[Congressional Record Volume 168, Number 115 (Wednesday, July 13, 2022)]
[House]
[Pages H6001-H6025]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            PROTECTING OUR GOLD STAR FAMILIES EDUCATION ACT

  Mr. TAKANO. Madam Speaker, pursuant to House Resolution 1224, I call 
up the bill (S. 3373), as amended, to improve the Iraq and Afghanistan 
Service Grant and the Children of Fallen Heroes Grant, and ask for its 
immediate consideration in the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 1224, an 
amendment in the nature of a substitute consisting of the text of Rules 
Committee Print 117-56, is considered as adopted, and the bill, as 
amended, is considered read.
  The text of the bill, as amended, is as follows:

                                S. 3373

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

     SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES 
                   CODE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Sergeant 
     First Class Heath Robinson Honoring our Promise to Address 
     Comprehensive Toxics Act of 2022'' or the ``Honoring our PACT 
     Act of 2022''.
       (b) Matters Relating to Amendments to Title 38, United 
     States Code.--
       (1) References.--Except as otherwise expressly provided, 
     when in this Act an amendment or repeal is expressed in terms 
     of an amendment to, or repeal of, a section or other 
     provision, the reference shall be considered to be made to a 
     section or other provision of title 38, United States Code.
       (2) Amendments to tables of contents.--Except as otherwise 
     expressly provided, when an amendment made by this Act to 
     title 38, United States Code, adds a section or larger 
     organizational unit to that title or amends the designation 
     or heading of a section or larger organizational unit in that 
     title, that amendment also shall have the effect of amending 
     any table of sections in that title to alter the table to 
     conform to the changes made by the amendment.
       (c) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; references to title 38, United States Code; table 
              of contents.

             TITLE I--EXPANSION OF HEALTH CARE ELIGIBILITY

                   Subtitle A--Toxic-exposed Veterans

Sec. 101. Short title.
Sec. 102. Definitions relating to toxic-exposed veterans.
Sec. 103. Expansion of health care for specific categories of toxic-
              exposed veterans and veterans supporting certain overseas 
              contingency operations.
Sec. 104. Assessments of implementation and operation.

    Subtitle B--Certain Veterans of Combat Service and Other Matters

Sec. 111. Expansion of period of eligibility for health care for 
              certain veterans of combat service.

              TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS

Sec. 201. Short title.
Sec. 202. Improvements to ability of Department of Veterans Affairs to 
              establish presumptions of service connection based on 
              toxic exposure.
Sec. 203. Outreach to claimants for disability compensation pursuant to 
              changes in presumptions of service connection.
Sec. 204. Reevaluation of claims for dependency and indemnity 
              compensation involving presumptions of service 
              connection.

 TITLE III--IMPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS 
                       FOR TOXIC-EXPOSED VETERANS

Sec. 301. Short title.
Sec. 302. Presumptions of toxic exposure.
Sec. 303. Medical nexus examinations for toxic exposure risk 
              activities.

              TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION

Sec. 401. Treatment of veterans who participated in cleanup of Enewetak 
              Atoll as radiation-exposed veterans for purposes of 
              presumption of service connection of certain disabilities 
              by Department of Veterans Affairs.
Sec. 402. Treatment of veterans who participated in nuclear response 
              near Palomares, Spain, or Thule, Greenland, as radiation-
              exposed veterans for purposes of presumption of service 
              connection of certain disabilities by Department of 
              Veterans Affairs.
Sec. 403. Presumptions of service connection for diseases associated 
              with exposures to certain herbicide agents for veterans 
              who served in certain locations.
Sec. 404. Addition of additional diseases associated with exposure to 
              certain herbicide agents for which there is a presumption 
              of service connection for veterans who served in certain 
              locations.
Sec. 405. Improving compensation for disabilities occurring in Persian 
              Gulf War veterans.
Sec. 406. Presumption of service connection for certain diseases 
              associated with exposure to burn pits and other toxins.
Sec. 407. Rule of construction.

                       TITLE V--RESEARCH MATTERS

Sec. 501. Interagency working group on toxic exposure research.
Sec. 502. Analysis and report on treatment of veterans for medical 
              conditions related to toxic exposure.
Sec. 503. Analysis relating to mortality of veterans who served in 
              Southwest Asia.
Sec. 504. Study on health trends of post-9/11 veterans.
Sec. 505. Study on cancer rates among veterans.
Sec. 506. Study on health effects of waste related to Manhattan Project 
              on certain veterans.

[[Page H6002]]

Sec. 507. Study on toxic exposure and mental health outcomes.
Sec. 508. Study on veterans in Territories of the United States.
Sec. 509. Department of Veterans Affairs public website for toxic 
              exposure research.
Sec. 510. Report on health effects of jet fuels used by Armed Forces.

TITLE VI--IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED 
                                VETERANS

Sec. 601. Short title; definitions.
Sec. 602. Publication of list of resources of Department of Veterans 
              Affairs for toxic-exposed veterans and veterans who 
              report toxic exposures and outreach program for such 
              veterans and caregivers and survivors of such veterans.
Sec. 603. Incorporation of toxic exposure screening for veterans.
Sec. 604. Training for personnel of the Department of Veterans Affairs 
              with respect to veterans who report toxic exposures.

                         TITLE VII--RESOURCING

Sec. 701. Authority to use appropriations to enhance claims processing 
              capacity and automation.
Sec. 702. Authorization of major medical facility leases of Department 
              of Veterans Affairs for fiscal year 2023.
Sec. 703. Treatment of major medical facility leases of the Department 
              of Veterans Affairs.
Sec. 704. Authority to enter into agreements with academic affiliates 
              and other entities to acquire space for the purpose of 
              providing health-care resources to veterans.
Sec. 705. Modifications to enhanced-use lease authority of Department 
              of Veterans Affairs.
Sec. 706. Authority for joint leasing actions of Department of Defense 
              and Department of Veterans Affairs.
Sec. 707. Appropriation of amounts for major medical facility leases.

                 TITLE VIII--RECORDS AND OTHER MATTERS

Sec. 801. Epidemiological study on Fort McClellan veterans.
Sec. 802. Biennial briefing on Individual Longitudinal Exposure Record.
Sec. 803. Correction of exposure records by members of the Armed Forces 
              and veterans.
Sec. 804. Federal cause of action relating to water at Camp Lejeune, 
              North Carolina.
Sec. 805. Cost of War Toxic Exposures Fund.
Sec. 806. Appropriation for fiscal year 2022.
Sec. 807. Authorization of electronic notice in claims under laws 
              administered by the Secretary of Veterans Affairs.
Sec. 808. Burn pit transparency.

  TITLE IX--IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS

Sec. 901. National rural recruitment and hiring plan for Veterans 
              Health Administration.
Sec. 902. Authority to buy out service contracts for certain health 
              care professionals in exchange for employment at rural or 
              highly rural facilities of Department of Veterans 
              Affairs.
Sec. 903. Qualifications for human resources positions within 
              Department of Veterans Affairs and plan to recruit and 
              retain human resources employees.
Sec. 904. Modification of pay cap for certain employees of Veterans 
              Health Administration.
Sec. 905. Expansion of opportunities for housekeeping aides.
Sec. 906. Modification of authority of the Secretary of Veterans 
              Affairs relating to hours, conditions of employment, and 
              pay for certain employees of Veterans Health 
              Administration.
Sec. 907. Waiver of pay limitation for certain employees of Department 
              of Veterans Affairs.
Sec. 908. Elimination of limitation on awards and bonus for employees 
              of Department of Veterans Affairs.
Sec. 909. Additional authority of the Secretary of Veterans Affairs 
              relating to recruitment and retention of personnel.

             TITLE I--EXPANSION OF HEALTH CARE ELIGIBILITY

                   Subtitle A--Toxic-exposed Veterans

     SEC. 101. SHORT TITLE.

       This title may be cited as the ``Conceding Our Veterans' 
     Exposure Now and Necessitating Training Act of 2022'' or the 
     ``COVENANT Act of 2022''.

     SEC. 102. DEFINITIONS RELATING TO TOXIC-EXPOSED VETERANS.

       (a) In General.--Section 1710(a)(2)(F) is amended by 
     striking ``who was exposed to a toxic substance, radiation, 
     or other conditions, as provided in subsection (e)'' and 
     inserting ``who is a toxic-exposed veteran, in accordance 
     with subsection (e)''.
       (b) Definitions of Toxic Exposure and Toxic-exposed 
     Veteran.--Section 101 is amended by adding at the end the 
     following new paragraphs:
       ``(37) The term `toxic exposure' includes the following:
       ``(A) A toxic exposure risk activity, as defined in section 
     1710(e)(4) of this title.
       ``(B) An exposure to a substance, chemical, or airborne 
     hazard identified in the list under section 1119(b)(2) of 
     this title.
       ``(38) The term `toxic-exposed veteran' means any veteran 
     described in section 1710(e)(1) of this title.''.
       (c) Definition of Toxic Exposure Risk Activity.--Section 
     1710(e)(4) is amended by adding at the end the following new 
     subparagraph:
       ``(C) The term `toxic exposure risk activity' means any 
     activity--
       ``(i) that requires a corresponding entry in an exposure 
     tracking record system (as defined in section 1119(c) of this 
     title) for the veteran who carried out the activity; or
       ``(ii) that the Secretary determines qualifies for purposes 
     of this subsection when taking into account what is 
     reasonably prudent to protect the health of veterans.''.

     SEC. 103. EXPANSION OF HEALTH CARE FOR SPECIFIC CATEGORIES OF 
                   TOXIC-EXPOSED VETERANS AND VETERANS SUPPORTING 
                   CERTAIN OVERSEAS CONTINGENCY OPERATIONS.

       (a) In General.--
       (1) Expansion.--Subsection (e) of section 1710, as amended 
     by section 102(c), is further amended--
       (A) in paragraph (1), by adding at the end the following 
     new subparagraphs:
       ``(G) Beginning not later than the applicable date 
     specified in paragraph (6), and subject to paragraph (2), a 
     veteran who participated in a toxic exposure risk activity 
     while serving on active duty, active duty for training, or 
     inactive duty training is eligible for hospital care 
     (including mental health services and counseling), medical 
     services, and nursing home care under subsection (a)(2)(F) 
     for any illness.
       ``(H) Beginning not later than the applicable date 
     specified in paragraph (6), and subject to paragraph (2), a 
     covered veteran (as defined in section 1119(c) of this title) 
     is eligible for hospital care (including mental health 
     services and counseling), medical services, and nursing home 
     care under subsection (a)(2)(F) for any illness.
       ``(I)(i) Beginning not later than the applicable date 
     specified in paragraph (6), and subject to paragraph (2), a 
     veteran who deployed in support of a contingency operation 
     specified in clause (ii) is eligible for hospital care 
     (including mental health services and counseling), medical 
     services, and nursing home care under subsection (a)(2)(F) 
     for any illness.
       ``(ii) A contingency operation specified in this clause is 
     any of the following:
       ``(I) Operation Enduring Freedom.
       ``(II) Operation Freedom's Sentinel.
       ``(III) Operation Iraqi Freedom.
       ``(IV) Operation New Dawn.
       ``(V) Operation Inherent Resolve.
       ``(VI) Resolute Support Mission.''; and
       (B) in paragraph (2)(B)--
       (i) by striking ``or (F)'' and inserting ``(F), (G), (H), 
     or (I)''; and
       (ii) by striking ``service or testing'' and inserting 
     ``service, testing, or activity''.
       (2) Phase in.--Such subsection is further amended by adding 
     at the end the following new paragraph:
       ``(6)(A) The Secretary shall determine the dates in 
     subparagraphs (G), (H), and (I) of paragraph (1) as follows:
       ``(i) October 1, 2024, with respect to a veteran described 
     in such subparagraph (G) or (H) who was discharged or 
     released from the active military, naval, air, or space 
     service during the period beginning on August 2, 1990, and 
     ending on September 11, 2001.
       ``(ii) October 1, 2026, with respect to a veteran described 
     in such subparagraph (G) or (H) who was discharged or 
     released from the active military, naval, air, or space 
     service during the period beginning on September 12, 2001, 
     and ending on December 31, 2006.
       ``(iii) October 1, 2028, with respect to a veteran 
     described in such subparagraph (G) or (H) who was discharged 
     or released from the active military, naval, air, or space 
     service during the period beginning on January 1, 2007, and 
     ending on December 31, 2012.
       ``(iv) October 1, 2030, with respect to a veteran described 
     in such subparagraph (G) or (H) who was discharged or 
     released from the active military, naval, air, or space 
     service during the period beginning on January 1, 2013, and 
     ending on December 31, 2018.
       ``(v) October 1, 2032, with respect to a veteran described 
     in such subparagraph (I).
       ``(B)(i) The Secretary may modify a date specified in 
     subparagraph (A) to an earlier date, as the Secretary 
     determines appropriate based on the number of veterans 
     receiving hospital care, medical services, and nursing home 
     care under subparagraphs (G), (H), and (I) of paragraph (1) 
     and the resources available to the Secretary.
       ``(ii) If the Secretary determines to modify a date under 
     clause (i), the Secretary shall--
       ``(I) notify the Committee on Veterans' Affairs of the 
     Senate and the Committee on Veterans' Affairs of the House of 
     Representatives of the proposed modification; and
       ``(II) publish such modified date in the Federal 
     Register.''.
       (b) Outreach Plans.--With respect to each of clauses (i) 
     through (v) of section 1710(e)(6)(A) of title 38, United 
     States Code (as added by subsection (a)(2)), not later than 
     180 days before the date specified in the clause (including a 
     date modified pursuant to such section), 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 the veterans 
     described in the clause to notify such veterans of their 
     eligibility for hospital care, medical services, or nursing 
     home care under subparagraph (G), (H), or (I), of section 
     1710(e)(1) of such title, as the case may be.

     SEC. 104. ASSESSMENTS OF IMPLEMENTATION AND OPERATION.

       (a) Initial Resource Assessment and Report.--Not later than 
     180 days after the date of the enactment of this Act, the 
     Secretary of Veterans Affairs shall--

[[Page H6003]]

       (1) complete an assessment to determine--
       (A) the personnel and material resources necessary to 
     implement section 103 (including the amendments made by such 
     section); and
       (B) the total number of covered veterans, as such term is 
     defined in section 1119(c) of title 38, United States Code 
     (as added by section 302), who receive hospital care or 
     medical services furnished by the Secretary under chapter 17 
     of such title, disaggregated by priority group specified in 
     section 1705(a) of such title; and
       (2) submit to the Committee on Veterans' Affairs of the 
     Senate and the Committee on Veterans' Affairs of the House of 
     Representatives a report containing the findings of the 
     assessment completed under paragraph (1), including a 
     specific determination as to whether the Department has the 
     personnel and material resources necessary to implement 
     section 103.
       (b) Information Systems.--Not later than October 1, 2024, 
     the Secretary shall establish information systems to assess 
     the implementation of section 103, including the amendments 
     made by such section, and use the results of assessments 
     under such systems to inform the reports under subsection 
     (c).
       (c) Annual Reports.--
       (1) Reports.--Not later than October 1, 2025, and on an 
     annual basis thereafter until October 1, 2033, 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 on the following:
       (A) The effect of the implementation of, and the provision 
     and management of care under, section 103 (including the 
     amendments made by such section) on the demand by veterans 
     described in subparagraphs (G), (H), and (I) of section 
     1710(e)(1) of title 38, United States Code (as added by such 
     section 103) for health care services furnished by the 
     Secretary.
       (B) Any differing patterns of demand for health care 
     services by such veterans, disaggregated by factors such as 
     the relative distance of the veteran from medical facilities 
     of the Department and whether the veteran had previously 
     received hospital care or medical services furnished by the 
     Secretary under chapter 17 of such title.
       (C) The extent to which the Secretary has met such demand.
       (D) Any changes, during the year covered by the report, in 
     the delivery patterns of health care furnished by the 
     Secretary under chapter 17 of such title, and the fiscal 
     impact of such changes.
       (2) Matters.--Each report under paragraph (1) shall 
     include, with respect to the year covered by the report, 
     detailed information on the following:
       (A) The total number of veterans enrolled in the patient 
     enrollment system who, during such year, received hospital 
     care or medical services furnished by the Secretary under 
     chapter 17 of title 38, United States Code.
       (B) Of the veterans specified in subparagraph (A), the 
     number of such veterans who, during the preceding three 
     fiscal years, had not received such care or services.
       (C) With respect to the veterans specified in subparagraph 
     (B), the cost of providing health care to such veterans 
     during the year covered by the report, shown in total and 
     disaggregated by--
       (i) the level of care; and
       (ii) whether the care was provided through the Veterans 
     Community Care Program.
       (D) With respect to the number of veterans described in 
     subparagraphs (G), (H), and (I) of section 1710(e)(1) of 
     title 38, United States Code (as added by section 103), the 
     following (shown in total and disaggregated by medical 
     facility of the Department, as applicable):
       (i) The number of such veterans who, during the year 
     covered by the report, enrolled in the patient enrollment 
     system.
       (ii) The number of such veterans who applied for, but were 
     denied, such enrollment.
       (iii) The number of such veterans who were denied hospital 
     care or a medical service furnished by the Secretary that was 
     considered to be medically necessary but not of an emergency 
     nature.
       (E) The numbers and characteristics of, and the type and 
     extent of health care furnished by the Secretary to, veterans 
     enrolled in the patient enrollment system (shown in total and 
     disaggregated by medical facility of the Department).
       (F) The numbers and characteristics of, and the type and 
     extent of health care furnished by the Secretary to, veterans 
     not enrolled in the patient enrollment system (disaggregated 
     by each class of eligibility for care under section 1710 of 
     title 38, United States Code, and further shown as a total 
     per class and disaggregated by medical facility of the 
     Department).
       (G) The specific fiscal impact (shown in total and 
     disaggregated by geographic health care delivery areas) of 
     changes in the delivery patterns of health care furnished by 
     the Secretary under chapter 17 of such title as a result of 
     the implementation of section 103 (including the amendments 
     made by such section).
       (d) Definitions.--In this section:
       (1) Patient enrollment system.--The term ``patient 
     enrollment system'' means the patient enrollment system of 
     the Department of Veterans Affairs established and operated 
     under section 1705(a) of title 38, United States Code.
       (2) Veterans community care program.--The term ``Veterans 
     Community Care Program'' means the program established under 
     section 1703 of title 38, United States Code.

    Subtitle B--Certain Veterans of Combat Service and Other Matters

     SEC. 111. EXPANSION OF PERIOD OF ELIGIBILITY FOR HEALTH CARE 
                   FOR CERTAIN VETERANS OF COMBAT SERVICE.

       (a) Expanded Period.--Section 1710(e)(3) 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 ``10-
     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) is 
     amended by inserting after ``Persian Gulf War'' the 
     following: ``(including 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) Outreach Plan.--Not later than December 1, 2022, 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 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 pursuant to such subparagraph.
       (d) Report on Enrollments.--Not later than January 30, 
     2024, 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 
     identifying, with respect to the one-year period beginning on 
     October 1, 2022, the number of veterans described in section 
     1710(e)(3)(B) of title 38, United States Code, as amended by 
     subsection (a)(2), who, during such period, enrolled in the 
     patient enrollment system of the Department of Veterans 
     Affairs established and operated under section 1705(a) of 
     such title.
       (e) Effective Date.--This section and the amendments made 
     by this section shall take effect on October 1, 2022.

              TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS

     SEC. 201. SHORT TITLE.

       This title may be cited as the ``Toxic Exposure in the 
     American Military Act of 2022'' or the ``TEAM Act of 2022''.

     SEC. 202. IMPROVEMENTS TO ABILITY OF DEPARTMENT OF VETERANS 
                   AFFAIRS TO ESTABLISH PRESUMPTIONS OF SERVICE 
                   CONNECTION BASED ON TOXIC EXPOSURE.

       (a) Advisory Committees, Panels, and Boards.--Chapter 11 is 
     amended by adding at the end the following new subchapter:

 ``SUBCHAPTER VII--DETERMINATIONS RELATING TO PRESUMPTIONS OF SERVICE 
                   CONNECTION BASED ON TOXIC EXPOSURE

     ``Sec. 1171. Procedures to determine presumptions of service 
       connection based on toxic exposure; definitions

       ``(a) Procedures.--The Secretary shall determine whether to 
     establish, or to remove, presumptions of service connection 
     based on toxic exposure pursuant to this subchapter, 
     whereby--
       ``(1) under section 1172 of this title--
       ``(A) the Secretary provides--
       ``(i) public notice regarding what formal evaluations the 
     Secretary plans to conduct; and
       ``(ii) the public an opportunity to comment on the proposed 
     formal evaluations;
       ``(B) the working group established under subsection (b) of 
     such section provides--
       ``(i) advice to the Secretary on toxic-exposed veterans and 
     cases in which veterans who, during active military, naval, 
     air, or space service, may have experienced a toxic exposure 
     or their dependents may have experienced a toxic exposure 
     while the veterans were serving in the active military, 
     naval, air, or space service;
       ``(ii) recommendations to the Secretary on corrections 
     needed in the Individual Longitudinal Exposure Record to 
     better reflect veterans and dependents described in clause 
     (i); and
       ``(iii) recommendations to the Secretary regarding which 
     cases of possible toxic exposure should be reviewed;
       ``(2) the Secretary provides for formal evaluations of such 
     recommendations under section 1173 of this title and takes 
     into account reports received by the Secretary from the 
     National Academies of Sciences, Engineering, and Medicine 
     under section 1176 of this title; and
       ``(3) the Secretary issues regulations under section 1174 
     of this title.
       ``(b) Definitions.--In this subchapter:
       ``(1) The term `illness' includes a disease or other 
     condition affecting the health of an individual, including 
     mental and physical health.
       ``(2) The term `Individual Longitudinal Exposure Record' 
     includes--
       ``(A) service records;
       ``(B) any database maintained by the Department of Defense 
     and shared with the Department of Veterans Affairs to serve 
     as a central portal for exposure-related data that compiles, 
     collates, presents, and provides available occupational and 
     environmental exposure information to support the needs of 
     the Department of Defense and the Department of Veterans 
     Affairs; or
       ``(C) any successor system to a database described in 
     subparagraph (B).

[[Page H6004]]

  


     ``Sec. 1172. Annual notice and opportunity for public comment

       ``(a) Notice Required.--(1)(A) Not less frequently than 
     once each year, the Secretary shall publish in the Federal 
     Register notice of the formal evaluations that the Secretary 
     plans to conduct pursuant to section 1173 of this title.
       ``(B) Each notice published under subparagraph (A) shall 
     include, for each formal evaluation referred to in the 
     notice, an explanation as to why the military environmental 
     exposures and adverse health outcomes that are the subject of 
     the formal evaluation were chosen by the Secretary for formal 
     evaluation under section 1173 of this title.
       ``(2)(A) With each notice published under paragraph (1), 
     the Secretary shall seek public comment on the military 
     environmental exposures and adverse health outcomes that are 
     the subject of the formal evaluations referred to in the 
     notice.
       ``(B) The Secretary shall--
       ``(i) consider all public comment received under 
     subparagraph (A); and
       ``(ii) publish in the Federal Register a response to the 
     comments received under subparagraph (A).
       ``(3)(A) For each notice published under paragraph (1), the 
     Secretary shall hold an open meeting for members of the 
     public to voice their comments in response to the notice.
       ``(B) To help evaluate presumptions of service connection, 
     the Secretary shall, not less frequently than quarterly, 
     collaborate with, partner with, and give weight to the advice 
     of veterans service organizations and such other stakeholders 
     as the Secretary considers appropriate.
       ``(4) Failure to include a military environmental exposure 
     or adverse health effect in a Federal Register notice 
     published pursuant to subsection (a) shall not preclude the 
     Secretary from initiating a formal evaluation of such 
     exposure or health effect.
       ``(b) Working Group.--(1) The Secretary shall establish a 
     working group within the Department (in this section referred 
     to as the `Working Group').
       ``(2) The Working Group shall include personnel of the 
     Veterans Health Administration and the Veterans Benefits 
     Administration.
       ``(3) The Secretary shall consult with, and seek the advice 
     of, the Working Group with respect to cases in which--
       ``(A) a veteran may have, during active military, naval, 
     air, or space service, experienced a toxic exposure; or
       ``(B) a dependent of a veteran may have experienced a toxic 
     exposure during the active military, naval, air, or space 
     service of the veteran.
       ``(c) Assessments.--(1) The Working Group shall assess 
     cases of the toxic exposure of veterans and their dependents 
     that occurred during active military, naval, air, or space 
     service, including by conducting ongoing surveillance and 
     reviewing such exposure described in scientific literature, 
     media reports, information from veterans, and information 
     from Congress.
       ``(2) The assessments under paragraph (1) shall cover 
     suspected and known toxic exposures occurring during active 
     military, naval, air, or space service, including by 
     identifying and evaluating new and emerging toxic exposures 
     that are not recognized under existing presumptions of 
     service connection.
       ``(3) The Working Group may conduct an assessment under 
     paragraph (1) in response to a comment received under 
     paragraph (2) or (3) of subsection (a).
       ``(4) The Working Group shall, in consultation with the 
     Secretary of Defense, on a periodic basis, assess the 
     Individual Longitudinal Exposure Record to ensure the 
     accuracy of data collected.
       ``(d) Development of Recommendations.--(1) Following an 
     assessment of a case of the toxic exposure of veterans that 
     occurred during active military, naval, air, or space service 
     under subsection (c), or their dependents, the Working Group 
     may develop a recommendation for formal evaluation under 
     section 1173 of this title to conduct a review of the health 
     effects related to the case of exposure if the Working Group 
     determines that the research may change the current 
     understanding of the relationship between an exposure to an 
     environmental hazard and adverse health outcomes in humans.
       ``(2) Upon receipt of evidence suggesting that previous 
     findings regarding the periods and locations of exposure 
     covered by an existing presumption of service connection are 
     no longer supported, the Working Group may nominate such 
     evidence for formal evaluation under section 1173 of this 
     title to modify the periods and locations.
       ``(e) Reports by the Working Group.--Not less frequently 
     than once each year, the Working Group shall submit to the 
     Secretary, the Committee on Veterans' Affairs of the Senate, 
     and the Committee on Veterans' Affairs of the House of 
     Representatives, and make publicly available, a report on--
       ``(1) recommendations developed under subsection (d), if 
     any; and
       ``(2) recommendations for such legislative or 
     administrative action as the Working Group considers 
     necessary for the Working Group to be more effective in 
     carrying out the requirements of this section.
       ``(f) Responses by Secretary.--In response to each report 
     submitted under subsection (e), the Secretary shall, not 
     later than 30 days after receiving the report, initiate a 
     formal evaluation pursuant to section 1173 of this title.

     ``Sec. 1173. Formal evaluation of recommendations

       ``(a) Formal Evaluations.--The Secretary shall establish a 
     process to conduct a formal evaluation with respect to each 
     recommendation made by the Working Group under section 1172 
     of this title.
       ``(b) Evidence, Data, and Factors.--The Secretary shall 
     ensure that each formal evaluation under subsection (a) 
     covers the following:
       ``(1) Scientific evidence, based on the review of available 
     scientific literature, including human, toxicological, 
     animal, and methodological studies, and other factors.
       ``(2) Claims data, based on the review of claim rate, grant 
     rate, and service connection prevalence, and other factors.
       ``(3) Other factors the Secretary determines appropriate, 
     such as--
       ``(A) the level of disability and mortality caused by the 
     health effects related to the case of toxic exposure being 
     evaluated;
       ``(B) the quantity and quality of the information available 
     and reviewed;
       ``(C) the feasibility of and period for generating relevant 
     information and evidence;
       ``(D) whether such health effects are combat- or 
     deployment-related;
       ``(E) the ubiquity or rarity of the health effects; and
       ``(F) any time frame during which a health effect must 
     become manifest.
       ``(c) Conduct of Evaluations.--(1) The Secretary shall 
     ensure that each formal evaluation under subsection (a)--
       ``(A) reviews scientific evidence in a manner that--
       ``(i) conforms to principles of scientific and data 
     integrity;
       ``(ii) is free from suppression or distortion of scientific 
     or technological findings, data, information, conclusions, or 
     technical results; and
       ``(B)(i) evaluates the likelihood that a positive 
     association exists between an illness and a toxic exposure 
     while serving in the active military, naval, air, or space 
     service; and
       ``(ii) assesses the toxic exposures and illnesses and 
     determines whether the evidence supports a finding of a 
     positive association between the toxic exposure and the 
     illness.
       ``(2) In carrying out paragraph (1)(B)(ii), a formal 
     evaluation under subsection (a) shall include reviewing all 
     relevant data to determine the strength of evidence for a 
     positive association based on the following four categories:
       ``(A) The `sufficient' category, where the evidence is 
     sufficient to conclude that a positive association exists.
       ``(B) The `equipoise and above' category, where the 
     evidence is sufficient to conclude that a positive 
     association is at least as likely as not, but not sufficient 
     to conclude that a positive association exists.
       ``(C) The `below equipoise' category, where the evidence is 
     not sufficient to conclude that a positive association is at 
     least as likely as not, or is not sufficient to make a 
     scientifically informed judgment.
       ``(D) The `against' category, where the evidence suggests 
     the lack of a positive association.
       ``(d) Recommendation for Establishing a Presumption of 
     Service Connection.--Not later than 120 days after the date 
     on which a formal evaluation is commenced, the element of the 
     Department that conducts the evaluation shall submit to the 
     Secretary a recommendation with respect to establishing a 
     presumption of service connection for the toxic exposure and 
     illness, or modifying an existing presumption of service 
     connection, covered by the evaluation.

     ``Sec. 1174. Regulations regarding presumptions of service 
       connection based on toxic exposure

       ``(a) Action Upon Recommendation.--Not later than 160 days 
     after the date on which the Secretary receives a 
     recommendation to establish or modify a presumption of 
     service connection under section 1173 of this title--
       ``(1) if the Secretary determines, in the discretion of the 
     Secretary, that the presumption, or modification, is 
     warranted, the Secretary shall--
       ``(A) commence issuing regulations in accordance with the 
     provisions of subchapter II of chapter 5 of title 5 (commonly 
     referred to as the Administrative Procedures Act) setting 
     forth the presumption or commence revising regulations to 
     carry out such modification; and
       ``(B) include in such regulations any time frame during 
     which a health effect must become manifest; or
       ``(2) if the Secretary determines, in the discretion of the 
     Secretary, that the presumption, or modification, is not 
     warranted, the Secretary shall publish in the Federal 
     Register a notice of the determination, including the reasons 
     supporting the determination.
       ``(b) Removal of Presumption.--(1)(A) The Secretary may--
       ``(i) issue a regulation to remove an illness from a 
     presumption of service connection previously established 
     pursuant to a regulation issued under subsection (a); and
       ``(ii) issue a regulation to remove a presumption of 
     service connection established pursuant to title IV of the 
     Sergeant First Class Heath Robinson Honoring our Promise to 
     Address Comprehensive Toxics Act of 2022 if the Secretary 
     concludes that evidence suggests the lack of a positive 
     association between the disease and the toxic exposure.
       ``(B) Under subparagraph (A)(ii), the Secretary shall not 
     consider the lack of evidence as sufficient to support a 
     decision for removal of a presumption.
       ``(2) Whenever an illness is removed from regulations 
     pursuant to paragraph (1), or the periods and locations of 
     exposure covered by a presumption of service connection are 
     modified under subsection (a)--
       ``(A) a veteran who was awarded compensation under chapter 
     11 of this title for such illness on the basis of the 
     presumption provided under such regulations before the 
     effective date of the removal or modification shall continue 
     to be entitled to receive compensation on that basis;
       ``(B) a survivor of a veteran who was awarded dependency 
     and indemnity compensation under

[[Page H6005]]

     chapter 13 of this title for the death of a veteran resulting 
     from such illness on the basis of such presumption shall 
     continue to be entitled to receive dependency and indemnity 
     compensation on such basis; and
       ``(C) no veteran or survivor covered under subparagraph (A) 
     or (B) shall have their compensation reduced solely because 
     of the removal of an illness pursuant to paragraph (1).

     ``Sec. 1175. Authority to modify process; congressional 
       oversight

       ``(a) In General.--The Secretary may modify the process 
     under which the working group established under subsection 
     (b) of section 1172 of this title conducts assessments under 
     such section, the Secretary conducts formal evaluations under 
     section 1173 of this title, and issues regulations under 
     section 1174 of this title if--
       ``(1) such evaluations cover the evidence, data, and 
     factors required by subsection (b) of such section 1173; and
       ``(2) a period of 180 days has elapsed following the date 
     on which the Secretary submits the notice under subsection 
     (b) regarding the modification.
       ``(b) Notice.--If the Secretary proposes to modify the 
     process under which the working group established under 
     subsection (b) of section 1172 of this title conducts 
     assessments under such section, the process under which the 
     Secretary conducts formal evaluations under section 1173 of 
     this title, or issues regulations under section 1174 of this 
     title, 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 notice of 
     the proposed modifications containing the following:
       ``(1) A description of the proposed modifications.
       ``(2) A description of any exceptions to the requirements 
     of such sections that are proposed because of limited 
     available scientific evidence, and a description of how such 
     evaluations will be conducted.

     ``Sec. 1176. Agreement with National Academies of Sciences, 
       Engineering, and Medicine concerning toxic exposures

       ``(a) Purpose.--The purpose of this section is to provide 
     for the National Academies of Sciences, Engineering, and 
     Medicine (in this section referred to as the `Academies'), an 
     independent nonprofit scientific organization with 
     appropriate expertise that is not part of the Federal 
     Government, to review and evaluate the available scientific 
     evidence regarding associations between diseases and toxic 
     exposures.
       ``(b) Agreement.--(1) The Secretary shall seek to enter 
     into a five-year agreement with the Academies to perform the 
     services covered by this section.
       ``(2) The Secretary shall seek to enter into an agreement 
     described in paragraph (1) not later than 60 days after the 
     date of the enactment of the Sergeant First Class Heath 
     Robinson Honoring our Promise to Address Comprehensive Toxics 
     Act of 2022.
       ``(3) An agreement under this section may be extended in 
     five-year increments.
       ``(c) Review of Scientific Evidence.--Under an agreement 
     between the Secretary and the Academies under this section, 
     the Academies shall review and summarize the scientific 
     evidence, and assess the strength thereof, concerning the 
     association between toxic exposures during active military, 
     naval, air, or space service and each disease suspected to be 
     associated with such exposure in the human population.
       ``(d) Scientific Determinations Concerning Diseases.--For 
     each disease reviewed under subsection (c), the Academies 
     shall determine, to the extent that available scientific data 
     permit meaningful determinations--
       ``(1) whether an association exists between toxic exposures 
     and the occurrence of the disease, taking into account the 
     strength of the scientific evidence and the appropriateness 
     of the statistical and epidemiological methods used to detect 
     the association;
       ``(2) the increased risk of the disease among those 
     reporting toxic exposures during active military, naval, air, 
     or space service;
       ``(3) whether there exists a plausible biological mechanism 
     or other evidence of a positive association between the toxic 
     exposure and the occurrence of the disease; and
       ``(4) determine the strength of evidence for a positive 
     association based on categories furnished under section 1173 
     of this title.
       ``(e) Cooperation of Federal Agencies.--The head of each 
     relevant Federal agency, including the Secretary of Defense, 
     shall cooperate fully with the Academies in performing the 
     services covered by this section.
       ``(f) Recommendations for Additional Scientific Studies.--
     (1) Under an agreement between the Secretary and the 
     Academies under this section, the Academies shall make any 
     recommendations for additional scientific studies to resolve 
     areas of continuing scientific uncertainty relating to toxic 
     exposures.
       ``(2) In making recommendations under paragraph (1), the 
     Academies shall consider--
       ``(A) the scientific information that is available at the 
     time of the recommendation;
       ``(B) the value and relevance of the information that could 
     result from additional studies; and
       ``(C) the cost and feasibility of carrying out such 
     additional studies.
       ``(g) Reports.--(1)(A) Under an agreement between the 
     Secretary and the Academies under this section, not later 
     than one year after the date of the enactment of the Sergeant 
     First Class Heath Robinson Honoring our Promise to Address 
     Comprehensive Toxics Act of 2022, the Academies shall submit 
     to the Secretary, the Committee on Veterans' Affairs of the 
     Senate, and the Committee on Veterans' Affairs of the House 
     of Representatives an initial report on the activities of the 
     Academies under the agreement.
       ``(B) The report submitted under subparagraph (A) shall 
     include the following:
       ``(i) The determinations described in subsection (d).
       ``(ii) A full explanation of the scientific evidence and 
     reasoning that led to such determinations.
       ``(iii) Any recommendations of the Academies under 
     subsection (f).
       ``(2) Under an agreement between the Secretary and the 
     Academies under this section, not less frequently than once 
     every two years after the date on which the initial report is 
     submitted under paragraph (1)(A), the Academies shall submit 
     to the Secretary, the Committee on Veterans' Affairs of the 
     Senate, and the Committee on Veterans' Affairs of the House 
     of Representatives an updated report on the activities of the 
     Academies under the agreement.
       ``(h) Alternative Contract Scientific Organization.--(1) If 
     the Secretary is unable within the time period prescribed in 
     subsection (b)(2) to enter into an agreement with the 
     Academies 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--
       ``(A) is not part of the Federal Government;
       ``(B) operates as a not-for-profit entity; and
       ``(C) has expertise and objectivity comparable to that of 
     the Academies.
       ``(2) If the Secretary enters into an agreement with 
     another organization as described in paragraph (1), any 
     reference in this subchapter to the Academies shall be 
     treated as a reference to the other organization.''.
       (b) Reports and Briefings.--
       (1) Report.--
       (A) In general.--Not later than two years after the date of 
     the enactment of this Act, 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 the implementation of, and 
     recommendations for, subchapter VII of chapter 11 of title 
     38, United States Code, as added by subsection (a).
       (B) Consultation.--The Secretary shall develop the report 
     under subparagraph (A) in consultation with organizations 
     recognized by the Secretary for the representation of 
     veterans under section 5902 of such title and any other 
     entity the Secretary determines appropriate.
       (2) Briefing.--On a quarterly basis during the two-year 
     period beginning on the date of the enactment of this Act, 
     the Secretary shall provide to the Committee on Veterans' 
     Affairs of the Senate and the Committee on Veterans' Affairs 
     of the House of Representatives a briefing on the 
     implementation of subchapter VII of chapter 11 of such title, 
     as added by subsection (a).
       (c) Independent Assessment.--
       (1) Agreement.--The Secretary shall seek to enter into an 
     agreement with the National Academies of Science, 
     Engineering, and Medicine (in this subsection referred to as 
     the ``Academies'') before the date that is 90 days after the 
     date of the enactment of this Act to perform the services set 
     forth under paragraph (2).
       (2) Assessment.--
       (A) In general.--Under an agreement between the Secretary 
     and the Academies under paragraph (1), the Academies shall 
     conduct an assessment of the implementation by the Department 
     of Veterans Affairs of the process established under 
     subchapter VII of chapter 11 of title 38, United States Code, 
     as added by subsection (a).
       (B) Elements.--The assessment conducted under subparagraph 
     (A) shall include the following:
       (i) An assessment of the Department's implementation of the 
     process established under subsection (a) to determine whether 
     the process is in accordance with current scientific 
     standards for assessing the link between exposure to 
     environmental hazards and the development of health outcomes,
       (ii) assess whether the criteria is fair and consistent, 
     and
       (iii) provide recommendations for improvements to the 
     process.
       (3) Report.--Not later than one year after the date on 
     which the Secretary enters into an agreement under paragraph 
     (1), 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 on the findings of 
     the Academies pursuant to such agreement.
       (4) Alternative contract scientific organization.--
       (A) In general.--If the Secretary is unable within the time 
     period prescribed in paragraph (1) to enter into an agreement 
     with the Academies for the purposes of this subsection on 
     terms acceptable to the Secretary, the Secretary shall seek 
     to enter into an agreement for the purposes of this 
     subsection with another appropriate scientific organization 
     that--
       (i) is not part of the Federal Government;
       (ii) operates as a not-for-profit entity; and
       (iii) has expertise and objectivity comparable to that of 
     the Academies.
       (B) Treatment.--If the Secretary enters into an agreement 
     with another organization as described in subparagraph (A), 
     any reference in this subsection to the Academies of 
     Sciences, Engineering, and Medicine shall be treated as a 
     reference to the other organization.
       (d) Conforming Amendments.--Chapter 11 is amended--
       (1) in section 1116--
       (A) by striking subsections (b), (c), (d), and (e);
       (B) by inserting after subsection (a) the following new 
     subsection (b):

[[Page H6006]]

       ``(b) The Secretary shall ensure that any determination 
     made on or after the date of the enactment of the Sergeant 
     First Class Heath Robinson Honoring our Promise to Address 
     Comprehensive Toxics Act of 2022 regarding a presumption of 
     service connection based on exposure to an herbicide agent 
     under this section is made pursuant to subchapter VII of this 
     chapter, including with respect to assessing reports received 
     by the Secretary from the National Academy of Sciences under 
     section 3 of the Agent Orange Act of 1991 (Public Law 102-
     4).''; and
       (C) by redesignating subsection (f) as subsection (c);
       (2) in section 1116B(b)(2)(A), by inserting ``pursuant to 
     subchapter VII of this chapter,'' before ``the Secretary 
     determines''; and
       (3) in section 1118--
       (A) by striking subsections (b) through (e); and
       (B) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b) The Secretary shall ensure that any determination 
     made on or after the date of the enactment of the Sergeant 
     First Class Heath Robinson Honoring our Promise to Address 
     Comprehensive Toxics Act of 2022 regarding a presumption of 
     service connection based on a toxic exposure under this 
     section is made pursuant to subchapter VII of this 
     chapter.''.

     SEC. 203. OUTREACH TO CLAIMANTS FOR DISABILITY COMPENSATION 
                   PURSUANT TO CHANGES IN PRESUMPTIONS OF SERVICE 
                   CONNECTION.

       (a) In General.--Subchapter VI of chapter 11 is amended by 
     adding at the end the following new section:

     ``Sec. 1167. Outreach pursuant to changes in presumptions of 
       service connection

       ``(a) In General.--Whenever a law, including through a 
     regulation or Federal court decision or settlement, 
     establishes or modifies a presumption of service connection, 
     the Secretary shall--
       ``(1) identify all claims for compensation under this 
     chapter that--
       ``(A) were submitted to the Secretary;
       ``(B) were evaluated and denied by the Secretary before the 
     date on which such provision of law went into effect; and
       ``(C) might have been evaluated differently had the 
     establishment or modification been applicable to the claim; 
     and
       ``(2) pursuant to subsection (b), conduct outreach to the 
     claimants.
       ``(b) Outreach.--(1) The Secretary shall conduct outreach 
     to inform claimants identified under subsection (a) that they 
     may submit a supplemental claim in light of the establishment 
     or modification of a presumption of service connection 
     described in subsection (a).
       ``(2) Outreach under paragraph (1) shall include the 
     following:
       ``(A) The Secretary shall publish on the internet website 
     of the Department a notice that such veterans may elect to 
     file a supplemental claim.
       ``(B) The Secretary shall notify, in writing or by 
     electronic means, veterans service organizations of the 
     ability of such veterans to file a supplemental claim.
       ``(C) The Secretary shall contact each claimant identified 
     under subsection (a) in the same manner that the Department 
     last provided notice of a decision.''.
       (b) Application.--Section 1167 of title 38, United States 
     Code, as added by subsection (a), shall apply with respect to 
     presumptions of service connection established or modified on 
     or after the date of the enactment of this Act, including 
     pursuant to amendments made by this Act.
       (c) Rule of Construction.--Nothing in this section shall be 
     construed as--
       (1) modifying the obligations of the Department of Veterans 
     Affairs under Federal court decisions or settlements in 
     effect as of the date of the enactment of this Act; or
       (2) requiring a retroactively applied effective date of a 
     supplemental claim earlier than the date a presumption of 
     service connection is established or modified.

     SEC. 204. REEVALUATION OF CLAIMS FOR DEPENDENCY AND INDEMNITY 
                   COMPENSATION INVOLVING PRESUMPTIONS OF SERVICE 
                   CONNECTION.

       (a) In General.--Subchapter I of chapter 13 is amended by 
     adding at the end the following new section:

     ``Sec. 1305. Reevaluation of dependency and indemnity 
       compensation determinations pursuant to changes in 
       presumptions of service connection

       ``(a) Reevaluation.--Whenever a law, including through a 
     regulation or Federal court decision or settlement, 
     establishes or modifies a presumption of service connection, 
     the Secretary shall--
       ``(1) identify all claims for dependency and indemnity 
     compensation under this chapter that--
       ``(A) were submitted to the Secretary;
       ``(B) were evaluated and denied by the Secretary before the 
     date on which such provision of law went into effect; and
       ``(C) might have been evaluated differently had the 
     establishment or modification been applicable to the claim;
       ``(2) allow for the reevaluation of such claims at the 
     election of the claimant; and
       ``(3) notwithstanding section 5110 of this title, with 
     respect to claims approved pursuant to such reevaluation, 
     provide compensation under this chapter effective as if the 
     establishment or modification of the presumption of service 
     connection had been in effect on the date of the submission 
     of the original claim described in paragraph (1).
       ``(b) Outreach.--(1) The Secretary shall conduct outreach 
     to inform relevant claimants that they may elect to have a 
     claim be reevaluated in light of the establishment or 
     modification of a presumption of service connection described 
     in subsection (a).
       ``(2) Outreach under paragraph (1) shall include the 
     following:
       ``(A) The Secretary shall publish on the internet website 
     of the Department a notice that such claimants may elect to 
     have a claim so reevaluated.
       ``(B) The Secretary shall notify, in writing or by 
     electronic means, veterans service organizations of the 
     ability of such claimants to elect to have a claim so 
     reevaluated.
       ``(C) The Secretary shall contact each claimant identified 
     under subsection (a) in the same manner that the Department 
     last provided notice of a decision.''.
       (b) Application.--Section 1305 of title 38, United States 
     Code, as added by subsection (a), shall apply with respect to 
     presumptions of service connection established or modified on 
     or after the date of the enactment of this Act, including 
     pursuant to amendments made by this Act.
       (c) Rule of Construction.--Nothing in this section shall be 
     construed as modifying the obligations of the Department of 
     Veterans Affairs under Federal court decisions or settlements 
     in effect as of the date of the enactment of this Act.

 TITLE III--IMPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS 
                       FOR TOXIC-EXPOSED VETERANS

     SEC. 301. SHORT TITLE.

       This title may be cited as the ``Veterans Burn Pits 
     Exposure Recognition Act of 2022''.

     SEC. 302. PRESUMPTIONS OF TOXIC EXPOSURE.

       Subchapter II of chapter 11 is amended by adding at the end 
     the following new section:

     ``Sec. 1119. Presumptions of toxic exposure

       ``(a) Consideration of Records.--If a veteran submits to 
     the Secretary a claim for compensation for a service-
     connected disability under section 1110 of this title with 
     evidence of a disability and a toxic exposure that occurred 
     during active military, naval, air, or space service, the 
     Secretary may, in adjudicating such claim, consider--
       ``(1) any record of the veteran in an exposure tracking 
     record system; and
       ``(2) if no record of the veteran in an exposure tracking 
     record system indicates that the veteran was subject to a 
     toxic exposure during active military, naval, air, or space 
     service, the totality of the circumstances of the service of 
     the veteran.
       ``(b) Presumption of Specific Toxic Exposure for Members 
     Who Served in Certain Locations.--(1) The Secretary shall, 
     for purposes of section 1110 and chapter 17 of this title, 
     presume that any covered veteran was exposed to the 
     substances, chemicals, and airborne hazards identified in the 
     list under paragraph (2) during the service of the covered 
     veteran specified in subsection (c)(1), unless there is 
     affirmative evidence to establish that the covered veteran 
     was not exposed to any such substances, chemicals, or hazards 
     in connection with such service.
       ``(2) The Secretary shall--
       ``(A) establish and maintain a list that contains an 
     identification of one or more such substances, chemicals, and 
     airborne hazards as the Secretary, in collaboration with the 
     Secretary of Defense, may determine appropriate for purposes 
     of this section; and
       ``(B) determine, using procedures consistent with section 
     1172 of this title and through the conduct of a formal 
     evaluation under section 1173 of this title, whether to 
     establish an end date for a covered veteran to qualify for 
     presumptions of exposure under this section, if appropriate, 
     but in no case establish an end date earlier than the last 
     day of the period specified in section 101(33) for the 
     Persian Gulf War.
       ``(3) Beginning not later than two years after the date of 
     the enactment of the Sergeant First Class Heath Robinson 
     Honoring our Promise to Address Comprehensive Toxics Act of 
     2022, and not less frequently than once every two years 
     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 
     identifying any additions or removals to the list under 
     paragraph (2) during the period covered by the report.
       ``(c) Definitions.--In this section:
       ``(1) The term `covered veteran' means any veteran who--
       ``(A) on or after August 2, 1990, performed active 
     military, naval, air, or space service while assigned to a 
     duty station in, including airspace above--
       ``(i) Bahrain;
       ``(ii) Iraq;
       ``(iii) Kuwait;
       ``(iv) Oman;
       ``(v) Qatar;
       ``(vi) Saudi Arabia;
       ``(vii) Somalia; or
       ``(viii) United Arab Emirates; or
       ``(B) on or after September 11, 2001, performed active 
     military, naval, air, or space service while assigned to a 
     duty station in, including airspace above--
       ``(i) Afghanistan;
       ``(ii) Djibouti;
       ``(iii) Egypt;
       ``(iv) Jordan;
       ``(v) Lebanon;
       ``(vi) Syria;
       ``(vii) Yemen;
       ``(viii) Uzbekistan; or
       ``(ix) any other country determined relevant by the 
     Secretary.
       ``(2) The term `exposure tracking record system'--
       ``(A) means any system, program, or pilot program used by 
     the Secretary of Veterans Affairs or the Secretary of Defense 
     to track how veterans or members of the Armed Forces have 
     been

[[Page H6007]]

     exposed to various occupational or environmental hazards; and
       ``(B) includes the Individual Longitudinal Exposure Record, 
     or successor system.
       ``(3) The term `toxic exposure risk activity' has the 
     meaning given such term in section 1710(e)(4) of this 
     title.''.

     SEC. 303. MEDICAL NEXUS EXAMINATIONS FOR TOXIC EXPOSURE RISK 
                   ACTIVITIES.

       Subchapter VI of chapter 11, as amended by section 203, is 
     further amended by adding at the end the following new 
     section:

     ``Sec. 1168. Medical nexus examinations for toxic exposure 
       risk activities

       ``(a) Medical Examinations and Medical Opinions.--(1) 
     Except as provided in subsection (b), if a veteran submits to 
     the Secretary a claim for compensation for a service-
     connected disability under section 1110 of this title with 
     evidence of a disability and evidence of participation in a 
     toxic exposure risk activity during active military, naval, 
     air, or space service, and such evidence is not sufficient to 
     establish a service connection for the disability, the 
     Secretary shall--
       ``(A) provide the veteran with a medical examination under 
     section 5103A(d) of this title; and
       ``(B) obtain a medical opinion (to be requested by the 
     Secretary in connection with the medical examination under 
     subparagraph (A)) as to whether it is at least as likely as 
     not that there is a nexus between the disability and the 
     toxic exposure risk activity.
       ``(2) When providing the Secretary with a medical opinion 
     under paragraph (1)(B) for a veteran, the health care 
     provider shall consider--
       ``(A) the total potential exposure through all applicable 
     military deployments of the veteran; and
       ``(B) the synergistic, combined effect of all toxic 
     exposure risk activities of the veteran.
       ``(3) The requirement under paragraph (2)(B) shall not be 
     construed as requiring a health care provider to consider the 
     synergistic, combined effect of each of the substances, 
     chemicals, and airborne hazards identified in the list under 
     section 1119(b)(2) of this title.
       ``(b) Exception.--Subsection (a) shall not apply if the 
     Secretary determines there is no indication of an association 
     between the disability claimed by the veteran and the toxic 
     exposure risk activity for which the veteran submitted 
     evidence.
       ``(c) Toxic Exposure Risk Activity Defined.--In this 
     section, the term `toxic exposure risk activity' has the 
     meaning given that term in section 1710(e)(4) of this 
     title.''.

              TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION

     SEC. 401. TREATMENT OF VETERANS WHO PARTICIPATED IN CLEANUP 
                   OF ENEWETAK ATOLL AS RADIATION-EXPOSED VETERANS 
                   FOR PURPOSES OF PRESUMPTION OF SERVICE 
                   CONNECTION OF CERTAIN DISABILITIES BY 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) Short Title.--This section may be cited as the ``Mark 
     Takai Atomic Veterans Healthcare Parity Act of 2022''.
       (b) Enewetak Atoll.--Section 1112(c)(3)(B) is amended by 
     adding at the end the following new clause:
       ``(v) Cleanup of Enewetak Atoll during the period beginning 
     on January 1, 1977, and ending on December 31, 1980.''.

     SEC. 402. TREATMENT OF VETERANS WHO PARTICIPATED IN NUCLEAR 
                   RESPONSE NEAR PALOMARES, SPAIN, OR THULE, 
                   GREENLAND, AS RADIATION-EXPOSED VETERANS FOR 
                   PURPOSES OF PRESUMPTION OF SERVICE CONNECTION 
                   OF CERTAIN DISABILITIES BY DEPARTMENT OF 
                   VETERANS AFFAIRS.

       (a) Short Title.--This section may be cited as the 
     ``Palomares or Thule Veterans Act of 2022''.
       (b) Palomares or Thule.--Section 1112(c)(3)(B), as amended 
     by section 401, is further amended by adding at the end the 
     following new clauses:
       ``(vi) Onsite participation in the response effort 
     following the collision of a United States Air Force B-52 
     bomber and refueling plane that caused the release of four 
     thermonuclear weapons in the vicinity of Palomares, Spain, 
     during the period beginning January 17, 1966, and ending 
     March 31, 1967.
       ``(vii) Onsite participation in the response effort 
     following the on-board fire and crash of a United States Air 
     Force B-52 bomber that caused the release of four 
     thermonuclear weapons in the vicinity of Thule Air Force 
     Base, Greenland, during the period beginning January 21, 
     1968, and ending September 25, 1968.''.

     SEC. 403. PRESUMPTIONS OF SERVICE CONNECTION FOR DISEASES 
                   ASSOCIATED WITH EXPOSURES TO CERTAIN HERBICIDE 
                   AGENTS FOR VETERANS WHO SERVED IN CERTAIN 
                   LOCATIONS.

       (a) Short Title.--This section may be cited as the 
     ``Veterans Agent Orange Exposure Equity Act of 2022''.
       (b) In General.--Section 1116, as amended by section 202, 
     is further amended--
       (1) by striking ``, during active military, naval, air, or 
     space service, served in the Republic of Vietnam during the 
     period beginning on January 9, 1962, and ending on May 7, 
     1975'' each place it appears and inserting ``performed 
     covered service'';
       (2) by striking ``performed active military, naval, air, or 
     space service in the Republic of Vietnam during the period 
     beginning on January 9, 1962, and ending on May 7, 1975'' 
     each place it appears and inserting ``performed covered 
     service''; and
       (3) by adding at the end the following new subsection:
       ``(d) In this section, the term `covered service' means 
     active military, naval, air, or space service--
       ``(1) performed in the Republic of Vietnam during the 
     period beginning on January 9, 1962, and ending on May 7, 
     1975;
       ``(2) performed in Thailand at any United States or Royal 
     Thai base during the period beginning on January 9, 1962, and 
     ending on June 30, 1976, without regard to where on the base 
     the veteran was located or what military job specialty the 
     veteran performed;
       ``(3) performed in Laos during the period beginning on 
     December 1, 1965, and ending on September 30, 1969;
       ``(4) performed in Cambodia at Mimot or Krek, Kampong Cham 
     Province during the period beginning on April 16, 1969, and 
     ending on April 30, 1969; or
       ``(5) performed on Guam or American Samoa, or in the 
     territorial waters thereof, during the period beginning on 
     January 9, 1962, and ending on July 31, 1980, or served on 
     Johnston Atoll or on a ship that called at Johnston Atoll 
     during the period beginning on January 1, 1972, and ending on 
     September 30, 1977.''.
       (c) Eligibility for Hospital Care and Medical Services.--
     Section 1710(e)(4), as amended by section 102(c), is further 
     amended by striking subparagraph (A) and inserting the 
     following new subparagraph:
       ``(A) The term `Vietnam-era herbicide-exposed veteran' 
     means a veteran who--
       ``(i) performed covered service, as defined in section 
     1116(d) of this title; or
       ``(ii) the Secretary finds may have been exposed during 
     active military, naval, air, or space service to dioxin 
     during the Vietnam era, regardless of the geographic area of 
     such service, or was exposed during such service to a toxic 
     substance found in a herbicide or defoliant used for military 
     purposes during such era, regardless of the geographic area 
     of such service.''.
       (d) Conforming Amendment.--The heading for section 1116 is 
     amended by striking ``the Republic of Vietnam'' and inserting 
     ``certain locations''.
       (e) Effective Date and Applicability.--The amendments made 
     by this section shall take effect on the date of the 
     enactment of this Act and shall apply as follows:
       (1) On the date of the enactment of this Act for claimants 
     for dependency and indemnity compensation under chapter 13 of 
     title 38, United States Code, and for veterans whom the 
     Secretary of Veterans Affairs determines are--
       (A) terminally ill;
       (B) homeless;
       (C) under extreme financial hardship;
       (D) more than 85 years old; or
       (E) capable of demonstrating other sufficient cause.
       (2) On October 1, 2022, for everyone not described in 
     paragraph (1).

     SEC. 404. ADDITION OF ADDITIONAL DISEASES ASSOCIATED WITH 
                   EXPOSURE TO CERTAIN HERBICIDE AGENTS FOR WHICH 
                   THERE IS A PRESUMPTION OF SERVICE CONNECTION 
                   FOR VETERANS WHO SERVED IN CERTAIN LOCATIONS.

       (a) Short Title.--This section may be cited as the ``Fair 
     Care for Vietnam Veterans Act of 2022''.
       (b) Monoclonal Gammopathy of Undetermined Significance.--
     Section 1116(a)(2) of title 38, United States Code, is 
     amended by adding at the end the following new subparagraph:
       ``(L) Monoclonal gammopathy of undetermined 
     significance.''.
       (c) Hypertension.--Such section, as amended by subsection 
     (b), is further amended by adding at the end the following 
     new subparagraph:
       ``(M) Hypertension.''.
       (d) Effective Dates and Applicability.--
       (1) Monoclonal gammopathy of undetermined significance.--
       (A) In general.--The amendment made by subsection (b) shall 
     take effect on the date of the enactment of this Act and 
     shall apply as follows:
       (i) On the date of the enactment of this Act for claimants 
     for dependency and indemnity compensation under chapter 13 of 
     title 38, United States Code, and for veterans whom the 
     Secretary of Veterans Affairs determines are--

       (I) terminally ill;
       (II) homeless;
       (III) under extreme financial hardship;
       (IV) more than 85 years old; or
       (V) capable of demonstrating other sufficient cause.

       (ii) On October 1, 2022, for everyone not described in 
     clause (i).
       (B) Retroactive application.--Notwithstanding any Federal 
     court decisions or settlements in effect on the day before 
     the date of the enactment of this Act, the Secretary of 
     Veterans Affairs shall award retroactive claims for a 
     condition under section 1116(a)(2)(L) of title 38, United 
     States Code, as added by subsection (b) of this section, only 
     to claimants for dependency and indemnity compensation under 
     chapter 13 of such title described in subparagraph (A)(i) of 
     this paragraph.
       (2) Hypertension.--
       (A) In general.--The amendment made by subsection (c) shall 
     take effect on the date of the enactment of this Act and 
     shall apply as follows:
       (i) On the date of the enactment of this Act for claimants 
     for dependency and indemnity compensation under chapter 13 of 
     title 38, United States Code, and for veterans whom the 
     Secretary of Veterans Affairs determines are--

       (I) terminally ill;
       (II) homeless;
       (III) under extreme financial hardship;
       (IV) more than 85 years old; or
       (V) capable of demonstrating other sufficient cause.

       (ii) On October 1, 2026, for everyone not described in 
     subparagraph (A).

[[Page H6008]]

       (B) Retroactive application.--Notwithstanding any Federal 
     court decisions or settlements in effect on the day before 
     the date of the enactment of this Act, the Secretary of 
     Veterans Affairs shall award retroactive claims for a 
     condition under section 1116(a)(2)(M) of title 38, United 
     States Code, as added by subsection (c) of this section, only 
     to claimants for dependency and indemnity compensation under 
     chapter 13 of such title described in subparagraph (A)(i) of 
     this paragraph.

     SEC. 405. IMPROVING COMPENSATION FOR DISABILITIES OCCURRING 
                   IN PERSIAN GULF WAR VETERANS.

       (a) Reduction in Threshold of Eligibility.--Subsection 
     (a)(1) of section 1117 is amended by striking ``became 
     manifest--'' and all that follows through the period at the 
     end and inserting ``became manifest to any degree at any 
     time.''.
       (b) Permanent Extension of Period of Eligibility.--Such 
     section is further amended--
       (1) by striking subsection (b);
       (2) by redesignating subsections (c) and (d) as subsections 
     (b) and (c), respectively; and
       (3) in subsection (a)(2)(C), by striking ``under subsection 
     (d)'' and inserting ``under subsection (c)''.
       (c) Establishing Singular Disability-based Questionnaire.--
     Such section is further amended by inserting after subsection 
     (c) (as redesignated by subsection (b)) the following new 
     subsection (d):
       ``(d) If a Persian Gulf veteran at a medical facility of 
     the Department presents with any one symptom associated with 
     Gulf War Illness, the Secretary shall ensure that health care 
     personnel of the Department use a disability benefits 
     questionnaire, or successor questionnaire, designed to 
     identify Gulf War Illness, in addition to any other 
     diagnostic actions the personnel determine appropriate.''.
       (d) Expansion of Definition of Persian Gulf Veteran.--
     Subsection (f) of such section is amended by inserting ``, 
     Afghanistan, Israel, Egypt, Turkey, Syria, or Jordan,'' after 
     ``operations''.
       (e) Training.--Such section is further amended by adding at 
     the end the following new subsection:
       ``(i)(1) The Secretary shall take such actions as may be 
     necessary to ensure that health care personnel of the 
     Department are appropriately trained to effectively carry out 
     this section.
       ``(2) Not less frequently than once each year, the 
     Secretary shall submit to Congress a report on the actions 
     taken by the Secretary to carry out paragraph (1).''.

     SEC. 406. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN 
                   DISEASES ASSOCIATED WITH EXPOSURE TO BURN PITS 
                   AND OTHER TOXINS.

       (a) Short Title.--This section may be cited as the 
     ``Presumptive Benefits for War Fighters Exposed to Burn Pits 
     and Other Toxins Act of 2022''.
       (b) In General.--Subchapter II of chapter 11, as amended by 
     section 302, is further amended by inserting after section 
     1119 the following new section:

     ``Sec. 1120. Presumption of service connection for certain 
       diseases associated with exposure to burn pits and other 
       toxins

       ``(a) Presumption of Service Connection.--For the purposes 
     of section 1110 of this title, and subject to section 1113 of 
     this title, a disease specified in subsection (b) becoming 
     manifest in a covered veteran shall be considered to have 
     been incurred in or aggravated during active military, naval, 
     air, or space service, notwithstanding that there is no 
     record of evidence of such disease during the period of such 
     service.
       ``(b) Diseases Specified.--The diseases specified in this 
     subsection are the following:
       ``(1) Asthma that was diagnosed after service of the 
     covered veteran as specified in subsection (c).
       ``(2) The following types of cancer:
       ``(A) Head cancer of any type.
       ``(B) Neck cancer of any type.
       ``(C) Respiratory cancer of any type.
       ``(D) Gastrointestinal cancer of any type.
       ``(E) Reproductive cancer of any type.
       ``(F) Lymphoma cancer of any type.
       ``(G) Lymphomatic cancer of any type.
       ``(H) Kidney cancer.
       ``(I) Brain cancer.
       ``(J) Melanoma.
       ``(K) Pancreatic cancer.
       ``(3) Chronic bronchitis.
       ``(4) Chronic obstructive pulmonary disease.
       ``(5) Constrictive bronchiolitis or obliterative 
     bronchiolitis.
       ``(6) Emphysema.
       ``(7) Granulomatous disease.
       ``(8) Interstitial lung disease.
       ``(9) Pleuritis.
       ``(10) Pulmonary fibrosis.
       ``(11) Sarcoidosis.
       ``(12) Chronic sinusitis.
       ``(13) Chronic rhinitis.
       ``(14) Glioblastoma.
       ``(15) Any other disease for which the Secretary 
     determines, pursuant to regulations prescribed under 
     subchapter VII that a presumption of service connection is 
     warranted based on a positive association with a substance, 
     chemical, or airborne hazard identified in the list under 
     section 1119(b)(2) of this title.
       ``(c) Covered Veteran Defined.--In this section, the term 
     `covered veteran' has the meaning given that term in section 
     1119(c) of this title.''.
       (c) Conforming Amendment.--Section 1113 is amended by 
     striking ``or 1118'' each place it appears and inserting 
     ``1118, or 1120''.
       (d) Effective Date and Applicability.--The amendments made 
     by this section shall take effect on the date of the 
     enactment of this Act and shall apply as follows:
       (1) On the date of the enactment of this Act for claimants 
     for dependency and indemnity compensation under chapter 13 of 
     title 38, United States Code, and veterans whom the Secretary 
     of Veterans Affairs determines are--
       (A) terminally ill;
       (B) homeless;
       (C) under extreme financial hardship;
       (D) more than 85 years old; or
       (E) capable of demonstrating other sufficient cause.
       (2) On the date of the enactment of this Act for everyone 
     not described in paragraph (1), with respect to paragraphs 
     (1), (2)(C), (2)(I), (5), (6), (7), (8), (9), (10), (11), 
     (12), (13), and (14), of section 1120(b) of title 38, United 
     States Code, as added by subsection (b).
       (3) On October 1, 2023, for everyone not described in 
     paragraph (1), with respect to paragraphs (3) and (4) of 
     section 1120(b) of such title, as so added.
       (4) On October 1, 2024, for everyone not described in 
     paragraph (1), with respect to subparagraphs (A), (B), (D), 
     (E), (F), (G), and (K) of section 1120(b)(2) of such title, 
     as so added.
       (5) On October 1, 2025, for everyone not described in 
     paragraph (1), with respect to subparagraphs (H) and (J) of 
     section 1120(b)(2) of such title, as so added.

     SEC. 407. RULE OF CONSTRUCTION.

       (a) Generally.--Nothing in this Act shall be construed to 
     prevent the Secretary of Veterans Affairs from processing 
     claims for benefits under title 38, United States Code, for a 
     condition or disease for which this Act establishes a 
     presumption of service connection, as a claim for benefits 
     for a condition or disease with direct service connection.
       (b) Effective Dates and Applicability.--The Secretary shall 
     not deny a claim for benefits under title 38, United States 
     Code, for a condition or disease for which this Act 
     establishes a presumption of service connection because the 
     claimant filed the claim prior to the effective date or date 
     of applicability for that particular condition or disease.

                       TITLE V--RESEARCH MATTERS

     SEC. 501. INTERAGENCY WORKING GROUP ON TOXIC EXPOSURE 
                   RESEARCH.

       (a) Establishment.--
       (1) In general.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall, in collaboration with the heads of the entities 
     described in paragraph (2), establish the Toxic Exposure 
     Research Working Group (in this section referred to as the 
     ``Working Group'').
       (2) Composition.--The Working Group shall consist of 
     employees, selected by the Secretary, of the following:
       (A) The Department of Veterans Affairs.
       (B) The Department of Defense.
       (C) The Department of Health and Human Services.
       (D) The Environmental Protection Agency.
       (E) Other entities of the Federal Government involved in 
     research activities regarding the health consequences of 
     toxic exposures experienced during active military, naval, 
     air, or space service.
       (b) Functions.--The Working Group shall perform the 
     following functions:
       (1) Identify collaborative research activities and 
     resources available among entities represented by members of 
     the Working Group to conduct such collaborative research 
     activities.
       (2) Develop a five-year strategic plan for such entities to 
     carry out collaborative research activities.
       (c) Reporting.--The Secretary shall submit to the Committee 
     on Veterans' Affairs of the Senate and the Committee on 
     Veterans' Affairs of the House of Representatives the 
     following:
       (1) Not later than one year after the date of the enactment 
     of this Act, a report on the establishment of the Working 
     Group under subsection (a).
       (2) Not later than two years after the date of the 
     enactment of this Act, a report containing the collaborative 
     research activities identified, and the strategic plan 
     developed, by the Working Group under subsection (b).
       (3) Not less frequently than annually during the five-year 
     period covered by the strategic plan under subsection (b), a 
     progress report on implementation of the strategic plan.
       (d) Termination.--The Working Group shall terminate after 
     submitting the final report under subsection (c).
       (e) Definitions.--In this section:
       (1) Active military, naval, air, or space service.--The 
     term ``active military, naval, air, or space service'' has 
     the meaning given that term in section 101 of title 38, 
     United States Code.
       (2) Collaborative research activity.--The term 
     ``collaborative research activity'' means a research 
     activity--
       (A) agreed upon by the Working Group;
       (B) conducted by an entity represented by a member of the 
     Working Group;
       (C) funded by the Federal Government; and
       (D) regarding the health consequences of toxic exposures 
     experienced during active military, naval, air, or space 
     service.
       (3) Toxic exposure.--The term ``toxic exposure'' has the 
     meaning given such term in section 101 of title 38, United 
     States Code, as amended by section 102(b).

     SEC. 502. 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 a toxic exposure.

[[Page H6009]]

       (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 the following:
       (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.
       (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 toxic exposures.
       (c) Toxic Exposure Defined.--In this section, the term 
     ``toxic exposure'' has the meaning given such term in section 
     101 of title 38, United States Code, as amended by section 
     102(b).

     SEC. 503. 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. 504. 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. 505. 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 sex of the veteran.
       (5) The type or types of cancer that the veteran has.

     SEC. 506. STUDY ON HEALTH EFFECTS OF WASTE RELATED TO 
                   MANHATTAN PROJECT ON CERTAIN VETERANS.

       (a) Study.--Not later than 180 days after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall enter into an agreement with the National Academies of 
     Sciences, Engineering, and Medicine for the conduct of a 
     study on the health trends of veterans who, while serving in 
     the active military, naval, air, or space service--
       (1) participated in activities relating to the Manhattan 
     Project (including activities relating to covered waste) in 
     connection with such service; or
       (2) resided at or near, as determined by the Secretary, the 
     locations described in subsection (b).
       (b) Covered Locations.--The locations described in this 
     subsection are the following locations:
       (1) In the county of St. Louis, Missouri, the following:
       (A) Coldwater Creek, Missouri.
       (B) The St. Louis Airport Site, Missouri.
       (C) The West Lake Landfill.
       (2) Oak Ridge, Tennessee.
       (3) Hanford, Washington.
       (4) Any other location that is proximate to covered waste, 
     as determined by the Secretary.
       (c) Elements.--The study under subsection (a) shall assess, 
     with respect to each veteran included in the study, the 
     following:
       (1) The age, sex, and race of the veteran.
       (2) The period and location of exposure to covered waste.
       (3) Any type of cancer, or other illness associated with 
     toxic exposure, that the veteran has.
       (4) A comparison of the overall health condition of the 
     veteran, including any illness of the veteran identified 
     pursuant to paragraph (3), with the overall health condition 
     of past and present civilian populations residing at the same 
     location of exposure, as determined by the Secretary.
       (d) Report.--Not later than three years after the date of 
     the enactment of this Act, 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 on the study under subsection (a) 
     and include in such report an analysis of the data available 
     and data reliability.
       (e) Definitions.--In this section:
       (1) Active military, naval, air, or space service; toxic 
     exposure.--The terms ``active military, naval, air, or space 
     service'' and ``toxic exposure'' have the meanings given 
     those terms in section 101 of title 38, United States Code, 
     as added by section 102(b).
       (2) Covered waste.--The term ``covered waste'' means any 
     waste arising from activities carried out in connection with 
     the Manhattan Project.
       (3) Illness.--The term ``illness'' has the meaning given 
     that term in section 1171 of title 38, United States Code, as 
     added by section 202.
       (4) Toxic exposure.--The term ``toxic exposure'' has the 
     meaning given such term in section 101 of title 38, United 
     States Code, as amended by section 102(b).

     SEC. 507. STUDY ON TOXIC EXPOSURE AND MENTAL HEALTH OUTCOMES.

       (a) Study Required.--Not later than 180 days after the date 
     of the enactment of this Act, the Secretary of Veterans 
     Affairs shall enter into an agreement with the National 
     Academies of Sciences, Engineering, and Medicine for the 
     conduct of a study of veterans to assess possible 
     relationships between toxic exposures experienced during 
     service in the Armed Forces and mental health conditions, 
     including chronic multisymptom illness, traumatic brain 
     injury, post-traumatic stress disorder, depression, episodes 
     of psychosis, schizophrenia, bipolar disorder, suicide 
     attempts, and suicide deaths.
       (b) Elements.--For each veteran included in the study under 
     subsection (a), the following information shall be collected 
     and assessed:
       (1) Age.
       (2) Sex.
       (3) Race and ethnicity.
       (4) Period and length of service in the Armed Forces.
       (5) The military occupational specialty or specialties of 
     the veteran.
       (6) History of toxic exposure during service in the Armed 
     Forces.
       (7) Any diagnosis of chronic multisymptom illness.
       (8) Any diagnosis of a mental health or cognitive disorder.
       (9) Any history of suicide attempt or suicidality.
       (10) If the veteran died by suicide.
       (11) Any confounding traumatic experiences that could 
     affect a veteran's mental health.
       (c) Report.--Not later than three years after the date of 
     the enactment of this Act, 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 the findings of the 
     National Academies of Sciences, Engineering, and Medicine 
     with respect to the study conducted under subsection (a).

     SEC. 508. STUDY ON VETERANS IN TERRITORIES OF THE UNITED 
                   STATES.

       (a) GAO Study.--
       (1) In general.--The Comptroller General of the United 
     States shall conduct a study on the state of access and 
     barriers to benefits and services furnished by the Veterans 
     Benefits Administration and the Veterans Health 
     Administration under laws administered by the Secretary of 
     Veterans Affairs to veterans in Territories and Freely 
     Associated States of the United States, including deficits in 
     the availability and accessibility of such benefits and 
     services compared to veterans elsewhere in the United States.
       (2) Elements.--The study under paragraph (1) shall 
     include--
       (A) the number of veterans in each Territory and Freely 
     Associated State of the United States;
       (B) the number of veterans in each Territory and Freely 
     Associated State who are enrolled in the system of annual 
     patient enrollment of the Department of Veterans Affairs 
     under section 1705(a) of title 38, United States Code;
       (C) a description of how the Department estimates the 
     number of veterans in each Territory and Freely Associated 
     State who are eligible for services under section 1710 of 
     such title but who are not enrolled as described in 
     subparagraph (B);
       (D) a detailed description of obstacles facing veterans in 
     each Territory and Freely Associated State in accessing 
     health care services, including those involving the 
     availability of such services to veterans in the Territory or 
     Freely Associated State in which the veterans reside, and any 
     distance impediments to receiving services at a regional 
     medical center of the Veterans Health Administration, a 
     community-based outpatient clinic, another full-service 
     medical facility of the Department, or a Vet Center, 
     respectively;
       (E) a detailed description of obstacles facing veterans in 
     each Territory and Freely Associated State in accessing 
     readjustment counseling

[[Page H6010]]

     services, including those involving the availability of such 
     services to veterans in the Territory in which the veterans 
     reside, and any distance impediments to receiving services at 
     a readjustment counseling services center of the Department;
       (F) a detailed description of obstacles facing veterans in 
     each Territory and Freely Associated State in accessing non-
     health care veterans benefits, including those involving the 
     availability of benefits and services to veterans in the 
     Territory or Freely Associated State in which the veterans 
     reside, and any distance impediments to accessing the nearest 
     office of the Veterans Benefits Administration;
       (G) an analysis of the staffing and quality of the offices 
     of the Veterans Benefits Administration and Veterans Health 
     Administration charged with serving veterans in the 
     Territories and Freely Associated States, including the 
     availability of the full- and part-time staff of each office 
     to the veterans they are charged with serving;
       (H) an analysis of the availability of the Veterans 
     Community Care Program established under section 1703 of 
     title 38, United States Code, to veterans in each Territory 
     and Freely Associated State;
       (I) an analysis of the economic and health outcomes for 
     veterans in each Territory or Freely Associated State 
     resulting from obstacles to accessing adequate assistance and 
     health care at facilities of the Department;
       (J) an analysis of the access to benefit assistance and 
     health care provided to veterans in the aftermath of major 
     disasters declared in each of the Territories and Freely 
     Associated States since September 4, 2017; and
       (K) such recommendations as the Comptroller General 
     considers appropriate for improving access of veterans in the 
     Territories and Freely Associated States to benefits and 
     health care services furnished by the Secretary, and reducing 
     barriers and deficits in the availability and accessibility 
     of such benefits and services compared to veterans elsewhere 
     in the United States.
       (b) Briefing.--Not later than one year after the date of 
     the enactment of this Act, the Comptroller General shall 
     provide to the Committee on Veterans' Affairs of the Senate 
     and the Committee on Veterans' Affairs of the House of 
     Representatives a briefing setting forth the results of the 
     study conducted under subsection (a), including any 
     recommendations developed under paragraph (2)(K) of such 
     subsection.
       (c) Definitions.--In this section:
       (1) Freely associated state.--The term ``Freely Associated 
     State'' includes the Federated States of Micronesia, the 
     Republic of the Marshall Islands, and the Republic of Palau.
       (2) Territory.--The term ``Territory'' includes American 
     Samoa, the Commonwealth of the Northern Marianas Islands, 
     Guam, Puerto Rico, and the Virgin Islands.
       (3) Vet center.--The term ``Vet Center'' has the meaning 
     given that term in section 1712A(h) of title 38, United 
     States Code.

     SEC. 509. DEPARTMENT OF VETERANS AFFAIRS PUBLIC WEBSITE FOR 
                   TOXIC EXPOSURE RESEARCH.

       (a) Website.--Not later than one year after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall establish, and maintain thereafter, a publicly 
     accessible internet website of the Department of Veterans 
     Affairs that serves as a clearinghouse for the publication of 
     all toxic exposure research carried out or funded by the 
     executive branch of the Federal Government.
       (b) Coordination.--In carrying out subsection (a), the 
     Secretary shall coordinate with--
       (1) the heads of each Federal agency carrying out or 
     funding toxic exposure research;
       (2) the War Related Illness and Injury Study Center of the 
     Department of Veterans Affairs, or successor center; and
       (3) any working group of the Department of Veterans Affairs 
     or other similar entity responsible for coordinating toxic 
     exposure research.
       (c) Definitions.--In this section:
       (1) Toxic exposure.--The term ``toxic exposure'' has the 
     meaning given that term in section 101 of title 38, United 
     States Code, as added by section 102(b).
       (2) Toxic exposure research.--The term ``toxic exposure 
     research'' means research on the health consequences of toxic 
     exposures experienced during service in the Armed Forces.

     SEC. 510. REPORT ON HEALTH EFFECTS OF JET FUELS USED BY ARMED 
                   FORCES.

       (a) Initial Report.--Not later than one year after the date 
     of the enactment of this Act, 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, and make publicly available, a 
     report on health effects of jet fuels used by the Armed 
     Forces.
       (b) Contents.--The report submitted under subsection (a) 
     shall include the following:
       (1) A discussion of the effect of various different types 
     of jet fuels used by the Armed Forces on the health of 
     individuals by length of exposure.
       (2) An identification of the immediate symptoms of jet fuel 
     exposure that may indicate future health risks.
       (3) A chronology of health safeguards implemented by the 
     Armed Forces intended to reduce the exposure of members of 
     the Armed Forces to jet fuel.
       (4) An identification of any areas relating to jet fuel 
     exposure about which new research needs to be conducted.
       (c) Follow-up Report.--Not later than five years after the 
     date of the submittal of the report under subsection (a), the 
     Secretary shall submit to the committees referred to in such 
     subsection an update to such report.

TITLE VI--IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED 
                                VETERANS

     SEC. 601. SHORT TITLE; DEFINITIONS.

       (a) Short Title.--This title may be cited as the ``Fairly 
     Assessing Service-related Toxic Exposure Residuals 
     Presumptions Act of 2022'' or the ``FASTER Presumption Act of 
     2022''.
       (b) Definitions.--In this title, the terms ``active 
     military, naval, air, or space service'', ``toxic exposure'', 
     and ``toxic-exposed veteran'' have the meanings given those 
     terms in section 101 of title 38, United States Code, as 
     amended by section 102.

     SEC. 602. PUBLICATION OF LIST OF RESOURCES OF DEPARTMENT OF 
                   VETERANS AFFAIRS FOR TOXIC-EXPOSED VETERANS AND 
                   VETERANS WHO REPORT TOXIC EXPOSURES 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) toxic-exposed veterans and veterans who report toxic 
     exposure;
       (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 toxic exposures, 
     including outreach with respect to benefits and support 
     programs.

     SEC. 603. 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 toxic exposures 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 toxic exposures 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 toxic 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.

     SEC. 604. TRAINING FOR PERSONNEL OF THE DEPARTMENT OF 
                   VETERANS AFFAIRS WITH RESPECT TO VETERANS WHO 
                   REPORT TOXIC EXPOSURES.

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

                         TITLE VII--RESOURCING

     SEC. 701. AUTHORITY TO USE APPROPRIATIONS TO ENHANCE CLAIMS 
                   PROCESSING CAPACITY AND AUTOMATION.

       (a) Authority.--The Secretary of Veterans Affairs may use, 
     from amounts appropriated to the Cost of War Toxic Exposures 
     Fund established by section 324 of title 38, United States 
     Code, as added by section 805 of this Act, such amounts as 
     may be necessary to continue the modernization, development, 
     and expansion of capabilities and capacity of information 
     technology systems and infrastructure of the Veterans 
     Benefits Administration, including for claims automation, to 
     support expected increased claims processing for newly 
     eligible veterans pursuant to this Act.

[[Page H6011]]

       (b) Plan for Modernization of Veterans Benefits 
     Administration Information Technology Systems.--
       (1) In general.--Not later than 180 days after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to the appropriate congressional committees a 
     plan for the modernization of the information technology 
     systems of the Veterans Benefits Administration. The plan 
     shall cover the first fiscal year that begins after the date 
     of the enactment of this Act and the subsequent four fiscal 
     years and shall include each of the following:
       (A) An identification of any information system to be 
     modernized or retired, if applicable, during the period 
     covered by the plan.
       (B) A description of how the Secretary intends to 
     incorporate the following principles into the modernization 
     of such information systems:
       (i) The purpose of automation should be to increase the 
     speed and accuracy of claims processing decisions.
       (ii) Automation should be conducted in a manner that 
     enhances the productivity of employees of the Department of 
     Veterans Affairs.
       (iii) Automation should be carried out in a manner that 
     achieves greater consistency in the processing and rating of 
     claims by relying on patterns of similar evidence in claim 
     files.
       (iv) To the greatest extent possible, automation should be 
     carried out by drawing from information in the possession of 
     the Department, other Government agencies, and applicants for 
     benefits.
       (v) Automation of any claims analysis or determination 
     process should not be end-to-end or lack intermediation.
       (vi) Employees of the Department should continue to make 
     decisions with respect to the approval of claims and the 
     granting of benefits.
       (vii) Automation should not be carried out in a manner that 
     reduces or infringes upon the due process rights of 
     applicants for benefits under the laws administered by the 
     Secretary; or the duties of the Secretary to assist and 
     notify claimants.
       (viii) Automation should be carried out while taking all 
     necessary measures to protect the privacy of claimants and 
     their personally identifiable information.
       (ix) Automation of claims processing should not eliminate 
     or reduce the workforce of the Veterans Benefits 
     Administration.
       (C) An identification of targets, for each fiscal year, by 
     which the Secretary intends to complete the modernization of 
     each information system or major component or functionality 
     of such system identified under subparagraph (A).
       (D) Cost estimates for the modernization of each 
     information system identified under paragraph (A) for each 
     fiscal year covered by the plan and in total.
       (2) Appropriate congressional committees.--In this section, 
     the term ``appropriate congressional committees'' means--
       (A) the Committee on Veterans' Affairs and the Subcommittee 
     on Military Construction, Veterans Affairs, and Related 
     Agencies of the Committee on Appropriations of the Senate; 
     and
       (B) the Committee on Veterans' Affairs and the Subcommittee 
     on Military Construction, Veterans Affairs, and Related 
     Agencies of the Committee on Appropriations of the House of 
     Representatives.

     SEC. 702. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES OF 
                   DEPARTMENT OF VETERANS AFFAIRS FOR FISCAL YEAR 
                   2023.

       (a) In General.--The Secretary of Veterans Affairs may 
     carry out the following major medical facility leases in 
     fiscal year 2023:
       (1) Lease for an outpatient clinic in the vicinity of 
     Allentown, Pennsylvania, in an estimated amount of 
     $31,832,000.
       (2) Lease for a facility for member services for the 
     Veterans Health Administration in the vicinity of Atlanta, 
     Georgia, in an estimated amount of $27,134,000.
       (3) Lease for an outpatient clinic in the vicinity of 
     Baltimore, Maryland, in an estimated amount of $43,041,000.
       (4) Lease for an outpatient clinic in the vicinity of Baton 
     Rouge, Louisiana, in an estimated amount of $29,550,000.
       (5) Lease for an outpatient clinic in the vicinity of 
     Beaufort, South Carolina, in an estimated amount of 
     $24,254,000.
       (6) Lease for an outpatient clinic in the vicinity of 
     Beaumont, Texas, in an estimated amount of $15,632,000.
       (7) Lease for an outpatient clinic in the vicinity of 
     Brainerd, Minnesota, in an estimated amount of $14,669,000.
       (8) Lease for a facility for research in the vicinity of 
     Buffalo, New York, in an estimated amount of $11,106,000.
       (9) Lease for an outpatient clinic in the vicinity of 
     Clarksville, Tennessee, in an estimated amount of 
     $75,135,000.
       (10) Lease of a facility for research in the vicinity of 
     Columbia, Missouri, in an estimated amount of $20,726,000.
       (11) Lease for an outpatient clinic in the vicinity of 
     Cookeville, Tennessee, in an estimated amount of $10,958,000.
       (12) Lease for a residential treatment facility in the 
     vicinity of Denver, Colorado, in an estimated amount of 
     $9,133,000.
       (13) Lease for an outpatient clinic in the vicinity of 
     Elizabethtown, Kentucky, in an estimated amount of 
     $16,671,000.
       (14) Lease for an outpatient clinic in the vicinity of 
     Farmington, Missouri, in an estimated amount of $17,940,000.
       (15) Lease for an outpatient clinic in the vicinity of 
     Hampton, Virginia, in an estimated amount of $63,085,000.
       (16) Lease for an outpatient clinic in the vicinity of 
     Jacksonville, North Carolina, in an estimated amount of 
     $61,450,000.
       (17) Lease for an outpatient clinic in the vicinity of 
     Killeen, Texas, in an estimated amount of $61,030,000.
       (18) Lease for an outpatient clinic in the vicinity of 
     Lawrence, Indiana, in an estimated amount of $15,811,000.
       (19) Lease for an outpatient clinic in the vicinity of 
     Lecanto, Florida, in an estimated amount of $15,373,000.
       (20) Lease for an outpatient clinic in the vicinity of 
     Nashville, Tennessee, in an estimated amount of $58,038,000.
       (21) Lease for an outpatient clinic in the vicinity of 
     North Kansas City, Missouri, in an estimated amount of 
     $40,027,000.
       (22) Lease for an outpatient clinic in the vicinity of 
     Pflugerville, Texas, in an estimated amount of $16,654,000.
       (23) Lease for an outpatient clinic in the vicinity of 
     Plano, Texas, in an estimated amount of $32,796,000.
       (24) Lease for an outpatient clinic in the vicinity of 
     Prince George's County, Maryland, in an estimated amount of 
     $31,754,000.
       (25) Lease for an outpatient clinic in the vicinity of 
     Rolla, Missouri, in an estimated amount of $21,352,000.
       (26) Lease for an outpatient clinic in the vicinity of Salt 
     Lake City, Utah, in an estimated amount of $29,466,000.
       (27) Lease for an outpatient clinic in the vicinity of 
     Sarasota, Florida, in an estimated amount of $36,517,000.
       (28) Lease for an outpatient clinic in the vicinity of 
     Springfield, Massachusetts, in an estimated amount of 
     $30,918,000.
       (29) Lease for a community living center in the vicinity of 
     Tampa, Florida, in an estimated amount of $51,682,000.
       (30) Lease for an outpatient clinic in the vicinity of The 
     Villages, Florida, in an estimated amount of $48,267,000.
       (31) Lease for an outpatient clinic in the vicinity of Tri-
     Cities, Washington, in an estimated amount of $36,136,000.
       (b) Treatment of Authorizations.--The authorization of 
     leases under subsection (a) shall be considered to be a 
     specific authorization by law of the funds for such leases 
     for purposes of section 8104(a)(2) of title 38, United States 
     Code, as in effect on the day before the date of the 
     enactment of this Act.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Secretary of Veterans Affairs for 
     fiscal year 2023, or the year in which funds are appropriated 
     for the Medical Facilities account, $998,137,000 for the 
     leases authorized in subsection (a).

     SEC. 703. TREATMENT OF MAJOR MEDICAL FACILITY LEASES OF THE 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) Congressional Approval of Major Medical Facility 
     Leases.--Paragraph (2) of subsection (a) of section 8104 of 
     title 38, United States Code, is amended--
       (1) by striking ``No funds'' and inserting ``(A) No 
     funds'';
       (2) by striking ``or any major medical facility lease'';
       (3) by striking ``or lease''; and
       (4) by adding at the end the following new subparagraph:
       ``(B) No funds may be appropriated for any fiscal year, and 
     the Secretary may not obligate or expend funds (other than 
     for advance planning and design), for any major medical 
     facility lease unless the Committee on Veterans' Affairs of 
     the Senate and the Committee on Veterans' Affairs of the 
     House of Representatives each adopt a resolution approving 
     the lease.''.
       (b) Modification of Definition of Major Medical Facility 
     Lease.--Subparagraph (B) of paragraph (3) of such subsection 
     is amended to read as follows:
       ``(B) The term `major medical facility lease'--
       ``(i) means a lease for space for use as a new medical 
     facility approved through the General Services Administration 
     under section 3307(a) of title 40 at an average annual rent 
     equal to or greater than the appropriate dollar threshold 
     described in such section, which shall be subject to annual 
     adjustment in accordance with section 3307(h) of such title; 
     and
       ``(ii) does not include a lease for space for use as a 
     shared Federal medical facility for which the Department's 
     estimated share of the lease costs does not exceed such 
     dollar threshold.''.
       (c) Separate Prospectus Requirement for Major Medical 
     Facility Leases.--Subsection (b) of such section is amended--
       (1) by striking paragraph (7);
       (2) in paragraph (1), by redesignating subparagraphs (A) 
     through (E) as clauses (i) through (v), respectively;
       (3) in paragraph (6), by redesignating subparagraphs (A) 
     through (C) as clauses (i) through (iii), respectively;
       (4) by redesignating paragraphs (1) through (6) as 
     subparagraphs (A) through (F), respectively;
       (5) in the matter preceding subparagraph (A), as 
     redesignated by paragraph (4)--
       (A) by striking ``Whenever the President'' and inserting 
     ``(1) Whenever the President'';
       (B) by striking ``the Congress'' and inserting 
     ``Congress''; and
       (C) by striking ``or a major medical facility lease (as 
     defined in subsection (a)(3)(b))'';
       (6) in subparagraph (A), as redesignated by paragraph (4), 
     by striking ``leased,'';
       (7) in subparagraph (E), as redesignated by paragraph (4)--
       (A) by striking ``or lease'' each place it appears; and
       (B) by striking ``or leases''; and
       (8) by adding at the end the following new paragraph:
       ``(2) Whenever the President or the Secretary submit to 
     Congress a request for the funding of a major medical 
     facility lease (as defined in subsection (a)(3)(B)), the 
     Secretary shall submit to each committee, on the same day, a 
     prospectus of the proposed medical facility. Any such 
     prospectus shall include the following:

[[Page H6012]]

       ``(A) A description of the facility to be leased.
       ``(B) An estimate of the cost to the Federal Government of 
     the facility to be leased.
       ``(C) An estimate of the energy performance of the proposed 
     lease space, to include a description of anticipated 
     utilization of renewable energy, energy efficient and climate 
     resilient elements, and related matters.
       ``(D) Current and projected workload and utilization data 
     regarding the facility to be leased, including information on 
     projected changes in workload and utilization over a five-
     year period, a ten-year period, and a twenty-year period.
       ``(E) A detailed analysis of how the lease is expected to 
     comply with Office of Management and Budget Circular A-11 and 
     section 1341 of title 31 (commonly referred to as the `Anti-
     Deficiency Act'). Any such analysis shall include--
       ``(i) an analysis of the classification of the lease as a 
     `lease purchase', a `capital lease', or an `operating lease' 
     as those terms are defined in Office of Management and Budget 
     Circular A-11;
       ``(ii) an analysis of the obligation of budgetary resources 
     associated with the lease; and
       ``(iii) an analysis of the methodology used in determining 
     the asset cost, fair market value, and cancellation costs of 
     the lease.''.
       (d) Interim Leasing Actions.--Such section is further 
     amended by adding at the end the following new subsection:
       ``(i)(1) Notwithstanding subsection (a)(2)(B), the 
     Secretary may carry out interim leasing actions as the 
     Secretary considers necessary for the following leases:
       ``(A) Major medical facility leases (as defined in 
     subsection (a)(3)(B)) approved pursuant to this section and 
     for which a prospectus for a replacement lease has been 
     submitted to Congress pursuant to subsection (b)(2).
       ``(B) Replacement leases that do not require approval under 
     this section and for which a prospectus has been submitted to 
     Congress pursuant to subsection (b)(2).
       ``(2) In this subsection, the term `interim leasing 
     actions' has the meaning given that term by the Administrator 
     of the General Services Administration.''.
       (e) Purchase Options.--Such section is further amended by 
     adding at the end the following new subsection:
       ``(j) The Secretary may obligate and expend funds to 
     exercise a purchase option included in any major medical 
     facility lease (as defined in subsection (a)(3)(B)).''.
       (f) Applicability.--The amendments made by this section 
     shall apply with respect to any lease that has not been 
     specifically authorized by law on or before the date of the 
     enactment of this Act.

     SEC. 704. AUTHORITY TO ENTER INTO AGREEMENTS WITH ACADEMIC 
                   AFFILIATES AND OTHER ENTITIES TO ACQUIRE SPACE 
                   FOR THE PURPOSE OF PROVIDING HEALTH-CARE 
                   RESOURCES TO VETERANS.

       Section 8103 of title 38, United States Code, is amended by 
     adding at the end the following new subsection:
       ``(h)(1) Notwithstanding any other provision of law 
     requiring the use of competitive procedures, including 
     section 2304 of title 10, when the Secretary determines it to 
     be in the best interest of the Department, the Secretary may 
     enter into a lease with an academic affiliate or covered 
     entity to acquire space for the purpose of providing health-
     care resources to veterans.
       ``(2) In this subsection:
       ``(A) The term `academic affiliate' means an institution or 
     organization described in section 7302(d) of this title.
       ``(B) The term `covered entity' means a unit or subdivision 
     of a State, local, or municipal government, public or 
     nonprofit agency, institution, or organization, or other 
     institution or organization as the Secretary considers 
     appropriate that owns property controlled by an academic 
     affiliate to be leased under this subsection.
       ``(C) The term `health -care resource' has the meaning 
     given that term in section 8152(1) of this title.
       ``(D) The term `space' means any room, unit, floor, wing, 
     building, parking facility, or other subdivision of a 
     building or facility owned or controlled by an academic 
     affiliate.''.

     SEC. 705. MODIFICATIONS TO ENHANCED-USE LEASE AUTHORITY OF 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) Modifications to Authority.--Paragraph (2) of section 
     8162(a) of title 38, United States Code, is amended to read 
     as follows:
       ``(2)(A) The Secretary may enter into an enhanced-use lease 
     on or after the date of the enactment of this paragraph only 
     if the Secretary determines--
       ``(i) that the lease will not be inconsistent with, and 
     will not adversely affect--
       ``(I) the mission of the Department; or
       ``(II) the operation of facilities, programs, and services 
     of the Department in the area of the leased property; and
       ``(ii) that--
       ``(I) the lease will enhance the use of the leased property 
     by directly or indirectly benefitting veterans; or
       ``(II) the leased property will provide supportive housing.
       ``(B) The Secretary shall give priority to enhanced-use 
     leases that, on the leased property--
       ``(i) provide supportive housing for veterans;
       ``(ii) provide direct services or benefits targeted to 
     veterans; or
       ``(iii) provide services or benefits that indirectly 
     support veterans.''.
       (b) Extension of Maximum Term of Enhanced-use Lease.--
     Section 8162(b)(2) of such title is amended by striking ``75 
     years'' and inserting ``99 years''.
       (c) Modification of Use of Proceeds.--Section 8165(a)(1) of 
     such title is amended by striking ``shall be deposited in the 
     Department of Veterans Affairs Medical Care Collections Fund 
     established under section 1729A of this title.'' and 
     inserting ``shall, at the discretion of the Secretary, be 
     deposited in--
       ``(A) the Department of Veterans Affairs Medical Care 
     Collections Fund established under section 1729A of this 
     title; or
       ``(B) the Medical Facilities or Construction, Minor 
     Projects account of the Department to be used to defray the 
     costs of administration, maintenance, repair, and related 
     expenses incurred by the Department with respect to property 
     that is owned by or under the jurisdiction or control of the 
     Department.''.
       (d) Repeal of Sunset.--Section 8169 of such title is 
     repealed.
       (e) Appropriation.--In addition to amounts otherwise 
     available, there is appropriated for fiscal year 2022, out of 
     any funds in the Treasury not otherwise appropriated, 
     $922,000,000 for an additional amount for the Department of 
     Veterans Affairs, to remain available until expended, to 
     enter into enhanced-use leases pursuant to section 8162 of 
     title 38, United States Code, as amended by this section.

     SEC. 706. AUTHORITY FOR JOINT LEASING ACTIONS OF DEPARTMENT 
                   OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS.

       (a) Department of Defense.--Section 1104A of title 10, 
     United States Code, is amended--
       (1) by inserting ``, or the leasing,'' after ``design, and 
     construction'' each place it appears; and
       (2) in subsection (c)(2), by inserting ``, or the 
     leasing,'' after ``design''.
       (b) Department of Veterans Affairs.--Section 8111B of title 
     38, United States Code, is amended--
       (1) in subsection (a), by inserting ``, or the leasing,'' 
     after ``design, and construction'';
       (2) in subsection (b), by adding at the end the following 
     new paragraph:
       ``(3) The Secretary of Veterans Affairs may transfer to the 
     Department of Defense amounts appropriated to the `Medical 
     Facilities' account of the Department of Veterans Affairs for 
     the purpose of leasing space for a shared medical facility if 
     the estimated share of the Department of Veterans Affairs for 
     the lease costs does not exceed the amount specified in 
     section 8104(a)(3)(B) of this title.''; and
       (3) in subsection (c), by adding at the end the following 
     new paragraph:
       ``(3) Any amount transferred to the Secretary of Veterans 
     Affairs by the Secretary of Defense for the purpose of 
     leasing space for a shared medical facility may be credited 
     to the `Medical Facilities' account of the Department of 
     Veterans Affairs and may be used for such purpose.''.

     SEC. 707. APPROPRIATION OF AMOUNTS FOR MAJOR MEDICAL FACILITY 
                   LEASES.

       (a) Fiscal Year 2023.--In addition to amounts otherwise 
     available, there is appropriated for fiscal year 2023, out of 
     any funds in the Treasury not otherwise appropriated, 
     $1,880,000,000 for an additional amount for the Medical 
     Facilities account of the Department of Veterans Affairs, to 
     remain available until expended, for major medical facility 
     leases authorized by section 702.
       (b) Additional Years.--In addition to amounts otherwise 
     available, there is appropriated, out of any funds in the 
     Treasury not otherwise appropriated, for an additional amount 
     for the Medical Facilities account of the Department of 
     Veterans Affairs, to remain available until expended, for 
     major medical facility leases authorized by section 702 or 
     approved pursuant to subchapter I of chapter 81 of title 38, 
     United States Code, as amended by section 703--
       (1) $100,000,000 for fiscal year 2024;
       (2) $200,000,000 for fiscal year 2025;
       (3) $400,000,000 for fiscal year 2026;
       (4) $450,000,000 for fiscal year 2027;
       (5) $600,000,000 for fiscal year 2028;
       (6) $610,000,000 for fiscal year 2029;
       (7) $620,000,000 for fiscal year 2030; and
       (8) $650,000,000 for fiscal year 2031.

                 TITLE VIII--RECORDS AND OTHER MATTERS

     SEC. 801. EPIDEMIOLOGICAL STUDY ON FORT MCCLELLAN VETERANS.

       The Secretary of Veterans Affairs shall conduct an 
     epidemiological study on the health trends of veterans who 
     served in the Armed Forces at Fort McClellan at any time 
     during the period beginning January 1, 1935, and ending on 
     May 20, 1999.

     SEC. 802. BIENNIAL BRIEFING 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, as determined by the Secretary 
     of Defense, and every two years thereafter, the Secretary of 
     Defense, in consultation with the Secretary of Veterans 
     Affairs, shall provide the appropriate committees of Congress 
     a briefing on--
       (1) the quality of the databases of the Department of 
     Defense that provide the information presented in such 
     Individual Longitudinal Exposure Record; and
       (2) the usefulness of such Individual Longitudinal Exposure 
     Record or system in supporting members of the Armed Forces 
     and veterans in receiving health care and benefits from the 
     Department of Defense and the Department of Veterans Affairs.
       (b) Elements.--Each briefing required by subsection (a) 
     shall include, for the period covered by the report, the 
     following:
       (1) An identification of potential exposures to 
     occupational or environmental hazards captured by the current 
     systems of the Department of Defense for environmental, 
     occupational, and health monitoring, and recommendations for 
     how to improve those systems.

[[Page H6013]]

       (2) An analysis of the quality and accuracy of the location 
     data used by the Department of Defense in determining 
     potential exposures to occupational or environmental hazards 
     by members of the Armed Forces and veterans, and 
     recommendations for how to improve the quality of such data 
     if necessary.
       (c) Definitions.--In this section:
       (1) Appropriate committees of congress.--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'' has the meaning 
     given such term in section 1171 of title 38, United States 
     Code, as added by section 202.

     SEC. 803. CORRECTION OF EXPOSURE RECORDS BY MEMBERS OF THE 
                   ARMED FORCES AND VETERANS.

       (a) In General.--The Secretary of Veterans Affairs shall 
     coordinate with the Secretary of Defense to provide a means 
     for veterans to update their records as necessary to reflect 
     exposures to occupational or environmental hazards by such 
     member or veteran in the Individual Longitudinal Exposure 
     Record.
       (b) Evidence.--
       (1) Provision of evidence.--To update a record under 
     subsection (a), a veteran shall provide such evidence as the 
     Secretary of Veterans Affairs considers necessary.
       (2) Regulations.--The Secretary of Veterans Affairs shall 
     prescribe by regulation the evidence considered necessary 
     under paragraph (1).
       (c) Definitions.--In this section:
       (1) Individual longitudinal exposure record.--The term 
     ``Individual Longitudinal Exposure Record'' has the meaning 
     given such term in section 1171 of title 38, United States 
     Code, as added by section 202.
       (2) Toxic exposure.--The term ``toxic exposure'' has the 
     meaning given such term in section 101 of title 38, United 
     States Code, as amended by section 102(b).

     SEC. 804. FEDERAL CAUSE OF ACTION RELATING TO WATER AT CAMP 
                   LEJEUNE, NORTH CAROLINA.

       (a) Short Title.--This section may be cited as the ``Camp 
     Lejeune Justice Act of 2022''.
       (b) In General.--An individual, including a veteran (as 
     defined in section 101 of title 38, United States Code), or 
     the legal representative of such an individual, who resided, 
     worked, or was otherwise exposed (including in utero 
     exposure) for not less than 30 days during the period 
     beginning on August 1, 1953, and ending on December 31, 1987, 
     to water at Camp Lejeune, North Carolina, that was supplied 
     by, or on behalf of, the United States may bring an action in 
     the United States District Court for the Eastern District of 
     North Carolina to obtain appropriate relief for harm that was 
     caused by exposure to the water at Camp Lejeune.
       (c) Burdens and Standard of Proof.--
       (1) In general.--The burden of proof shall be on the party 
     filing the action to show one or more relationships between 
     the water at Camp Lejeune and the harm.
       (2) Standards.--To meet the burden of proof described in 
     paragraph (1), a party shall produce evidence showing that 
     the relationship between exposure to the water at Camp 
     Lejeune and the harm is--
       (A) sufficient to conclude that a causal relationship 
     exists; or
       (B) sufficient to conclude that a causal relationship is at 
     least as likely as not.
       (d) Exclusive Jurisdiction and Venue.--The United States 
     District Court for the Eastern District of North Carolina 
     shall have exclusive jurisdiction over any action filed under 
     subsection (b), and shall be the exclusive venue for such an 
     action. Nothing in this subsection shall impair the right of 
     any party to a trial by jury.
       (e) Exclusive Remedy.--
       (1) In general.--An individual, or legal representative of 
     an individual, who brings an action under this section for a 
     harm described in subsection (b), including a latent disease, 
     may not thereafter bring a tort action against the United 
     States for such harm pursuant to any other law.
       (2) Health and disability benefits relating to water 
     exposure.--Any award made to an individual, or legal 
     representative of an individual, under this section shall be 
     offset by the amount of any disability award, payment, or 
     benefit provided to the individual, or legal representative--
       (A) under--
       (i) any program under the laws administered by the 
     Secretary of Veterans Affairs;
       (ii) the Medicare program under title XVIII of the Social 
     Security Act (42 U.S.C. 1395 et seq.); or
       (iii) the Medicaid program under title XIX of the Social 
     Security Act (42 U.S.C. 1396 et seq.); and
       (B) in connection with health care or a disability relating 
     to exposure to the water at Camp Lejeune.
       (f) Immunity Limitation.--The United States may not assert 
     any claim to immunity in an action under this section that 
     would otherwise be available under section 2680(a) of title 
     28, United States Code.
       (g) No Punitive Damages.--Punitive damages may not be 
     awarded in any action under this section.
       (h) Disposition by Federal Agency Required.--An individual 
     may not bring an action under this section before complying 
     with section 2675 of title 28, United States Code.
       (i) Exception for Combatant Activities.--This section does 
     not apply to any claim or action arising out of the combatant 
     activities of the Armed Forces.
       (j) Applicability; Period for Filing.--
       (1) Applicability.--This section shall apply only to a 
     claim accruing before the date of enactment of this Act.
       (2) Statute of limitations.--A claim in an action under 
     this section may not be commenced after the later of--
       (A) the date that is two years after the date of enactment 
     of this Act; or
       (B) the date that is 180 days after the date on which the 
     claim is denied under section 2675 of title 28, United States 
     Code.
       (3) Inapplicability of other limitations.--Any applicable 
     statute of repose or statute of limitations, other than under 
     paragraph (2), shall not apply to a claim under this section.

     SEC. 805. COST OF WAR TOXIC EXPOSURES FUND.

       (a) In General.--Chapter 3 is amended by adding at the end 
     the following new section:

     ``Sec. 324. Cost of War Toxic Exposures Fund

       ``(a) Establishment.--There is hereby established in the 
     Treasury of the United States an account to be known as the 
     `Cost of War Toxic Exposures Fund' (the `Fund'), to be 
     administered by the Secretary.
       ``(b) Deposits.--There shall be deposited in the Fund such 
     amounts as may be appropriated to the Fund pursuant to 
     subsection (c).
       ``(c) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Fund for fiscal year 2023 and each 
     subsequent fiscal year such sums as are necessary to increase 
     funding, over the fiscal year 2021 level, for investment in--
       ``(1) the delivery of veterans' health care associated with 
     exposure to environmental hazards in the active military, 
     naval, air, or space service in programs administered by the 
     Under Secretary for Health;
       ``(2) any expenses incident to the delivery of veterans' 
     health care and benefits associated with exposure to 
     environmental hazards in the active military, naval, air, or 
     space service, including administrative expenses, such as 
     information technology and claims processing and appeals, and 
     excluding leases as authorized or approved under section 8104 
     of this title; and
       ``(3) medical and other research relating to exposure to 
     environmental hazards.
       ``(d) Budget Scorekeeping.--(1) Immediately upon enactment 
     of the Sergeant First Class Heath Robinson Honoring our 
     Promise to Address Comprehensive Toxics Act of 2022, expenses 
     authorized to be appropriated to the Fund in subsection (c) 
     shall be estimated for fiscal year 2023 and each subsequent 
     fiscal year and treated as budget authority that is 
     considered to be direct spending--
       ``(A) in the baseline for purposes of section 257 of the 
     Balanced Budget and Emergency Deficit Control Act of 1985 (2 
     U.S.C. 907);
       ``(B) by the Chairman of the Committee on the Budget of the 
     Senate and the Chair of the Committee on the Budget of the 
     House of Representatives, as appropriate, for purposes of 
     budget enforcement in the Senate and the House of 
     Representatives;
       ``(C) under the Congressional Budget Act of 1974 (2 U.S.C. 
     621 et seq.), including in the reports required by section 
     308(b) of such Act (2 U.S.C. 639); and
       ``(D) for purposes of the Statutory Pay-As-You-Go Act of 
     2010 (2 U.S.C. 931 et seq.).
       ``(2) No amount appropriated to the Fund in fiscal year 
     2023 or any subsequent fiscal year pursuant to this section 
     shall be counted as discretionary budget authority and 
     outlays or as direct spending for any estimate of an 
     appropriation Act under the Congressional Budget and 
     Impoundment Control Act of 1974 (2 U.S.C. 621 et seq.) and 
     any other Act.
       ``(3) Notwithstanding the Budget Scorekeeping Guidelines 
     and the accompanying list of programs and accounts set forth 
     in the joint explanatory statement of the committee of 
     conference accompanying Conference Report 105-217, and for 
     purposes of the Balanced Budget and Emergency Deficit Control 
     Act of 1985 (2 U.S.C. 900 et seq.) and the Congressional 
     Budget Act of 1974 (2 U.S.C. 621 et seq.), the Fund shall be 
     treated as if it were an account designated as `Appropriated 
     Entitlements and Mandatories for Fiscal Year 1997' in the 
     joint explanatory statement of the committee of conference 
     accompanying Conference Report 105-217.
       ``(e) Estimates for Congressional Consideration.--The 
     Secretary shall include in documents submitted to Congress in 
     support of the President's budget submitted pursuant to 
     section 1105 of title 31 detailed estimates of the sums 
     described in subsection (c) for the applicable fiscal year.
       ``(f) Procedures for Estimates.--The Secretary may, after 
     consultation with the Committee on Appropriations of the 
     Senate and the Committee on Appropriations of the House of 
     Representatives, establish policies and procedures for 
     developing the annual detailed estimates required by 
     subsection (e).''.
       (b) Sequestration.--Section 256(h)(4) of the Balanced 
     Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 
     906(h)(4)) is amended by adding at the end the following new 
     subparagraph:
       ``(G) Cost of War Toxic Exposures Fund.''.

     SEC. 806. APPROPRIATION FOR FISCAL YEAR 2022.

       (a) Appropriation.--In addition to amounts otherwise 
     available, there is appropriated for fiscal year 2022, out of 
     any funds in the Treasury not otherwise appropriated, 
     $500,000,000 for the Cost of War Toxic Exposures Fund, 
     established by section 324 of title 38, United States Code, 
     as added by section 805 of this Act, to remain available 
     until September 30, 2024.
       (b) Spend Plan.--Not later than 30 days after enactment of 
     this Act, the Secretary of Veterans Affairs shall submit a 
     plan for expending amounts made available by subsection (a) 
     by

[[Page H6014]]

     program, project or activity to the Committee on 
     Appropriations of the Senate and the Committee on 
     Appropriations of the House of Representatives. Funds may not 
     be obligated until such Committees issue an approval, or 
     absent a response, a period of 30 days has elapsed.

     SEC. 807. AUTHORIZATION OF ELECTRONIC NOTICE IN CLAIMS UNDER 
                   LAWS ADMINISTERED BY THE SECRETARY OF VETERANS 
                   AFFAIRS.

       (a) In General.--Title 38, United States Code, is amended 
     as follows:
       (1) By striking section 5100 and inserting the following:

     ``Sec. 5100. Definitions

       ``In this chapter:
       ``(1) The term `claimant' means any individual applying 
     for, or submitting a claim for, any benefit under the laws 
     administered by the Secretary.
       ``(2) The term `notice' means a communication issued 
     through means (including electronic means) prescribed by the 
     Secretary.''.
       (2) In section 5104, by adding at the end the following new 
     subsection:
       ``(c) The Secretary may provide notice under subsection (a) 
     electronically if a claimant (or the claimant's 
     representative) elects to receive such notice electronically. 
     A claimant (or the claimant's representative) may revoke such 
     an election at any time, by means prescribed by the 
     Secretary.
       ``(d) The Secretary shall annually--
       ``(1) solicit recommendations from stakeholders on how to 
     improve notice under this section; and
       ``(2) publish such recommendations on a publicly available 
     website of the Department.''.
       (3) In section 5104B(c), in the matter preceding paragraph 
     (1) by striking ``in writing'' and inserting ``to the 
     claimant (and any representative of such claimant)''.
       (4) In section 5112(b)(6), by striking ``(at the payee's 
     last address of record)''.
       (5) In section 7104--
       (A) in the heading, by adding ``; decisions; notice'' at 
     the end; and
       (B) by striking subsection (e) and inserting the following:
       ``(e) After reaching a decision on an appeal, the Board 
     shall promptly issue notice (as that term is defined in 
     section 5100 of this title) of such decision to the 
     following:
       ``(1) The appellant.
       ``(2) Any other party with a right to notice of such 
     decision.
       ``(3) Any authorized representative of the appellant or 
     party described in paragraph (2).
       ``(f)(1) The Secretary may provide notice under subsection 
     (e) electronically if a claimant (or the claimant's 
     representative) elects to receive such notice electronically.
       ``(2) A claimant (or the claimant's representative) may 
     revoke such an election at any time, by means prescribed by 
     the Secretary.''.
       (6) In section 7105(b)(1)(A), by striking ``mailing'' and 
     inserting ``issuance''.
       (7) In section 7105A(a), by striking ``mailed'' and 
     inserting ``issued''.
       (8) In section 7266(a), by striking ``mailed'' and 
     inserting ``issued''.
       (b) Rule of Construction.--None of the amendments made by 
     this section shall be construed to apply section 5104(a) of 
     such title to decisions of the Board of Veterans' Appeals 
     under chapter 71 of such title.

     SEC. 808. BURN PIT TRANSPARENCY.

       (a) Annual Report on Disability Claims.--
       (1) In general.--Not later than 180 days after the date of 
     the enactment of this Act, and annually thereafter, the 
     Secretary of Veterans Affairs shall submit to the appropriate 
     congressional committees a report detailing the following:
       (A) The total number of covered veterans.
       (B) The total number of claimed issues for disability 
     compensation under chapter 11 of title 38, United States 
     Code, approved and the total number denied by the Secretary 
     of Veterans Affairs with respect to a covered veteran, and a 
     breakdown of the reasons for the denials.
       (C) A comprehensive list of the top 10 conditions from each 
     body system for which the Secretary awarded service 
     connection for covered veterans.
       (D) Any updates or trends with respect to the information 
     described in subparagraphs (A), (B), and (C), that the 
     Secretary determines appropriate.
       (2) Covered veteran defined.--In this subsection, the term 
     ``covered veteran'' means a veteran who deployed to the 
     Southwest Asia theater of operations any time after August 
     1990, or Afghanistan, Syria, Djibouti, or Uzbekistan after 
     September 19, 2001, and who submits a claim for disability 
     compensation under chapter 11 of title 38, United States 
     Code.
       (b) Information Regarding the Airborne Hazards and Open 
     Burn Pit Registry.--
       (1) Notice.--The Secretary of Veterans Affairs shall ensure 
     that a medical professional of the Department of Veterans 
     Affairs informs a veteran of the Airborne Hazards and Open 
     Burn Pit Registry if the veteran presents at a medical 
     facility of the Department for treatment that the veteran 
     describes as being related to, or ancillary to, the exposure 
     of the veteran to toxic airborne chemicals and fumes caused 
     by open burn pits.
       (2) Display.--In making information public regarding the 
     number of participants in the Airborne Hazards and Open Burn 
     Pit Registry, the Secretary shall display such numbers by 
     both State and by congressional district.
       (c) Definitions.--In this section:
       (1) Airborne hazards and open burn pit registry.--The term 
     ``Airborne Hazards and Open Burn Pit Registry'' means the 
     registry established by the Secretary of Veterans Affairs 
     under section 201 of the Dignified Burial and Other Veterans' 
     Benefits Improvement Act of 2012 (Public Law 112-260; 38 
     U.S.C. 527 note).
       (2) Appropriate congressional committees.--The term 
     ``appropriate congressional committees'' means--
       (A) the Committee on Veterans' Affairs and the Committee on 
     Armed Services of the Senate; and
       (B) The Committee on Veterans' Affairs and the Committee on 
     Armed Services of the House of Representatives.
       (3) Open burn pit.--The term ``open burn pit'' has the 
     meaning given that term in section 201(c) of the Dignified 
     Burial and Other Veterans' Benefits Improvement Act of 2012 
     (Public Law 112-260; 38 U.S.C. 527 note).

  TITLE IX--IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS

     SEC. 901. NATIONAL RURAL RECRUITMENT AND HIRING PLAN FOR 
                   VETERANS HEALTH ADMINISTRATION.

       (a) In General.--Not later than 18 months after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs, 
     in collaboration with the directors of each community-based 
     outpatient clinic and medical center of the Department of 
     Veterans Affairs, shall develop and implement a national 
     rural recruitment and hiring plan for the Veterans Health 
     Administration to--
       (1) recruit health care professionals for rural and highly 
     rural community-based outpatient clinics and rural and highly 
     rural medical centers of the Department;
       (2) determine which such clinics or centers have a staffing 
     shortage of health care professionals;
       (3) develop best practices and techniques for recruiting 
     health care professionals for such clinics and centers;
       (4) not less frequently than annually, provide virtually 
     based, on-demand training to human resources professionals of 
     the Veterans Health Administration on the best practices and 
     techniques developed under paragraph (3); and
       (5) provide recruitment resources, such as pamphlets and 
     marketing material to--
       (A) Veterans Integrated Service Networks of the Department;
       (B) rural and highly rural community-based outpatient 
     clinics of the Department; and
       (C) rural and highly rural medical centers of the 
     Department.
       (b) Annual Report.--Not later than 18 months 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 that includes--
       (1) the plan developed and implemented under subsection 
     (a); and
       (2) an assessment of the outcomes related to recruitment 
     and retention of employees of the Veterans Health 
     Administration at rural and highly rural facilities of the 
     Department.
       (c) Definitions.--In this section, the terms ``rural'' and 
     ``highly rural'' have the meanings given those terms under 
     the rural-urban commuting areas coding system of the 
     Department of Agriculture.

     SEC. 902. AUTHORITY TO BUY OUT SERVICE CONTRACTS FOR CERTAIN 
                   HEALTH CARE PROFESSIONALS IN EXCHANGE FOR 
                   EMPLOYMENT AT RURAL OR HIGHLY RURAL FACILITIES 
                   OF DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--For any covered health care professional 
     to whom the Secretary of Veterans Affairs has offered 
     employment with the Department of Veterans Affairs, the 
     Secretary may buy out the non-Department service contract of 
     such individual in exchange for such individual agreeing to 
     be employed at a rural or highly rural facility of the 
     Department for a period of obligated service specified in 
     subsection (c).
       (b) Payment of Amounts.--
       (1) In general.--Payment of any amounts for a buy out of a 
     service contract for a covered health care professional under 
     subsection (a) shall be made directly to the individual or 
     entity with respect to which the covered health care 
     professional has a service obligation under such contract.
       (2) Limitation on total amount.--The total amount paid by 
     the Department under this section shall not exceed 
     $40,000,000 per fiscal year.
       (c) Obligated Service.--In exchange for a contract buy out 
     under subsection (a), a covered health care professional 
     shall agree to be employed for not less than four years at a 
     rural or highly rural facility of the Department.
       (d) Liability.--
       (1) In general.--Except as provided in paragraph (2), if a 
     covered health care professional fails for any reason to 
     complete the period of obligated service of the individual 
     under subsection (c), the United States shall be entitled to 
     recover from the individual an amount equal to--
       (A) the total amount paid under subsection (a) to buy out 
     the non-Department service contract of the individual; 
     multiplied by
       (B) a fraction--
       (i) the numerator of which is--

       (I) the total number of months in the period of obligated 
     service of the individual; minus
       (II) the number of months served by the individual; and

       (ii) the denominator of which is the total number of months 
     in the period of obligated service of the individual.
       (2) Exception.--Liability shall not arise under paragraph 
     (1) in the case of an individual covered by that paragraph if 
     the individual does not obtain, or fails to maintain, 
     employment as an employee of the Department due to staffing 
     changes approved by the Under Secretary for Health.
       (e) Annual Report.--
       (1) In general.--Not later than 18 months after the date of 
     the enactment of this Act, and not less frequently than 
     annually thereafter,

[[Page H6015]]

     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 the use by the Secretary of the 
     authority under this section.
       (2) Elements.--Each report required by paragraph (1) shall 
     include the following:
       (A) The number of health care professionals for whom a 
     service contract buyout payment was made under subsection (a) 
     in the previous fiscal year, disaggregated by occupation or 
     specialty.
       (B) The average, highest, and lowest amount of the service 
     contract buyout payments made under subsection (a) for each 
     occupation or specialty in the previous fiscal year.
       (C) Each location where contract buyout authority under 
     subsection (a) was utilized and the number of covered health 
     care professionals who agreed to be employed at such location 
     in the previous fiscal year.
       (f) Definitions.--In this section:
       (1) Covered health care professional.--The term ``covered 
     health care professional'' means a physician, nurse 
     anesthetist, physician assistant, or nurse practitioner 
     offered employment with the Department regardless of the 
     authority under which such employment is offered.
       (2) Rural; highly rural.--The terms ``rural'' and ``highly 
     rural'' have the meanings given those terms under the rural-
     urban commuting areas coding system of the Department of 
     Agriculture.
       (g) Sunset.--This section shall terminate on September 30, 
     2027.

     SEC. 903. QUALIFICATIONS FOR HUMAN RESOURCES POSITIONS WITHIN 
                   DEPARTMENT OF VETERANS AFFAIRS AND PLAN TO 
                   RECRUIT AND RETAIN HUMAN RESOURCES EMPLOYEES.

       (a) Establishment of Qualifications.--Not later than 180 
     days after the date of the enactment of this Act, the 
     Secretary of Veterans Affairs shall--
       (1) establish qualifications for each human resources 
     position within the Department of Veterans Affairs in 
     coordination with the Office of Personnel Management;
       (2) establish standardized performance metrics for each 
     such position; and
       (3) submit to the Committee on Veterans' Affairs of the 
     Senate and the Committee on Veterans' Affairs of the House of 
     Representatives a report containing the qualifications and 
     standardized performance metrics established under paragraphs 
     (1) and (2).
       (b) Improvement of Human Resources Actions.--Not later than 
     90 days after the date of the enactment of this Act, the 
     Secretary shall establish or enhance systems of the 
     Department to monitor the hiring and other human resources 
     actions that occur at the local, regional, and national 
     levels of the Department to improve the performance of those 
     actions.
       (c) Report.--Not later than one year after the 
     establishment of the qualifications and performance metrics 
     under subsection (a), the Comptroller General of the United 
     States 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) a description of the implementation of such 
     qualifications and performance metrics;
       (2) an assessment of the quality of such qualifications and 
     performance metrics;
       (3) an assessment of performance and outcomes based on such 
     metrics; and
       (4) such other matters as the Comptroller General considers 
     appropriate.
       (d) Plan to Recruit and Retain Human Resources Employees.--
     Not later than one year after the date of the enactment of 
     this Act, 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 plan for the recruitment and retention of 
     human resources employees within the Department of Veterans 
     Affairs.

     SEC. 904. MODIFICATION OF PAY CAP FOR CERTAIN EMPLOYEES OF 
                   VETERANS HEALTH ADMINISTRATION.

       (a) In General.--Section 7455(c) is amended--
       (1) in paragraph (1), by striking ``30 percent'' inserting 
     ``50 percent'';
       (2) in paragraph (2), by striking ``level IV'' inserting 
     ``level II''; and
       (3) by adding at the end the following new paragraph:
       ``(3)(A) Notwithstanding section 5304 of title 5 or any 
     other provision of law, but subject to the limitation under 
     paragraph (2), pursuant to an increase under subsection (a), 
     the Secretary may pay a special rate or an adjusted rate of 
     basic pay in excess of the rate of basic pay payable for 
     level IV of the Executive Schedule.
       ``(B) If an employee is in receipt of a special rate of pay 
     under subparagraph (A) in excess of the rate of basic pay 
     payable for level IV of the Executive Schedule with an 
     established special rate supplement of greater value than a 
     supplement based on the applicable locality-based 
     comparability payment percentage under section 5304 of title 
     5, but a pay adjustment would cause such established special 
     rate supplement to be of lesser value, the special rate 
     supplement shall be converted to a supplement based on the 
     applicable locality-based comparability percentage unless the 
     Secretary determines that some other action is 
     appropriate.''.
       (b) Pay for Critical Positions.--Section 7404(a)(1)(B) is 
     amended by inserting ``7306 or'' before ``7401(4)''.

     SEC. 905. EXPANSION OF OPPORTUNITIES FOR HOUSEKEEPING AIDES.

       Section 3310 of title 5, United States Code, is amended by 
     inserting ``(other than for positions of housekeeping aides 
     in the Department of Veterans Affairs)'' after ``competitive 
     service''.

     SEC. 906. MODIFICATION OF AUTHORITY OF THE SECRETARY OF 
                   VETERANS AFFAIRS RELATING TO HOURS, CONDITIONS 
                   OF EMPLOYMENT, AND PAY FOR CERTAIN EMPLOYEES OF 
                   VETERANS HEALTH ADMINISTRATION.

       (a) Expansion of Eligibility of Employees for Certain 
     Awards.--Section 7404(c) is amended--
       (1) by striking ``Notwithstanding'' and inserting ``(1) 
     Notwithstanding'';
       (2) by inserting ``or 7401(4)'' after ``section 7306'';
       (3) by striking ``who is not eligible for pay under 
     subchapter III'' and inserting ``or in a covered executive 
     position under section 7401(1) of this title'';
       (4) by striking ``sections 4507 and 5384'' and inserting 
     ``section 4507''; and
       (5) by adding at the end the following new paragraph:
       ``(2) In this subsection, the term `covered executive 
     position' means a position that the Secretary has determined 
     is of equivalent rank to a Senior Executive Service position 
     (as such term is defined in section 3132(a) of title 5) and 
     is subject to an agency performance management system.''.
       (b) Authority for Awards Programs of Department of Veterans 
     Affairs.--
       (1) In general.--Subchapter I of chapter 74 is amended by 
     inserting after section 7404 the following new section:

     ``Sec. 7404A. Awards

       ``(a) Superior Accomplishments and Performance Awards 
     Program.--The Secretary may establish an awards program for 
     personnel listed in section 7421(b) of this title consistent 
     with chapter 45 of title 5, to the extent practicable.
       ``(b) Executive Performance Awards Program.--
     Notwithstanding section 7425 of this title or any other 
     provision of law, the Secretary may establish a performance 
     awards program consistent with section 5384 of title 5 for--
       ``(1) personnel appointed under section 7401(1) of this 
     title for a position that the Secretary has determined is of 
     equivalent rank to a Senior Executive Service position (as 
     such term is defined in section 3132(a) of title 5) and is 
     subject to an agency performance management system; and
       ``(2) personnel appointed under section 7306 or 7401(4) of 
     this title.
       ``(c) Payment of Awards.--Awards under this section may be 
     paid based on criteria established by the Secretary and shall 
     not be considered in calculating the limitation under section 
     7431(e)(4) of this title.
       ``(d) Not Considered Basic Pay.--Awards under this section 
     shall not be considered basic pay for any purpose.
       ``(e) Regulations.--The Secretary may prescribe regulations 
     for the administration of this section.''.
       (2) Limitation on past awards.--Notwithstanding any other 
     provision of law, awards made by the Secretary of Veterans 
     Affairs for any period on or after January 1, 2017, and 
     before the date of the enactment of this Act for an employee 
     under section 7306 or 7401(4) of title 38, United States 
     Code, or for a position described in section 7401(1) of such 
     title that the Secretary has determined is of equivalent rank 
     to a Senior Executive Service position (as such term is 
     defined in section 3132(a) of title 5, United States Code), 
     may be subject to section 7404A of title 38, United States 
     Code, as added by paragraph (1).
       (c) Modification of Employees Subject to Regulation by 
     Secretary of Veterans Affairs of Hours and Conditions of 
     Employment and Leaves of Absence.--
       (1) In general.--Section 7421 is amended--
       (A) in subsection (a), by striking ``chapter'' and 
     inserting ``title''; and
       (B) in subsection (b), by adding at the end the following 
     new paragraph:
       ``(9) Any position for which the employee is appointed 
     under section 7306 or 7401(4) of this title.''.
       (2) Administration of full-time employees.--Section 7423 is 
     amended--
       (A) in subsection (a)(2), by adding at the end the 
     following new subparagraph:
       ``(D) The Secretary may exclude from the requirements of 
     paragraph (1) employees hired under section 7306 or 7401(4) 
     of this title or for a position described in section 7401(1) 
     of this title that the Secretary has determined is of 
     equivalent rank to a Senior Executive Service position (as 
     such term is defined in section 3132(a) of title 5).''; and
       (B) in subsection (e)(1), by striking ``7401(1)'' and 
     inserting ``7421(b)''.
       (3) Additional pay authorities.--Section 7410(a) is 
     amended--
       (A) by striking ``The Secretary'' and inserting ``(1) The 
     Secretary'';
       (B) by striking ``the personnel described in paragraph (1) 
     of section 7401 of this title'' and inserting ``personnel 
     appointed under section 7306 of this title or section 7401(4) 
     of this title, or personnel described in section 7401(1) of 
     this title,''; and
       (C) by striking ``in the same manner, and subject to the 
     same limitations, as in the case of'' and inserting ``in a 
     manner consistent with''; and
       (D) by adding at the end the following new paragraph:
       ``(2) Payments under paragraph (1) shall not be considered 
     in calculating the limitation under section 7431(e)(4) of 
     this title.''.
       (4) Treatment of pay authority changes.--For the purposes 
     of the amendments made by paragraph (3), the Secretary of 
     Veterans Affairs shall treat any award or payment made by the 
     Secretary between January 1, 2017, and the date of the 
     enactment of this Act to employees appointed under sections 
     7306, 7401(1), and 7401(4) of title 38, United States Code, 
     that the Secretary has determined are of equivalent rank to a 
     Senior Executive Service position (as such

[[Page H6016]]

     term is defined in section 3132(a) of title 5, United States 
     Code), as if such amendments had been in effect at the time 
     of such award or payment.
       (5) Treatment of prior leave balances.--Notwithstanding any 
     other provision of law, the Secretary may adjust the leave 
     balance and carryover leave balance of any employee described 
     in section 7421(b)(9) of title 38, United States Code, as 
     amended by paragraph (1)(B), to ensure any leave accrued or 
     carried over before the date of the enactment of this Act 
     remains available to such employee.
       (d) Treatment of Certain Employees as Appointed Under 
     Section 7306.--Section 7306 is amended--
       (1) in subsection (a), by redesignating the second 
     paragraph (11) as paragraph (12); and
       (2) by adding at the end the following new subsection:
       ``(g) For purposes of applying any provision of chapter 74 
     of this title, including sections 7404, 7410, and 7421, or 
     any other provision of law, the Secretary may treat any 
     appointment for a position under this chapter to be an 
     appointment under this section.''.
       (e) Conforming Amendment.--Section 7431(e)(4) is amended by 
     striking ``In no case'' and inserting ``Except as provided in 
     sections 7404A(c) and 7410(a)(2) of this title, in no case''.

     SEC. 907. WAIVER OF PAY LIMITATION FOR CERTAIN EMPLOYEES OF 
                   DEPARTMENT OF VETERANS AFFAIRS.

       Subchapter I of chapter 7 is amended by inserting after 
     section 703 the following new section:

     ``Sec. 704. Waiver of pay limitation for certain employees

       ``(a) Employees of Veterans Health Administration Impacted 
     by Closure or Realignment.--Notwithstanding any other 
     provision of law, the Secretary may waive any annual premium 
     or aggregate limitation on pay for an employee of the 
     Veterans Health Administration for the calendar year during 
     which--
       ``(1) the official duty station of the employee is closed; 
     or
       ``(2) the office, facility, activity, or organization of 
     the employee is realigned.
       ``(b) Employees Providing Care to Veterans Exposed to Open 
     Burn Pits.--
       ``(1) In general.--Notwithstanding any other provision of 
     law, the Secretary may waive any annual premium or aggregate 
     limitation on pay for an employee of the Department whose 
     primary duties include providing expanded care for veterans 
     exposed to open burn pits.
       ``(2) Open burn pit defined.--In this subsection, the term 
     `open burn pit' has the meaning given that term in section 
     201(c) of the Dignified Burial and Other Veterans' Benefits 
     Improvement Act of 2012 (Public Law 112-260; 38 U.S.C. 527 
     note).
       ``(c) Coordination With Office of Personnel Management.--In 
     implementing this section, the Secretary shall coordinate 
     with the Director of the Office of Personnel Management.
       ``(d) Reports.--
       ``(1) In general.--For each quarter that the Secretary 
     waives a limitation under this section, the Secretary shall 
     submit to the Committee on Veterans' Affairs of the Senate, 
     the Committee on Veterans' Affairs of the House of 
     Representatives, and the Office of Personnel Management a 
     report on the waiver or waivers.
       ``(2) Contents.--Each report submitted under paragraph (1) 
     with respect to a waiver or waivers shall include the 
     following:
       ``(A) Where the waiver or waivers were used, including in 
     which component of the Department and, as the case may be, 
     which medical center of the Department.
       ``(B) For how many employees the waiver or waivers were 
     used, disaggregated by component of the Department and, if 
     applicable, medical center of the Department.
       ``(C) The average amount by which each payment exceeded the 
     pay limitation that was waived, disaggregated by component of 
     the Department and, if applicable, medical center of the 
     Department.
       ``(e) Employee Defined.--In this section, the term 
     `employee' means any employee regardless of the authority 
     under which the employee was hired.
       ``(f) Termination.--This section shall terminate on 
     September 30, 2027.''.

     SEC. 908. ELIMINATION OF LIMITATION ON AWARDS AND BONUS FOR 
                   EMPLOYEES OF DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Section 705(a) of the Veterans Access, 
     Choice, and Accountability Act of 2014 (Public Law 113-146; 
     38 U.S.C. 703 note) is amended by striking paragraph (3).
       (b) Applicability.--Subsection (a) shall take effect on the 
     date of the enactment of this Act and apply as if such 
     subsection had been enacted on September 30, 2021.

     SEC. 909. ADDITIONAL AUTHORITY OF THE SECRETARY OF VETERANS 
                   AFFAIRS RELATING TO RECRUITMENT AND RETENTION 
                   OF PERSONNEL.

       Subchapter I of chapter 7 is amended by inserting after 
     section 705 the following new section:

     ``Sec. 706. Additional authority relating to recruitment and 
       retention of personnel

       ``(a) Recruitment and Relocation Bonuses.--The Secretary 
     may pay a recruitment or relocation bonus under section 
     5753(e) of title 5 without regard to any requirements for 
     certification or approval under that section.
       ``(b) Retention Bonuses.--(1) The Secretary may pay a 
     retention bonus under section 5754(f) of title 5 without 
     regard to any requirement for certification or approval under 
     that subsection.
       ``(2) The Secretary may pay a retention bonus as specified 
     in subsection (e)(2) of section 5754 of title 5 and may pay 
     the bonus as a single lump-sum payment at the beginning of 
     the full period of service required by an agreement under 
     subsection (d) of such section.
       ``(c) Merit Awards.--The Secretary may grant a cash award 
     under section 4502(b) of title 5 without regard to any 
     requirement for certification or approval under that section.
       ``(d) Incentives for Critical Skills.--(1) Subject to the 
     provisions of this paragraph, the Secretary may provide a 
     critical skill incentive to an employee in a case in which 
     the Secretary determines--
       ``(A) the employee possesses a high-demand skill or skill 
     that is at a shortage;
       ``(B) such skill is directly related to the duties and 
     responsibilities of the employee's position; and
       ``(C) employment of an individual with such skill in such 
     position serves a critical mission-related need of the 
     Department.
       ``(2) An incentive provided to an employee under paragraph 
     (1) may not to exceed 25 percent of the basic pay of the 
     employee.
       ``(3) Provision of an incentive under paragraph (1) shall 
     be contingent on the employee entering into a written 
     agreement to complete a period of employment with the 
     Department.
       ``(4) An incentive provided under paragraph (1) shall not 
     be considered basic pay for any purpose.
       ``(5) The Secretary may prescribe conditions, including 
     with respect to eligibility, and limitations on provision of 
     incentive under paragraph (1).
       ``(6) Incentive provided under paragraph (1) shall not be 
     included in the calculation of total amount of compensation 
     under section 7431(e)(4) of this title.
       ``(e) Student Loan Repayments.--(1) Subject to the 
     provisions of this subsection, the Secretary may repay a 
     student loan pursuant to section 5379(b) of title 5.
       ``(2) Paragraph (2) of such section shall not apply to 
     payment under this subsection.
       ``(3) Payment under this subsection shall be made subject 
     to such terms, limitations, or conditions as may be mutually 
     agreed to by the Secretary and the employee concerned, except 
     that the amount paid by the Secretary under this subsection 
     may not exceed--
       ``(A) $40,000 for any employee in any calendar year; or
       ``(B) a total of $100,000 in the case of any employee.
       ``(f) Expedited Hiring Authority for College Graduates; 
     Competitive Service.--(1) Subject to paragraph (2) of this 
     subsection, the Secretary may expedite hiring for college 
     graduates under section 3115 of title 5 without regard to 
     subsection (e) of such section or any regulations prescribed 
     by the Office of Personnel Management for administration of 
     such subsection.
       ``(2) The number of employees the Secretary may appoint 
     under section 3115 of title 5 may not exceed the number equal 
     to 25 percent of individuals that the Secretary appointed 
     during the previous fiscal year to a position in the 
     competitive service classified in a professional or 
     administrative occupational category, at the GS-11 level, or 
     an equivalent level, or below, under a competitive examining 
     procedure.
       ``(g) Expedited Hiring Authority for Post-secondary 
     Students; Competitive Service.--(1) Subject to paragraph (2) 
     of this subsection, the Secretary may expedite hiring of 
     post-secondary students under section 3116 of title 5, 
     without regard to subsection (d) of such section or any 
     regulations prescribed by the Office of Personnel Management 
     for administration of such subsection.
       ``(2) The number of employees the Secretary may appoint 
     under section 3116 of title 5 may not exceed the number equal 
     to 25 percent of the number of students that the Secretary 
     appointed during the previous fiscal year to a position at 
     the GS-11 level, or an equivalent level, or below.
       ``(h) Pay Authority for Critical Positions.--(1) Subject to 
     the provisions of this subsection, the Secretary may 
     authorize the fixing of the rate of pay for a critical 
     position in the Department consistent with the authorities 
     and requirements of section 5377 of title 5 that apply to the 
     Office of Personnel Management.
       ``(2) The Secretary may fix the rate of pay for a critical 
     position under this subsection in excess of the limitation 
     set forth by section 5377(d)(2) of such title.
       ``(3) Basic pay may not be fixed under this subsection at a 
     rate greater than the rate payable for the Vice President of 
     the United States established under section 104 of title 3, 
     except upon written approval of the President.
       ``(4) Notwithstanding section 5377(f) of title 5, the 
     Secretary may authorize the exercise of authority under this 
     subsection with respect to up to 200 positions at any time.
       ``(i) Rates of Special Pay.--(1) The Secretary may 
     establish a rate for special pay under section 5305(a)(1) of 
     title 5.
       ``(2) In applying such section to the Secretary's authority 
     under paragraph (1)--
       ``(A) `50 percent' shall be substituted for `30 percent'; 
     and
       ``(B) `level II of the Executive Schedule' shall be 
     substituted for `level IV of the Executive Schedule'.
       ``(j) Waiver of Limitations on Certain Payments Under Pay 
     Comparability System.--The Secretary may waive the limitation 
     in section 5307 of title 5 for an employee or a payment.
       ``(k) Termination.--The authorities under this section 
     shall terminate on September 30, 2027.''.

  The SPEAKER pro tempore. The bill, as amended, shall be debatable for 
1 hour equally divided and controlled by the chair and ranking minority 
member of the Committee on Veterans' Affairs or their respective 
designees.
  The gentleman from California (Mr. Takano) and the gentleman from 
Illinois (Mr. Bost), each will control 30 minutes.

[[Page H6017]]

  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and to insert extraneous material on S. 3373, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I stand before this Chamber in support of S. 3373, as 
amended, which is now the Sergeant First Class Heath Robinson Honoring 
our Promise to Address Comprehensive Toxics Act of 2022.
  This measure addresses a technical drafting error in the Senate 
amendment to my PACT Act. As you know, the PACT Act passed the House 
with strong bipartisan support in March of this year.
  Today, despite the current rancorous political debates taking place 
across America, this Chamber has the chance to help the country heal 
after 20 years of war.
  We have an opportunity to make good on the promise we made to our 
servicemembers when our country sent them into harm's way: that we 
would take care of them and pay for that care when they come home.
  For too long, veterans have faced an uphill battle to prove that the 
rare illnesses and cancers they were experiencing stemmed from their 
time in the military.
  For too long, Congress and the Department of Veterans Affairs have 
been slow to accept responsibility and cost of that care, and for too 
long the United States has not made good on our promise to our 
veterans.
  But today, I make a plea for unity so that we may right this wrong 
and make good on our commitment to honor our pact with America's 
veterans. Today, we can finally recognize toxic exposure as a cost of 
war.

                              {time}  1345

  In the past, we saw Vietnam war veterans living with the effects of 
Agent Orange, fighting the VA for the care and benefits they were due. 
The Blue Water Navy Vietnam Veterans Act was signed into law in 2019, 
but it came nearly four decades too late. This bill could have been 
passed 2 years earlier when my friend, then-Republican chairman, Dr. 
Phil Roe, was leading this committee, but two Senators held up that 
bill. During that needless delay, many veterans succumbed to their 
illnesses, and their families were not compensated. Now is our chance 
to make amends for that.
  There is absolutely no reason for veterans and their survivors to 
fight the VA for the care and benefits they have earned through their 
service. Never again should veterans be made to suffer the indignity of 
fighting their own government.
  After Blue Water, I vowed that we would never again fail to live up 
to our promises to our veterans. That is why, at the beginning of the 
117th Congress, I made addressing the effects of toxic exposure my top 
priority as chairman.
  Throughout our history, America has cast aside party affiliation on 
behalf of veterans, coming together to pass landmark legislation to 
properly recognize those who have served, such as in 1944 when Congress 
passed the GI Bill. The GI Bill was transformational for a generation 
of veterans. By 1956, nearly 8 million veterans had used the GI Bill's 
education benefits and millions more still benefit from it today.
  We have an opportunity to make a generational impact today. The PACT 
Act will directly affect one out of every five veterans, or 3.5 million 
people. It will also send a strong message to future generations of 
veterans that America will take care of them when their service ends.
  The way this country has dealt with toxic exposure has been piecemeal 
and inadequate. President Biden recognizes this, too. Shortly after he 
was sworn in, I met with the President about our shared priorities for 
veterans. Upon learning of my goal to pass comprehensive legislation to 
help toxic-exposed veterans, the President leaned over to me and talked 
about his son, Beau, who served near burn pits in Iraq and Kosovo.
  It might be hard for most Americans to imagine what a burn pit looks 
like because they are illegal in the United States. Picture walking 
next to and breathing fumes from a burning pit the size of a football 
field. This pit contained everything from household trash, plastics, 
and human waste to jet fuel and discarded equipment burning day and 
night. Beau Biden lived near these burn pits and breathed the fumes 
that emanated from them.
  President Biden believes that constant exposure to these burn pits, 
and the toxic fumes they emitted, led to Beau's cancer and early death. 
It was during that meeting when I knew I had a partner in President 
Biden.
  At the State of the Union, President Biden called on Congress to pass 
bipartisan legislation to comprehensively address the effects of toxic 
exposure and improve the delivery of benefits for toxic-exposed 
veterans. I cannot thank him enough for throwing his support behind 
this effort and placing those who have served our country at the center 
of his unity agenda.
  To my colleagues who previously voted ``no'' on the PACT Act in 
March, I ask you the same question I asked you then: Are you willing to 
support our troops and honor our Nation's promise to them? Or will you 
allow naked partisanship to once again deny our veterans the care they 
deserve?
  Just this Congress alone, every single Democrat in this body voted to 
make sure each day in uniform counts toward GI Bill benefits. Every 
single Democrat voted to ensure a smooth transition from Active Duty to 
civilian life. Every single Democrat voted to honor our pact with 
toxic-exposed veterans. There is no question as to where Democrats 
stand on prioritizing America's veterans. We are backing up our thank-
you with concrete action.
  Frankly, all the bills that I mentioned should have passed with 
unanimous support. If the American people knew the context of these 
bills and knew the content of them, they would demand unanimous support 
from this Chamber.
  But I take this moment now to recognize my Republican colleagues in 
this Chamber who put keeping our promise to veterans above 
partisanship. I thank the Republican cosponsors of this bill, 
Representatives Fitzpatrick and Cline.
  Further, I recognize the 34 Republicans who in March showed their 
support for veterans by voting ``yes'' on final passage, including 
Veterans' Affairs Committee members, General Bergman and Representative 
Mace. I also recognize the commitment of Representatives Bilirakis and 
Kinzinger, who do not serve on this committee, but demonstrated early 
leadership by supporting this legislation. I am also glad to see my 
colleague, Ranking Member Bost, finally stand in support of this bill 
today.
  Moreover, in June, an overwhelming bipartisan majority of 84 Senators 
voted in favor of the PACT Act in the Senate. This proved the value of 
the cause and showed that it had momentum, so the trajectory of this 
effort is clear.
  But here is also a very rare situation where there is a chance for 
redemption. For those of my Republican colleagues who previously 
hesitated, sat on the sidelines, or chose politics over veterans, you 
get a second chance to do the right thing. There is no reason why this 
time this measure should not garner at least 400 votes in this Chamber.
  Why is it that a Republican leader and Republican whip, who aspire to 
be in the majority but do not show the fortitude to govern, are 
continuing to oppose this bill and are asking you to do the same? Do 
not let them stand in the way with unconvincing arguments about 
budgetary constraints when the true cost of war, the human cost of war, 
is abundantly clear.
  For example, as the House considers the National Defense 
Authorization Act this week, a bill that authorizes $838.8 billion, 
spending which I believe could be justifiable, I am reminded of the 
stark reality of how this Congress approaches Federal spending.

  It has become a battle of defense spending versus everything else. 
That everything else includes veterans, schoolchildren, the elderly, 
and our constituents. I vigorously object to veterans being pitted 
against their fellow Americans to fight for funding. Do

[[Page H6018]]

we really want to support veterans by limiting school lunches for 
children? Do we support veterans by limiting help for seniors? You can 
be damn sure our veterans didn't sign up to serve our country, watch 
their families make sacrifices, or go to war far from home so Members 
of this body could perpetuate a false choice that pits Americans 
against one another.
  The right choice, the choice we are going to make today, is simple: 
Recognize toxic exposure as a cost of war, period.
  Using hypocritical arguments about fiscal responsibility as a reason 
to oppose this bill when the truth of the moral responsibility of 
caring for our veterans is made crystal clear, is not consistent with 
American values. Make no mistake: When our country goes to war, we 
don't nickel and dime the Department of Defense, and we shouldn't try 
to pinch pennies when it comes to covering the care for toxic-exposed 
veterans.
  We don't hear these arguments about needing offsets when we are asked 
rightly to support more body armor or protection from IEDs. This 
Congress steps up to the plate to provide our servicemembers with what 
they need to fight our wars. So why are Members of this body arguing 
that we need to scrounge around to find money for our veterans? It is 
time for Congress to fully support toxic-exposed veterans as they fight 
the rare cancers and illnesses after returning home.
  Now, I must express dismay also about the procedural steps we must 
now undertake because a single Senator is preventing the Senate from 
quickly fixing the technical issue in this bill. This Senator, already 
having watched the bill pass the Senate the first time with strong 
support, knowing the veteran sacrifice behind it, and the blood, sweat, 
and tears shed by the veteran community to finally get this done, chose 
instead to object because he doesn't like the funding mechanism in this 
bill.
  His position is the losing one, it was the losing one, and he has 
held up this bill for no other reason other than sour grapes; and to 
what end is unclear when veterans suffer in the meantime. Therefore, we 
Members of the House must take this route to push forward and do what 
we know is right.
  The Honoring our PACT Act would not have been possible were it not 
for the veterans who selflessly shared their stories, their pain, and 
their trauma, opening the eyes of their fellow Americans to the 
realities of being exposed to toxic substances.
  Throughout this process, I have met many toxic-exposed veterans whose 
sacrifice and courage continued long after they hung up their uniform. 
I am forever humbled by the courage of Dr. Kate Hendricks Thomas, a 
Marine veteran who served near a burn pit in Fallujah who later fought 
the VA for 3 years to get the care she needed.
  I am sorry to say she passed away this spring, but not before 
selflessly fighting for a comprehensive bill that would aid over 3.5 
million veterans like her living with the effects of toxic exposure, a 
bill that she herself would not benefit from. We also honor the valor 
of Wesley Black, Heath Robinson, Jennifer Kepner, and so many others 
who are no longer with us.
  This bill would also not have been possible without the support of 
over 40 veteran service organizations. Each of these organizations 
understand that toxic-exposed veterans are still in the heat of battle. 
I thank them for their impact and advocacy for the Honoring our PACT 
Act.
  I also thank my staff, who worked tirelessly to listen and engage 
with advocates and stakeholders and spent countless hours drafting and 
redrafting this bill to get it right.
  I also thank Speaker Pelosi for always being a tireless advocate for 
veterans, along with Majority Leader Hoyer.
  I also thank Senate Majority Leader Schumer for his work with 
Senators Tester and Moran and the Senate Veterans' Affairs Committee to 
pass this bill.
  I also point out that Jon Stewart and John Feal kept us accountable.
  Most importantly, to the families of veterans who tragically lost 
their lives as a result of being exposed to toxic substances during 
their time in service, I thank you for your sacrifices.
  This legislative effort will help our veterans heal, and it offers 
hope that our country can do the same. It sends a message to all 
Americans that their Government will not allow their grievances to go 
unaddressed. It acknowledges the suffering endured by our Vietnam war 
veterans and demonstrates to them that we have learned from our 
mistakes and that their struggle and their suffering was not in vain.
  We are setting a new standard with the PACT Act. We are telling our 
veterans: The burden of proof is not on you. Because of your sacrifice 
to our country, this Congress and the American people are giving you 
the benefit of the doubt that you have earned.
  Let's pass this bill and ease the anxiety in the minds of our 
veterans who are living with cancer or other illnesses and terminal 
diseases and let them know that their families are going to be taken 
care of. I believe this is what the American people want and what 
everyone in this Chamber should want. It is what our veterans deserve, 
and it is the right thing to do.
  Madam Speaker, I encourage all my colleagues to honor their pact with 
the veterans by voting ``yes'' on this bill.
  Madam Speaker, I reserve the balance of my time.
  Mr. BOST. Madam Speaker, I yield myself as much time as I may 
consume.
  Madam Speaker, I rise in support of S. 3373, as amended, the Sergeant 
First Class Heath Robinson Honoring our Promise to Address 
Comprehensive Toxics Act.
  When we were debating the House version of the PACT Act 4 months ago, 
I couldn't have said that. I am glad that I can today.
  The bill is not perfect, but expanding healthcare and benefits for 
veterans who were exposed to burn pits or other dangerous toxins while 
serving our country is the right thing to do.
  I come from a long line of veterans. My grandfather, Marines; my 
father, Army; my uncle, Marines; I was in the Marines; my son, Marines; 
my grandson, Marines; and my granddaughter enlisted this year in the 
United States Navy.

                              {time}  1400

  I know exactly how high the stakes are when this country sends young 
men and young women to serve. I know exactly how high the stakes are 
when they come home. I know exactly how often we have failed to meet 
them and give them what they need. That is why I helped lead the charge 
to provide disability benefits to blue water Navy Vietnam veterans a 
few years ago.
  We were decades late in giving those veterans the help they need. My 
vow then and now was to make sure that other generations of veterans 
don't have to wait for benefits they earned while they were serving or 
the healthcare they require.
  DOD estimates that 3.5 million veterans have been exposed to 
dangerous toxins in Iraq and Afghanistan over the past 20 years. Some 
of them are already sick and suffering from the health effects of that 
exposure. They need help, and this bill will give it to them.
  This bill will also make sure that the VA can actually give that help 
to them, unlike the earlier PACT Act that could not.
  I am grateful for the hard work of the Senate Committee on Veterans' 
Affairs Chairman Jon Tester and Ranking Member Jerry Moran. They took a 
flawed House bill and made it better.
  There are several aspects of their work that make today's vote on the 
PACT Act very different than the prior one. This is a better bill than 
the one the House passed in March.
  It reflects bipartisan negotiations and input from VA, which is 
ultimately responsible for putting this into practice.
  It incorporates the good work the VA is already doing to address 
toxic exposure--namely, the scientific framework that the VA has been 
using since last year to expand benefits to toxic-exposed veterans.
  It removes certain provisions from the House bill that VA told us 
could not and would not get done. It adds other provisions that would 
make VA work more transparently to veterans and taxpayers, more 
flexible, and more scientifically sound.
  All of those things were missing from the prior House version. Most 
importantly, the earlier version of the bill ignored the massive 
operational impacts this effort will have on VA's

[[Page H6019]]

healthcare and benefit systems. In contrast, this bill addresses this 
head-on.
  To ensure that the VA has the staff capacity it needs to better serve 
toxic-exposed veterans, this bill would: authorize 31 VA medical 
facility leases; make it easier for Congress to authorize additional VA 
medical facility leases going forward, something the committee has been 
trying to do for decades; make it easier for VA to recruit and retain 
the staff it needs to implement the bill; and give VA resources to 
process claims faster using modern technology.
  These changes and additions are critical to the bill's success, and 
they give me confidence to vote for this bill without fearing that it 
would be impossible to implement or risk breaking the VA for veterans 
everywhere, those who are already receiving benefits.
  Many of us are concerned about the CBO score for this bill and the 
funding mechanism it contains. The total score went from $325 billion 
over 10 years in the prior version to $681 billion in this version. I 
don't criticize my colleagues for being concerned about that. That is 
an increase of $356 billion.
  That number gives me a lot of pause when I consider the strain that 
rising inflation is already putting on American families. Anyone who is 
trying to serve these veterans, it should give them pause, too, because 
not only is it the veterans that will be paying, but it is their 
children and grandchildren, as well.
  However, only about $285 billion of the score is truly new spending. 
The costs of expanding care and benefits for toxic exposure actually 
decreased by about $40 billion from the prior version of this bill to 
this one. The rest of the score is a result of the cost of war toxic 
exposure fund.
  The fund pays for expanding healthcare for veterans who experience 
toxic exposure. That is reasonable. However, the fund is also a 
budgetary ploy by the Democrats to take existing healthcare costs that 
have nothing to do with toxic exposure and transfer them from 
discretionary to mandatory spending. That is causing CBO's score to be 
artificially high because almost $400 billion in costs that are already 
funded by current law are being scored against the bill.
  Even worse, this ploy would put even more government spending on 
autopilot and limit our ability to control and oversee it, which is our 
right under the Constitution. That is wrong.
  Now, some of my colleagues will vote against the bill because of 
that, and like I said before, I don't blame them. I am not. I am voting 
for it because, as the Republican leader of the Veterans' Affairs 
Committee and as a veteran, I know that, on balance, this is a good 
bill that will help millions of veterans, servicemembers, survivors, 
and military families. That is why I will be supporting this bill 
today.
  I have already thanked our Senate colleagues for their work on this 
bill, but I also thank many Members on both sides of the aisle who have 
introduced the various standalone bills that make up the PACT Act, 
including Chairman Takano for his hard work and commitment to this 
issue. I thank our staff because they also have worked to make sure 
that this bill would come about, not only that it would come about, but 
it would be able to be implemented.
  I recognize the many veterans service organizations who have held our 
feet to the fire every step of the way to get it done. I know they will 
stay by our side every day ahead to make sure VA does it right. I look 
forward to doing the work with them.
  Madam Speaker, I reserve the balance of my time.
  Mr. TAKANO. Madam Speaker, I certainly welcome the support of the 
ranking member on this bill.
  May I inquire as to the time remaining in debate.
  The SPEAKER pro tempore. The gentleman from California has 14\1/2\ 
minutes remaining. The gentleman from Illinois has 22 minutes 
remaining.
  Mr. TAKANO. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Virginia (Mrs. Luria), my good friend who is the chairwoman of the 
Disability Assistance and Memorial Affairs Subcommittee.
  Mrs. LURIA. Madam Speaker, I rise in strong support of the Honoring 
our PACT Act. As we near final passage of this historic and 
comprehensive legislation to address toxic exposures afflicting 
veterans across several generations, it has been a privilege to lay the 
groundwork for this endeavor as chair of the Disability Assistance and 
Memorial Affairs Subcommittee.
  Many pieces of legislation that have passed through our jurisdiction 
are on their way to being included in this package and becoming law. In 
particular, I am honored to have introduced the COVENANT Act, a 
cornerstone of the PACT Act.
  This bill is best known for providing access to care for those 
veterans exposed to burn pits and many others who have struggled too 
long to receive care for health conditions caused by burn pits and 
other toxic exposures. To put it simply, this bill will see that 3.5 
million veterans are eligible for Priority Group 6 VA healthcare. It 
concedes exposure to airborne hazards and recognizes 23 new airborne 
hazard-related conditions as presumptively service-connected.
  When signed into law, I don't think I would be wrong in saying that 
this is possibly the largest increase in access to veterans healthcare 
that any of us have seen in our lifetimes. This legislation will assist 
many of our fellow servicemembers and veterans who have suffered for 
too long.
  The PACT Act has been a long time coming, but today the House is 
prepared to send this essential veterans assistance package back to the 
Senate and, ultimately, to the President's desk. We are finally 
recognizing the true cost of war for all who deployed in defense of our 
Nation.
  I thank Chairman Takano for his unwavering leadership through this 
process, as well as my fellow Members on and off the committee for 
their important contributions to this historic legislation.
  Lastly, I thank the veterans, the survivors, and the veterans service 
organizations, VSOs, who have made their voices heard. This is for you.
  I wholeheartedly urge my colleagues to vote ``yes'' on the Honoring 
our PACT Act.
  Mr. BOST. Madam Speaker, I yield 2 minutes to the gentleman from 
Michigan (Mr. Bergman), the highest ranking officer that serves in 
Congress today. He has served with many of the men and women who will 
benefit from this bill today.
  Mr. BERGMAN. Madam Speaker, I rise in strong support today of S. 
3373, the Sergeant First Class Heath Robinson Honoring our Promise to 
Address Comprehensive Toxics Act of 2022.
  I associate myself with the comments of our Republican leader on the 
Veterans' Affairs Committee, Mr. Bost, who also happens to be a fellow 
marine. He articulated very well the elements of where we were, where 
we are, and where we are going.
  This is the latest version of what many of my constituents know as 
the PACT Act, and it has only improved since it passed the House last 
March.
  As a Vietnam veteran myself and as the ranking member of the House 
Veterans' Affairs Subcommittee on Health, I am more than familiar with 
the struggles faced by veterans, young and old, across our Nation who 
have been exposed to toxic substances during their time of service.
  This legislation will finally establish a comprehensive framework for 
the VA to provide veterans and their survivors for generations to come 
with the toxic exposure-related care and benefits that they deserve.
  For example, this bill will instantly provide presumptive benefits 
for veterans and survivors who are terminally ill, homeless, over the 
age of 85, experiencing extreme financial hardship, or able to show 
another emergent need.
  It will also supercharge toxic exposure research, improve the way in 
which the VA interacts with toxic-exposed veterans, and authorize 31 
major medical facility leases.
  Whether it is from burn pits or Agent Orange, toxic exposure is 
perhaps the most widespread and urgent issue facing our military 
community.
  Madam Speaker, I urge my colleagues to join me in supporting this 
bipartisan solution based on what the veterans themselves have been 
telling us for a long time. It is time to act.
  Mr. TAKANO. Madam Speaker, I yield 1 minute to the gentleman from 
Indiana (Mr. Mrvan), my good friend who is the chairman of the 
Subcommittee on Technology Modernization and on the Veterans' Affairs 
Committee.

[[Page H6020]]

  

  Mr. MRVAN. Madam Speaker, I rise today in support of the final 
version of the Honoring our PACT Act, which will uphold our obligation 
to ensure that veterans receive the world-class healthcare they 
deserve.

  As a Member of Congress and a member of the Veterans' Affairs 
Committee, we have a responsibility to support all veterans when they 
return home from protecting our freedoms and defending our democracy.
  As I walked the parade routes of the Fourth of July and visited the 
veterans service organizations, it is not enough to simply say ``thank 
you for your service'' to our veterans. It is through our actions that 
we provide proof we have our veterans' backs and value their service.
  Ultimately, veterans living with toxic exposures must not be denied 
the care and benefits they have earned.
  I encourage all of my colleagues to join me in supporting this 
measure. Again, I thank Chairman Takano, all the Members, and all of my 
colleagues on the House Veterans' Affairs Committee for their 
leadership to finalize this critical legislation to have our veterans' 
backs.
  Mr. BOST. Madam Speaker, I yield 3 minutes to the gentleman from 
Texas (Mr. Roy), who has served from the time of being in Congress on 
the Veterans' Affairs Committee.
  Mr. ROY. Madam Speaker, I thank the ranking member for yielding.
  As a member of the Veterans' Affairs Committee and as someone who 
represents San Antonio, an inordinate number of veterans, Joint Base 
San Antonio, Army Futures Command, I regret to rise in opposition to 
the legislation before us.
  I respect the enormous amount of work that has gone into this 
legislation by the committee staff, by the ranking member, by the 
chairman, by the Senate. Obviously, it is an important issue, and it is 
critical. I have many friends here, particularly veterans, who support 
this measure, and I understand why.
  Every single one of us wants to make sure that we take care of this 
issue, and frankly, it has been way too long in getting to it. I agree 
with that completely. But, unfortunately, I cannot support this bill 
because this bill spends about $285 billion that we don't have.

                              {time}  1415

  We have to address the issue in this body of spending money we don't 
have. The chairman said: Well, why don't you raise it on other issues? 
I raised it on every single issue. I raised it on a $2 million bill 
about 30 minutes ago on the floor.
  At some point, we have to pay for the stuff that we are spending it 
on or the very things that these veterans sacrificed for will be made 
completely and utterly worthless. We are destroying the Republic that 
these men and women sacrificed for, and we are destroying it in this 
Chamber by our incompetence and by our irresponsible refusal to 
actually manage the affairs of the Republic appropriately.
  Putting this bill on autopilot to the tune of $680 billion of 
mandatory spending with $280 billion unpaid for, which we can pay for 
right now with existing COVID funds, we could pay for it right now with 
the elimination of the SALT deduction, we could pay for it right now 
with any number of spending cuts and/or tax increases--if we wanted to 
have that debate on the floor of the House--but we are not doing it.
  We do a disservice to the veterans who are sick because of the burn 
pits. We do a disservice to the veterans who laid their lives on the 
line and died for this country. We do a disservice to the military that 
we say that we support when we are not spending money that we actually 
have, as opposed to printing money and borrowing money.
  Putting it on autopilot, when 60 percent of our spending every year 
is already on autopilot--when we are $30.5 trillion in debt. Instead of 
the established scientific framework, we put 20 conditions in without 
scientific evidence which will cause a backlog, which the VA even 
acknowledges will cause a backlog. These are real concerns that we 
ought to address.
  Fundamentally, you have to pay for that which we are spending. We are 
undermining the sacrifice of the very veterans that we say that we are 
helping with this measure by not doing it with fiscal responsibility.
  Mr. TAKANO. Madam Speaker, nothing could be more important or a 
higher priority in defense of our Republic than to address the 
unaddressed grievances of our veterans. We are keeping our promise to 
our veterans. We are saying today that doing so is a cost of war.
  Madam Speaker, I yield 1 minute to the gentleman from Maryland (Mr. 
Trone), a member of the House Veterans' Affairs Committee and active 
member of the Economic Opportunity Subcommittee.
  Mr. TRONE. Madam Speaker, today I rise to urge my colleagues to pass 
the Honoring our PACT Act to give our veterans the healthcare they 
earned.
  Over 3.5 million veterans have been exposed to toxins, such as burn 
pits, during deployment, causing horrific health impacts. To add insult 
to injury, the disability benefit claims process places the burden on 
our vets themselves to jump through hoops. This is a shameful problem--
a shameful problem--one we are determined to fix.
  This legislation, which includes my FASTER Presumptions Act, will 
help cut the red tape and streamline procedures for veterans who have 
earned it to access their healthcare benefits faster. Our veterans 
served our country with honor and we have to honor their service.
  Madam Speaker, I urge my colleagues to honor our PACT through this 
bill, and I thank Chairman Takano for his leadership.
  Mr. BOST. Madam Speaker, I yield 3 minutes to the gentlewoman from 
Iowa (Mrs. Miller-Meeks), who has actually served in health situations 
in our military, a veteran herself, and is very aware of the things 
that we are dealing with here.
  Mrs. MILLER-MEEKS. Madam Speaker, I rise in support of the Sergeant 
First Class Heath Robinson Honoring our PACT Act.
  When the House first passed the PACT Act in March, I spoke on the 
floor and urged my colleagues to find a bipartisan solution to give 
toxic-exposed veterans the care and support that we as a country owe 
them. This bill is that bipartisan solution, and I am proud to support 
it.
  As a 24-year military veteran, I have seen firsthand the effects that 
toxic exposure has had on my fellow servicemembers, whether it is 
herbicides like Agent Orange in southeast Asia or burn pits in the 
Middle East.
  In fact, my knowledge is so intimate that my husband, who is also a 
30-year veteran, and I, have a close friend, Jay, who, after his 
deployment to Desert Storm, that very brief conflict, in coming back to 
the United States came off of the plane and collapsed. He developed a 
heart condition called cardiomyopathy, which led this 30-year-old to 
have a heart transplant, aseptic necrosis of his hip with a replacement 
of his hip, and soon his untimely and young death.
  Exposure to these substances can lead to severe life-altering 
diseases. However, under the current system at the VA, it can be 
extraordinarily costly, time-consuming, and in some cases, impossible 
for a sick or disabled veteran to prove that their condition is related 
to the toxins to which they were exposed during their military service.
  The bill we are voting on today ensures that this will no longer be 
the case. Under the framework created by the PACT Act, toxic-exposed 
veterans will finally receive the care and benefits they deserve and 
have earned. This bill ensures the VA will administer those benefits in 
a responsible, fair way.
  This new version of the PACT Act includes important reforms to build 
on the VA's existing framework for toxic-exposed veterans, and it 
ensures that the VA has the flexibility to respond and adapt to new 
scientific evidence on toxic substances.
  Importantly, it also ensures that veterans who are most in need--
those who are terminally ill, homeless, elderly, or experiencing 
hardship--receive their benefits immediately so they do not have to 
wait any longer for our government to act.
  Madam Speaker, I urge all my colleagues to support the PACT Act. This 
bill is not perfect by any means, but we should not allow perfect to be 
the enemy of the good. Make no mistake, this is a good bill for our 
Nation's veterans. I am proud to support this bill and I am proud to 
stand with the men and women of our Armed Forces.

[[Page H6021]]

  

  Mr. TAKANO. Madam Speaker, I yield 1 minute to the gentlewoman from 
Michigan (Ms. Slotkin), my good friend who serves on the Disability 
Assistance and Memorial Affairs Subcommittee of the Veterans' Affairs 
Committee.
  Ms. SLOTKIN. Madam Speaker, I rise in support of the PACT Act and my 
bill contained within on burn pits.
  Most of us here all know about Agent Orange and the horrible effects 
it had on our veterans in Vietnam. We also remember how long it took 
for Congress and the VA to respond and make sure our veterans had the 
care and benefits they needed.
  The bill we will vote on today is a landmark piece of legislation 
that will address the Agent Orange of the post-9/11 generation: burn 
pits.
  For anyone who doesn't know, burn pits are used to dispose of waste 
on a military base, usually abroad in a combat zone, with jet fuel used 
to light the fuse. For years, we have used these burn pits in places 
like Iraq and Afghanistan. I lived near one in Iraq on three tours.
  Just as with Agent Orange, we have learned over the years that the 
toxins our servicemembers have been exposed to have horrible 
consequences, strange cancer diagnoses, respiratory issues that have 
affected millions of veterans, including those in Michigan.
  This issue has been deeply personal to me as an Army wife and someone 
who lived near those burn pits while with the CIA.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. TAKANO. Madam Speaker, I yield an additional 30 seconds to the 
gentlewoman.
  Ms. SLOTKIN. Madam Speaker, for years, 9/11 veterans have walked into 
their local VA center only to be turned away.
  Madam Speaker, one of the most important things I have worked on in 
my short 3\1/2\ years here is this bill. It is the biggest veterans' 
healthcare bill we have passed in decades.
  Last week, I visited our local VA in Lansing--and they know it is 
coming--another 3.5 veterans will have access to healthcare because of 
this bill.
  We do important things in this body all the time, but I think fewer 
are more important than this one we are going to vote on today.
  Madam Speaker, I urge my colleagues on both sides of the aisle--I am 
glad many of my colleagues on the other side of the aisle have switched 
their positions--to now vote on this bill.
  Mr. BOST. Madam Speaker, I yield 3 minutes to the gentleman from 
Montana (Mr. Rosendale), the ranking member of the Technology 
Modernization Subcommittee of the Veterans' Affairs Committee.
  Mr. ROSENDALE. Madam Speaker, the Senate version of the PACT Act 
helps connect veterans who were exposed to burn pits or dangerous 
toxins in service to our country with the healthcare and benefits they 
have earned and were promised.
  This legislation also codifies the scientific framework that the VA 
is already using to provide benefits to toxic-exposed veterans, better 
reflects current practice, and improves transparency.
  The previous House-passed version, which I voted against, ignored the 
work the VA is already doing to improve services to toxic-exposed 
veterans.
  This bill improves and codifies the pilot program that the VA 
established last year to extend compensation benefits to toxic-exposed 
veterans.
  This bill also includes provisions to increase transparency, provide 
flexibility, and keep pace with scientific advancements for toxic 
exposure.
  In addition, this legislation includes workforce enhancements, and 
other changes, to ensure the VA can improve services to toxic-exposed 
veterans without compromising care and benefits.
  The prior House version of the PACT Act failed to address the 
operational impact on the VA of servicing the benefits of toxic-exposed 
veterans, which would have left veterans waiting in a backlog of 1.5 
million claims. This new version includes provisions that address the 
operational impacts head-on.
  Madam Speaker, this legislation is not perfect. I do not support 
everything that is in this piece of legislation. But as the saying 
goes: We cannot let the search for perfect be the enemy of the good, 
or, in this case, what is right and necessary.
  Our veterans have waited far too long to receive the help that they 
were promised. It is far past time for Congress to stop screwing 
around, breaking our own rules, while America's veterans suffer and 
literally die.
  Since my time in Congress began, I have been a strong advocate for 
Montana veterans, and I work tirelessly in the House Veterans' Affairs 
Committee to ensure that all America's veterans are able to receive the 
quality care that they were promised, and the care that they have 
earned.
  We are willing to spend far too much money to engage in conflict, and 
far too little to care for our warriors once they come home.
  Madam Speaker, I intend to vote for this legislation and I encourage 
my colleagues to do the same.
  Mr. TAKANO. Madam Speaker, I welcome the support of the gentleman 
from Montana.
  Madam Speaker, I yield 1 minute to gentleman from California (Mr. 
Ruiz), my good friend and member of the House Veterans' Affairs 
Committee, where he is an active member of the Disability Assistance 
and Memorial Affairs Subcommittee.
  Mr. RUIZ. Madam Speaker, once again, we stand at the precipice of 
making a monumental change in the lives of our servicemen and 
servicewomen and veterans.
  Yet, here we are voting on the Honoring our PACT Act for the third 
time because of a Senate technical issue. Enough is enough. Our 
veterans do not have time for technicalities. Their lives are literally 
on the line.
  As a cofounder of the bipartisan, bicameral Burn Pits Caucus, I have 
spent years fighting to ensure that our veterans exposed to toxins from 
burn pits get the care and benefits they need and deserve.

  My bill, the Presumptive Benefits for War Fighters Exposed to Burn 
Pits and Other Toxins Act is the foundation that the Honoring our PACT 
Act is built on. It removes the burden from the veterans to prove that 
23 illnesses or conditions--including various cancers--that they are 
suffering from are due to their service near burn pits.
  Madam Speaker, I implore the House to pass this fix to the Senate's 
blue slip error, and I urge the Senate to pass the Honoring our PACT 
Act immediately. Our veterans' lives are on the line.
  Mr. BOST. Madam Speaker, I yield to the gentleman from Texas (Mr. 
Ellzey), a Navy veteran and F-18 pilot.
  Mr. ELLZEY. Madam Speaker, I come before the House of Representatives 
to discuss the newest and best version of the PACT Act before us today.
  Putting the needs of our veterans first is something we can all agree 
on. On March 3, the House passed a version of the PACT Act that was 
unworkable and unaffordable. At that time, I joined my colleagues in 
calling for negotiations and refinements that would best help the 
veterans and gain bipartisan support, and I voted ``no'' on that 
original bill.
  The bill that we have before us today is the result of those long and 
difficult negotiations. This version of the bill reinforces why I 
opposed it during the initial passage. When we work together and put 
the well-being of veterans above partisan politics, we get a workable, 
effective bill that will save the lives of those who have given so much 
for us.
  It is not a perfect bill. There remains language, including the costs 
and mandatory spending that are somewhat troubling, but I am confident 
that we will be vigilant about carrying out our oversight of the 
implementation of those provisions and the spending associated with 
them. I also call on the moneys moved to mandatory spending be moved 
back to discretionary when we take back the majority.
  America's veterans who were exposed to toxins during their voluntary 
military service in combat to preserve America's liberty and freedoms 
will finally receive the healthcare and benefits they need.

                              {time}  1430

  I support this legislation because it requires the VA to contact 
every single veteran who filed a claim for benefits that related to 
toxic exposure but had

[[Page H6022]]

the claim originally denied, allowing them to refile their claim. I 
support this legislation because it expands the screening of possible 
toxic exposure to every veteran receiving VA care.
  America's obligation to our veterans is best conveyed by the words of 
Abraham Lincoln: ``To care for him who shall have borne the battle, and 
for his widow, and his orphan.''
  Madam Speaker, I urge all Members to vote in favor of the amendments 
to H.R. 3967.
  Mr. TAKANO. Madam Speaker, may I inquire as to the time remaining.
  The SPEAKER pro tempore. The gentleman from California has 8 minutes 
remaining. The gentleman from Illinois has 10 minutes remaining.
  Mr. TAKANO. Madam Speaker, I yield 1 minute to the gentleman from 
Arizona (Mr. Gallego), who is my good friend. He is an active member of 
the House Veterans' Affairs Committee and serves on the Economic 
Opportunity Subcommittee.
  Mr. GALLEGO. Madam Speaker, I rise in support of the Honoring Our 
PACT Act--overdue, desperately needed legislation providing care for 
veterans who have been exposed to toxic substances while serving their 
country.
  I am especially grateful for the provisions in this bill that provide 
healthcare to veterans harmed by burn pits. When I was in Iraq, 
exposure to burn pits was an everyday, constant fact of life.
  Too many veterans--my dear friends from Lima Company 325 and other 
marines--are sick from that exposure with respiratory diseases, cancer, 
and other chronic conditions that young men should not be having right 
now.
  Too many veterans live in fear that their next doctor's appointment 
will reveal an illness that--in addition to harming their health--could 
drive them into bankruptcy because the VA refuses to care for them. I 
am one of those people who does have that fear.
  Every day we go without fighting for those veterans is a choice to 
let down those who have sacrificed most for our Nation. We will not let 
them down today.
  Madam Speaker, I am proud to vote for this bill on behalf of my 
fellow veterans, and I urge all my colleagues to join me in doing so.
  Mr. BOST. Madam Speaker, I yield 1 minute to the gentleman from the 
State of Michigan (Mr. Meijer).
  Mr. MEIJER. Madam Speaker, I rise today in support of the Sergeant 
First Class Heath Robinson Honoring our PACT Act.
  We have an urgent moral obligation to take care of the men and women 
who have served and sacrificed in uniform to defend our Nation. I have 
seen the impacts of burn pit and toxic exposure hazards firsthand both 
as a U.S. Army soldier in Iraq and also as somebody who has served 
alongside others in the Veterans' Affairs Committee and who have 
constituents today who are suffering from those ailments.
  This comprehensive, bipartisan package will expand VA coverage; and 
to those 3.45 million toxic-exposed veterans, provide the VA additional 
resources so it can better care for our veterans and also create the 
framework for establishing future toxic exposure-related presumptions 
of service connection so we don't have to go through this again.
  I am especially proud that a bill I introduced last year with my 
colleague from Michigan, Congresswoman Slotkin, the Veterans Burn Pit 
Exposure Recognition Act, was included in this final package.
  Madam Speaker, I look forward to supporting final passage of this 
bill, and I encourage all my colleagues to ensure its swift passage. 
With this bill, we will make good on the promises we made to our 
Nation's servicemembers and veterans.
  Mr. TAKANO. Madam Speaker, I yield 1 minute to the distinguished 
gentlewoman from California (Ms. Pelosi) who has been a tremendous 
supporter of this legislation.
  Ms. PELOSI. Madam Speaker, I thank the gentleman for yielding, and I 
thank him for his leadership as chair of the Veterans' Affairs 
Committee. I am grateful for the bipartisan support that the bill is 
receiving here.
  Madam Speaker, I rise today in strong support of the landmark 
Honoring our PACT Act. As you know, PACT stands for Promise to Address 
Comprehensive Toxics Act, now named after Sergeant First Class Heath 
Robinson. I am going to talk about him in a moment.
  This bipartisan legislation honors our duty to deliver healthcare 
that millions of veterans need and that they have certainly earned. 
This is the second time the House has voted on this important bill, and 
we are proud that after the Senate passes this version, we will finally 
send it to the President to be signed into law.
  For their relentless leadership on this legislation, let me salute 
Chairman Mark Takano and his ranking member as well who made addressing 
toxic exposure a top priority in this Congress; Congressman Raul Ruiz, 
whose experience as a physician informed a key provision of this bill 
establishing presumption of exposure; and Congresswoman Elaine Luria, a 
Navy veteran who authored a provision expanding health benefits to 
veterans exposed to burn pits.
  Also included in this legislation--and I am so pleased about it--is 
legislation by Congressman Matt Cartwright, author of the Camp Lejeune 
Justice Act, to allow veterans or their loved ones to seek damages 
related to injuries incurred while serving at Camp Lejeune.
  We have had many people come from the area. The legislators from 
North Carolina,   David Price and others, have been relentless in their 
pursuit of this legislation. Families would come here and tell their 
stories of their loved ones' service at Camp Lejeune where the water 
supply was causing serious health problems not only for the 
servicemember, which would be horrible enough, but for their family 
members as well. This is corrected in this legislation and is a very 
important improvement.
  From the deserts of Iraq to the mountains of Afghanistan and on the 
bases and military theaters around the world, a generation of 
courageous Americans have donned the Stars and Stripes to protect our 
freedom. These heroes have put their lives on the line to fight the 
enemy. Yet, tragically, many of them have confronted another deadly 
threat: exposure to burn pits and toxins which have taken a severe toll 
on their health.
  Make no mistake: burn pit exposures are pervasive. Eighty-six percent 
of the Iraq and Afghanistan veterans report having been exposed to 
these toxic fumes. I don't want to go into what is in these pits. It is 
so disgusting.
  They are deadly. The VA has seen over a 60 percent increase in rates 
of cancers tied to toxic exposure in the last 20 years. But when these 
veterans come home, they are forced into a convoluted claims process 
which cruelly saddles them with the burden of proof, and nearly three-
quarters of burn pit-related claims are denied. Think of the injustice 
of that.
  Tragically, this problem is not new to our Nation. Many veterans of 
the Vietnam war were forced to wait four long decades before their 
exposure to Agent Orange was recognized and they could claim benefits. 
This was, of course, addressed with the Blue Water Navy Vietnam Act 
that was passed by the Congress in 2019. Some Agent Orange provisions 
have been in subsequent NDAA legislation.
  I know this issue well. Before I was in Congress, I was participating 
in sit-ins with hunger strikes for Vietnam vets in the early eighties. 
More than one time we were joined by Dick Gregory who had experience in 
hunger strikes for civil rights reasons, and he was instructing the 
veterans on how to hydrate, et cetera, so that they could survive the 
hunger strikes hopefully in time to make a difference. But it took 
decades. We cannot and will not let that happen to another generation.
  There are potentially up to 3.5 million veterans deployed after the 
attacks of September 11--3.5 million deployed since September 11--who 
may have been exposed to toxic fumes and substances, and we must act 
now to save lives.
  The PACT Act is a comprehensive bill--others have discussed what it 
does--that meets the challenge of toxic exposures for veterans in three 
ways. First, it expands access to VA healthcare to post-9/11 combat 
veterans exposed to toxins. Second, it grants presumptions of exposure 
for veterans with rare cancers, COPD, and other debilitating diseases. 
Third, it creates a permanent, streamlined process to ensure that 
future Secretaries will review and approve new exposure swiftly.

[[Page H6023]]

  Why do we have these burn pits?
  We always keep saying here that on the battlefield we leave no 
soldier behind and when they come home, we leave no veteran behind. And 
yet, they come home with hidden injuries--whether they are 
psychological or exposures to a burn pit--the consequences of which do 
not show up for a while.
  We have spent more than $6 trillion recruiting, training, and 
deploying our servicemembers overseas during the last 20 years. But 
let's be clear: This is only part of the price tag. When we send our 
troops into conflict, we have to understand that we are responsible for 
the consequences. Burn pit exposure is one of them. Toxic exposures are 
a cost of war, and we must treat it as such. This is not a question of 
dollars. It is a matter of values.
  In all of the Congress' work for veterans, it is imperative that 
veterans' groups, our veterans, their families, and the veterans 
service organizations, the VSOs, are not only at the table, but they 
are also leading the way. Mr. Takano has been a leader at that table 
for years.
  The overwhelming support of VSOs, especially a group now called Burn 
Pits 360, was absolutely crucial to crafting this bill, steering it 
through the legislative process, and securing its passage in the House 
today.
  I have quoted Lincoln over and over again. Lincoln said: ``Public 
sentiment is everything. With it, nothing can fail; against it, nothing 
can succeed.''
  Well, our veterans caused public sentiment to be aroused to such a 
point that here we are getting this done. They enlisted Jon Stewart and 
John Feal, two people who had been there with us on the 9/11 health 
benefits for people exposed at the time of 9/11. And they had been real 
champions in the public visibility of this issue; not only to help 
mobilize support for us to pass it, but to give hope to people who have 
been affected to know that there is a chance that this can be 
accomplished.
  So I thank Jon Stewart, and I thank John Feal.
  At the same time, it is with great pride and patriotism that the PACT 
Act has strong bipartisan and bicameral support worthy of our heroic 
veterans. This Congress is also grateful to Secretary McDonough, the 
VA, and the entire administration for their support.
  Mr. Speaker, I thank President Biden for making this a priority in 
his State of the Union Address, especially when he talked about his 
beloved son, Beau.
  Madam Speaker, since we passed the PACT Act, it has been renamed. It 
has a new name of a veteran we lost from toxic exposure.
  Sergeant First Class Heath Robinson was exposed to burn pits while 
deployed to Kosovo and Iraq, and afterward he battled a rare, deadly 
lung cancer. Sadly, he died in 2020 at just age 39, leaving behind his 
wife and daughter. Today, in his memory, we redouble our efforts to 
ensure tragic stories like his can never happen again. He is 
representative of so many other stories and the toll that this has 
taken.
  Again, we say that when our troops go to war on the battlefield, we 
leave no soldier behind. When they come home, we leave no veteran 
behind. Our PACT Act is an historic victory for our veterans and for 
their advocacy that honors that pledge now and for the future.
  Madam Speaker, I urge a bipartisan vote on the Honoring our PACT Act. 
I hope it will be almost unanimous. I look forward to seeing it swiftly 
passed by the Senate and signed into law by the President.
  Madam Speaker, again, I am grateful for the leadership of Mr. Takano.

                              {time}  1445

  Mr. BOST. Madam Speaker, I yield 1 minute to the gentleman from 
Florida (Mr. Bilirakis), a gentleman who has served on this committee 
and has understood these issues for all of his time in Congress.
  Mr. BILIRAKIS. Madam Speaker, inspired by the story of my constituent 
Lauren Price, I first filed comprehensive burn pit legislation with my 
colleague, Congressman Ruiz, in 2018.
  Lauren developed a terminal illness due to her exposure to burn pit 
toxins in Iraq. Despite her illness, she was passionate about making 
sure her brothers and sisters in arms would finally be able to access 
the medical care and benefits they have earned. Lauren worked 
tirelessly to help me craft legislation and testified at multiple 
congressional hearings.
  Since 2018, I have continued to work with my colleagues in the House 
and the Senate to push this critical issue forward. While Lauren 
tragically passed before she was able to get help, today, finally, we 
will pass the PACT Act to make sure no other veterans have to go 
through what Lauren went through.
  Mr. TAKANO. Mr. Speaker, I so welcome the support of the gentleman 
from Florida. He got it right the first time. He voted ``yes'' the 
first time. I know he is going to vote ``yes'' the second time.
  Mr. Speaker, I yield 1 minute to the gentlewoman from Minnesota (Ms. 
Omar), my good friend who serves on the Education and Labor Committee 
and the Foreign Affairs Committee.
  Ms. OMAR. Mr. Speaker, I rise today in support of the Honoring our 
PACT Act. I thank Chairman Takano for yielding and for his incredible 
leadership on this bill.
  We ask young men and women to serve our country in uniform. We should 
not also be asking them to be exposing their bodies to toxins and to 
live with the consequences of those toxins for the rest of their lives.
  Whether it is Agent Orange in Vietnam or burn pits or other toxic 
exposures in Iraq and Afghanistan, this has been part of our military's 
history. This bill helps us correct the historic injustices for 
veterans and communities like the ones in Camp Lejeune, North Carolina.
  I am proud today that we will pass the most comprehensive legislation 
in decades to address the severe health problems that so many of our 
veterans are facing and to make it easier for them to get the relief 
and the care they need.
  Mr. Speaker, thousands of my constituents will benefit from what we 
are doing here today, and it is my great honor to support this bill.
  Mr. BOST. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
Georgia (Mr. Carter), a gentleman who is very much in support of our 
veterans.
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker, today, I rise in support of H.R. 3967, the Honoring our 
PACT Act. However, I want to make sure that my colleagues across the 
aisle know how disappointed I am in these budget gimmicks that have 
become a part of this final legislation.
  As many of you are aware, I have the honor and privilege of 
representing the First Congressional District of Georgia. We have every 
branch of the military in our district. With every branch represented 
in my district, I take pride in my ability to serve and aid our men and 
women in uniform.
  I promised them I would vote for this bill. I am going to vote for 
this bill. But I do so begrudgingly, and the reason why is because I 
think it is despicable, Mr. Speaker, that my colleagues on the other 
side of the aisle are using our veterans in order to gain the ability 
to use billions of dollars, almost $700 billion, on pet projects that 
they want to spend on. I think that is a slap in the face of our 
veterans.
  Our veterans did not sacrifice, did not serve, in order to bankrupt 
our country. But that is what our colleagues on the other side of the 
aisle want to do.
  Now, they deserve this. They need it. There is no question about 
that. Anyone who votes for it or against it agrees they need this, and 
we are going to make sure they get it. But I want to make sure that the 
point is made that this is despicable to use a budget gimmick like this 
against our veterans in order to be able to fund pet projects that my 
colleagues on the other side of the aisle want to fund.
  Mr. TAKANO. Mr. Speaker, I welcome the even begrudging ``yes'' vote 
from the gentleman from Georgia. I will just say there is no budget 
gimmick here. This vote is going to unite America. It is going to heal 
America.
  Mr. Speaker, I yield 1 minute to the gentlewoman from Michigan (Mrs. 
Dingell), my good friend who serves on the Energy and Commerce 
Committee and the Natural Resources Committee.
  Mrs. DINGELL. Mr. Speaker, I rise in support of the Honoring our PACT 
Act.
  Toxic exposure has devastating health consequences for our veterans,

[[Page H6024]]

including many in my district. I talk to them every week when I am 
home.
  One is the Michigan president of the VFW, Kevin Hensley, who is a 
veteran of the U.S. Air Force who was stationed near open burn pits and 
has been diagnosed with several severe illnesses after inhaling that 
toxic smoke. Despite his sacrifices and his dedication yet today, he 
faces challenges every day receiving care through the VA, and that is 
simply unacceptable.
  With the passage and enactment of this legislation, we can lift the 
barriers that have been blocking veterans from accessing the life-
changing care they need. This bipartisan package will expand healthcare 
access to veterans across the country, and it will finally ensure that 
veterans receive the support they deserve.
  I thank the chairman of the Veterans' Affairs Committee for his 
leadership in advancing the PACT Act, the ranking member, and all the 
members of the Veterans' Affairs Committee.
  Mr. BOST. Mr. Speaker, I yield 1 minute to the gentleman from Ohio 
(Mr. Davidson).
  Mr. DAVIDSON. Mr. Speaker, during deployments and war, the military 
incinerated waste in large burn pits. Many contained hazardous 
materials that emitted toxic fumes. Our veterans have long suffered 
from the practice, but the VA has not been able to adequately recognize 
the effects and provide care for those who suffer from such exposures.

  To be clear, this is not a benefit. It is a moral obligation to care 
for these veterans.
  It is not a great bill. Congress has already squandered two decades 
trying to do the right thing here. When BP spilled oil and contaminated 
the Gulf, their responsibility for cleanup was not optional. Why should 
America's government have less responsibility for the harm caused to 
our veterans?
  It is free to join our military, but for some, service costs 
everything. Others return with wounds that are seen and unseen. We must 
recognize the cost of war, and the bill for our veterans harmed by 
toxic burn pits is long overdue. Please pass this bill.
  Mr. TAKANO. Mr. Speaker, I have no further speakers. I am prepared to 
close, and I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  While I wholeheartedly support the intent of the PACT Act and intend 
to vote for it, I am opposed to the precedent that the funding 
mechanism in this bill sets.
  Later, I will be offering a motion to commit that would prohibit 
creation of the cost of war toxic exposure fund. Democrats are using 
the fund to move almost $400 billion of existing VA healthcare spending 
from the discretionary to the mandatory side of the ledger for purposes 
completely unrelated to veterans.
  We should not use this bill to create more entitlement spending. That 
is dangerous, and it is a very dangerous budget ploy. It will put more 
spending on autopilot. It will limit our ability to do our job, 
constitutionally, of oversight of the second-largest bureaucracy in the 
world that serves millions of veterans and survivors. It will hurt 
taxpayers who are already suffering everywhere, from the gas pump to 
the grocery store.
  My motion to commit is simple, and I hope my colleagues will support 
it.
  Mr. Speaker, I ask unanimous consent to include the text of the 
amendment in the Record immediately prior to the vote on the motion to 
commit.
  The SPEAKER pro tempore (Mr. Kilmer). Is there objection to the 
request of the gentleman from Illinois?
  There was no objection.
  Mr. BOST. Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself the balance of my time.
  I am delighted that the ranking member is offering his support for 
this bill. I accept that support, but I do not accept his objections.
  This bill, I mean, yes, I do say that we are creating entitlements. 
But the entitlements we are creating are 3.5 million veterans eligible 
for healthcare, veterans that were exposed to toxic substances. We are 
conceding exposure to them. We are making it possible for them to not 
have to fight their government.
  Yes, we are creating entitlements with our 23 presumptive illnesses. 
It is going to mean that those veterans are entitled to benefits, and 
their families will be entitled to benefits, so those veterans that are 
suffering from terminal illnesses are not going to have to worry about 
their families being without resources after they pass.
  Mr. Speaker, I ask that all of my colleagues join me in finally doing 
what is right and passing this very important piece of legislation, S. 
3373, as amended. I hope we get 400 votes.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BOST. Mr. Speaker, I yield myself the balance of my time.
  Nineteen months ago, when I took over as the lead Republican on the 
Veterans' Affairs Committee, I told my colleagues that helping toxic-
exposed veterans was my top priority. Today, I am proud to say that we 
are delivering on that promise.
  It was not an easy road to get here, but the PACT Act will make a 
difference for veterans, their families, and their survivors.
  Today, I am thinking of veterans like Lauren Price, Heath Robinson, 
Kate Hendricks Thomas, veterans who raised their right hands like I 
did. They did their duty, and they did it well. But unlike me, their 
lives were cut short.
  They were young, seemingly healthy adults who had endured a different 
battle on the stateside. Their lives were changed in an instant when 
they developed rare cancers in the blink of an eye, possibly due to 
their repeated exposure to burning chemicals while they served 
overseas.
  Lauren left behind her husband, Jim, and five children. Heath left 
behind his wife and a young daughter. Kate left behind her husband and 
a young son.
  The bill we will vote on today is in honor of them and the hundreds 
of thousands of veterans just like them. Lauren, Heath, and Kate left 
us too soon and would want us to do everything in our power to try to 
prevent what happened to them from happening to their fellow brothers 
and sisters in arms.
  The PACT Act will grant their wish for generations. It will help over 
3 million veterans get the care and benefits they are due before it is 
too late.
  We have made this mistake in the past. We don't need to make it 
again. We need to move forward with this bill, and we will work in a 
bipartisan way to make sure that is exactly what happens once it is 
signed into law and implemented by the VA.
  Mr. Speaker, I encourage my colleagues to support the bill, and I 
yield back the balance of my time.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 1224, the previous question is ordered 
on the bill, as amended.
  The question is on third reading of the bill.
  The bill was ordered to be read a third time and was read a third 
time.


                            Motion to Commit

  Mr. BOST. Mr. Speaker, I have a motion to commit at the desk.
  The SPEAKER pro tempore. The Clerk will report the motion to commit.
  The Clerk read as follows:
       Mr. Bost of Illinois moves to commit the bill S. 3373 to 
     the Committee on Veterans' Affairs.

  The material previously referred to by Mr. Bost is as follows:
        Beginning on page 117, strike line 14 and all that follows 
     through page 119, line 13, and insert the following:
       ``(c) Authorization of Appropriations.--(1) There is 
     authorized to be appropriated to the Fund for fiscal year 
     2023 and each subsequent fiscal year such sums as are 
     necessary, pursuant to the limitation in paragraph (2), to 
     increase funding, over the fiscal year 2021 level, for 
     investment in--
       ``(A) the delivery of veterans' health care associated with 
     exposure to environmental hazards in the active military, 
     naval, air, or space service in programs administered by the 
     Under Secretary for Health;
       ``(B) any expenses incident to the delivery of veterans' 
     health care and benefits associated with exposure to 
     environmental hazards in the active military, naval, air, or 
     space service, including administrative expenses, such as 
     information technology and claims processing and appeals, and 
     excluding leases as authorized or approved under section 8104 
     of this title; and
       ``(C) medical and other research relating to exposure to 
     environmental hazards.
       ``(2) Limitation.--For the period of fiscal years 2023 
     through 2031, amounts authorized to be appropriated to the 
     Fund may not exceed a cumulative total of $116,800,000,000.

[[Page H6025]]

       ``(d) Budget Scorekeeping.--(1) Immediately upon enactment 
     of the Sergeant First Class Heath Robinson Honoring our 
     Promise to Address Comprehensive Toxics Act of 2022, expenses 
     authorized to be appropriated to the Fund in subsection (c) 
     shall be estimated for fiscal year 2023 through fiscal year 
     2031 and treated as budget authority that is considered to be 
     direct spending--
       ``(A) in the baseline for purposes of section 257 of the 
     Balanced Budget and Emergency Deficit Control Act of 1985 (2 
     U.S.C. 907);
       ``(B) by the Chairman of the Committee on the Budget of the 
     Senate and the Chair of the Committee on the Budget of the 
     House of Representatives, as appropriate, for purposes of 
     budget enforcement in the Senate and the House of 
     Representatives;
       ``(C) under the Congressional Budget Act of 1974 (2 U.S.C. 
     621 et seq.), including in the reports required by section 
     308(b) of such Act (2 U.S.C. 639); and
       ``(D) for purposes of the Statutory Pay-As-You-Go Act of 
     2010 (2 U.S.C. 931 et seq.).
       ``(2)(A) Except as provided in subparagraph (B), amounts 
     appropriated to the Fund for fiscal years 2023 through 2031 
     pursuant to this section shall be counted as direct spending 
     under the Congressional Budget and Impoundment Control Act of 
     1974 (2 U.S.C. 621 et seq.) and any other Act.
       ``(B) Any amounts appropriated to the Fund in excess of the 
     amount specified under subsection (c)(2) shall be scored as 
     discretionary budget authority and outlays for any estimate 
     of an appropriations Act.''.

  The SPEAKER pro tempore. Pursuant to clause 2(b) of rule XIX, the 
previous question is ordered on the motion to commit.
  The question is on the motion to commit.
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Mr. BOST. Mr. Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  Pursuant to section 8 of rule XX, further proceedings on this 
question are postponed.

                          ____________________