[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3541 Reported in Senate (RS)]

<DOC>





                                                       Calendar No. 263
117th CONGRESS
  2d Session
                                S. 3541

   To improve health care and services for veterans exposed to toxic 
                  substances, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            February 1, 2022

    Mr. Tester (for himself, Mr. Moran, Ms. Hassan, Mr. Tillis, Mr. 
 Manchin, Mr. Sullivan, Mr. Blumenthal, Mr. Boozman, Mrs. Murray, Mr. 
   Tuberville, Ms. Hirono, Mr. Cassidy, Mr. Sanders, Mr. Cramer, Ms. 
   Sinema, Mr. Rounds, Mr. Brown, and Mrs. Blackburn) introduced the 
 following bill; which was read twice and referred to the Committee on 
                           Veterans' Affairs

             February 8 (legislative day, February 3), 2022

               Reported by Mr. Tester, without amendment

_______________________________________________________________________

                                 A BILL


 
   To improve health care and services for veterans exposed to toxic 
                  substances, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care for Burn Pit Veterans 
Act''.

SEC. 2. EXPANSION OF ELIGIBILITY FOR HEALTH CARE FROM DEPARTMENT OF 
              VETERANS AFFAIRS FOR CERTAIN VETERANS EXPOSED TO TOXIC 
              SUBSTANCES.

    (a) In General.--Section 1710(e)(3) of title 38, United States 
Code, 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 
                ``ten-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) of such title 
is amended by inserting after ``Persian Gulf War'' the following: ``(to 
include 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) Report.--Not later than October 1, 2024, 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--
            (1) the number of veterans who enrolled in the system of 
        annual patient enrollment of the Department of Veterans Affairs 
        established and operated under section 1705(a) of title 38, 
        United States Code, to receive care pursuant to eligibility 
        under subparagraph (B) of section 1710(e)(3) of such title, as 
        amended by subsection (a)(2); and
            (2) of the veterans described in paragraph (1), the number 
        of such veterans who reported a health concern related to 
        exposure to a toxic substance or radiation.
    (d) Outreach Plan.--Not later than December 1, 2022, 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 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 under such 
subparagraph.
    (e) Effective Date.--This section and the amendments made by this 
section shall take effect on October 1, 2022.

SEC. 3. 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 exposures to toxic 
substances 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 
exposures of veterans to toxic substances 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 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.
    (f) Active Military, Naval, Air, or Space Service Defined.--In this 
section, the term ``active military, naval, air, or space service'' has 
the meaning given that term in section 101(24) of title 38, United 
States Code.

SEC. 4. TRAINING FOR PERSONNEL OF THE DEPARTMENT OF VETERANS AFFAIRS 
              WITH RESPECT TO VETERANS EXPOSED TO TOXIC SUBSTANCES.

    (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 exposure to toxic substances and 
inform such personnel of how to ask for additional information from 
veterans regarding different 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 exposure to 
        toxic substances.
            (2) Annual training.--Training provided to processors under 
        paragraph (1) shall be provided not less frequently than 
        annually.

SEC. 5. 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 the exposure of the veteran to a toxic substance.
    (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--
            (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; and
            (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 
        exposure to a toxic substance.

SEC. 6. 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. 7. 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. 8. 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 gender of the veteran.
            (5) The type or types of cancer that the veteran has.

SEC. 9. PUBLICATION OF LIST OF RESOURCES OF DEPARTMENT OF VETERANS 
              AFFAIRS FOR VETERANS EXPOSED TO TOXIC SUBSTANCES 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) veterans who were exposed to toxic substances;
                    (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 exposure to toxic substances, including outreach 
with respect to benefits and support programs.

SEC. 10. REPORT 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, the Secretary of Veterans Affairs shall submit to the 
appropriate committees of Congress a report on the data quality of the 
Individual Longitudinal Exposure Record and the usefulness of the 
Individual Longitudinal Exposure Record in supporting veterans in 
receiving health care and benefits from the Department of Veterans 
Affairs.
    (b) Elements.--The report required by subsection (a) shall include 
the following:
            (1) An identification of exposures to toxic substances that 
        may not be fully captured by the current systems for 
        environmental and occupational health monitoring and 
        recommendations for how to improve those systems.
            (2) An analysis of the quality of the location data in 
        determining exposures of veterans to toxic substances and 
        recommendations for how to improve the quality of that location 
        data.
            (3) Recommendations on how to improve the usefulness of the 
        Individual Longitudinal Exposure Record.
    (c) Definitions.--In this section:
            (1) Appropriate committees of congress defined.--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'' includes any pilot 
        program or other program used by the Department of Veterans 
        Affairs or the Department of Defense to track how members of 
        the Armed Forces or veterans have been exposed to various 
        occupational or environmental hazards.
                                                       Calendar No. 263

117th CONGRESS

  2d Session

                                S. 3541

_______________________________________________________________________

                                 A BILL

   To improve health care and services for veterans exposed to toxic 
                  substances, and for other purposes.

_______________________________________________________________________

             February 8 (legislative day, February 3), 2022

                       Reported without amendment