[Congressional Record Volume 149, Number 90 (Wednesday, June 18, 2003)]
[Senate]
[Pages S8133-S8134]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GRAHAM of Florida:
  S. 1281. A bill to amend title 38, United Stated Code, to presume 
additional diseases of former prisoners of war to be service-connected 
for compensation purposes, to enhance the Dose Reconstruction Program 
of the Department of Defense, to enhance and fund certain other 
epidemiological studies, and for other purposes; to the Committee on 
Veterans' Affairs.
  Mr. GRAHAM of Florida. Madam President, today I introduce legislation 
that would take one more step toward finding answers for veterans who 
may have been exposed to radiation, Agent Orange, or other hazards 
during their military service.
  The last century saw the nature of war change forever. When mustard 
gas drifted across the trenches of World War I, troops learned that 
dangers less tangible, but no less deadly, than bullets might fill the 
air. Since then, many veterans have questioned whether health effects 
of the environmental hazards that they faced on and off the battlefield 
might appear years or even decades later.
  Congress, VA, the military, and scores of independent researchers 
have struggled to answer those questions. Many veterans still wait for 
scientific evidence to fill the gaps. However, research in some areas 
has linked specific exposures to a risk of later disease, and we must 
respond to those new findings and encourage further investigation.
  Peer-reviewed studies published in recent years suggest that veterans 
held prisoner during World War II, the Korean War, and in Vietnam 
suffer from some chronic diseases at a higher rate than expected. 
Scientists now report that the toll taken by malnutrition, long periods 
of forced confinement, and untreated infections appears to pose a 
lifelong risk. Based on these findings, I have introduced legislation 
that would add heart disease, strokes, and chronic liver diseases to 
the list of diseases that can be presumptively connected to service for 
certain former prisoners of war. This would allow eligible veterans 
with these conditions to seek VA benefits without having to prove that 
their illnesses resulted from deprivations suffered during captivity.
  Other veterans who were exposed to large doses of ionizing radiation 
in post-war Japan or during nuclear tests, and who suffer from 
illnesses thought to be caused by radiation, can currently claim 
eligibility for VA benefits. However, some veterans who believe they 
received high doses of radiation have been frustrated to find that 
their military records do not reflect the same assumptions. Congress 
mandated nearly 20 years ago that veterans who suffer from diseases 
that they suspect might be linked to radiation exposure during service 
could request a dose reconstruction, or a scientific estimate of past 
exposure levels, to remedy this.
  Many veterans felt that this method fell short of expectations, and 
Congress responded in 1998 by requiring an independent review of the 
Dose Reconstruction Program conducted by the Department of Defense. A 
panel of experts convened by the National Academy of Sciences reported 
recently that this contractor-operated program suffered from a 
shockingly cavalier approach to quality assurance, resulting in data 
that failed to meet the standards assumed by VA and veterans. This is 
not acceptable. Provisions introduced here would require the 
Secretaries of VA and Defense to establish permanent independent 
oversight of the Dose Reconstruction Program, and to create an advisory 
board to improve the program as necessary.
  Our understanding of the consequences of exposure to the herbicides 
and dioxin in Agent Orange remains far from complete. It has been 
almost 25 years since Congress required the Air Force to conduct an 
epidemiologic study of the veterans of Operation Ranch Hand, the unit 
responsible for aerial spraying of herbicides during the Vietnam War. 
The last scheduled round of physical examinations took place just last 
month, and the fate of the millions of medical records and specimens 
remains undecided. Experts agree that both samples and data should be 
preserved for further research, but do not share an opinion on the best 
way to do so. The bill that I have introduced would task the National 
Academy of Sciences to develop research recommendations for extending 
the Air Force Health Study, or for preserving the samples and making 
them accessible to independent researchers as requested by many 
veterans' organizations.
  Finally, the legislation that I have introduced would ensure that the 
scientific body charged with tracking veterans' and military health can 
continue its mission. The Medical Follow-Up Agency, MFUA, a board of 
the Institute of Medicine--the health agency of the National Academy of 
Sciences--was created at the end of World War II at the urging of the 
Army Surgeon General. For many years, it received funding only 
sporadically. In 1988, the now-defunct Office of Technology Assessment 
reported that MFUA's critical contribution to understanding military 
health issues was limited by a lack of consistent funding, which caused 
high staff turnover, incohesiveness in the research portfolio, and 
failure to maintain records.
  Congress responded with Public Law 102-585, which required that VA 
and the military each contribute $250,000 in annual core funding to 
MFUA for 10 years. MFUA's staff uses this funding to update, maintain, 
and improve long-term epidemiological studies of military and veterans 
populations. Congress, VA, the military, and independent scientists 
have relied on these studies to evaluate whether specific exposures 
might have long-term health effects that suggest a need for benefits, 
new treatments, or further research. The legislation that I have 
introduced would extend MFUA's core funding for 10 more years.
  This legislation would demonstrate to those who serve their nation 
now

[[Page S8134]]

that our commitment to them will not end with the wars that they fight. 
We must continue to seek remedies for the sometimes invisible wounds of 
the new battlefield, and ensure that those who have borne them receive 
the support that they need. I urge my colleagues in the Senate to join 
me in supporting this legislation.
  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. 1281

       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 ``Veterans Information and 
     Benefits Enhancement Act of 2003''.

     SEC. 2. PRESUMPTION OF ADDITIONAL DISEASES OF FORMER 
                   PRISONERS OF WAR TO BE SERVICE-CONNECTED FOR 
                   COMPENSATION PURPOSES.

       (a) Presumption.--Section 1112(b) of title 38, United 
     States Code, is amended--
       (1) in paragraph (14), by striking ``or'' at the end; and
       (2) by inserting after paragraph (15) the following new 
     paragraphs:
       ``(16) cardiovascular disease (heart disease),
       ``(17) cerebrovascular disease (stroke), or
       ``(18) chronic liver disease, including cirrhosis and 
     primary liver carcinoma,''.
       (b) Effective Date.--(1) The amendments made by subsection 
     (a) shall take effect on the date of the enactment of this 
     Act.
       (2) No benefit may be paid by reason of the amendments made 
     by subsection (a) for any period before the date of the 
     enactment of this Act.

     SEC. 3. DOSE RECONSTRUCTION PROGRAM OF DEPARTMENT OF DEFENSE.

       (b) Review of Mission, Procedures, and Administration.--(1) 
     The Secretary of Veterans Affairs and the Secretary of 
     Defense shall jointly conduct a review of the mission, 
     procedures, and administration of the Dose Reconstruction 
     Program of the Department of Defense.
       (2) In conducting the review under paragraph (1), the 
     Secretaries shall--
       (A) determine whether any additional actions are required 
     to ensure that the quality assurance and quality control 
     mechanisms of the Dose Reconstruction Program are adequate 
     and sufficient for purposes of the program; and
       (B) determine the actions that are required to ensure that 
     the mechanisms of the Dose Reconstruction Program for 
     communication and interaction with veterans are adequate and 
     sufficient for purposes of the program, including mechanisms 
     to permit veterans to review the assumptions utilized in 
     their dose reconstructions.
       (3) Not later than 90 days after the date of the enactment 
     of this Act, the Secretaries shall jointly submit to Congress 
     a report on the review under paragraph (1). The report shall 
     set forth--
       (A) the results of the review;
       (B) a plan for any actions determined to be required under 
     paragraph (2); and
       (C) such other recommendations for the improvement of the 
     mission, procedures, and administration of the Dose 
     Reconstruction Program as the Secretaries jointly consider 
     appropriate.
       (b) On-Going Review and Oversight.--The Secretaries shall 
     jointly take appropriate actions to ensure the on-going 
     independent review and oversight of the Dose Reconstruction 
     Program, including the establishment of the advisory board 
     required by subsection (c).
       (c) Advisory Board.--(1) In taking actions under subsection 
     (b), the Secretaries shall jointly appoint an advisory board 
     to provide review and oversight of the Dose Reconstruction 
     Program.
       (2) The advisory board under paragraph (1) shall be 
     composed of the following:
       (A) At least one expert in historical dose reconstruction 
     of the type conducted under the Dose Reconstruction Program.
       (B) At least one expert in radiation health matters.
       (C) At least one expert in risk communications matters.
       (D) A representative of the Department of Veterans Affairs.
       (E) A representative of the Defense Threat Reduction 
     Agency.
       (F) At least three veterans, including at least one veteran 
     who is a member of an atomic veterans group.
       (3) The advisory board under paragraph (1) shall--
       (A) conduct periodic, random audits of dose reconstructions 
     and decisions on claims for radiogenic diseases under the 
     Dose Reconstruction Program;
       (B) assist the Department of Veterans Affairs and the 
     Defense Threat Reduction Agency in communicating to veterans 
     information on the mission, procedures, and evidentiary 
     requirements of the Dose Reconstruction Program; and
       (C) carry out such other activities with respect to the 
     review and oversight of the Dose Reconstruction Program as 
     the Secretaries shall jointly specify.
       (4) The advisory board under paragraph (1) may make such 
     recommendations on modifications in the mission or procedures 
     of the Dose Reconstruction Program as the advisory board 
     considers appropriate as a result of the audits conducted 
     under paragraph (3)(A).

     SEC. 4. STUDY ON DISPOSITION OF AIR FORCE HEALTH STUDY.

       (a) In General.--The Secretary of Veterans Affairs shall, 
     in accordance with this section, carry out a study to 
     determine the appropriate disposition of the Air Force Health 
     Study, an epidemiologic study of Air Force personnel who were 
     responsible for conducting aerial spray missions of 
     herbicides during the Vietnam era.
       (b) Study Through National Academy of Sciences.--Not later 
     than sixty days after the date of the enactment of this Act, 
     the Secretary shall seek to enter into an agreement with the 
     National Academy of Sciences, or another appropriate 
     scientific organization, to carry out the study required by 
     subsection (a).
       (c) Elements.--Under the study under subsection (a), the 
     National Academy of Sciences, or other appropriate scientific 
     organization, shall address the following:
       (1) The scientific merit of retaining and maintaining the 
     medical records, other study data, and laboratory specimens 
     collected in the course of the Air Force Health Study after 
     the currently-scheduled termination date of the study in 
     2006.
       (2) Whether or not any obstacles exist to retaining and 
     maintaining the medical records, other study data, and 
     laboratory specimens referred to in paragraph (1), including 
     privacy concerns.
       (3) The advisability of providing independent oversight of 
     the medical records, other study data, and laboratory 
     specimens referred to in paragraph (1), and of any further 
     study of such records, data, and specimens, and, if so, the 
     mechanism for providing such oversight.
       (4) The advisability of extending the Air Force Health 
     Study, including the potential value and relevance of 
     extending the study, the potential cost of extending the 
     study, and the Federal or non-Federal entity best suited to 
     continue the study if extended.
       (5) The advisability of making the laboratory specimens of 
     the Air Force Health Study available for independent 
     research, including the potential value and relevance of such 
     research, and the potential cost of such research.
       (d) Report.--Not later than 60 days after entering into an 
     agreement under subsection (b), the National Academy of 
     Sciences, or other appropriate scientific organization, shall 
     submit to the Secretary and Congress a report on the results 
     of the study under subsection (a). The report shall include 
     the results of the study, including the matters addressed 
     under subsection (c), and such other recommendations as the 
     Academy, or other appropriate scientific organization, 
     considers appropriate as a result of the study.

     SEC. 5. FUNDING OF MEDICAL FOLLOW-UP AGENCY OF INSTITUTE OF 
                   MEDICINE OF NATIONAL ACADEMY OF SCIENCES FOR 
                   EPIDEMIOLOGICAL RESEARCH ON MEMBERS OF THE 
                   ARMED FORCES AND VETERANS.

       (a) Funding by Department of Veterans Affairs.--(1) The 
     Secretary of Veterans Affairs shall make available to the 
     National Academy of Sciences in each of fiscal years 2004 
     through 2013, $250,000 for the Medical Follow-Up Agency of 
     the Institute of Medicine of the Academy for purposes of 
     epidemiological research on members of the Armed Forces and 
     veterans.
       (2) The Secretary of Veterans Affairs shall make available 
     amounts under paragraph (1) for a fiscal year from amounts 
     available for the Department of Veterans Affairs for that 
     fiscal year.
       (b) Funding by Department of Defense.--(1) The Secretary of 
     Defense shall make available to the National Academy of 
     Sciences in each of fiscal years 2004 through 2013, $250,000 
     for the Medical Follow-Up Agency for purposes of 
     epidemiological research on members of the Armed Forces and 
     veterans.
       (2) The Secretary of Defense shall make available amounts 
     under paragraph (1) for a fiscal year from amounts available 
     for the Department of Defense for that fiscal year.
       (c) Use of Funds.--The Medical Follow-Up Agency shall use 
     funds made available under subsections (a) and (b) for 
     epidemiological research on members of the Armed Forces and 
     veterans.
       (d) Supplement Not Supplant.--Amounts made available to the 
     Medical Follow-Up Agency under this section for a fiscal year 
     for the purposes referred to in subsection (c) are in 
     addition to any other amounts made available to the Agency 
     for that fiscal year for those purposes.
                                 ______