[Congressional Record Volume 166, Number 127 (Monday, July 20, 2020)]
[Senate]
[Pages S4300-S4301]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 2475. Mrs. BLACKBURN submitted an amendment intended to be 
proposed to amendment SA 2301 proposed by Mr. Inhofe to the bill S. 
4049, to authorize appropriations for fiscal year 2021 for military 
activities of the Department of Defense, for military construction, and 
for defense activities of the Department of Energy, to prescribe 
military personnel strengths for such fiscal year, and for other 
purposes; which was ordered to lie on the table; as follows:

        At the appropriate place in title X, insert the following:

         Subtitle __--K2 Veterans Toxic Exposure Accountability

     SEC. __1. STUDY ON TOXIC EXPOSURE AT KARSHI KHANABAD AIR 
                   BASE, UZBEKISTAN.

       (a) Study.--
       (1) In general.--The Secretary of Defense shall conduct a 
     study on toxic exposure by members of the Armed Forces 
     deployed to Karshi Khanabad Air Base, Uzbekistan, at any time 
     during the period beginning October 1, 2001, and ending 
     December 31, 2005.
       (2) Matters included.--The study under paragraph (1) shall 
     include the following:
       (A) An assessment regarding the conditions of Karshi 
     Khanabad Air Base, Uzbekistan, during the period beginning 
     October 1, 2001, and ending December 31, 2005, including an 
     identification of toxic substances contaminating the Air Base 
     during such period.
       (B) An epidemiological study of the health consequences of 
     a member of the Armed Forces deployed to the Air Base during 
     such period.
       (C) An assessment of any association between exposure to 
     toxic substances identified under subparagraph (A) and the 
     health consequences studied under subparagraph (B).
       (b) Report.--Not later than 180 days after the date of the 
     enactment of this Act, the Secretary of Defense and the 
     Secretary of Veterans Affairs shall jointly submit to the 
     appropriate congressional committees a report containing--
       (1) the study under subsection (a); and
       (2) a description of--
       (A) the benefits administered by the Secretary of Veterans 
     Affairs that a veteran may be eligible to receive by reason 
     of being exposed to toxic substances at Karshi Khanabad Air 
     Base, Uzbekistan, while serving in the Armed Forces; and
       (B) the outreach conducted by the Secretary to inform such 
     veterans of such benefits.

     SEC. __2. ESTABLISHMENT OF K2 TOXIC EXPOSURE REGISTRY.

       (a) Establishment of Registry.--
       (1) In general.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall--
       (A) establish and maintain a registry for eligible 
     individuals who may have been exposed to toxic substances at 
     Karshi Khanabad Air Base, Uzbekistan, at any time during the 
     period beginning October 1, 2001, and ending December 31, 
     2005;
       (B) include any information in such registry that the 
     Secretary of Veterans Affairs determines necessary to 
     ascertain and monitor the health effects of the exposure of 
     members to such substances;
       (C) develop a public information campaign to inform 
     eligible individuals about the registry, including how to 
     register and the benefits of registering; and
       (D) periodically notify eligible individuals of significant 
     developments in the study and treatment of conditions 
     associated with such exposure.
       (2) Updates.--The Secretary shall take actions necessary to 
     ensure that the registry may be updated with the cause of 
     death of a deceased registered individual by--
       (A) an individual designated by such deceased registered 
     individual; or
       (B) if no such individual is designated, an immediate 
     family member of such deceased registered individual.
       (3) Coordination.--The Secretary of Veterans Affairs shall 
     coordinate with the Secretary of Defense in carrying out 
     paragraph (1).
       (b) Report to Congress.--
       (1) Reports by independent scientific organization.--The 
     Secretary of Veterans Affairs shall enter into an agreement 
     with an independent scientific organization to prepare 
     reports as follows:
       (A) Not later than two years after the date on which the 
     registry under subsection (a) is established, an initial 
     report containing the following:
       (i) An assessment of the effectiveness of actions taken by 
     the Secretaries to collect and maintain information on the 
     health effects of exposure to toxic substances at Karshi 
     Khanabad Air Base, Uzbekistan.
       (ii) Recommendations to improve the collection and 
     maintenance of such information.
       (iii) Using established and previously published 
     epidemiological studies, recommendations regarding the most 
     effective and prudent means of addressing the medical needs

[[Page S4301]]

     of eligible individuals with respect to conditions that are 
     likely to result from such exposure.
       (B) Not later than five years after completing the initial 
     report described in subparagraph (A), a follow-up report 
     containing the following:
       (i) An update to the initial report described in 
     subparagraph (A).
       (ii) An assessment of whether and to what degree the 
     content of the registry established under subsection (a) is 
     current and scientifically up-to-date.
       (2) Submittal to congress.--
       (A) Initial report.--Not later than two years after the 
     date on which the registry under subsection (a) is 
     established, the Secretary of Veterans Affairs shall submit 
     to Congress the initial report prepared under paragraph 
     (1)(A).
       (B) Follow-up report.--Not later than five years after 
     submitting the report under subparagraph (A), the Secretary 
     of Veterans Affairs shall submit to Congress the follow-up 
     report prepared under paragraph (1)(B).
       (c) Definitions.--In this section:
       (1) The term ``eligible individual'' means any individual 
     who was deployed as a member of the Armed Forces to Karshi 
     Khanabad Air Base, Uzbekistan, at any time during the period 
     beginning October 1, 2001, and ending December 31, 2005.
       (2) The term ``immediate family member'', with respect to a 
     deceased individual, means--
       (A) the spouse, parent, brother, sister, or adult child of 
     the individual;
       (B) an adult person to whom the individual stands in loco 
     parentis; or
       (C) any other adult person--
       (i) living in the household of the individual at the time 
     of the death of the individual; and
       (ii) related to the individual by blood or marriage.
       (3) The term ``registered individual'' means an individual 
     registered with the registry under subsection (a).

     SEC. __3. DETERMINATION OF PRESUMPTIONS OF SERVICE CONNECTION 
                   FOR ILLNESSES ASSOCIATED WITH K2 EXPOSURE.

       (a) In General.--
       (1) Determination required.--Not later than 60 days after 
     the date on which the Secretary of Veterans Affairs receives 
     the results of a covered study, the Secretary shall make a 
     determination whether a positive association exists between--
       (A) the exposure of humans to toxic substances at Karshi 
     Khanabad Air Base, Uzbekistan, at any time during the period 
     beginning October 1, 2001, and ending December 31, 2005; and
       (B) the occurrence of a diagnosed illness in humans.
       (2) Bases of determination.--In making a determination 
     under paragraph (1), the Secretary shall consider--
       (A) whether the evidence is statistically significant, 
     capable of replication, and able to withstand peer review 
     demonstrating that there is positive association between the 
     exposure and the occurrence of a diagnosed illness;
       (B) the results of a covered study; and
       (C) all other sound medical and scientific evidence 
     available to the Secretary.
       (3) Presumption.--If the Secretary determines that a 
     positive association exists between exposure and a diagnosed 
     illness pursuant to paragraph (1), the Secretary shall 
     prescribe regulations providing that--
       (A) a presumption of service connection is warranted for 
     the illness covered by that determination if the illness 
     first becomes manifest within the period, if any, prescribed 
     in such regulations in a covered veteran; and
       (B) such covered veteran shall be presumed to have been 
     exposed to toxic substances at Karshi Khanabad Air Base, 
     Uzbekistan, at any time during the period beginning October 
     1, 2001, and ending December 31, 2005, unless there is 
     conclusive evidence to establish that--
       (i) the covered veteran was not exposed to toxic substances 
     in the course of such service in the Armed Forces; or
       (ii) the illness first became manifest prior to the covered 
     veteran's exposure.
       (4) Submission.--Upon the date on which the Secretary makes 
     the determination under paragraph (1), the Secretary shall 
     submit to the Committees on Veterans' Affairs of the House of 
     Representatives and the Senate an explanation of such 
     determination.
       (b) Regulations.--
       (1) Proposed regulations.--
       (A) Timing.--If the Secretary determines under subsection 
     (a)(1) that a presumption of service connection is warranted 
     for an illness, the Secretary shall, not later than 180 days 
     after making such determination--
       (i) issue proposed regulations setting forth the 
     determination; or
       (ii) submit the initial report under subparagraph (B).
       (B) Reports.--If the Secretary does not issue proposed 
     regulations by the deadline established in subparagraph (A), 
     the Secretary shall submit to the Committees on Veterans' 
     Affairs of the House of Representatives and the Senate a 
     report on the status of such proposed regulations. On a 
     quarterly basis thereafter until the date on which the 
     Secretary issues such proposed regulations, the Secretary 
     shall submit to such committees an update on such status.
       (2) Final regulations.--Not later than 180 days after the 
     date on which the Secretary issues any proposed regulations 
     under this subsection, the Secretary shall prescribe final 
     regulations. Such regulations shall be effective on the date 
     of issuance.
       (3) Presumption not warranted.--
       (A) Publication.--If the Secretary determines under 
     subsection (a) that a presumption of service connection is 
     not warranted for an illness, or proposes to remove a 
     previously established presumption, the Secretary shall 
     publish in the Federal Register a notice of that 
     determination not later than 180 days after making the 
     determination. The notice shall include an explanation of the 
     evidence and scientific basis for that determination.
       (B) Removal of previous presumption.--If an illness already 
     presumed to be service connected under this section is 
     subject to a notice published under subparagraph (A), the 
     Secretary shall issue proposed regulations removing the 
     presumption for the illness not later than 180 days after 
     publication of such notice.
       (4) Effect of removal.--Whenever the presumption of service 
     connection for an illness under this section is removed under 
     this subsection--
       (A) 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
       (B) 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.
       (c) Effective Date of Benefit Awards.--The effective date 
     of any benefit awarded by reason of this section shall be 
     determined in accordance with section 5110 of title 38, 
     United States Code, but shall in no case be earlier than the 
     effective date of the final regulations prescribed pursuant 
     to subsection (b)(2).
       (d) Definitions.--In this section:
       (1) The term ``covered study'' includes--
       (A) the study conducted under section __1; and
       (B) any subsequent study or any study conducted by the 
     National Academies of Sciences, Engineering, and Medicine 
     regarding the effects of exposure of humans to toxic 
     substances at Karshi Khanabad Air Base, Uzbekistan, at any 
     time during the period beginning October 1, 2001, and ending 
     December 31, 2005.
       (2) The term ``covered veteran'' means a veteran who was 
     deployed as a member of the Armed Forces to Karshi Khanabad 
     Air Base, Uzbekistan, at any time during the period beginning 
     October 1, 2001, and ending December 31, 2005.

     SEC. __4. ACCESS OF THE NATIONAL ACADEMIES OF SCIENCES, 
                   ENGINEERING, AND MEDICINE TO INFORMATION FROM 
                   THE DEPARTMENT OF DEFENSE.

       Upon request by the National Academies of Sciences, 
     Engineering, and Medicine (in this section referred to as the 
     ``Academies''), the Secretary of Defense shall provide to the 
     Academies information in the possession of the Department of 
     Defense that the Academies determine useful in performing a 
     covered study, as that term is defined in section __3(d). 
     Such information includes, at a minimum, all environmental 
     sampling data relative to any location included in the study.
                                 ______