[Congressional Record Volume 168, Number 31 (Wednesday, February 16, 2022)]
[Senate]
[Pages S733-S735]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 HEALTH CARE FOR BURN PIT VETERANS ACT

  Mr. MORAN. Mr. President, I rise this afternoon here on the Senate 
floor to mark what will soon be the passage, in just a matter of 
moments, of a vital veterans bill and to thank my colleagues--both 
Republicans and Democrats--who came together to support the Health Care 
for Burn Pit Veterans Act. This is an important bill, and it will 
remove hurdles for post-9/11 Iraq and Afghanistan veterans, in 
particular, who were exposed to burn pits, so they can receive 
healthcare from the VA without delay.
  This legislation is cosponsored by every single member of the Senate 
VA Committee, and I commend each of my Senate colleagues in their 
support for this legislation.
  Supporting our veterans has a way of bringing us together, and I am 
so glad that is true. I am on the floor this afternoon with the 
Chairman of the Senate Committee on Veterans Affairs, and I appreciate 
how he and my Senate colleagues understand the urgency of this bill and 
are quickly moving to pass it by unanimous consent.
  Post-9/11 veterans are the newest generation of American heroes to 
suffer from toxic exposure encountered during military service; and 
passing this legislation marks just a first step--a first step--of a 
phased approach to solving the complex challenges of caring for those 
veterans exposed to burn pits and other toxic exposures.
  For way too long, we have heard from veterans who got sick after 
exposure to burn pits and need lifesaving care. There is a bipartisan 
consensus on our committee that this phased approach--delivering 
healthcare now and reforming the benefit system next--is the most 
effective pathway forward for toxic exposure veterans and all other 
veterans as well.
  Servicemembers are willing to make the ultimate sacrifice for their 
country. We know that. We respect that. We honor that. We must match 
that level of commitment by crafting thoughtful and effective solutions 
to make certain we hold up our end of the bargain and continuously work 
toward the best outcomes for those who served and sacrificed.
  I once joined a roundtable in Wichita, KS, with local members of the 
Vietnam Veterans of America and was moved by their stories--not only of 
their own health consequences from Agent Orange but their concerns of 
how their exposure was affecting the health of their children and 
grandchildren. From that veteran feedback, I introduced the Toxic 
Exposure Research Act with Senator Blumenthal, which was signed into 
law in 2016.
  I have since heard from many veterans in Kansas and across the 
country who are sick and dying from the effects of toxic exposure 
caused by burn pits. Addressing the needs of veterans exposed to burn 
pits cannot wait. This legislation could be lifesaving for those 
exposed or suffering. When our men and women in uniform go into harm's 
way on our behalf, we owe it to them to take care of them when they 
come home for whatever injuries are incurred during their service. This 
is not a question of resources; this is a question of getting reform 
done the right way.
  The Senate soon will act to pass this bill, moving us closer to 
completing phase 1 of this approach to provide timely, sustainable care 
to our veterans. I will continue to work with veterans, advocates in 
the VA, and, importantly, my colleagues on the Senate Committee on 
Veterans' Affairs and its chairman, Senator Tester, of Montana, to make 
sure we are crafting legislative solutions that are veteran-centric.
  I call upon my colleagues in the House to quickly take action and act 
on this bill and act on our promise as a nation so post-9/11 veterans 
who are suffering from toxic exposures can get the care they need.
  I thank my colleagues on the committee, Chairman Tester, and our 
respective staffs for working to craft this feasible path forward. And 
I want to thank many veteran organizations that have expressed their 
support for this legislation, including the Disabled Veterans of 
America, Veterans of Foreign Wars, the Wounded Warrior Project, Iraq 
and American Veterans of America, the American Legion, Military 
Officers Association of America, and Military-Veterans Advocacy.
  I am confident that if we continue to work together with the VA and 
with veterans' groups, we will keep the needs of veterans foremost in 
our minds and that we can deliver meaningful reforms for the current 
generation of veterans and for all those who come thereafter.
  I yield the floor to the Senator from Montana.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. TESTER. Mr. President, I want to thank my friend, the Senator 
from Kansas, Senator Moran, the ranking

[[Page S734]]

member of the Veterans' Affairs Committee.
  When we started this Congress, the No. 1 issue that was put forth by 
the veterans service organizations representing the veterans in this 
country was toxic exposure. It was incumbent that the Veterans' Affairs 
Committee do something about toxic exposure. We created the bill called 
the COST of War.
  We are at a point now where we are going to try to implement that 
bill in phases. The phase we are working on today has six major 
components to it. No. 1, it expands the screening period of healthcare 
eligibility for combat veterans who served after September 11, 2001, 
from 5 years to 10. No. 2, it provides an open enrollment period for 
any post-9/11 combat veteran who is more than 10 years from separation. 
No. 3, after we do the first two things, it tells the VA to have an 
outreach plan to contact veterans who did not enroll during their 
initial period of enhanced eligibility so that they can sign up for the 
potential benefits. It directs the VA to incorporate a clinical 
screening regarding a veteran's potential exposures and symptoms 
commonly associated with toxic substances. The fifth thing it does is 
it mandates toxic exposure early education and training for healthcare 
and benefits personnel who work at the VA. And, finally, it strengthens 
Federal research on toxic exposure.
  This is a big bill; it is an important bill; and it does right by our 
veterans in this country. Toxic exposure is not something that is new. 
We have dealt with it since World War I, World War II, Agent Orange, 
and the Vietnam war, and, right now, toxic exposure due to burn pits.
  When we get done with this process, it is not going to take an act of 
Congress to get the benefits they need to get moving into the future. 
This is a giant step forward in that regard.
  So I want to thank both the minority and majority staffs, the Senator 
from Kansas, who has been an incredible help to be able to work 
together to get this to the point where it is today.
  Mr. President, as if in legislative session, I ask unanimous consent 
that the Senate proceed to the immediate consideration of Calendar No. 
263, S. 3541.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (S. 3541) to improve health care and services for 
     veterans exposed to toxic substances, and for other purposes.

  There being no objection, the Senate proceeded to consider the bill.
  Mr. TESTER. I ask unanimous consent that the bill be considered read 
a third time.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The bill was ordered to be engrossed for a third reading and was read 
the third time.
  Mr. TESTER. I know of no further debate on the bill.
  The PRESIDING OFFICER. If there is no further debate on the bill, the 
bill having been read the third time, the question is, Shall the bill 
pass?
  The bill (S. 3541) was passed as follows:

                                S. 3541

       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.

[[Page S735]]

  


     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.

  Mr. TESTER. I ask unanimous consent that the motion to reconsider be 
considered made and laid upon the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. TESTER. I yield the floor.

                          ____________________