[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4261 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4261
To improve the research of Gulf War Illness, the Research Advisory
Committee on Gulf War Veterans' Illnesses, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 14, 2014
Mr. Coffman (for himself, Mrs. Kirkpatrick, and Mr. Michaud) introduced
the following bill; which was referred to the Committee on Veterans'
Affairs
_______________________________________________________________________
A BILL
To improve the research of Gulf War Illness, the Research Advisory
Committee on Gulf War Veterans' Illnesses, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Gulf War Health Research Reform Act
of 2014''.
SEC. 2. IMPROVEMENTS TO RESEARCH ADVISORY COMMITTEE ON GULF WAR
VETERANS' ILLNESSES.
(a) Independence of Committee.--Subsection (b) of section 707 of
the Veterans Health Care Act of 1992 (Public Law 102-585; 38 U.S.C. 527
note) is amended--
(1) by striking ``Not later than'' and inserting ``(1)
Establishment.--Not later than''; and
(2) by adding at the end the following new paragraphs:
``(2) Independence.--(A) The Committee established under paragraph
(1) shall be an independent advisory committee which shall provide
advice and counsel to the congressional veterans committees and to the
Secretary of Veterans Affairs (as the head of the department designated
under subsection (a) that established the Committee under paragraph
(1)).
``(B) In carrying out the functions, powers, and duties of the
Committee, the Committee shall be independent of the Secretary of
Veterans Affairs. The Committee shall exert independent control of the
budget allocations, staffing levels and expenditures, personnel
decisions and processes, procurements, and other administrative and
management functions of the Committee. The administration and
management of the Committee shall be subject to the usual and customary
Federal audit procedures.
``(3) Duties.--(A) The Committee shall provide to Congress, the
Secretary of Veterans Affairs, and the heads of other departments and
agencies of the Federal Government that conduct research on illnesses
in Gulf War veterans advice with respect to proposed research studies,
research plans, or research strategies relating to the health
consequences of military service in the Southwest Asia theater of
operations during the Gulf War.
``(B) The Committee may not conduct scientific research or review
research proposals submitted to the Secretary of Veterans Affairs prior
to funding. The Secretary shall appoint three members from the
Committee who have appropriate scientific expertise to the committee
designated to review such research proposals relating to illnesses in
Gulf War veterans.
``(C) The guiding principle for the Committee shall be the premise
that the fundamental goal of Gulf War health-related research, either
basic or applied, conducted by the Federal Government is to ultimately
improve the health of ill Gulf War veterans, and that the choice and
success of research efforts shall be judged accordingly. The Committee
shall assess the overall effectiveness of such research conducted by
the Federal Government to answer central questions on the nature,
causes, and treatments for health consequences of military service in
the Southwest Asia theater of operations during the Gulf War.
``(D) The Committee shall meet in public session to review research
funded by the Department of Veterans Affairs relevant to understanding
and treating the health consequences of military service in the Gulf
War, and the processes conducted to solicit, review, and select such
funded research to assess methods, results, and implications of such
research. The Committee may review research plans, initiatives, and
activities from other departments and agencies of the Federal
Government supporting research relating to the health consequences of
military service in the Southwest Asia theater of operations during the
Gulf War.
``(4) Reports and Recommendations.--(A) Not later than December 1
of each year, the Committee shall submit to the congressional veterans
committees and the Secretary of Veterans Affairs an annual report
summarizing the activities of the Committee during the period covered
by the report.
``(B) The Committee shall submit to the congressional veterans
committees, the Secretary of Veterans Affairs, and the head of any
other department or agency of the Federal Government that conducts
research on illnesses in Gulf War veterans any other reports and
recommendations of the Committee regarding Gulf War-related research.
``(C) Reports, recommendations, publications, and other documents
of the Committee shall not be subject to review or approval by the
Secretary of Veterans Affairs.
``(D) The Committee may submit to the Secretary of Veterans Affairs
proposed recommendations of the Committee for comment for a period not
to exceed 30 days.
``(E) Each report submitted by the Committee shall be approved by
the Committee meeting in public session prior to such submission.
``(5) Membership.--(A) The Committee shall be composed of 12
members appointed as follows:
``(i) One member appointed jointly by the chairman of the
congressional veterans committees, who shall serve as chairman
of the Committee.
``(ii) Two members appointed by the chairman of the
Committee on Veterans' Affairs of the House of Representatives.
``(iii) Two members appointed by the chairman of the
Committee on Veterans' Affairs of the Senate.
``(iv) Two members appointed by the ranking member of the
Committee on Veterans' Affairs of the House of Representatives.
``(v) Two members appointed by the ranking member of the
Committee on Veterans' Affairs of the Senate.
``(vi) Three members appointed by the Secretary of Veterans
Affairs, of whom not less than one shall be a veteran.
``(B)(i) The first 11 vacancies from among the members of the
Committee (not including a member serving as chairman of the Committee)
occurring on or after the date of the enactment of the Gulf War Health
Research Reform Act of 2014 shall be filled by--
``(I) the chairman of the Committee on Veterans' Affairs of
the House of Representatives appointing a member for the first
and sixth vacancy;
``(II) the chairman of the Committee on Veterans' Affairs
of the Senate appointing a member for the second and seventh
vacancy;
``(III) the ranking member of the Committee on Veterans'
Affairs of the House of Representatives appointing a member for
the third and eighth vacancy;
``(IV) the ranking member of the Committee on Veterans'
Affairs of the Senate appointing a member for the fourth and
ninth vacancy; and
``(V) the Secretary of Veterans Affairs appointing a member
for the fifth, tenth, and eleventh vacancy.
``(ii) A vacancy in the Committee of a member serving as chairman
shall be filled jointly by the chairmen of the congressional veterans
committees.
``(iii) Except as provided by clause (i) or (ii), a vacancy in the
Committee of a member shall be filled in the manner in which the
appointment of such member was made. A member appointed to fill a
vacancy occurring before the expiration of the term for which the
member's predecessor was appointed shall be appointed only for the
remainder of that term.
``(C) Of the members of the Committee who are appointed on or after
the date of the enactment of the Gulf War Health Research Reform Act of
2014--
``(i) not fewer than three members shall be veterans;
``(ii) not fewer than eight members shall be scientists or
physicians who have experience in biomedicine, epidemiology,
immunology, environmental health, neurology, toxicology, or
other appropriate disciplines; and
``(iii) the chairman shall be a veteran or an expert
described in clause (ii), or both.
``(D) Each member of the Committee who is appointed on or after the
date of the enactment of the Gulf War Health Research Reform Act of
2014 shall be appointed for a three-year term. Except as provided by
section 2(c)(3) of such Act, a member may be reappointed once (not
including the initial appointment of a member made before the date of
the enactment of such Act).
``(6) Meetings.--(A) The Committee shall meet at the call of the
chairman, but not less than twice annually.
``(B) A majority of the members of the Committee shall constitute a
quorum, but a lesser number of members may hold hearings.
``(C)(i) The Secretary of Veterans Affairs, the head of the Office
of Research and Development of the Department of Veterans Affairs, and
the head of the Office of Public Health of the Department shall attend
each meeting of the Committee.
``(ii) The Secretary of Veterans Affairs may delegate the
attendance of the Secretary under clause (i) to a level not below the
Deputy Under Secretary for Health of the Department of Veterans
Affairs, but the Secretary shall attend at least one meeting each year
without making such delegation.
``(D) Each meeting of the Committee shall be open to the public.
``(7) Compensation and Staff.--(A) Except with respect to a member
who serves a scientific director under subparagraph (C)(ii) and is
treated as staff for purposes of compensation, each member of the
Committee shall be paid at the daily rate provided for temporary and
intermittent services under section 3109(b) of title 5, United States
Code, for each day during which the member attends meetings of the
Committee.
``(B) The members of the Committee shall be allowed travel
expenses, including per diem in lieu of subsistence, at rates
authorized for employees of agencies under subchapter I of chapter 57
of title 5, United States Code, while away from their homes or regular
places of business in the performance of service of the Committee.
``(C)(i) The chairman of the Committee may appoint a staff of not
more than four employees to provide the Committee scientific and
administrative support. Such employees may be--
``(I) detailees of the Department of Veterans Affairs or
other departments or agencies of the Federal Government;
``(II) individuals employed as temporary employees of the
Federal Government; or
``(III) at the request of the chairman of the Committee,
provided under a contract entered into by the Secretary of
Veterans Affairs and a medical school or other medical research
institution selected by the chairman of the Committee.
``(ii) The chairman of the Committee may appoint, from the members
of the Committee, a scientific director to supervise the operations of
the Committee. Such director shall count as one of the four employees
authorized under clause (i).
``(iii) At the request of the chairman of the Committee, the
Secretary of Veterans Affairs shall procure services from
nongovernmental consultants to assist the Committee in preparing
reports, background papers, and other material for consideration by the
Committee. Such services may be procured under the contract described
in clause (i)(III).
``(8) Application of Federal Advisory Committee Act.--(A) Except as
otherwise provided by this subsection, the Committee shall be subject
to the Federal Advisory Committee Act (5 U.S.C. App.).
``(B) The Secretary of Veterans Affairs shall consult with the
chairman of the congressional veterans committees in designating an
officer or employee of the Department under section 10 of the Federal
Advisory Committee Act (5 U.S.C. App.).
``(C) Notwithstanding such section 10, such designated officer or
employee may not have authority--
``(i) over the agenda or conduct of a meeting;
``(ii) to adjourn a meeting of the Committee; or
``(iii) to take any other action that is inconsistent with
the independence of the Committee under paragraph (2).
``(9) Funding.--Amounts for the activities of the Committee shall
be derived from amounts appropriated to the Department of Veterans
Affairs for purposes of this subsection.
``(10) Termination.--(A) Except as provided by subparagraph (B),
the Committee shall terminate on the date that is two years after the
date on which the Committee submits to the congressional veterans
committees, the Secretary of Defense, and the Secretary of Veterans
Affairs a report (signed by not less than nine concurring members)
explaining that each Secretary is carrying out an effective research
program relating to the health consequences of military service in the
Southwest Asia theater of operations during the Gulf War.
``(B) If during the two-year period described in subparagraph (A)
the Committee notifies the congressional veterans committees, the
Secretary of Defense, and the Secretary of Veterans Affairs that the
information contained in the report submitted under subparagraph (A) is
no longer applicable, the two-year period shall toll until the date on
which the Committee submits a new report described in subparagraph
(A).''.
(b) Definitions; Redesignation; Conforming Amendments.--
(1) Definitions.--Such section 707 is further amended by
adding at the end the following new subsection:
``(f) Definitions.--In this section:
``(1) The term `congressional veterans committees' means
the Committees on Veterans' Affairs of the House of
Representatives and the Senate.
``(2) The term `Gulf War' means the Southwest Asia theater
of operations from August 2, 1990, to July 31, 1991.
``(3) The term `Gulf War veteran' means an individual who
served as a member of the Armed Forces in the Gulf War.''.
(2) Redesignation.--Subsection (a) of such section 707 is
amended by striking ``, and may redesignate from time to
time,''.
(3) Conforming amendments.--Such section 707 is further
amended--
(A) in paragraph (1) of subsection (b), as
designated by subsection (a)(1) and amended by
paragraph (2)--
(i) by inserting ``(in this subsection
referred to as the `Committee')'' after ``an
advisory committee''; and
(ii) by striking ``and representatives of
such veterans'' and inserting ``representatives
of such veterans, and individuals from the
scientific and medical community'';
(B) by striking ``Persian Gulf theater of
operations during the Persian Gulf War'' each place it
appears and inserting ``Gulf War'';
(C) by striking ``Persian Gulf War veterans'' each
place it appears and inserting ``Gulf War veterans'';
and
(D) by striking ``during the Persian Gulf War''
each place it appears and inserting ``during the Gulf
War''.
(c) Members Currently Serving.--
(1) Membership.--Notwithstanding paragraph (5)(A) of
subsection (b) of such section 707, as amended by subsection
(a)(2), the chairmen and ranking members of the congressional
veterans committees shall jointly designate 10 members of the
Research Advisory Committee on Gulf War Veterans' Illnesses
established pursuant to such subsection (b) who are serving as
members as of the date of the enactment of this Act to continue
to serve as members for periods determined pursuant to
paragraph (2) rather than for the term for which the members
were appointed before such date of enactment.
(2) Period of service.--The chairmen and ranking members of
the congressional veterans committees shall jointly determine
the period of service of each member specified in paragraph (1)
in a manner that staggers the periods of such members in
periods of one, two, or three years beginning on the date of
the enactment of this Act. In determining such staggered
periods, the chairmen and ranking members shall take into
account the order of filling vacancies pursuant to subsection
(b)(5)(B) of such section 707, as amended by subsection (a)(2).
Any vacancies occurring of such members shall be filled in
accordance with such subsection.
(3) New members.--Upon designating members under paragraph
(1), the chairmen of the congressional veterans committees
shall each appoint one additional member to the committee from
among individuals who have not served on the Research Advisory
Committee on Gulf War Veterans' Illnesses. Such appointments
shall be treated as the first and second vacancies described in
subclauses (I) and (II) of subsection (b)(5)(B)(i) of such
section 707, as amended by subsection (a)(2), respectively.
(4) Reappointment.--A member of the Committee specified in
paragraph (1) who has served more than three years may not be
reappointed after the period for the member specified in
paragraph (2) expires.
SEC. 3. RESEARCH CASE DEFINITION OF GULF WAR ILLNESS.
(a) Standard Definition.--Except as provided by subsection (b), the
Secretary of Veterans Affairs shall ensure that any research conducted
or funded by the Secretary on the chronic multisymptom illness that
afflicts approximately 25 percent of Gulf War veterans--
(1) refers to the illness as ``Gulf War Illness''; and
(2) uses the research case definition of such illness that
is recommended from time to time by the Research Advisory
Committee on Gulf War Veterans' Illnesses established by
section 707 of the Veterans Health Care Act of 1992 (Public Law
102-585; 38 U.S.C. 527 note).
(b) Alternative Definition.--During any period in which the
Research Advisory Committee on Gulf War Veterans' Illnesses has not
recommended a research case definition for Gulf War Illness, the
Secretary of Veterans Affairs shall ensure that any research on such
illness conducted or funded by the Secretary uses a research case
definition that is consistent with the definition of the term ``chronic
multisymptom illness in Persian Gulf War veterans'' provided by section
805(e) of the Veterans' Benefits Act of 2010 (Public Law 111-275; 124
Stat. 2890).
(c) Advice.--The Research Advisory Committee on Gulf War Veterans'
Illnesses shall submit to the Secretary of Defense advice regarding the
best type of organization and process for the Gulf War Illness Research
Program of the Congressionally Directed Medical Research Program to use
to develop a research case definition of ``Gulf War Illness''.
SEC. 4. STUDIES AND REPORTS ON GULF WAR ILLNESS.
(a) Conduct of New Studies.--
(1) Evaluation of animal studies.--In conducting or funding
any study relating to illnesses of Gulf War veterans on or
after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall ensure that such study is conducted in a
manner such that animal studies are considered to the same
extent in all respects as human studies.
(2) Sufficient evidence of association.--In conducting or
funding any study relating to illnesses of Gulf War veterans,
or other health matters of veterans, on or after the date of
the enactment of this Act, the Institute of Medicine of the
National Academies shall ensure that such study is conducted in
a manner that defines ``sufficient evidence of an association''
in the ``categories of association'' used in the study as the
following: ``Evidence is sufficient to conclude that there is a
positive association. That is, a positive association has been
observed between an exposure to a specific agent and a health
outcome in human or animal studies in which chance, bias, and
confounding could be ruled out with reasonable confidence.''.
(b) Sense of Congress on National Cohort Study.--It is the sense of
Congress that the Secretary of Veterans Affairs should conduct an
additional follow-up study of a national cohort of Gulf War and Gulf-
War-Era veterans that includes questions described in the ``Symptom
Inventory Required to Ascertain Case Status for Gulf War Multisymptom
Illness, as Defined by both the Fukuda and Kansas criteria'' published
by the Research Advisory Committee on Gulf War Veterans' Illnesses on
June 9, 2012, in appendix F of the document titled ``Research Advisory
Committee on Gulf War Veterans' Illnesses Findings and
Recommendations''.
(c) Sense of Congress on Study on Risk of Developing Multiple
Sclerosis, Multiple Sclerosis, Parkinson's Disease, Brain Cancers, and
Other Conditions.--It is the sense of Congress that the Secretary of
Veterans Affairs should submit to the congressional veterans committees
each report required by section 804 of the Veterans' Benefits
Improvement Act of 2008 (Public Law 110-389; 122 Stat. 4187).
(d) Sense of Congress on Previously Conducted Studies.--It is the
sense of Congress that the Secretary of Veterans Affairs should--
(1) seek to enter into an agreement with the Institute of
Medicine of the National Academies to carry out the review
described in section 805 of the Veterans' Benefits Act of 2010
(Public Law 111-275; 124 Stat. 2890), regardless of any
previous review conducted under such section, in a manner that
ensures that the Institute of Medicine convenes to conduct the
review a group of medical professionals who are experienced in
treating individuals who served as members of the Armed Forces
in the Southwest Asia Theater of Operations of the Persian Gulf
War during 1990 or 1991 and who have been diagnosed with Gulf
War illness, chronic multisymptom illness, or another health
condition related to chemical and environmental exposure that
may have occurred during such service;
(2) seek to enter into an agreement with the Institute of
Medicine to carry out the review described in section 1603 of
the Persian Gulf War Veterans Act of 1998 (Public Law 105-277;
38 U.S.C. 1117 note), regardless of any previous review
conducted under such section, addressing the matters originally
reviewed by the Institute of Medicine in the reports titled
``Gulf War and Health: Volume 1. Depleted Uranium, Sarin,
Pyridostigmine Bromide, and Vaccines'', ``Gulf War and Health:
Volume 2. Insecticides and Solvents'', and ``Gulf War and
Health: Volume 3. Fuels, Combustion Products, and
Propellants''; and
(3) not disseminate or use for research, clinical care,
benefits, or any other purpose the results of the report of the
Institute of Medicine titled ``Gulf War and Health Report:
Volume 9. Treatment for Chronic Multisymptom Illness''.
(e) Sense of Congress on Consultation.--It is the sense of Congress
that the Secretary of Veterans Affairs should, prior to entering into a
contract or agreement with the Institute of Medicine of the National
Academies with respect to research or studies on the health of Gulf War
veterans, obtain the advice of the Research Advisory Committee on Gulf
War Veterans' Illnesses established by section 707 of the Veterans
Health Care Act of 1992 (Public Law 102-585; 38 U.S.C. 527 note)
regarding the scope of work and the charge to be given to the Institute
of Medicine.
(f) Sense of Congress on Inclusion of Certain Professionals in
Scientific or Medical Groups.--It is the sense of Congress that, in any
contract requiring the Institute of Medicine of the National Academies
to convene a committee to study the health of Gulf War veterans, the
Secretary of Veterans Affairs should ensure that any such committee
convened should contain not less than three members of the Research
Advisory Committee on Gulf War Veterans' Illnesses established by
section 707 of the Veterans Health Care Act of 1992 (Public Law 102-
585; 38 U.S.C. 527 note).
(g) Sense of Congress on Notification of Undue Influence.--It is
the sense of Congress that the Secretary of Veterans Affairs should
promptly notify the congressional veterans committees of any employee
or contractor of the Federal Government whom the Secretary believes
influenced, or attempted to influence, the outcome of a report or study
on the health of Gulf War veterans conducted by the Department of
Veterans Affairs or the Institute of Medicine of the National Academies
if such influence was not related to a scientifically objective
outcome.
SEC. 5. DEFINITIONS.
In this Act:
(1) The term ``congressional veterans committees'' means
the Committees on Veterans' Affairs of the House of
Representatives and the Senate.
(2) The term ``Gulf War'' means the Southwest Asia theater
of operations from August 2, 1990, to July 31, 1991.
(3) The term ``Gulf War veteran'' means an individual who
served as a member of the Armed Forces in the Gulf War.
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