[Congressional Record Volume 143, Number 145 (Friday, October 24, 1997)]
[Senate]
[Pages S11200-S11205]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER (for himself, Mr. Daschle, Mr. Akaka, Mr. 
        Wellstone, and Mrs. Murray):
  S. 1320. A bill to provide a scientific basis for the Secretary of 
Veterans Affairs to assess the nature of the association between 
illnesses and exposure to toxic agents and environmental or other 
wartime hazards as a result of service in the Persian Gulf during the 
Persian Gulf War for purposes of determining a service connection 
relating to such illnesses, and for other purposes; to the Committee on 
Veterans' Affairs.


                 the persian gulf veterans act of 1997

  Mr. ROCKEFELLER. Mr. President, I am proud to introduce today the 
Persian Gulf War Veterans Act of 1997, legislation which establishes a 
clear framework for the compensation and health care needs of Persian 
Gulf war veterans. This bill implements the recommendation of the 
Presidential Advisory Committee on Gulf War Veterans' Illnesses to 
create a permanent statutory authority for the compensation of ill gulf 
war veterans. It builds upon the system of scientific review and 
determinations for presumptive compensation that currently exists for 
veterans exposed to agent orange during the Vietnam war.
  As ranking member of the Committee on Veterans' Affairs, I have 
witnessed firsthand the struggles of many of our Nation's gulf war 
veterans. The Persian Gulf war will undoubtedly go down in history as 
one of our country's most decisive military victories. Despite our 
fears of potentially huge troop injuries and losses, the careful 
planning and strategy of our military leaders paid off. The ground war 
lasted only four days, and the casualties we experienced, while deeply 
regrettable, were fortunately few. But as with any war, the human costs 
of the gulf war have been high, and the casualties have continued long 
after the battle was over.

[[Page S11201]]

  Many of the men and women who served in the gulf have suffered 
chronic, debilitating health problems. Unnecessarily compounding their 
pain has been their difficulty in getting the government they served to 
acknowledge their problems and provide the appropriate care and 
benefits they deserve. This legislation will go a long way to address 
some of these concerns. We can't wait the 20 years we waited after the 
Vietnam war to assess the effects of agent orange, or the 40 years we 
waited after World War II to concede the problems of radiation-exposed 
veterans. We must learn from the lessons of the past and act now. We 
have already waited too long.
  For the past 6 years, we have looked to the leaders of the Department 
of Defense and the Department of Veterans Affairs for a resolution of 
these difficult issues. While they have made some progress, I think we 
can all agree there is much more to be done. This legislation will 
require VA to enlist the National Academy of Sciences--an independent, 
nonprofit, scientific organization--to review and evaluate the research 
regarding links between illnesses and exposure to toxic agents and 
wartime hazards. Based on the findings of the NAS, VA will then 
determine whether a diagnosed or undiagnosed illness found to be 
associated with gulf war service warrants a presumption of service 
connection for compensation purposes. This will provide an ongoing 
scientific basis and nonpolitical framework for the VA to use in 
compensating Persian Gulf war veterans.


                         SUMMARY OF PROVISIONS

  Mr. President, I will now highlight some of the provisions contained 
in this legislation.
  First, this legislation calls for the Secretary of the Department of 
Veterans Affairs to contract with the National Academy of Sciences 
[NAS] to provide a scientific basis for determining the association 
between illnesses and exposures to environmental or wartime hazards as 
a result of service in the Persian Gulf. The NAS will review the 
scientific literature to assess health exposures during the gulf war 
and health problems among veterans, and report to Congress and the VA.
  Second, this legislation authorizes VA to presume that diagnosed or 
undiagnosed illnesses that have a positive association with exposures 
to environmental or wartime hazards were incurred in or aggravated by 
service even if there was no evidence of the illness during service. 
Having that authority, VA will determine whether there is a sound 
medical and scientific basis to warrant a presumption of service 
connection for compensation for diagnosed or undiagnosed illnesses, 
based on NAS' report. Within 60 days of that determination, VA will 
publish proposed regulations to presumptively service connect these 
illnesses.
  Third, this bill requires NAS to provide recommendations for 
additional research that should be conducted to better understand the 
possible adverse health effects of exposures to toxic agents or 
environmental or wartime hazards associated with gulf war service. The 
VA, in conjunction with the Department of Defense (DOD) and the 
Department of Health and Human Services [HHS], will review and act upon 
the recommendations for additional research and future studies.
  Fourth, this legislation tasks NAS with assessing potential treatment 
models for the chronic undiagnosed illnesses that have affected so many 
of our gulf war veterans. They will make recommendations for additional 
studies to determine the most appropriate and scientifically sound 
treatments. VA and DOD will review this information and submit a report 
to Congress describing whether they will implement these treatment 
models and their rationale for their decisions.
  Fifth, this legislation calls for the establishment of a system to 
monitor the health status of Persian Gulf war veterans. VA, in 
collaboration with DOD, will develop a plan to establish and operate a 
computerized information data set to collect information on the 
illnesses and health problems of gulf war veterans. This data base will 
also track the treatment provided to veterans with chronic undiagnosed 
illnesses to determine whether these veterans are getting sicker or 
better over time. VA and DOD will submit this plan for review and 
comment by NAS. After this review, VA and DOD will implement the 
agreed-upon plan and provide annual reports to Congress on the health 
status of Persian Gulf war veterans.
  Finally, this legislation requires that VA, in consultation with DOD 
and HHS, carry out an ongoing outreach program to provide information 
to gulf war veterans. This information will include health risks, if 
any, from exposures during service in the gulf war theater of 
operations, and any services or benefits that are available.


                               DISCUSSION

  After the war, DOD and VA acknowledged that they couldn't define what 
health problems were affecting Persian Gulf war veterans. Nonetheless, 
we did not want to make these veterans wait for the science to catch up 
before we could provide health care and compensation for their service-
related conditions.
  That is why, back in 1993, we provided Persian Gulf war veterans with 
priority health care at VA facilities for conditions related to their 
exposure to environmental hazards. Congress went on to pass legislation 
in 1994 that confirmed that VA could provide compensation to Persian 
Gulf war veterans who suffered from chronic undiagnosed illnesses. 
Prior to this authority, VA asserted that it could not compensate 
veterans whose health problems could not be diagnosed.
  However, some gulf war veterans are falling between the cracks and 
still cannot receive compensation under current law. These veterans 
have been diagnosed with a condition several years after leaving 
service, such as chronic fatigue syndrome or migraines. Therefore, they 
are not eligible for compensation under VA's undiagnosed illness 
authority, nor are they eligible under the guidelines for diagnosed 
illnesses because the diagnosis was not made within the proscribed 
period following service. At the same time, these illnesses are due to 
unknown causes which could, someday, be tied to their gulf service. We 
cannot require veterans to wait for that day to arrive. This 
legislation will address this unfortunate catch-22 unwittingly created 
through previous legislation.
  We will continue to retrace the steps and decisions that were made in 
deploying almost 697,000 men and women to the Persian Gulf in 1990. 
Hopefully, we will learn from the lessons of this war to prevent some 
of these same health problems in future deployments where our troops 
will again face the threat of an everchanging and increasingly toxic 
combat environment. But we also must address what our ill gulf war 
veterans need now. We need to provide a permanent statutory authority 
to compensate them. We need to be able to answer the questions of How 
many veterans are ill? and Are our ill veterans getting sicker over 
time?
  Mr. President, this legislation targets these important issues. As 
Veterans' Day approaches, we prepare to honor those who offered to make 
the ultimate sacrifice for our country. Many of us will be called upon 
to make speeches in support of these brave men and women. I ask my 
colleagues in the Senate to join me now in supporting this legislation. 
Let us honor our gulf war veterans through our deeds--and not just our 
words--this Veterans' Day.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1320

       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 ``Persian Gulf War Veterans 
     Act of 1997''.

     SEC. 2. PRESUMPTION OF SERVICE CONNECTION FOR ILLNESSES 
                   ASSOCIATED WITH SERVICE IN THE PERSIAN GULF 
                   DURING THE PERSIAN GULF WAR.

       (a) In General.--(1) Subchapter II of chapter 11 of title 
     38, United States Code, is amended by adding at the end the 
     following:

     ``Sec. 1118. Presumptions of service connection for illnesses 
       associated with service in the Persian Gulf during the 
       Persian Gulf War

       ``(a)(1) For purposes of section 1110 of this title, and 
     subject to section 1113 of this title, each illness (if any) 
     described in paragraph (2) shall be considered to have been 
     incurred in or aggravated by service referred to in that 
     paragraph, notwithstanding that there is no record of 
     evidence of such illness during the period of such service.
       ``(2) An illness referred to in paragraph (1) is any 
     diagnosed or undiagnosed illness that--

[[Page S11202]]

       ``(A) the Secretary determines in regulations prescribed 
     under this section to warrant a presumption of service 
     connection by reason of having a positive association with 
     exposure to a biological, chemical, or other toxic agent or 
     environmental or wartime hazard known or presumed to be 
     associated with service in the Armed Forces in the Southwest 
     Asia theater of operations during the Persian Gulf War; and
       ``(B) becomes manifest within the period (if any) 
     prescribed in such regulations in a veteran who served on 
     active duty in that theater of operations during that war and 
     by reason of such service was exposed to such agent or 
     hazard.
       ``(3) For purposes of this subsection, a veteran who served 
     on active duty in the Southwest Asia theater of operations 
     during the Persian Gulf War and has an illness described in 
     paragraph (2) shall be presumed to have been exposed by 
     reason of such service to the agent or hazard associated with 
     the illness in the regulations prescribed under this section 
     unless there is conclusive evidence to establish that the 
     veteran was not exposed to the agent or hazard by reason of 
     such service.
       ``(b)(1)(A) Whenever the Secretary makes a determination 
     described in subparagraph (B), the Secretary shall prescribe 
     regulations providing that a presumption of service 
     connection is warranted for the illness covered by that 
     determination for purposes of this section.
       ``(B) A determination referred to in subparagraph (A) is a 
     determination based on sound medical and scientific evidence 
     that a positive association exists between--
       ``(i) the exposure of humans to a biological, chemical, or 
     other toxic agent or environmental or wartime hazard known or 
     presumed to be associated with service in the Southwest Asia 
     theater of operations during the Persian Gulf War; and
       ``(ii) the occurrence of a diagnosed or undiagnosed illness 
     in humans.
       ``(2)(A) In making determinations for purposes of paragraph 
     (1), the Secretary shall take into account--
       ``(i) the reports submitted to the Secretary by the 
     National Academy of Sciences under section 3 of the Persian 
     Gulf War Veterans Act of 1997; and
       ``(ii) all other sound medical and scientific information 
     and analyses available to the Secretary.
       ``(B) In evaluating any report, information, or analysis 
     for purposes of making such determinations, the Secretary 
     shall take into consideration whether the results are 
     statistically significant, are capable of replication, and 
     withstand peer review.
       ``(3) An association between the occurrence of an illness 
     in humans and exposure to an agent or hazard shall be 
     considered to be positive for purposes of this subsection if 
     the credible evidence for the association is equal to or 
     outweighs the credible evidence against the association.
       ``(c)(1)(A) Not later than 60 days after the date on which 
     the Secretary receives a report from the National Academy of 
     Sciences under section 3 of the Persian Gulf War Veterans Act 
     of 1997, the Secretary shall determine whether or not a 
     presumption of service connection is warranted for each 
     illness (if any) covered by the report.
       ``(B) If the Secretary determines that a presumption of 
     service connection is warranted, the Secretary shall, not 
     later than 60 days after making the determination, issue 
     proposed regulations setting forth the Secretary's 
     determination.
       ``(C)(i) If the Secretary determines that a presumption of 
     service connection is not warranted, the Secretary shall, not 
     later than 60 days after making the determination, publish in 
     the Federal Register a notice of the determination. The 
     notice shall include an explanation of the scientific basis 
     for the determination.
       ``(ii) If an illness already presumed to be service 
     connected under this section is subject to a determination 
     under clause (i), the Secretary shall, not later than 60 days 
     after publication of the notice under that clause, issue 
     proposed regulations removing the presumption of service 
     connection for the illness.
       ``(2) Not later than 90 days after the date on which the 
     Secretary issues any proposed regulations under paragraph 
     (1), the Secretary shall issue final regulations. Such 
     regulations shall be effective on the date of issuance.
       ``(d) Whenever the presumption of service connection for an 
     illness under this section is removed under subsection (c)--
       ``(1) a veteran who was awarded compensation for the 
     illness on the basis of the presumption before the effective 
     date of the removal of the presumption shall continue to be 
     entitled to receive compensation on that basis; and
       ``(2) a survivor of a veteran who was awarded dependency 
     and indemnity compensation for the death of a veteran 
     resulting from the illness on the basis of the presumption 
     before that date shall continue to be entitled to receive 
     dependency and indemnity compensation on that basis.
       ``(e) Subsections (b) through (d) shall cease to be 
     effective 10 years after the first day of the fiscal year in 
     which the National Academy of Sciences submits to the 
     Secretary the first report under section 3 of the Persian 
     Gulf War Veterans Act of 1997.''.
       (2) The table of sections at the beginning of such chapter 
     is amended by inserting after the item relating to section 
     1117 the following new item:

``1118. Presumptions of service connection for illnesses associated 
              with service in the Persian Gulf during the Persian Gulf 
              War.''.

       (b) Conforming Amendments.--Section 1113 of title 38, 
     United States Code, is amended--
       (1) by striking out ``or 1117'' each place it appears and 
     inserting in lieu thereof ``1117, or 1118''; and
       (2) in subsection (a), by striking out ``or 1116'' and 
     inserting in lieu thereof ``, 1116, or 1118''.
       (c) Compensation for Undiagnosed Gulf War Illnesses.--
     Section 1117 of title 38, United States Code, is amended--
       (1) by redesignating subsections (c), (d), and (e) as 
     subsections (d), (e), and (f), respectively; and
       (2) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c)(1) Whenever the Secretary determines as a result of a 
     determination under section 1118(c) of this title that a 
     presumption of service connection for an undiagnosed illness 
     (or combination of undiagnosed illnesses) is no longer 
     warranted under this section--
       ``(A) a veteran who was awarded compensation under this 
     section for such illness (or combination of illnesses) on the 
     basis of the presumption shall continue to be entitled to 
     receive compensation under this section on that basis; and
       ``(B) a survivor of a veteran who was awarded dependency 
     and indemnity compensation for the death of a veteran 
     resulting from the disease on the basis of the presumption 
     before that date shall continue to be entitled to receive 
     dependency and indemnity compensation on that basis.
       ``(2) This subsection shall cease to be effective 10 years 
     after the first day of the fiscal year in which the National 
     Academy of Sciences submits to the Secretary the first report 
     under section 3 of the Persian Gulf War Veterans Act of 
     1997.''.

     SEC. 3. AGREEMENT WITH NATIONAL ACADEMY OF SCIENCES.

       (a) Purpose.--The purpose of this section is to provide for 
     the National Academy of Sciences, an independent nonprofit 
     scientific organization with appropriate expertise, to review 
     and evaluate the available scientific evidence regarding 
     associations between illnesses and exposure to toxic agents 
     or environmental or wartime hazards associated with Gulf War 
     service.
       (b) Agreement.--The Secretary of Veterans Affairs shall 
     seek to enter into an agreement with the National Academy of 
     Sciences for the Academy to perform the services covered by 
     this section and sections 4(a)(6) and 5(d). The Secretary 
     shall seek to enter into the agreement not later than two 
     months after the date of enactment of this Act.
       (c) Identification of Agents and Illnesses.--(1) Under the 
     agreement under subsection (b), the National Academy of 
     Sciences shall--
       (A) identify the biological, chemical, or other toxic 
     agents or environmental or wartime hazards to which members 
     of the Armed Forces who served in the Southwest Asia theater 
     of operations during the Persian Gulf War may have been 
     exposed by reason of such service; and
       (B) identify the illnesses (including diagnosed illnesses 
     and undiagnosed illnesses) that are manifest in such members.
       (2) In identifying illnesses under paragraph (1)(B), the 
     Academy shall review and summarize the relevant scientific 
     evidence regarding illnesses among the members described in 
     paragraph (1)(B) and among other appropriate populations of 
     individuals, including mortality, symptoms, and adverse 
     reproductive health outcomes among such members and 
     individuals.
       (d) Determinations of Associations Between Agents and 
     Illnesses.--(1) For each agent or hazard and illness 
     identified under subsection (c), the National Academy of 
     Sciences shall determine, to the extent that available 
     scientific data permit meaningful determinations--
       (A) whether a statistical association exists between 
     exposure to the agent or hazard and the illness, taking into 
     account the strength of the scientific evidence and the 
     appropriateness of the scientific methodology used to detect 
     the association;
       (B) the increased risk of the illness among human 
     populations exposed to the agent or hazard; and
       (C) whether a plausible biological mechanism or other 
     evidence of a causal relationship exists between exposure to 
     the agent or hazard and the illness.
       (2) The Academy shall include in its reports under 
     subsection (h) a full discussion of the scientific evidence 
     and reasoning that led to its conclusions under this 
     subsection.
       (e) Review of Potential Treatment Models for Certain 
     Illnesses.--Under the agreement under subsection (b), the 
     National Academy of Sciences shall separately review, for 
     each chronic undiagnosed illness identified under subsection 
     (c)(1)(B) and for any chronic illness that the Academy 
     determines to warrant the review, the available scientific 
     data in order to identify empirically valid models of 
     treatment for such illnesses which employ successful 
     treatment modalities for populations with similar symptoms.
       (f) Recommendations for Additional Scientific Studies.--(1) 
     Under the agreement under subsection (b), the National 
     Academy of Sciences shall make any recommendations that it 
     considers appropriate for additional scientific studies 
     (including studies relating to treatment models) to resolve

[[Page S11203]]

     areas of continuing scientific uncertainty relating to the 
     health consequences of exposure to toxic agents or 
     environmental or wartime hazards associated with Gulf War 
     service.
       (2) In making recommendations for additional studies, the 
     Academy shall consider the available scientific data, the 
     value and relevance of the information that could result from 
     such studies, and the cost and feasibility of carrying out 
     such studies.
       (g) Subsequent Reviews.--(1) Under the agreement under 
     subsection (b), the National Academy of Sciences shall 
     conduct on a periodic and ongoing basis additional reviews of 
     the evidence and data relating to its activities under this 
     section.
       (2) As part of each review under this subsection, the 
     Academy shall--
       (A) conduct as comprehensive a review as is practicable of 
     the evidence referred to in subsection (c) and the data 
     referred to in subsections (d), (e), and (f) that became 
     available since the last review of such evidence and data 
     under this section; and
       (B) make its determinations on the basis of the results of 
     such review and all other reviews conducted for the purposes 
     of this section.
       (h) Reports.--(1) Under the agreement under subsection (b), 
     the National Academy of Sciences shall submit to the 
     committees and officials referred to in paragraph (4) 
     periodic written reports regarding the Academy's activities 
     under the agreement.
       (2) The first report under paragraph (1) shall be 
     transmitted not later than 18 months after the date of 
     enactment of this Act. That report shall include--
       (A) the determinations and discussion referred to in 
     subsection (d);
       (B) the results of the review of models of treatment under 
     subsection (e); and
       (C) any recommendations of the Academy under subsection 
     (f).
       (3)(A) Reports shall be submitted under this subsection at 
     least once every two years, as measured from the date of the 
     report under paragraph (2).
       (B) In any report under this subsection (other than the 
     report under paragraph (2)), the Academy may specify an 
     absence of meaningful developments in the scientific or 
     medical community with respect to the activities of the 
     Academy under this section during the 2-year period preceding 
     the date of such report.
       (4) Reports under this subsection shall be submitted to the 
     following:
       (A) The designated congressional committees.
       (B) The Secretary of Veterans Affairs.
       (C) The Secretary of Defense.
       (i) Sunset.--This section shall cease to be effective 10 
     years after the last day of the fiscal year in which the 
     National Academy of Sciences submits the first report under 
     subsection (h).
       (j) Alternative Contract Scientific Organization.--(1) If 
     the Secretary is unable within the time period set forth in 
     subsection (b) to enter into an agreement with the National 
     Academy of Sciences 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 is not part 
     of the Government and operates as a not-for-profit entity and 
     that has expertise and objectivity comparable to that of the 
     National Academy of Sciences.
       (2) If the Secretary enters into such an agreement with 
     another organization, any reference in this section and in 
     section 1118 of title 38, United States Code (as added by 
     section 2), to the National Academy of Sciences shall be 
     treated as a reference to the other organization.

     SEC. 4. MONITORING OF HEALTH STATUS AND TREATMENT OF PERSIAN 
                   GULF WAR VETERANS.

       (a) Information Data Base.--(1) The Secretary of Veterans 
     Affairs shall, in consultation with the Secretary of Defense, 
     develop a plan for the establishment and operation of a 
     single computerized information data base for the collection, 
     storage, and analysis of information on--
       (A) the diagnosed and undiagnosed illnesses suffered by 
     current and former members of the Armed Forces who served in 
     the Southwest Asia theater of operations during the Persian 
     Gulf War; and
       (B) the treatment provided such members for--
       (i) any chronic undiagnosed illnesses; and
       (ii) any chronic illnesses for which the National Academy 
     of Sciences has identified a valid model of treatment 
     pursuant to its review under section 3(e).
       (2) The plan shall provide for the commencement of the 
     operation of the data base not later than 18 months after the 
     date of enactment of this Act.
       (3) The Secretary shall ensure in the plan that the data 
     base provides the capability of monitoring and analyzing 
     information on--
       (A) the illnesses covered by paragraph (1)(A);
       (B) the treatments covered by paragraph (1)(B); and
       (C) the efficacy of such treatments.
       (4) In order to meet the requirement under paragraph (3), 
     the plan shall ensure that the data base includes the 
     following:
       (i) Information in the Persian Gulf War Veterans Health 
     Registry established under section 702 of the Persian Gulf 
     War Veterans' Health Status Act (title VII of Public Law 102-
     585; 38 U.S.C. 527 note).
       (ii) Information in the Comprehensive Clinical Evaluation 
     Program for Veterans established under section 734 of the 
     National Defense Authorization Act for Fiscal Years 1992 and 
     1993 (10 U.S.C. 1074 note).
       (iii) Information derived from other examinations and 
     treatment provided veterans who served in the Southwest Asia 
     theater of operations during the Persian Gulf War.
       (iv) Information derived from other examinations and 
     treatment provided current members of the Armed Forces 
     (including members on active duty and members of the reserve 
     components) who served in that theater of operations during 
     that war.
       (v) Such other information as the Secretary of Veterans 
     Affairs and the Secretary of Defense consider appropriate.
       (5) Not later than one year after the date of enactment of 
     this Act, the Secretary shall submit the plan developed under 
     paragraph (1) to the following:
       (A) The designated congressional committees.
       (B) The Secretary of Veterans Affairs.
       (C) The Secretary of Defense.
       (D) The National Academy of Sciences.
       (6)(A) The agreement under section 3 shall require the 
     evaluation of the plan developed under paragraph (1) by the 
     National Academy of Sciences. The Academy shall complete the 
     evaluation of the plan not later than 90 days after the date 
     of its submittal to the Academy under paragraph (5).
       (B) Upon completion of the evaluation, the Academy shall 
     submit a report on the evaluation to the committees and 
     individuals referred to in subparagraphs (A) through (D) of 
     paragraph (5).
       (7) Not later than 90 days after receipt of the report 
     under paragraph (6), the Secretary shall--
       (A) modify the plan in light of the evaluation of the 
     Academy in the report; and
       (B) commence implementation of the plan as so modified.
       (b) Compilation and Analysis of Information in Database.--
     (1) The Secretary of Veterans Affairs shall compile and 
     analyze, on an ongoing basis, all clinical data in the data 
     base under subsection (a) that is likely to be scientifically 
     useful in determining the association, if any, between the 
     illnesses (including diagnosed illnesses and undiagnosed 
     illnesses) of veterans covered by such data and exposure to 
     toxic agents or environmental or wartime hazards associated 
     with Gulf War service.
       (2) The Secretary of Defense shall compile and analyze, on 
     an ongoing basis, all clinical data in the data base that is 
     likely to be scientifically useful in determining the 
     association, if any, between the illnesses (including 
     diagnosed illnesses and undiagnosed illnesses) of current 
     members of the Armed Forces (including members on active duty 
     and members of the reserve components) and exposure to such 
     agents or hazards.
       (c) Annual Report.--Not later than April 1 of each year 
     after a year in which the Secretary of Veterans Affairs and 
     the Secretary of Defense carry out activities under 
     subsection (b), the Secretaries shall jointly submit to the 
     designated congressional committees a report containing--
       (1) with respect to the data compiled in accordance with 
     subsection (b) during the preceding year--
       (A) an analysis of the data;
       (B) a discussion of the types, incidences, and prevalence 
     of the disabilities and illnesses identified through such 
     data;
       (C) an explanation for the incidence and prevalence of such 
     disabilities and illnesses;
       (D) other reasonable explanations for the incidence and 
     prevalence of such disabilities and illnesses; and
       (E) an analysis of the scientific validity of drawing 
     conclusions from the incidence and prevalence of such 
     disabilities and illnesses, as evidenced by such data, about 
     any association between such disabilities and illnesses, as 
     the case may be, and exposure to a toxic agent or 
     environmental or wartime hazard associated with Gulf War 
     service; and
       (2) with respect to the most current information received 
     under section 3(h) regarding treatment models reviewed under 
     section 3(e)--
       (A) an analysis of the information;
       (B) the results of any consultation between such 
     Secretaries regarding the implementation of such treatment 
     models in the health care systems of the Department of 
     Veterans Affairs and the Department of Defense; and
       (C) in the event either such Secretary determines not to 
     implement such treatment models, an explanation for such 
     determination.

     SEC. 5. SCIENTIFIC RESEARCH FEASIBILITY STUDIES PROGRAM.

       (a) Establishment of Program.--The Secretary of Veterans 
     Affairs, the Secretary of Defense, and the Secretary of 
     Health and Human Services shall jointly carry out a program 
     to provide for the conduct of studies of the feasibility of 
     conducting additional scientific research on health hazards 
     resulting from exposure to toxic agents or environmental or 
     wartime hazards associated with Gulf War service.
       (b) Program Requirements.--(1) Under the program under 
     subsection (a), the Secretaries shall, pursuant to criteria 
     prescribed pursuant to paragraph (2), jointly award contracts 
     or furnish financial assistance to non-Government entities 
     for the conduct of studies referred to in subsection (a).
       (2) The Secretaries shall jointly prescribe criteria for--
       (A) the selection of entities to be awarded contracts or to 
     receive financial assistance under the program; and

[[Page S11204]]

       (B) the approval of studies to be conducted under such 
     contracts or with such financial assistance.
       (c) Report.--The Secretaries shall jointly report the 
     results of studies conducted under the program to the 
     designated congressional committees.
       (d) Consultation With National Academy of Sciences.--(1) To 
     the extent provided under the agreement entered into by the 
     Secretary of Veterans Affairs and the National Academy of 
     Sciences under section 3--
       (A) the Secretary shall consult with the Academy regarding 
     the establishment and administration of the program under 
     subsection (a); and
       (B) the Academy shall review the studies conducted under 
     contracts awarded pursuant to the program and the studies 
     conducted with financial assistance furnished pursuant to the 
     program.
       (2) The agreement shall require the Academy to submit any 
     recommendations that the Academy considers appropriate 
     regarding any studies reviewed for purposes of this 
     subsection to the following:
       (A) The designated congressional committees.
       (B) The Secretary of Veterans Affairs.
       (C) The Secretary of Defense.
       (D) The Secretary of Health and Human Services.

     SEC. 6. OUTREACH.

       (a) Outreach by Secretary of Veterans Affairs.--The 
     Secretary of Veterans Affairs shall, in consultation with the 
     Secretary of Defense and the Secretary of Health and Human 
     Services, carry out an ongoing program to provide veterans 
     who served in the Southwest Asia theater of operations during 
     the Persian Gulf War the information described in subsection 
     (c).
       (b) Outreach by Secretary of Defense.--The Secretary of 
     Defense shall, in consultation with the Secretary of Veterans 
     Affairs and the Secretary of Health and Human Services, carry 
     out an ongoing program to provide current members of the 
     Armed Forces (including members on active duty and members of 
     the reserve components) who served in that theater of 
     operations during that war the information described in 
     subsection (c).
       (c) Covered Information.--Information under this subsection 
     is information relating to--
       (1) the health risks, if any, resulting from exposure to 
     toxic agents or environmental or wartime hazards associated 
     with Gulf War service; and
       (2) any services or benefits available with respect to such 
     health risks.

     SEC. 7. DEFINITIONS.

       In this Act:
       (1) The term ``toxic agent or environmental or wartime 
     hazard associated with Gulf War service'' means a biological, 
     chemical, or other toxic agent or environmental or wartime 
     hazard that is known or presumed to be associated with 
     service in the Armed Forces in the Southwest Asia theater of 
     operations during the Persian Gulf War.
       (2) The term ``designated congressional committees'' means 
     the following:
       (A) The Committees on Veterans' Affairs and Armed Services 
     of the Senate.
       (B) The Committees on Veterans' Affairs and National 
     Security of the House of Representatives.

  Mr. DASCHLE. Mr. President, several years ago, I authored legislation 
that today allows Vietnam veterans to receive disability compensation 
for their exposure to Agent Orange and other toxic herbicides. This 
legislation, known as the Agent Orange Act of 1991, called for the 
National Academy of Sciences to review scientific and medical 
information related to the health effects of exposure to Agent Orange. 
In addition, it provided permanent presumptions of service connection 
for soft-tissue sarcoma, non-Hodgkin's lymphoma, chloracne, and any 
additional diseases the Secretary of Veterans Affairs, based on the 
Academy review and other relevant information, may determine to be 
associated with such exposure.
  For more than a decade, many in Congress and the Department of 
Veterans Affairs [VA] debated whether there was a connection between 
exposure to Agent Orange and other toxic herbicides and the illnesses 
suffered by Vietnam veterans. There were allegations of bureaucratic 
attempts to thwart scientific investigations of the issue and alter, 
bury, or delay Government reports that did exist. Ultimately, 
independent scientific evidence and a long-term effort to uncover 
Government information convinced Congress to pass the Agent Orange Act 
of 1991.
  With the help and guidance of Senator Rockefeller and many others who 
cosponsored this legislation in the House and Senate, Vietnam veterans 
exposed to Agent Orange and other herbicides are beginning to receive 
the treatment and compensation they deserve. And, with the passage of 
additional legislation last year, approximately 2,800 children of 
Vietnam veterans whose exposure to Agent Orange has been linked to 
their children's diagnosis of spina bifida, a congenital defect in the 
spine, are now eligible for health care and related services from the 
VA.
  Although we have made great strides to determine the cause of 
illnesses suffered by Vietnam veterans and their children and agreed to 
provide them with just compensation, we have yet to do the same for 
those men and women who served in the Persian gulf war. When the first 
reports of gulf war illness emerged, several of us warned that we 
needed to be sure that we did not repeat the mistakes that were made 
with respect to Agent Orange. We needed to act quickly to ask all the 
appropriate questions and secure timely answers. Whatever our 
investigation might reveal, we needed to uncover the truth and act 
accordingly. Our Nation's veterans deserve no less.
  Unfortunately, the effort to get to the truth has been undermined by 
actions painfully reminiscent of the Agent Orange experience. I am 
hopeful, though, that those actions are behind us and that we are now 
moving ahead with a single-minded commitment to the truth.
  Countless studies have been conducted to determine whether there is a 
connection between a wide range of toxins as well as environmental and 
wartime hazards and the illnesses suffered by Persian Gulf war veterans 
and their families. Despite these efforts, the actual causes of Persian 
Gulf war illnesses remain unknown, and many veterans and their families 
continue to suffer.
  Mr. President, it is time for Congress, the VA, the Department of 
Defense [DOD] and the Department of Health and Human Services [HHS] to 
step up their efforts to find the causes of Persian Gulf war illnesses. 
More importantly, we must provide veterans and their families with 
proper medical care and compensation regardless of whether we know the 
particular causes of their illnesses.
  That is why I am proud to join my friend and colleague from West 
Virginia, Senator Rockefeller, in introducing the Persian Gulf War 
Veterans Act of 1991. As ranking member of the Senate Veterans' Affairs 
Committee, Senator Rockefeller has been a tireless advocate for all 
veterans. His commitment and dedication to improving the lives of 
veterans and their families is well known, and he and his staff on the 
Veterans' Affairs Committee deserve to be commended for their work in 
drafting this important legislation.

  Since the Persian Gulf war ended in 1991, many veterans have been 
suffering from a variety of symptoms, including extreme fatigue, joint 
and muscle pain, short-term memory loss, diarrhea, unexplained rashes, 
night sweats, headaches, and bleeding gums. Many believe that these 
illnesses may be caused by exposure to a wide range of toxins as well 
as environmental and wartime hazards. Among the potentially hazardous 
substances to which United States servicemembers may have been exposed 
are smoke from oil-well fires set by retreating Iraqi soldiers; 
pesticides and repellents; depleted uranium used in munitions; 
infectious diseases; petroleum products; and vaccines to protect 
against chemical warfare agents.
  U.S. servicemembers may have also been exposed to chemical warfare 
agents. For 5 years, the Pentagon had steadfastly insisted that no 
United States soldiers had been exposed to chemical weapons in Iraq. In 
June of last year, however, the Pentagon revealed that chemical 
munitions had been unknowingly destroyed near an ammunition dump at 
Khamisiyah in southern Iraq and that 20,000 United States troops may 
have been exposed. In July of this year, the Pentagon changed its 
assessment again and announced that nearly 100,000 U.S. servicemembers 
may have actually been exposed to trace levels of poisonous sarin gas.
  Much like the Agent Orange Act of 1991, the Persian Gulf War Veterans 
Act of 1997 calls for the Department of Veterans Affairs to contract 
with the National Academy of Sciences to evaluate the available 
scientific evidence regarding associations between illnesses suffered 
by Persian Gulf war veterans and their exposure to toxins or 
environmental or wartime hazards. Specifically, the Academy would 
identify the biological, chemical, or other

[[Page S11205]]

toxic agents or environmental or wartime hazards to which U.S. service 
members may have been exposed during the Persian Gulf war.
  The National Academy of Sciences would be required to identify those 
diagnosed and undiagnosed illnesses among Persian Gulf war veterans. In 
addition, it would be responsible for reviewing potential treatment for 
chronic undiagnosed illnesses. As it did under the Agent Orange 
legislation, the Academy would also be authorized to make 
recommendations for additional scientific studies regarding the 
exposure that Persian Gulf war veterans may have had to toxic agents or 
environmental or wartime hazards.
  Based upon the assessments of the National Academy of Sciences and 
any other relevant scientific and medical information, the Secretary of 
Veterans Affairs would then determine whether a presumption of service 
connection is warranted for various diagnosed or undiagnosed illnesses. 
The Secretary would provide compensation when there is a positive 
association between the illness and exposure to one or more toxic 
agents or environmental or wartime hazards during the Persian Gulf war. 
A positive association is regarded as one where credible evidence for 
the association is equal to or outweighs credible evidence against the 
association. Like the Agent Orange Act, this legislation provides for 
ongoing Academy reviews and puts a mechanism in place whereby the 
Secretary may provide compensation for additional illnesses as the 
scientific evidence warrants.
  The bill Senator Rockefeller and I are introducing today also 
requires the VA to collaborate with the Pentagon to operate a 
computerized database for the collection, storage, and analysis of 
information on the diagnosed and undiagnosed illnesses suffered by 
Persian Gulf war veterans. I should point out that the database would 
also include information on the treatment veterans receive for chronic 
undiagnosed illnesses. The VA would be required to continuously compile 
and analyze the information in this database that is likely to 
determine the association between the diagnosed and undiagnosed 
illnesses suffered by veterans and their exposure to toxic agents or 
environmental or wartime hazards during the Persian Gulf war.
  In June, the General Accounting Office issued a report stating that, 
``although efforts have been made to diagnose veterans' problems and 
care had been provided to many eligible veterans, neither DOD nor VA 
has systematically attempted to determine whether ill Gulf War veterans 
are any better or worse today than when they were first examined.'' The 
database we are proposing would correct that deficiency. It would 
permit VA and DOD to determine whether Persian Gulf war veterans are 
getting better over time and whether they are responding to the 
treatment they are receiving.
  The bill we are introducing today also calls for enhanced outreach to 
those who served in the Persian Gulf war. Specifically, it would 
require the VA to consult with DOD and HHS to create an ongoing program 
to provide information to veterans and their families. For example, 
they would receive information pertaining to the possible health risks 
to Persian Gulf war veterans who were exposed to toxic agents or 
environmental or wartime hazards. In addition, veterans would receive 
valuable information on any services or benefits available to them.
  Mr. President, as I mentioned previously, we have made great strides 
to determine the cause of illnesses suffered by Vietnam veterans and 
their children and agreed to provide them with just compensation. We 
must now enhance our efforts to help those who served our country 
during the Persian Gulf war. Passage of this legislation is essential 
to providing answers to the many questions we have about the causes of 
Persian Gulf war illnesses. More importantly, it will ensure that our 
veterans are receiving proper medical care and the compensation they 
have earned. I again thank Senator Rockefeller for his leadership on 
this issue and hope my colleagues will support this important 
legislation.

                          ____________________