[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3373 Enrolled Bill (ENR)]
S.3373
One Hundred Seventeenth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Monday,
the third day of January, two thousand and twenty two
An Act
To improve the Iraq and Afghanistan Service Grant and the Children of
Fallen Heroes Grant.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES CODE;
TABLE OF CONTENTS.
(a) 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) 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.
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.
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--EXPANSION OF HEALTH CARE ELIGIBILITY
Subtitle A--Toxic-exposed Veterans
SEC. 101. 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) 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.''.
(c) Definition of Toxic Exposure Risk Activity.--Section 1710(e)(4)
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) 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) 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:
``(6)(A) 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) 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) publish such modified date in the Federal Register.''.
(b) 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. ASSESSMENTS OF IMPLEMENTATION AND OPERATION.
(a) 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
(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) 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) 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
(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) 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:
``(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) 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) 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) Effective Date.--This section and the amendments made by this
section shall take effect on October 1, 2022.
TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS
SEC. 201. 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 is amended
by adding at the end the following new subchapter:
``SUBCHAPTER VII--DETERMINATIONS RELATING TO PRESUMPTIONS OF SERVICE
CONNECTION BASED ON TOXIC EXPOSURE
``Sec. 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) public notice regarding what formal evaluations
the Secretary plans to conduct; and
``(ii) the public an opportunity to comment on the
proposed formal evaluations;
``(B) 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) 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) 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).
``Sec. 1172. Annual notice and opportunity for public comment
``(a) 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) 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) 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) 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.
``(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) 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) 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) 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) 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. 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;
``(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) 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) 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.--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. Regulations regarding presumptions of service connection
based on toxic exposure
``(a) 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--
``(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) 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. 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) 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) 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. Agreement with National Academies of Sciences,
Engineering, and Medicine concerning toxic exposures
``(a) 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) 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) 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) An agreement under this section may be extended in five-year
increments.
``(c) 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.
``(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) The determinations described in subsection (d).
``(ii) A full explanation of the scientific evidence and
reasoning that led to such determinations.
``(iii) Any recommendations of the Academies under subsection
(f).
``(2) 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.--
(1) Report.--
(A) 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) 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) 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) 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) 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 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) Conforming Amendments.--Chapter 11 is amended--
(1) in section 1116--
(A) by striking subsections (b), (c), (d), and (e);
(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 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 is amended by adding
at the end the following new section:
``Sec. 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;
``(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) The Secretary shall publish on the internet website of
the Department a notice that such veterans may elect to file a
supplemental claim.
``(B) 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) 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) 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 is amended by adding at
the end the following new section:
``Sec. 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;
``(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) 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) 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) 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) 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--IMPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS
FOR TOXIC-EXPOSED VETERANS
SEC. 301. 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 amended by adding at the end the
following new section:
``Sec. 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
``(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) The Secretary shall--
``(A) 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) 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) 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) 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;
``(vii) Yemen;
``(viii) Uzbekistan; or
``(ix) 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. 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) 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.''.
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.
(a) 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) is amended by adding at
the end the following new clause:
``(v) Cleanup of Enewetak Atoll during the period beginning
on January 1, 1977, and ending on December 31, 1980.''.
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.
(a) Short Title.--This section may be cited as the ``Palomares or
Thule Veterans Act of 2022''.
(b) 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. PRESUMPTIONS OF SERVICE CONNECTION FOR DISEASES
ASSOCIATED WITH EXPOSURES TO CERTAIN HERBICIDE AGENTS FOR
VETERANS WHO SERVED IN CERTAIN LOCATIONS.
(a) Short Title.--This section may be cited as the ``Veterans Agent
Orange Exposure Equity Act of 2022''.
(b) 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'' each
place it appears and inserting ``performed covered service''; and
(3) by adding at the end the following new subsection:
``(d) 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), is further amended by
striking subparagraph (A) and inserting the following new subparagraph:
``(A) 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 is amended
by striking ``the Republic of Vietnam'' and inserting ``certain
locations''.
(e) 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) 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).
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.
(a) 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 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) 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) 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) 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) 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, 2026, for everyone not described in
subparagraph (A).
(B) 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 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) 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. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN DISEASES
ASSOCIATED WITH EXPOSURE TO BURN PITS AND OTHER TOXINS.
(a) Short Title.--This section may be cited as the ``Presumptive
Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of
2022''.
(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. 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) 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 is amended by striking ``or
1118'' each place it appears and inserting ``1118, or 1120''.
(d) 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) 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. 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) 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.
(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) 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. ANALYSIS AND REPORT ON TREATMENT OF VETERANS FOR MEDICAL
CONDITIONS RELATED TO TOXIC EXPOSURE.
(a) 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 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) 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) 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;
(D) Jordan;
(E) Lebanon;
(F) Syria; or
(G) Yemen.
SEC. 504. 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) 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) 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) resided at or near, as determined by the Secretary, the
locations described in subsection (b).
(b) 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) Any other location that is proximate to covered waste, as
determined by the Secretary.
(c) 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) 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 and
present civilian populations residing at the same location of
exposure, as determined by the Secretary.
(d) 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) 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 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) 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 availability of the
full- and part-time staff of each office to the veterans they
are charged with serving;
(H) 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) 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) 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) 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) 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. DEPARTMENT OF VETERANS AFFAIRS PUBLIC WEBSITE FOR TOXIC
EXPOSURE RESEARCH.
(a) 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:
(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) 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) 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--IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED
VETERANS
SEC. 601. 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. 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) 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--
(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. INCORPORATION OF TOXIC EXPOSURE SCREENING FOR VETERANS.
(a) 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) 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.
SEC. 604. 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) 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) 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. 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 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) 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) 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) 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.
(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.
(b) Treatment of 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
(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) An estimate of the cost to the Federal Government of the
facility to be leased.
``(C) 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) 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) 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) 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:
``(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) 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) 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) 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) 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;
``(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 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) 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) 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'
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 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. BIENNIAL BRIEFING ON INDIVIDUAL LONGITUDINAL EXPOSURE
RECORD.
(a) 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) 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, and health
monitoring, and recommendations for how to improve those systems.
(2) 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. CORRECTION OF EXPOSURE RECORDS BY MEMBERS OF THE ARMED
FORCES AND VETERANS.
(a) 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. 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) 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.--
(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) 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) 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
(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 is amended by adding at the end the
following new section:
``Sec. 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) 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) 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.).
``(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) 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) 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. 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 and inserting the following:
``Sec. 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.
``(2) The term `notice' means a communication issued through
means (including electronic means) prescribed by the Secretary.''.
(2) In section 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) The Secretary shall annually--
``(1) solicit recommendations from stakeholders on how to
improve notice under this section; and
``(2) 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) in the heading, by adding ``; decisions; notice'' at
the end; and
(B) 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) 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. 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.
(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) A comprehensive list of the top 10 conditions from each
body system for which the Secretary awarded service connection
for covered veterans.
(D) Any updates or trends with respect to the information
described in subparagraphs (A), (B), and (C), that the
Secretary determines appropriate.
(2) 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).
TITLE IX--IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS
SEC. 901. NATIONAL RURAL RECRUITMENT AND HIRING PLAN FOR VETERANS
HEALTH ADMINISTRATION.
(a) 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) 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) 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) the plan developed and implemented under subsection (a);
and
(2) 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. 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 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) 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.
(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. QUALIFICATIONS FOR HUMAN RESOURCES POSITIONS WITHIN
DEPARTMENT OF VETERANS AFFAIRS AND PLAN TO RECRUIT AND RETAIN
HUMAN RESOURCES EMPLOYEES.
(a) Establishment of Qualifications.--Not later than 180 days after
the date of the enactment of this Act, the Secretary of Veterans
Affairs shall--
(1) 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) 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) 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) 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.--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 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) 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) 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.''.
(b) Authority for Awards Programs of Department of Veterans
Affairs.--
(1) In general.--Subchapter I of chapter 74 is amended by
inserting after section 7404 the following new section:
``Sec. 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) 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) 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) 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 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) 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 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) 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) 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) 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 is amended by inserting after section 703
the following new section:
``Sec. 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) 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).
(b) 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 is amended by inserting after section 705
the following new section:
``Sec. 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) 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) 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.
``(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) 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) 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'.
``(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.''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.