupational and 
environmental health chemical hazard of particular concern, review and 
summarize the scientific evidence, and assess the strength thereof, 
concerning the association between the exposure to such hazard and 
acute and long-term health consequences of such exposure.
    (c) Scientific Determinations Concerning Health Consequences.--
            (1) In general.--For each incident of exposure reviewed 
        under subsection (b), the Institute of Medicine shall determine 
        (to the extent that available scientific data permit meaningful 
        determinations)--
                    (A) whether a statistical association with the 
                acute and long-term health consequences exists, taking 
                into account the strength of the scientific evidence 
                and the appropriateness of the statistical and 
                epidemiological methods used to detect the association; 
                and
                    (B) whether there exists a plausible biological 
                mechanism or other evidence of a causal relationship 
                between the occupational and environmental health 
                chemical hazard and the health consequences.
            (2) Discussion and reasoning.--The Institute of Medicine 
        shall include in its reports under subsection (f) a full 
        discussion of the scientific evidence and reasoning that led to 
        its conclusions under this subsection.
    (d) Recommendations for Additional Scientific Studies.--
            (1) In general.--The Institute of Medicine shall make any 
        recommendations it has for additional scientific studies to 
        resolve areas of continuing scientific uncertainty relating to 
        exposure to occupational and environmental health chemical 
        hazards of particular concern.
            (2) Considerations.--In making recommendations for further 
        study, the Institute of Medicine shall consider the following:
                    (A) The scientific information that is currently 
                available.
                    (B) The value and relevance of the information that 
                could result from additional studies.
    (e) Subsequent Reviews.--The agreement under subsection (a) shall 
require the Institute of Medicine--
            (1) to conduct periodically as comprehensive a review as is 
        practicable of the evidence referred to in subsection (b) that 
        has become available since the last review of such evidence 
        under this section; and
            (2) to make its determinations and estimates on the basis 
        of the results of such review and all other reviews conducted 
        for the purposes of this section.
    (f) Reports.--
            (1) Reports to congress.--
                    (A) In general.--The agreement under subsection (a) 
                shall require the Institute of Medicine to submit, not 
                later than the end of the 18-month period beginning on 
                the date of the enactment of this Act and not less 
                frequently than once every 2 years thereafter, to the 
                appropriate committees of Congress a report on the 
                activities of the Institute of Medicine under the 
                agreement.
                    (B) Contents.--The report described in subparagraph 
                (A) shall include the following:
                            (i) The determinations and discussion 
                        referred to in subsection (c).
                            (ii) Any recommendations of the Institute 
                        of Medicine under subsection (d).
            (2) Reports to secretary of defense.--The agreement under 
        subsection (a) shall require the Institute of Medicine, in the 
        case that the Institute of Medicine makes any conclusive 
        determination under subsection (c)(1) with respect to any 
        incident of exposure studied under subsection (b), to submit, 
        not later than 30 days after the date of such determination, to 
        the Secretary of Defense a report describing such 
        determination.
    (g) Notice to Members and Former Members of the Armed Forces.--The 
Secretary of Defense shall notify members and former members of the 
Armed Forces listed in a registry established under section 2(a) for 
exposure to an occupational and environmental health chemical hazard of 
particular concern of--
            (1) any conclusive determinations made with respect to such 
        exposure under subsection (c)(1); and
            (2) any other significant developments in research on the 
        health consequences of exposure to such hazard.
    (h) Limitation on Authority.--The agreement under this section 
shall be effective for a fiscal year to the extent that appropriations 
are available to carry out the agreement.
    (i) Sunset.--This section shall cease to be effective 10 years 
after the last day of the fiscal year in which the Institute of 
Medicine submits to the Secretary of Defense the first report under 
subsection (f).
    (j) Alternative Contract Scientific Organization.--
            (1) In general.--If the Secretary of Defense is unable 
        within the time period prescribed in subsection (a)(2) to enter 
        into an agreement described in subsection (a)(1) with the 
        Institute of Medicine on terms acceptable to the Secretary, the 
        Secretary shall seek to enter into such an agreement with 
        another appropriate scientific organization that--
                    (A) is not part of the Government;
                    (B) operates as a not-for-profit entity; and
                    (C) has expertise and objectivity comparable to 
                that of the Institute of Medicine.
            (2) Treatment.--If the Secretary enters into an agreement 
        with another organization as described in paragraph (1), any 
        reference in this section to the Institute of Medicine shall be 
        treated as a reference to the other organization.
    (k) Definitions.--In this section:
            (1) Appropriate committees of congress.--The term 
        ``appropriate committees of Congress'' means--
                    (A) the Committee on Armed Services, the Committee 
                on Veterans' Affairs, and the Committee on 
                Appropriations of the Senate; and
                    (B) the Committee on Armed Services, the Committee 
                on Veterans' Affairs, and the Committee on 
                Appropriations of the House of Representatives.
            (2) Occupational and environmental health chemical hazard 
        of particular concern.--The term ``occupational and 
        environmental health chemical hazard of particular concern'' 
        means an occupational and environmental health chemical hazard 
        that the Secretary of Defense determines is of particular 
        concern after considering appropriate guidelines and standards 
        for exposure, including the following:
                    (A) The military exposure guidelines specified in 
                the January 2002 Chemical Exposure Guidelines for 
                Deployed Military Personnel, United States Army Center 
                for Health Promotion and Preventive Medicine Technical 
                Guide 230 (or any successor technical guide that 
                establishes military exposure guidelines for the 
                assessment of the significance of field exposures to 
                occupational and environmental health chemical hazards 
                during deployments).
                    (B) Occupational and environmental health chemical 
                exposure standards promulgated by the Occupational 
                Safety and Health Administration.

SEC. 4. REVISION IN AUTHORITIES FOR PROVISION OF HEALTH CARE FOR 
              CERTAIN VETERANS EXPOSED TO OCCUPATIONAL AND 
              ENVIRONMENTAL HEALTH CHEMICAL HAZARDS.

    (a) Authorized Inpatient Care.--Section 1710(e) of title 38, United 
States Code, is amended--
            (1) in paragraph (1), by adding at the end the following:
    ``(F) A veteran who was exposed in the line of duty to an 
occupational and environmental health chemical hazard of particular 
concern is eligible (subject to paragraph (2)) for hospital care, 
medical services, and nursing home care under subsection (a)(2)(F) for 
any disability, notwithstanding that there is insufficient medical 
evidence to conclude that such disability may be associated with such 
exposure.'';
            (2) in paragraph (2), by adding at the end the following:
    ``(C) In the case of a veteran described in paragraph (1)(F), 
hospital care, medical services, and nursing home care may not be 
provided under subsection (a)(2)(F) with respect to--
            ``(i) a disability that is found, in accordance with 
        guidelines issued by the Under Secretary for Health, to have 
        resulted from a cause other than an exposure described in 
        paragraph (1)(F); or
            ``(ii) a health effect for which the National Academy of 
        Sciences, in a report issued in accordance with section 3 of 
        the Health Care for Members of the Armed Forces Exposed to 
        Chemical Hazards Act of 2009, has determined that there is 
        limited or suggestive evidence of the lack of a positive 
        association between occurrence of the health consequences in 
        humans and exposure to an occupational and environmental health 
        chemical hazard of particular concern.''; and
            (3) in paragraph (4), by adding at the end the following:
            ``(C) The term `occupational and environmental health 
        chemical hazard of particular concern' means an occupational 
        and environmental health chemical hazard that the Secretary of 
        Defense determines is of particular concern after considering 
        appropriate guidelines and standards for exposure, including 
        the following:
                    ``(i) The military exposure guidelines specified in 
                the January 2002 Chemical Exposure Guidelines for 
                Deployed Military Personnel, United States Army Center 
                for Health Promotion and Preventive Medicine Technical 
                Guide 230 (or any successor technical guide that 
                establishes military exposure guidelines for the 
                assessment of the significance of field exposures to 
                occupational and environmental health chemical hazards 
                during deployments).
                    ``(ii) Occupational and environmental health 
                chemical exposure standards promulgated by the 
                Occupational Safety and Health Administration.''.
    (b) Technical Amendment.--Section 1710(e)(4) of such title is 
amended in the matter before subparagraph (A) by striking ``For 
purposes of this subsection--'' and inserting ``In this subsection:''.
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