[House Report 117-253]
[From the U.S. Government Publishing Office]
117th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 117-253
======================================================================
PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 3967) TO IMPROVE HEALTH
CARE AND BENEFITS FOR VETERANS EXPOSED TO TOXIC SUBSTANCES, AND FOR
OTHER PURPOSES
_______
February 28, 2022.--Referred to the House Calendar and ordered to be
printed.
_______
Mr. McGovern, from the Committee on Rules,
submitted the following
R E P O R T
[To accompany H. Res. 950]
The Committee on Rules, having had under consideration
House Resolution 950, by a record vote of 9 to 4, report the
same to the House with the recommendation that the resolution
be adopted.
SUMMARY OF PROVISIONS OF THE RESOLUTION
The resolution provides for consideration of H.R. 3967, the
Honoring our PACT Act of 2021, under a structured rule. The
resolution provides one hour of general debate on the bill
equally divided and controlled by the chair and ranking
minority member of the Committee on Veterans' Affairs. The
resolution waives all points of order against consideration of
the bill. The resolution provides that an amendment in the
nature of a substitute consisting of the text of Rules
Committee Print 117-33, modified by the amendment printed in
part A of this report, shall be considered as adopted and the
bill, as amended, shall be considered as read. The resolution
waives all points of order against provisions in the bill, as
amended. The resolution provides that following debate, each
further amendment printed in part B of this report not earlier
considered as part of amendments en bloc pursuant to section 3
shall be considered only in the order printed in the report,
may be offered only by a Member designated in the report, shall
be considered as read, shall be debatable for the time
specified in the report equally divided and controlled by the
proponent and an opponent, may be withdrawn by the proponent at
any time before the question is put thereon, shall not be
subject to amendment, and shall not be subject to a demand for
division of the question. Section 3 of the resolution provides
that at any time after debate the chair of the Committee on
Veterans' Affairs or his designee may offer amendments en bloc
consisting of further amendments printed in part B of this
report not earlier disposed of. Amendments en bloc shall be
considered as read, shall be debatable for 20 minutes equally
divided and controlled by the chair and ranking minority member
of the Committee on Veterans' Affairs or their designees, shall
not be subject to amendment, and shall not be subject to a
demand for division of the question. The resolution waives all
points of order against the amendments printed in part B of
this report and amendments en bloc described in section 3 of
the resolution. The resolution provides one motion to recommit.
EXPLANATION OF WAIVERS
The waiver of all points of order against consideration of
H.R. 3967 includes a waiver of section 306 of the Congressional
Budget Act, which prohibits consideration of legislation within
the jurisdiction of the Committee on the Budget unless referred
to or reported by the Budget Committee.
Although the resolution waives all points of order against
provisions in H.R. 3967, as amended, the Committee is not aware
of any points of order. The waiver is prophylactic in nature.
Although the resolution waives all points of order against
the amendments to H.R. 3967 printed in part B of this report
and amendments en bloc described in section 3 of the
resolution, the Committee is not aware of any points of order.
The waiver is prophylactic in nature.
COMMITTEE VOTES
The results of each record vote on an amendment or motion
to report, together with the names of those voting for and
against, are printed below:
Rules Committee record vote No. 195
Motion by Mr. Cole to eliminate all the unprecedented
pandemic authorities granted to the Speaker. Defeated: 4-8
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Nay Mr. Cole.......................... Yea
Mr. Perlmutter.................................. Nay Mr. Burgess....................... Yea
Mr. Raskin...................................... Nay Mr. Reschenthaler................. Yea
Ms. Scanlon..................................... Nay Mrs. Fischbach.................... Yea
Mr. Morelle..................................... Nay
Mr. DeSaulnier.................................. ............
Ms. Ross........................................ Nay
Mr. Neguse...................................... Nay
Mr. McGovern, Chairman.......................... Nay
----------------------------------------------------------------------------------------------------------------
Rules Committee record vote No. 196
Motion by Mr. Cole to eliminate the martial law authorities
granted to the Speaker. Defeated: 4-9
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Nay Mr. Cole.......................... Yea
Mr. Perlmutter.................................. Nay Mr. Burgess....................... Yea
Mr. Raskin...................................... Nay Mr. Reschenthaler................. Yea
Ms. Scanlon..................................... Nay Mrs. Fischbach.................... Yea
Mr. Morelle..................................... Nay
Mr. DeSaulnier.................................. Nay
Ms. Ross........................................ Nay
Mr. Neguse...................................... Nay
Mr. McGovern, Chairman.......................... Nay
----------------------------------------------------------------------------------------------------------------
Rules Committee record vote No. 197
Motion by Mr. Cole to add language in the rule that would
stop the tolling of days for Resolutions of Inquiry. Defeated:
4-9
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Nay Mr. Cole.......................... Yea
Mr. Perlmutter.................................. Nay Mr. Burgess....................... Yea
Mr. Raskin...................................... Nay Mr. Reschenthaler................. Yea
Ms. Scanlon..................................... Nay Mrs. Fischbach.................... Yea
Mr. Morelle..................................... Nay
Mr. DeSaulnier.................................. Nay
Ms. Ross........................................ Nay
Mr. Neguse...................................... Nay
Mr. McGovern, Chairman.......................... Nay
----------------------------------------------------------------------------------------------------------------
Rules Committee record vote No. 198
Motion by Mr. Reschenthaler to add to the rule a section
providing for the consideration of S. 3541, Healthcare for Burn
Pit Veterans Act, under a closed rule. Defeated: 4-9
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Nay Mr. Cole.......................... Yea
Mr. Perlmutter.................................. Nay Mr. Burgess....................... Yea
Mr. Raskin...................................... Nay Mr. Reschenthaler................. Yea
Ms. Scanlon..................................... Nay Mrs. Fischbach.................... Yea
Mr. Morelle..................................... Nay
Mr. DeSaulnier.................................. Nay
Ms. Ross........................................ Nay
Mr. Neguse...................................... Nay
Mr. McGovern, Chairman.......................... Nay
----------------------------------------------------------------------------------------------------------------
Rules Committee record vote No. 199
Motion by Mrs. Torres to report the rule. Adopted: 9-4
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Yea Mr. Cole.......................... Nay
Mr. Perlmutter.................................. Yea Mr. Burgess....................... Nay
Mr. Raskin...................................... Yea Mr. Reschenthaler................. Nay
Ms. Scanlon..................................... Yea Mrs. Fischbach.................... Nay
Mr. Morelle..................................... Yea
Mr. DeSaulnier.................................. Yea
Ms. Ross........................................ Yea
Mr. Neguse...................................... Yea
Mr. McGovern, Chairman.......................... Yea
----------------------------------------------------------------------------------------------------------------
SUMMARY OF THE AMENDMENT TO H.R. 3967 IN PART A CONSIDERED AS ADOPTED
1. Takano (CA): Revises the seating of members on the
Federal Advisory Committee created in Title II of the bill, to
ensure for staggered terms. Authorizes the Secretary of the
Veterans Administration to allow for claimants to opt-in to
receiving notifications through electronic communication. Adds
Thule, Greenland to the list of locations to which veterans are
presumed to have been exposed to radiation. Authorizes funding
for an expansion of VA's disability claims automation system.
Creates a Veterans Toxic Exposure Fund to authorize funding for
the activities in the bill.
SUMMARY OF THE AMENDMENTS TO H.R. 3967 IN PART B MADE IN ORDER
1. Bush, Cori (MO): Includes race and ethnicity as a
demographic for a study on the incidence of cancer in veterans.
(10 minutes)
2. Bush, Cori (MO): Includes race, age, period of service,
military occupation, gender, and disability status of veterans
in an epidemiological study on the health trends of veterans
who served in the Armed Forces after September 11, 2001. (10
minutes)
3. Bush, Cori (MO): Amends the review of known cases of
toxic exposure on military installations of the Department of
Defense to include both in the United States and abroad. (10
minutes)
4. Bush, Cori (MO): Includes a study on veteran health
outcomes related to waste from the Manhattan project in St.
Louis. (10 minutes)
5. Bost (IL): Replaces the text of the bill with the Health
Care for Burn Pit Veterans Act, which expands healthcare
eligibility for certain combat veterans exposed to toxic
substances to last for ten years after separation instead of
five years, requires toxic exposure-related education and
training for VA personnel, and requires screenings and studies
to better identify potential associations between veteran
medical conditions and toxic exposure. (10 minutes)
6. Brownley (CA), Miller-Meeks (IA): Ensures toxic exposed
veterans have access to mammography screenings. (10 minutes)
7. Cartwright (PA): Requires the Secretary of the VA to
share a list of resources for toxic-exposed veterans,
caregivers of toxic-exposed veterans, and survivors of toxic-
exposed vets with national veterans services organizations and
other veteran groups. (10 minutes)
8. Gibbs (OH): Allows veterans an additional 24-hour
period, at minimum, to notify the VA when receiving care at a
non-VA facility. This additional time-period will allow
flexibility if a veteran needs additional time to recoup from a
severe medical condition or if they are dealing with other
complicating factors. (10 minutes)
9. Golden (ME), Wild (PA): Ensures that mental health
services and counseling are included when providing hospital
services to give holistic care for affected veterans. (10
minutes)
10. Gottheimer (NJ): Requires a study by the Department of
Veterans Affairs to examine the possible relationship between
toxic exposures experienced during service in the Armed Forces
and mental health outcomes. (10 minutes)
11. Gottheimer (NJ): Defines outreach materials on
illnesses that may be related to toxic exposure as fact sheets
under the Veterans and Family Information Act. (10 minutes)
12. Hartzler (MO): Enhances VA hiring competitiveness by
allowing VA to release physicians from non-compete agreements
after committing to VA service for at least one year,
authorizes VA to make job offers up to 2 years prior to
completion of residency and updates statutory minimum
requirements for VA physicians to include medical residency.
(10 minutes)
13. Jackson Lee (TX): Adds a study on whether data
collection established under this bill should include data on
the toxic exposure of National Guard service personnel when
deployed in connection with a natural disaster in the United
States or its territories. (10 minutes)
14. Levin, Andy (MI), Wild (PA): Amends the definition of
``illnesses'' to include both mental and physical health. (10
minutes)
15. Levin, Mike (CA): Adds a new section similar to the
Commitment to Veteran Support and Outreach Act, which
authorizes VA to award grants to expand outreach and claims
assistance carried out through County Veterans Service Officers
(CVSOs). (10 minutes)
16. Newman (IL): Requires the Department of Defense (DOD)
to conduct a study on the exposure of members of the Armed
Forces to herbicide agents, including Agent Orange and Agent
Purple, in the Panama Canal Zone during the period beginning on
January 1, 1958, and ending on December 31, 1999. (10 minutes)
17. Pappas (NH): Requires coordination between the
Department of Defense and the Department of Veterans Affairs to
establish guidelines used for training active duty personnel to
provide awareness of potential risks of toxic exposure, as well
as ways to prevent such exposures during combat. (10 minutes)
18. Plaskett (VI): Requires a GAO study and report on
access and barriers to veterans benefits and services for
veterans in territories of the United States. (10 minutes)
19. Porter (CA): Directs the Department of Veterans Affairs
to establish a public website, housed within the War Related
Illness and Injury Study Center of the Department, to be a
clearinghouse for the publication of all Federally funded
research on toxic exposure. (10 minutes)
20. Ross (NC), Rouzer (NC): Requires the DOD to submit to
Congress a report on sources of PFAS on military installations
other than AFFF and any recommendation regarding whether to
expand eligibility for the registry to individuals exposed to
PFAS from other sources. (10 minutes)
21. Ruiz (CA), Slotkin (MI), Welch (VT), Bilirakis (FL):
Requires the Department of Defense (DOD) to provide budget
information regarding incinerators and waste-to-energy waste
disposal alternatives to burn pits. DOD must include the
information as a dedicated budget line item in the President's
FY2023 through the Fiscal Year 2027 budget. (10 minutes)
22. Ruiz (CA), Ryan (OH), Gonzalez-Colon, Jenniffer (PR):
Allows veterans in the burn pits registry to designate a
registered individual or an immediate family member to update
the registry with the cause of death of the individual. (10
minutes)
23. Ryan (OH), Mast (FL), Kelly, Trent (MS), Fitzpatrick
(PA), Cheney (WY), Young (AK), Ruiz (CA), Hayes (CT),
Cartwright (PA): Adds the text of the SFC Heath Robinson Burn
Pit Transparency Act, which requires the Department of the VA
to document, track, and then notify Congress of specified data
points related to exposure cases as reported by veterans to the
VA. (10 minutes)
24. Scanlon (PA): Authorizes $150,000,000 for fiscal year
2023 to expand capacity of the Veterans Benefits Management
System of the Department of Veterans Affairs to accommodate
expected increased claims processing for newly eligible
veterans. (10 minutes)
25. Slotkin (MI): Creates an interagency working group to
1) Identify collaborative research activities and resources, 2)
Establish a 5-year strategic plan for coordination/planning for
research surrounding toxic exposure, and 3) Submit a report to
the VA Secretary with milestones/goals as part of the
implementation. (10 minutes)
26. Spanberger (VA): Requires the Secretary of Veterans
Affairs to submit a publicly available report to Congress that
includes (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; and (4) an
identification of any areas relating to jet fuel exposure about
which new research needs to be conducted. (10 minutes)
27. Torres, Norma (CA): Requires the publication of the
list of resources provided by the VA to toxic-exposed veterans
be made available in English, Spanish, Chinese, and the 7 other
most commonly spoken languages in the United States. (10
minutes)
28. Torres, Norma (CA): Revises Section 505 to include
language about the feasibility and advisability of VA looking
at available early detection diagnostics and how they might be
incorporated into veterans' care. (10 minutes)
PART A--TEXT OF AMENDMENT TO H.R. 3967 CONSIDERED AS ADOPTED
Page 21, strike lines 5 through 7 and insert the following:
``(4)(A) Except as provided by subparagraph (B), each member
of the Committee shall be appointed for a two-year term, and
may serve not more than three successive terms.
``(B) With respect to the five members who are initially
appointed by the Secretary under subparagraph (A)(i), the
Secretary shall determine the length of the term of each such
member in a manner that ensures the expiration of the terms on
a staggered basis.''.
Page 33, after line 6, insert the following new subsection:
(c) Rule of Construction.--Nothing in section 1172(a)(2)(A)
of title 38, United States Code, as added by subsection (a),
shall be construed so as to require the advice and consent of
the Senate in the appointment of members of the Formal Advisory
Committee on Toxic Exposure.
Page 41, line 8, insert ``OR THULE, GREENLAND,'' after
``SPAIN,''.
Page 41, line 13, insert ``or Thule'' after ``Palomares''.
Page 41, line 14, insert ``or Thule'' after ``Palomares''.
Page 41, line 16, strike ``clause'' and insert ``clauses''.
Page 41, after line 23, add the following new clause:
``(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.''.
Add at the end of title VII the following new sections:
SEC. 7__. VETERANS TOXIC EXPOSURES FUND.
Chapter 3 is amended by adding at the end the following new
section:
``Sec. 324. Veterans Toxic Exposures Fund
``(a) Establishment.--There is hereby established in the
Treasury of the United States an account to be known as the
``Veterans Toxic Exposures Fund'' (the ``Fund''), to be
administered through the Department of Veterans Affairs, to
provide for investment in the delivery of veterans' health
care, research, and benefits associated with hazardous exposure
in service.
``(b) 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 the Veterans
Health Administration of the Department of Veterans Affairs,
for any expenses incident to the delivery of veterans' health
care and benefits associated with exposure to environmental
hazards in service, including administrative expenses, such as
claims processing and appeals, and for medical research related
to hazardous exposures. Amounts appropriated to the Fund
pursuant to this subsection shall be counted as direct spending
under the Congressional Budget and Impoundment Control Act of
1974 and any other Act.
``(c) 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, United States Code, detailed estimates of the
sums described in subsection (b) for the applicable fiscal
year.
``(d) Procedures for Estimates.--The Secretary, after
consultation with the Committees on Appropriations of the House
of Representatives and the Senate, may establish policies and
procedures for developing the annual detailed estimates
required in subsection (c).''.
SEC. 7__. AUTHORIZATION OF ELECTRONIC NOTICE IN CLAIMS UNDER LAWS
ADMINISTERED BY THE SECRETARY OF VETERANS AFFAIRS.
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 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) The Secretary may provide notice under subsection (e)
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.''.
(5) In section 7105(b)(1)(A), by striking ``mailing''
and inserting ``issuance''.
(6) In section 7105A(a), by striking ``mailed'' and
inserting ``issued''.
(7) In section 7266(a), by striking ``mailed'' and
inserting ``issued''.
SEC. 7__. AUTHORIZATION OF APPROPRIATIONS FOR EXPANSION OF CLAIMS
AUTOMATION.
There is authorized to be appropriated to the Secretary of
Veterans Affairs $30,000,000 for fiscal year 2023 to support
expected increased claims processing for newly eligible
veterans pursuant to this Act and the amendments made by this
Act by--
(1) supporting the automation of processing claims by
the Veterans Benefits Administration of the Department
of Veterans Affairs;
(2) adding self-service features to the system by
which individuals file claims;
(3) removing duplicative efforts regarding the
processing of claims; and
(4) reducing the dependency of the Department on the
legacy claim system.
PART B--TEXT OF AMENDMENTS TO H.R. 3967 MADE IN ORDER
1. An Amendment To Be Offered by Representative Bush of Missouri or Her
Designee, Debatable for 10 Minutes
Page 55, line 20, strike ``age'' and insert ``race and
ethnicity''.
Page 55, after line 20, insert the following new paragraph
(and redesignate the subsequent paragraphs accordingly):
(2) The age of the veteran.
----------
2. An Amendment To Be Offered by Representative Bush of Missouri or Her
Designee, Debatable for 10 Minutes
Page 55, after line 6, insert the following new subsection
(and redesignate the subsequent subsection accordingly):
(b) Elements.--The study under subsection (a) shall assess,
with respect to each veteran included in the study, the
following:
(1) The race and ethnicity of the veteran.
(2) The age of the veteran.
(3) The period of service and length of service of
the veteran in the Armed Forces.
(4) Any military occupational speciality of the
veteran.
(5) The gender of the veteran.
(6) The disability status of the veteran.
----------
3. An Amendment To Be Offered by Representative Bush of Missouri or Her
Designee, Debatable for 10 Minutes
Page 58, line 5, strike ``located in the United States''.
----------
4. An Amendment To Be Offered by Representative Bush of Missouri or Her
Designee, Debatable for 10 Minutes
At the end of title V, add the following:
SEC. 507. STUDY ON HEALTH EFFECTS OF WASTE RELATED TO MANHATTAN PROJECT
ON CERTAIN VETERANS.
(a) Study.--The Secretary of Veterans Affairs shall conduct 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 in the county of St.
Louis, Missouri:
(1) Coldwater Creek.
(2) The St. Louis Airport Site.
(3) The West Lake Landfill.
(4) Any other location in the county of St. Louis,
Missouri 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, gender, 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.
(d) Report.--Not later than one year after the date of the
enactment of this Act, the Secretary shall submit to the
Committees on Veterans' Affairs of the House of Representatives
and the Senate a report on the study under subsection (a).
(e) Definitions.--In this section:
(1) The term ``covered waste'' means any waste
arising from activities carried out in connection with
the Manhattan Project.
(2) The term ``illness'' has the meaning given that
term in section 1171 of title 38, United States Code,
as added by section 202.
(3) The term ``toxic exposure'' has the meaning given
that term in section 101 of such title, as added by
section 102(b).
----------
5. An Amendment To Be Offered by Representative Bost of Illinois or His
Designee, Debatable for 10 Minutes
Strike page 1, line 1, and all that follows through page 80,
line 7, and insert the following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Care for Burn Pit
Veterans Act''.
SEC. 2. EXPANSION OF ELIGIBILITY FOR HEALTH CARE FROM DEPARTMENT OF
VETERANS AFFAIRS FOR CERTAIN VETERANS EXPOSED TO
TOXIC SUBSTANCES.
(a) In General.--Section 1710(e)(3) of title 38, United
States Code, is amended--
(1) in subparagraph (A)--
(A) by striking ``January 27, 2003'' and
inserting ``September 11, 2001''; and
(B) by striking ``five-year period'' and
inserting ``ten-year period'';
(2) by amending subparagraph (B) to read as follows:
``(B) With respect to a veteran described in
paragraph (1)(D) who was discharged or released from
the active military, naval, air, or space service after
September 11, 2001, and before October 1, 2013, but did
not enroll to receive such hospital care, medical
services, or nursing home care under such paragraph
pursuant to subparagraph (A) before October 1, 2022,
the one-year period beginning on October 1, 2022.'';
and
(3) by striking subparagraph (C).
(b) Clarification of Coverage.--Section 1710(e)(1)(D) of such
title is amended by inserting after ``Persian Gulf War'' the
following: ``(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) Report.--Not later than October 1, 2024, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans'
Affairs of the House of Representatives and the Senate a report
on--
(1) the number of veterans who enrolled in the system
of annual patient enrollment of the Department of
Veterans Affairs established and operated under section
1705(a) of title 38, United States Code, to receive
care pursuant to eligibility under subparagraph (B) of
section 1710(e)(3) of such title, as amended by
subsection (a)(2); and
(2) of the veterans described in paragraph (1), the
number of such veterans who reported a health concern
related to exposure to a toxic substance or radiation.
(d) Outreach Plan.--Not later than December 1, 2022, the
Secretary shall submit to the Committees on Veterans' Affairs
of the House of Representatives and the Senate a plan to
conduct outreach to veterans described in subparagraph (B) of
section 1710(e)(3) of title 38, United States Code, as amended
by subsection (a)(2), to notify such veterans of their
eligibility for hospital care, medical services, or nursing
home care under such subparagraph.
(e) Effective Date.--This section and the amendments made by
this section shall take effect on October 1, 2022.
SEC. 3. INCORPORATION OF TOXIC EXPOSURE SCREENING FOR VETERANS.
(a) In General.--Beginning not later than 90 days after the
date of the enactment of this Act, the Secretary of Veterans
Affairs shall incorporate a screening to help determine
potential exposures to toxic substances during active military,
naval, air, or space service as part of a health care screening
furnished by the Secretary to veterans enrolled in the system
of annual patient enrollment of the Department of Veterans
Affairs established and operated under section 1705 of title
38, United States Code, to improve understanding by the
Department of exposures of veterans to toxic substances while
serving in the Armed Forces.
(b) Timing.--The Secretary shall ensure that a veteran
described in subsection (a) completes the screening required
under such subsection not less frequently than once every five
years.
(c) Determination of Questions.--
(1) In general.--The questions included in the
screening required under subsection (a) shall be
determined by the Secretary with input from medical
professionals.
(2) Specific questions.--At a minimum, the screening
required under subsection (a) shall, with respect to a
veteran, include--
(A) a question about the potential exposure
of the veteran to an open burn pit; and
(B) a question regarding exposures that are
commonly associated with service in the Armed
Forces.
(3) Open burn pit defined.--In this subsection, the
term ``open burn pit'' means an area of land that--
(A) is designated by the Secretary of Defense
to be used for disposing solid waste by burning
in the outdoor air; and
(B) does not contain a commercially
manufactured incinerator or other equipment
specifically designed and manufactured for the
burning of solid waste.
(d) Print Material.--In developing the screening established
under subsection (a), the Secretary shall ensure that print
materials complementary to such screening that outline related
resources for veterans are available at each medical center of
the Department to veterans who may not have access to the
internet.
(e) Screening Updates.--The Secretary shall consider updates
to the content of the screening required under subsection (a)
not less frequently than biennially to ensure the screening
contains the most current information.
(f) Active Military, Naval, Air, or Space Service Defined.--
In this section, the term ``active military, naval, air, or
space service'' has the meaning given that term in section
101(24) of title 38, United States Code.
SEC. 4. TRAINING FOR PERSONNEL OF THE DEPARTMENT OF VETERANS AFFAIRS
WITH RESPECT TO VETERANS EXPOSED TO TOXIC
SUBSTANCES.
(a) Health Care Personnel.--The Secretary of Veterans Affairs
shall provide to health care personnel of the Department of
Veterans Affairs education and training to identify, treat, and
assess the impact on veterans of illnesses related to exposure
to toxic substances and inform such personnel of how to ask for
additional information from veterans regarding different
exposures.
(b) Benefits Personnel.--
(1) In general.--The Secretary shall incorporate a
training program for processors of claims under the
laws administered by the Secretary who review claims
for disability benefits relating to service-connected
disabilities based on exposure to toxic substances.
(2) Annual training.--Training provided to processors
under paragraph (1) shall be provided not less
frequently than annually.
SEC. 5. ANALYSIS AND REPORT ON TREATMENT OF VETERANS FOR MEDICAL
CONDITIONS RELATED TO TOXIC EXPOSURE.
(a) In General.--The Secretary of Veterans Affairs shall
analyze, on a continuous basis, all clinical data that--
(1) is obtained by the Department of Veterans Affairs
in connection with hospital care, medical services, and
nursing home care furnished under section 1710(a)(2)(F)
of title 38, United States Code; and
(2) is likely to be scientifically useful in
determining the association, if any, between the
medical condition of a veteran and the exposure of the
veteran to a toxic substance.
(b) Annual Report.--Not later than one year after the date of
the enactment of this Act, and annually thereafter, the
Secretary shall submit to the Committees on Veterans' Affairs
of the House of Representatives and the Senate a report
containing--
(1) the aggregate data compiled under subsection (a);
(2) an analysis of such data;
(3) a description of the types and incidences of
medical conditions identified by the Department under
such subsection;
(4) the explanation of the Secretary for the
incidence of such medical conditions and other
explanations for the incidence of such conditions as
the Secretary considers reasonable; and
(5) the views of the Secretary on the scientific
validity of drawing conclusions from the incidence of
such medical conditions, as evidenced by the data
compiled under subsection (a), regarding any
association between such conditions and exposure to a
toxic substance.
SEC. 6. ANALYSIS RELATING TO MORTALITY OF VETERANS WHO SERVED IN
SOUTHWEST ASIA.
(a) Analysis.--
(1) In general.--Not later than 270 days after the
date of the enactment of this Act, the Secretary of
Veterans Affairs, in coordination with the Secretary of
Defense, shall conduct an updated analysis of total and
respiratory disease mortality in covered veterans.
(2) Elements.--The analysis required by paragraph (1)
shall include, to the extent practicable, the following
with respect to each covered veteran:
(A) Metrics of airborne exposures.
(B) The location and timing of deployments of
the veteran.
(C) The military occupational specialty of
the veteran.
(D) The Armed Force in which the veteran
served.
(E) Pre-existing health status of the
veteran, including with respect to asthma.
(F) Relevant personal information of the
veteran, including cigarette and e-cigarette
smoking history, diet, sex, gender, age, race,
and ethnicity.
(b) Covered Veteran Defined.--In this section, the term
``covered veteran'' means any veteran who--
(1) on or after August 2, 1990, served on active duty
in--
(A) Bahrain;
(B) Iraq;
(C) Kuwait;
(D) Oman;
(E) Qatar;
(F) Saudi Arabia;
(G) Somalia; or
(H) the United Arab Emirates; or
(2) on or after September 11, 2001, served on active
duty in--
(A) Afghanistan;
(B) Djibouti;
(C) Egypt;
(D) Jordan;
(E) Lebanon;
(F) Syria; or
(G) Yemen.
SEC. 7. STUDY ON HEALTH TRENDS OF POST 9/11 VETERANS.
The Secretary of Veterans Affairs shall conduct an
epidemiological study on the health trends of veterans who
served in the Armed Forces after September 11, 2001.
SEC. 8. STUDY ON CANCER RATES AMONG VETERANS.
(a) In General.--The Secretary of Veterans Affairs shall
conduct a study on the incidence of cancer in veterans to
determine trends in the rates of the incidence of cancer in
veterans.
(b) Elements.--The study required by subsection (a) shall
assess, with respect to each veteran included in the study, the
following:
(1) The age of the veteran.
(2) The period of service and length of service of
the veteran in the Armed Forces.
(3) The military occupational specialty or
specialties of the veteran.
(4) The gender of the veteran.
(5) The type or types of cancer that the veteran has.
SEC. 9. PUBLICATION OF LIST OF RESOURCES OF DEPARTMENT OF VETERANS
AFFAIRS FOR VETERANS EXPOSED TO TOXIC SUBSTANCES
AND OUTREACH PROGRAM FOR SUCH VETERANS AND
CAREGIVERS AND SURVIVORS OF SUCH VETERANS.
(a) Publication of List of Resources.--
(1) In general.--Not later than one year after the
date of the enactment of this Act, and annually
thereafter, the Secretary of Veterans Affairs shall
publish a list of resources of the Department of
Veterans Affairs for--
(A) veterans who were exposed to toxic
substances;
(B) families and caregivers of such veterans;
and
(C) survivors of such veterans who are
receiving death benefits under the laws
administered by the Secretary.
(2) Update.--The Secretary shall periodically update
the list published under paragraph (1).
(b) Outreach.--The Secretary shall develop, with input from
the community, an informative outreach program for veterans on
illnesses that may be related to exposure to toxic substances,
including outreach with respect to benefits and support
programs.
SEC. 10. REPORT ON INDIVIDUAL LONGITUDINAL EXPOSURE RECORD.
(a) In General.--Not later than one year after the date on
which the Individual Longitudinal Exposure Record achieves full
operational capability, the Secretary of Veterans Affairs shall
submit to the appropriate congressional committees a report on
the data quality of the Individual Longitudinal Exposure Record
and the usefulness of the Individual Longitudinal Exposure
Record in supporting veterans in receiving health care and
benefits from the Department of Veterans Affairs.
(b) Elements.--The report required by subsection (a) shall
include the following:
(1) An identification of exposures to toxic
substances that may not be fully captured by the
current systems for environmental and occupational
health monitoring and recommendations for how to
improve those systems.
(2) An analysis of the quality of the location data
in determining exposures of veterans to toxic
substances and recommendations for how to improve the
quality of that location data.
(3) Recommendations on how to improve the usefulness
of the Individual Longitudinal Exposure Record.
(c) Definitions.--In this section:
(1) The term ``appropriate congressional committees''
means--
(A) the Committee on Armed Services and the
Committee on Veterans' Affairs of the House of
Representatives; and
(B) the Committee on Armed Services and the
Committee on Veterans' Affairs of the Senate.
(2) The term ``Individual Longitudinal Exposure
Record'' includes any pilot program or other program
used by the Department of Veterans Affairs or the
Department of Defense to track how members of the Armed
Forces or veterans have been exposed to various
occupational or environmental hazards.
----------
6. An Amendment To Be Offered by Representative Brownley of California
or Her Designee, Debatable for 10 Minutes
Page 14, after line 19, insert the following:
SEC. 105. REVISION OF BREAST CANCER MAMMOGRAPHY POLICY OF DEPARTMENT OF
VETERANS AFFAIRS TO PROVIDE MAMMOGRAPHY SCREENING
FOR VETERANS WHO SERVED IN LOCATIONS ASSOCIATED
WITH TOXIC EXPOSURE.
(a) In General.--Section 7322 of title 38, United States
Code, is amended--
(1) in subsection (a), by striking ``The'' and
inserting ``In General.--The'';
(2) in subsection (b)--
(A) by striking ``The'' and inserting
``Standards for Screening.--The''; and
(B) in paragraph (2)(B), by inserting ``a
record of service in a location and during a
period specified in subsection (d),'' after
``risk factors,''; and
(3) by adding at the end the following new
subsections:
``(c) Eligibility for Screening for Veterans Exposed to Toxic
Substances.--The Under Secretary for Health shall ensure that,
under the policy developed under subsection (a), any veteran
who, during active military, naval, or air service, was
deployed in support of a contingency operation in a location
and during a period specified in subsection (d), is eligible
for a mammography screening by a health care provider of the
Department.
``(d) Locations and Periods Specified.--(1) The locations and
periods specified in this subsection are the following:
``(A) Iraq during following periods:
``(i) The period beginning on August 2, 1990,
and ending on February 28, 1991.
``(ii) The period beginning on March 19,
2003, and ending on such date as the Secretary
determines burn pits are no longer used in
Iraq.
``(B) The Southwest Asia theater of operations, other
than Iraq, during the period beginning on August 2,
1990, and ending on such date as the Secretary
determines burn pits are no longer used in such
location, including the following locations:
``(i) Kuwait.
``(ii) Saudi Arabia.
``(iii) Oman.
``(iv) Qatar.
``(C) Afghanistan during the period beginning on
September 11, 2001, and ending on such date as the
Secretary determines burn pits are no longer used in
Afghanistan.
``(D) Djibouti during the period beginning on
September 11, 2001, and ending on such date as the
Secretary determines burn pits are no longer used in
Djibouti.
``(E) Syria during the period beginning on September
11, 2001, and ending on such date as the Secretary
determines burn pits are no longer used in Syria.
``(F) Jordan during the period beginning on September
11, 2001, and ending on such date as the Secretary
determines burn pits are no longer used in Jordan.
``(G) Egypt during the period beginning on September
11, 2001, and ending on such date as the Secretary
determines burn pits are no longer used in Egypt.
``(H) Lebanon during the period beginning on
September 11, 2001, and ending on such date as the
Secretary determines burn pits are no longer used in
Lebanon.
``(I) Yemen during the period beginning on September
11, 2001, and ending on such date as the Secretary
determines burn pits are no longer used in Yemen.
``(J) Such other locations and corresponding periods
as set forth by the Airborne Hazards and Open Burn Pit
Registry established 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).
``(K) Such other locations and corresponding periods
as the Secretary, in collaboration with the Secretary
of Defense, may determine appropriate in a report
submitted under paragraph (2).
``(2) Not later than two years after the date of the
enactment of the Supporting Expanded Review for Veterans In
Combat Environments Act of 2021, and not less frequently than
once every two years thereafter, the Secretary of Veterans
Affairs, in collaboration with the Secretary of Defense, shall
submit to Congress a report specifying other locations and
corresponding periods for purposes of paragraph (1)(K).
``(3) A location under this subsection shall not include any
body of water around or any airspace above such location.
``(4) In this subsection, the term `burn pit' means an area
of land that is used for disposal of solid waste by burning in
the outdoor air.''.
(b) Report on Breast Cancer Rates for Veterans Deployed to
Certain Areas.--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 that compares the rates of breast
cancer among members of the Armed Forces deployed to the
locations and during the periods specified in section 7322(d)
of title 38, United States Code, as added by subsection (a), as
compared to members of the Armed Forces who were not deployed
to those locations during those periods and to the civilian
population.
----------
7. An Amendment To Be Offered by Representative Cartwright of
Pennsylvania or His Designee, Debatable for 10 Minutes
Page 61, after line 20, insert the following:
(c) Veterans Organizations.--To the extent practicable, the
Secretary shall share with national veterans service
organizations and other veterans groups, including such
organizations and groups that improve access by veterans to
health care and benefits, the list of resources under
subsection (a) and the outreach program under subsection (b).
----------
8. An Amendment To Be Offered by Representative Gibbs of Ohio or His
Designee, Debatable for 10 Minutes
Page 15, line 2, insert ``and Other Matters'' after
``Service''.
Page 17, after line 6, insert the following new section:
SEC. 112. AUTHORIZATION PERIOD FOR EMERGENCY TREATMENT IN NON-
DEPARTMENT OF VETERANS AFFAIRS MEDICAL FACILITIES.
Section 1703(a)(3) of title 38, United States Code, is
amended--
(1) by striking ``A covered veteran'' and inserting
``(A) Except as provided by subparagraph (B), a covered
veteran''; and
(2) by adding at the end the following new
subparagraph:
``(B) In the case of an emergency which existed at the time
of admission of a covered veteran to a health care provider,
the Secretary shall deem the care or services received by the
veteran during such admission to be authorized under
subparagraph (A) if the covered veteran (or an individual
acting on behalf of the covered veteran) makes an application
for such authorization during the period following such
admission that the Secretary determines appropriate for
purposes of this paragraph, except such period may not be less
than 96 hours.''.
----------
9. An Amendment To Be Offered by Representative Golden of Maine or His
Designee, Debatable for 10 Minutes
Page 6, line 5, insert ``(including mental health services
and counseling)'' after ``hospital care''.
Page 6, line 11, insert ``(including mental health services
and counseling)'' after ``hospital care''.
Page 6, line 17, insert ``(including mental health services
and counseling)'' after ``hospital care''.
Page 50, line 14, insert ``(including mental health services
and counseling)'' after ``hospital care''.
----------
10. An Amendment To Be Offered by Representative Gottheimer of New
Jersey or His Designee, Debatable for 10 Minutes
At the end of title V, insert the following:
SEC. 507. STUDY ON TOXIC EXPOSURE AND MENTAL HEALTH OUTCOMES.
(a) Study Required.--The Secretary of the Department 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 outcomes,
including chronic multisymptom illness, traumatic brain injury,
post-traumatic stress disorder, depression, psychosis, 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) Gender.
(3) Race and ethnicity.
(4) Period and length of service in the Armed Forces.
(5) History of toxic exposure during service in the
Armed Forces.
(6) Any diagnosis of chronic multisymptom illness.
(7) Any diagnosis of a mental health or cognitive
disorder.
(8) Any history of suicide attempt or suidcidality.
(9) If the veteran died by suicide.
(c) Report.--Not later than two years after the date after
the enactment of this Act, the Secretary shall submit to the
Committees on Veterans' Affairs of the Senate and House of
Representatives a report containing the findings of the study
conducted under subsection (a).
----------
11. An Amendment To Be Offered by Representative Gottheimer of New
Jersey or His Designee, Debatable for 10 Minutes
Page 61, line 20, insert after the period the following:
``Information distributed under the outreach program shall be
treated as a fact sheet of the Department of Veterans Affairs
for purposes of making the information available in multiple
languages pursuant to section 2 of the Veterans and Family
Information Act (Public Law 117-62; 38 U.S.C. 6303 note).''.
----------
12. An Amendment To Be Offered by Representative Hartzler of Missouri
or Her Designee, Debatable for 10 Minutes
Add at the end of title VII the following new sections:
SEC. 7__. NON-APPLICABILITY OF NON-DEPARTMENT OF VETERANS AFFAIRS
COVENANTS NOT TO COMPETE TO APPOINTMENT OF VETERANS
HEALTH ADMINISTRATION PERSONNEL.
(a) In General.--Subchapter I of chapter 74 of title 38,
United States Code, is amended by adding at the end the
following new section:
``Sec. 7414. Effect of non-Department covenants not to compete
``(a) Non-Applicability.--Except as provided in subsection
(b), in the case of an individual who is an applicant for
appointment to a position in the Veterans Health Administration
described in section 7401 of this title, any covenant not to
compete into which the individual has entered with a non-
Department facility or party shall have no force or effect with
respect to the appointment of the individual to such a
position.
``(b) Service Obligation.--(1) Any individual who is
appointed to such a position in the Veterans Health
Administration shall, as a condition of such appointment, agree
to provide clinical services at a Department medical facility
for the duration of the period described in paragraph (2).
``(2) The period described in this paragraph is the period
that begins on the date on which an individual is appointed to
such a position and ends on the latter of the following dates:
``(A) The date that is one year after such date of
appointment.
``(B) The date of the termination of any covenant not
to compete entered into between the individual and a
non-Department facility or party.
``(3) The Secretary may waive the requirement under paragraph
(1) with respect to an individual at the discretion of the
Secretary.
``(c) Termination of Department Employment.--In the case of
an individual who is appointed to such a position in the
Veterans Health Administration who has entered into a covenant
not to compete that is rendered non-applicable pursuant to
subsection (a), if the individual's employment at the Veterans
Health Administration is terminated for any reason before the
specified termination date of such covenant, subsection (a)
shall not apply with respect to such covenant after the date of
the termination of the individual's employment at the Veterans
Health Administration.
``(d) Covenant Not To Compete.--In this section, the term
`covenant not to compete' means an agreement--
``(1) between an employee and employer or a
contractor and principal that restricts such employee
or contractor from performing--
``(A) any work for another employer for a
specified period of time;
``(B) any work in a specified geographical
area; or
``(C) work for another employer performing
work that is similar to the work such employee
or contractor performed for the employer or
principal, included as a party to the
agreement; and
``(2) that is entered into after the date of
enactment of this Act.''.
(b) Clerical Amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 7413 the following new item:
``7414. Effect of non-Department covenants not to compete.''.
SEC. 7__. RECRUITMENT OF PHYSICIANS ON A CONTINGENT BASIS PRIOR TO
COMPLETION OF TRAINING REQUIREMENTS.
Section 7402 of title 38, United States Code, is amended--
(1) in subsection (b)(1)--
(A) in the matter preceding subparagraph (A)
by inserting ``or to be offered an appointment
to such position on a contingent basis under
subsection (h)'' after ``position''; and
(B) by striking subparagraph (B) and
inserting the following:
``(B)(i) have completed a residency leading to board
eligibility in a specialty, satisfactory to the
Secretary; or
``(ii) with respect to an offer for an appointment on
a contingent basis under subsection (h), complete such
a residency by not later than two years after the date
of such offer; and''; and
(2) by adding at the end the following new
subsection:
``(h)(1) The Secretary may appoint an individual under
subsection (b)(1) on a contingent basis in accordance with this
subsection if the Secretary reasonably anticipated that the
individual will have completed the requirements for appointment
under such subsection (b)(1) by not later than two years after
the date on which the individual is so appointed.
``(2) An individual who is appointed to a position on a
contingent basis under paragraph (1) shall be appointed to such
position on a permanent basis if, by not later than two years
after the date of the contingent appointment, the individual
completes all the requirements for appointment under subsection
(b)(1).
``(3) An individual who is appointed on a contingent basis
under paragraph (1) who fails to complete the requirements for
appointment under subsection (b)(1) by not later than two years
after the date on which the individual is so appointed may not
be appointed to such position on a permanent basis.''.
----------
13. An Amendment To Be Offered by Representative Jackson Lee of Texas
or Her Designee, Debatable for 10 Minutes
Page 74, after line 19, insert the following new subsection:
(c) Report on National Guard Use of ILER.--Not later than one
year after the date of the enactment of this Act, the Secretary
of Defense shall submit to the appropriate committees of
Congress a report on the feasibility of modifying the
Individual Longitudinal Exposure Record to ensure that a member
of the National Guard who is deployed in the United States in
connection with a natural disaster, without regard to duty
status (including any duty under title 10 or title 32, United
States Code, or State active duty), may record information
regarding a suspected exposure by the member to toxic
substances during such deployment.
----------
14. An Amendment To Be Offered by Representative Levin of Michigan or
His Designee, Debatable for 10 Minutes
Page 19, line 11, insert ``, including mental and physical
health'' after ``individual''.
----------
15. An Amendment To Be Offered by Representative Levin of California or
His Designee, Debatable for 10 Minutes
Add at the end of title VII the following new section:
SEC. 7__. AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO AWARD GRANTS
TO STATES TO IMPROVE OUTREACH TO VETERANS.
(a) In General.--Chapter 63 of title 38, United States Code,
is amended--
(1) by redesignating sections 6307 and 6308 and
sections 6308 and 6309, respectively; and
(2) by inserting after section 6306 the following new
section 6307:
``Sec. 6307. Grants to States to improve outreach to veterans
``(a) Purpose.--It is the purpose of this section to provide
for assistance by the Secretary to States to carry out programs
that--
``(1) improve outreach and assistance to veterans and
the spouses, children, and parents of veterans, to
ensure that such individuals are fully informed about
any veterans and veterans-related benefits and programs
(including State veterans programs) for which they may
be eligible; and
``(2) facilitate opportunities for such individuals
to receive competent, qualified services in the
preparation, presentation, and prosecution of veterans
benefits claims.
``(b) Authority.--The Secretary may award grants to States--
``(1) to carry out, coordinate, improve, or otherwise
enhance outreach activities;
``(2) to increase the number of county or tribal
veterans service officers serving in the State by
hiring new, additional such officers; or
``(3) to expand, carry out, coordinate, improve, or
otherwise enhance existing programs, activities, and
services of the State's existing organization that has
been recognized by the Department of Veterans Affairs
pursuant to section 5902, in the preparation,
presentation, and prosecution of claims for veterans
benefits through representatives who hold positions as
county or Tribal veterans service officers.
``(c) Application.--(1) To be eligible for a grant under this
section, a State shall submit to the Secretary an application
therefor at such time, in such manner, and containing such
information as the Secretary may require.
``(2) Each application submitted under paragraph (1) shall
include the following:
``(A) A detailed plan for the use of the grant.
``(B) A description of the programs through which the
State will meet the outcome measures developed by the
Secretary under subsection (i).
``(C) A description of how the State will distribute
grant amounts equitably among counties (or Tribal
lands, as the case may be) with varying levels of
urbanization.
``(D) A plan for how the grant will be used to meet
the unique needs of American Indian or Alaska Native
veterans, elderly veterans, women veterans, and
veterans from other underserved communities.
``(d) Distribution.--The Secretary shall seek to ensure that
grants awarded under this section are equitably distributed
among States with varying levels of urbanization.
``(e) Priority.--The Secretary shall prioritize awarding
grants under this section that will serve the following areas:
``(1) Areas with a critical shortage of county or
tribal veterans service officers.
``(2) Areas with high rates of--
``(A) suicide among veterans; or
``(B) referrals to the Veterans Crisis Line.
``(f) Use of County or Tribal Veterans Service Officers.--A
State that receives a grant under this section to carry out an
activity described in subsection (b)(1) shall carry out the
activity through--
``(1) a county or Tribal veterans service officer of
the State; or
``(2) if the State does not have a county or tribal
veterans service officer, or if the county or Tribal
veterans service officers of the State cover only a
portion of that State, an appropriate entity of a
State, local, or Tribal government, or another publicly
funded entity, as determined by the Secretary.
``(g) Required Activities.--Any grant awarded under this
section shall be used--
``(1) to expand existing programs, activities, and
services;
``(2) to hire and maintain new, additional county or
Tribal veterans service officers; or
``(3) for travel and transportation to facilitate
carrying out paragraph (1) or (2).
``(h) Other Permissible Activities.--A grant under this
section may be used to provide education and training,
including on-the-job training, for State, county, local, and
tribal government employees who provide (or when trained will
provide) veterans outreach services in order for those
employees to obtain and maintain accreditation in accordance
with procedures approved by the Secretary.
``(i) Outcome Measures.--(1) The Secretary shall develop and
provide to each State that receives a grant under this section
written guidance on the following:
``(A) Outcome measures.
``(B) Policies of the Department.
``(2) In developing outcome measures under paragraph (1), the
Secretary shall consider the following goals:
``(A) Increasing the use of veterans and veterans-
related benefits, particularly among vulnerable
populations.
``(B) Increasing the number of county and tribal
veterans service officers recognized by the Secretary
for the representation of veterans under chapter 59 of
this title.
``(j) Tracking Requirements.--(1) With respect to each grant
awarded under this section, the Secretary shall track the use
of veterans benefits among the population served by the grant,
including the average period of time between the date on which
a veteran or other eligible claimant applies for such a benefit
and the date on which the veteran or other eligible claimant
receives the benefit, disaggregated by type of benefit.
``(2) Not less frequently than annually during the life of
the grant program established under this section, the Secretary
shall submit to Congress a report on--
``(A) the information tracked under paragraph (1);
``(B) how the grants awarded under this section serve
the unique needs of American Indian or Alaska Native
veterans, elderly veterans, women veterans, and
veterans from other underserved communities; and
``(C) other information provided by States pursuant
to the grant reporting requirements.
``(k) Performance Review.--(1) The Secretary shall--
``(A) review the performance of each State that
receives a grant under this section; and
``(B) make information regarding such performance
publicly available.
``(l) Remediation Plan.--(1) In the case of a State that
receives a grant under this section and does not meet the
outcome measures developed by the Secretary under subsection
(i), the Secretary shall require the State to submit a
remediation plan under which the State shall describe how and
when it plans to meet such outcome measures.
``(2) The Secretary may not award a subsequent grant under
this section to a State described in paragraph (1) unless the
Secretary approves the remediation plan submitted by the State.
``(m) Maximum Amount.--The amount of a grant awarded under
this section may not exceed 10 percent of amounts made
available for grants under this section for the fiscal year in
which the grant is awarded.
``(n) Supplement, Not Supplant.--Any grant awarded under this
section shall be used to supplement and not supplant State and
local funding that is otherwise available.
``(o) Authorization of Appropriations.--There is authorized
to be appropriated to the Secretary for each of fiscal years
2023 through 2027, $50,000,000 to carry out this section.
``(p) Definitions.--In this section:
``(1) The term `county or tribal veterans service
officer' includes a local equivalent veterans service
officer.
``(2) The term `State' includes each Indian Tribe,
the District of Columbia, the Commonwealth of Puerto
Rico, the Commonwealth of the Northern Mariana Islands,
and any territory or possession of the United States.
``(3) The term `Veterans Crisis Line' means the toll-
free hotline for veterans established under section
1720F(h) of this title.''.
(b) Clerical Amendment.--The table of sections at the
beginning of chapter 63 of such title is amended by striking
the items relating to sections 6307 and 6308 and inserting the
following new items:
``6307. Grants to States to improve outreach to veterans.
``6308. Outreach for eligible dependents.
``6309. Biennial report to Congress.''.
(c) Authorization of Additional Full-time Equivalent
Employee.--During fiscal years 2023 through 2027, the Secretary
of Veterans Affairs may hire an additional full-time equivalent
employee in the Office of the General Counsel of the Department
of Veterans Affairs, as compared to the number of full-time
equivalent employees that would otherwise be authorized for
such office, to carry out duties under the accreditation,
discipline, and fees program.
----------
16. An Amendment To Be Offered by Representative Newman of Illinois or
Her Designee, Debatable for 10 Minutes
Add at the end of title VII the following new section:
SEC. 7__. STUDY AND REPORT ON HERBICIDE AGENT EXPOSURE IN PANAMA CANAL
ZONE.
(a) Study.--The Secretary of Defense shall conduct a study on
the exposure of members of the Armed Forces to herbicide
agents, including Agent Orange and Agent Purple, in the Panama
Canal Zone during the period beginning on January 1, 1958, and
ending on December 31, 1999.
(b) Report.--Not later than one year after the date of the
enactment of this Act, the Secretary shall submit to Congress a
report on the study conducted under subsection (a).
----------
17. An Amendment To Be Offered by Representative Pappas of New
Hampshire or His Designee, Debatable for 10 Minutes
Page 65, after line 22, insert the following:
SEC. 605. GUIDELINES FOR ACTIVE DUTY MILITARY ON POTENTIAL RISKS AND
PREVENTION OF TOXIC EXPOSURES.
Not later than 90 days after the date of the enactment of
this Act, the Secretary of Defense and the Secretary of
Veterans Affairs shall jointly coordinate and establish
guidelines to be used during training of members of the Armed
Forces serving on active duty to provide the members awareness
of the potential risks of toxic exposures and ways to prevent
being exposed during combat.
----------
18. An Amendment To Be Offered by Representative Plaskett of Virgin
Islands or Her Designee, Debatable for 10 Minutes
At the end of title V, add the following:
SEC. 506. 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
under laws administered by the Secretary of Veterans
Affairs to veterans in Territories 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
of the United States;
(B) the number of veterans in each Territory
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) the number of veterans in each Territory
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 in accessing
health care services, including those involving
the availability of such services to veterans
in the Territory in which the veterans reside,
and the distance required of veterans to
journey to receive services at a regional
medical center of the Veterans Health
Administration, a community-based outpatient
clinic, or other full-service medical facility
of the Department, or death center,
respectively;
(E) a detailed description of obstacles
facing veterans in each Territory in accessing
readjustment counseling services, including
those involving the availability of such
services to veterans in the Territory in which
the veterans reside, and the distance required
of veterans to journey to receive services at a
readjustment counseling services center of the
Department;
(F) a detailed description of obstacles
facing veterans in each Territory in accessing
other veterans benefits, including those
involving the availability of benefits and
services to veterans in the Territory in which
the veterans reside, and the distance required
of the veterans to journey to the nearest
office of the Veterans Benefits Administration;
(G) an analysis of the staffing and
recordkeeping levels and quality of the offices
of the Department charged with serving veterans
in the Territories, including the availability
of the full- and part-time staff of each office
to the veterans they are charged with serving,
and the continuity of care provided by such
staff to such veterans;
(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;
(I) an analysis of the economic and health
consequences for veterans in each Territory
resulting from obstacles to accessing adequate
assistance and health care at facilities of the
Department;
(J) an analysis of the access to assistance
and health care provided to veterans in the
aftermath of major disasters declared in each
of the Territories since September 4, 2017; and
(K) recommendations for improving access of
veterans in the Territories to benefits and
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) Report.--Not later than one year after the date of the
enactment of this Act, the Comptroller General of the United
States shall submit to Congress a final report setting forth
the results of the study conducted under subsection (a),
including the recommendations developed under paragraph (2)(K)
of such subsection.
(c) Territory Defined.--In this section, the term
``Territory'' includes American Samoa, the Commonwealth of the
Northern Marianas Islands, Guam, Puerto Rico, and the Virgin
Islands.
----------
19. An Amendment To Be Offered by Representative Porter of California
or Her Designee, Debatable for 10 Minutes
Add at the end of title V the following new section:
SEC. 507. 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 publically 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) Relation to War Related Illness and Injury Study
Center.--The website developed and maintained under subsection
(a) shall be housed under the website of the War Related
Illness and Injury Study Center of the Department of Veterans
Affairs, or successor center.
(c) Coordination.--In carrying out subsection (a), the
Secretary shall coordinate with--
(1) the heads of each Federal department or 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.
(d) Definitions.--In this section:
(1) 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) The term ``toxic exposure research'' means
research on the health consequences of toxic exposures
experienced during service in the Armed Forces.
----------
20. An Amendment To Be Offered by Representative Ross of North Carolina
or Her Designee, Debatable for 10 Minutes
Page 67, after line 10, insert the following:
(1) Initial report.--Not later than one year after
the date of the enactment of this Act, the Secretary of
Defense shall submit to Congress a report regarding the
following:
(A) Sources of PFAS on military installations
other than AFFF.
(B) Any recommendation of the Secretary
regarding whether to expand eligibility for the
registry to individuals exposed to sources of
PFAS described in subparagraph (A).
Page 67, line 11, strike ``(1) initial'' and insert ``(2)
Interim''.
Page 68, line 3, strike ``(2)'' and insert ``(3)''.
Page 68, line 14, strike ``(3)'' and insert ``(4)''.
----------
21. An Amendment To Be Offered by Representative Ruiz of California or
His Designee, Debatable for 10 Minutes
At the end of title VII, insert the following:
SEC. 707. BUDGET INFORMATION FOR ALTERNATIVES TO BURN PITS.
The Secretary of Defense shall include in the budget
submission of the President under section 1105(a) of title 31,
United States Code, for each of fiscal years 2023 through 2027,
a dedicated budget line item for incinerators and waste-to-
energy waste disposal alternatives to burn pits.
----------
22. An Amendment To Be Offered by Representative Ruiz of California or
His Designee, Debatable for 10 Minutes
At the end of title VII, insert the following:
SEC. 707. BURN PIT REGISTRY UPDATES.
(a) Individuals Eligible to Update.--
(1) In general.--Not later than 180 days after the
date of the enactment of this Act, the Secretary of
Veterans Affairs shall take actions necessary to ensure
that the burn pit registry may be updated with the
cause of death of a deceased registered individual by--
(A) an individual designated by such deceased
registered individual; or
(B) if no such individual is designated, an
immediate family member of such deceased
registered individual.
(2) Designation.--The Secretary shall provide, with
respect to the burn pit registry, a process by which a
registered individual may make a designation for
purposes of paragraph (1)(A).
(b) Definitions.--In this section:
(1) The term ``burn pit registry'' means the registry
established 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) The term ``immediate family member'', with
respect to a deceased individual, means--
(A) the spouse, parent, brother, sister, or
adult child of the individual;
(B) an adult person to whom the individual
stands in loco parentis; or
(C) any other adult person--
(i) living in the household of the
individual at the time of the death of
the individual; and
(ii) related to the individual by
blood or marriage.
(3) The term ``registered individual'' means an
individual registered with the burn pit registry.
----------
23. An Amendment To Be Offered by Representative Ryan of Ohio or His
Designee, Debatable for 10 Minutes
At the end of title VII, add the following:
SEC. 707. BURN PIT TRANSPARENCY.
(a) Short Title.--This section may be cited as the ``SFC
Heath Robinson Burn Pit Transparency Act''.
(b) Notifications and Reports Regarding Reported Cases of
Burn Pit Exposure.--
(1) Quarterly notifications.--
(A) In general.--On a quarterly basis, the
Secretary of Veterans Affairs shall submit to
the appropriate congressional committees a
report on each reported case of burn pit
exposure by a covered veteran reported during
the previous quarter.
(B) Elements.--Each report submitted under
subparagraph (A) shall include, with respect to
each reported case of burn pit exposure of a
covered veteran included in the report, the
following:
(i) Notice of the case, including the
medical facility at which the case was
reported.
(ii) Notice of, as available--
(I) the enrollment status of
the covered veteran with
respect to the patient
enrollment system of the
Department of Veterans Affairs
under section 1705(a) of title
38, United States Code;
(II) a summary of all health
care visits by the covered
veteran at the medical facility
at which the case was reported
that are related to the case;
(III) the demographics of the
covered veteran, including age,
sex, and race;
(IV) any non-Department of
Veterans Affairs health care
benefits that the covered
veteran receives;
(V) the Armed Force in which
the covered veteran served and
the rank of the covered
veteran;
(VI) the period in which the
covered veteran served;
(VII) each location of an
open burn pit from which the
covered veteran was exposed to
toxic airborne chemicals and
fumes during such service;
(VIII) the medical diagnoses
of the covered veteran and the
treatment provided to the
veteran; and
(IX) whether the covered
veteran is registered in the
Airborne Hazards and Open Burn
Pit Registry.
(C) Protection of information.--The Secretary
shall ensure that the reports submitted under
subparagraph (A) do not include the identity of
covered veterans or contain other personally
identifiable data.
(2) Annual report on cases.--
(A) In general.--Not later than 180 days
after the date of the enactment of this Act,
and annually thereafter, the Secretary of
Veterans Affairs, in collaboration with the
Secretary of Defense, shall submit to the
appropriate congressional committees a report
detailing the following:
(i) The total number of covered
veterans.
(ii) The total number of claims 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 for
each such denial, the rationale of the
denial.
(iii) A comprehensive list of--
(I) the conditions for which
covered veterans seek
treatment; and
(II) the locations of the
open burn pits from which the
covered veterans were exposed
to toxic airborne chemicals and
fumes.
(iv) Identification of any illnesses
relating to exposure to open burn pits
that formed the basis for the Secretary
to award benefits, including
entitlement to service connection or an
increase in disability rating.
(v) The total number of covered
veterans who died after seeking care
for an illness relating to exposure to
an open burn pit.
(vi) Any updates or trends with
respect to the information described in
clauses (i), (ii), (iii), (iv), and (v)
that the Secretary determines
appropriate.
(B) Matters included in first report.--The
Secretary shall include in the first report
under paragraph (1) information specified in
paragraph (1)(B) with respect to reported cases
of burn pit exposure made during the period
beginning January 1, 1990, and ending on the
day before the date of the enactment of this
Act.
(3) Information regarding the airborne hazards and
open burn pit registry.--
(A) 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.
(B) 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.
(4) Comptroller general report.--Not later than 180
days after the date of the enactment of this Act, the
Comptroller General of the United States shall submit
to the appropriate congressional committees a report
containing an assessment of the effectiveness of any
memorandum of understanding or memorandum of agreement
entered into by the Secretary of Veterans Affairs with
respect to--
(A) the processing of reported cases of burn
pit exposure; and
(B) the coordination of care and provision of
health care relating to such cases at medical
facilities of the Department of Veterans
Affairs and at non-Department facilities.
(5) Definitions.--In this section:
(A) 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).
(B) The term ``appropriate congressional
committees'' means--
(i) the Committee on Veterans'
Affairs and the Committee on Armed
Services of the Senate; and
(ii) The Committee on Veterans'
Affairs and the Committee on Armed
Services of the House of
Representatives.
(C) The term ``covered veteran'' means a
veteran who presents at a medical facility of
the Department of Veterans Affairs (or in a
non-Department facility pursuant to section
1703 or 1703A of title 38, United States Code)
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 at any time
while serving in the Armed Forces.
(D) 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).
(E) The term ``reported case of burn pit
exposure'' means each instance in which a
veteran presents at a medical facility of the
Department of Veterans Affairs (or in a non-
Department facility pursuant to section 1703 or
1703A of title 38, United States Code) 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 at any time
while serving in the Armed Forces.
----------
24. An Amendment To Be Offered by Representative Scanlon of
Pennsylvania or Her Designee, Debatable for 10 Minutes
Add at the end of title VII the following new section:
SEC. 7__. AUTHORIZATION OF APPROPRIATIONS FOR EXPANSION OF CLAIMS
AUTOMATION.
There is authorized to be appropriated to the Secretary of
Veterans Affairs $150,000,000 for fiscal year 2023 to continue
the modernization and expansion of capabilities and capacity of
the Veterans Benefits Management System of the Department of
Veterans Affairs to support expected increased claims
processing for newly eligible veterans pursuant to this Act and
the amendments made by this Act.
----------
25. An Amendment To Be Offered by Representative Slotkin of Michigan or
Her Designee, Debatable for 10 Minutes
Strike section 501 and insert the following:
SEC. 501. INTERAGENCY WORKING GROUP ON TOXIC EXPOSURE RESEARCH.
(a) In General.--Subchapter II of chapter 73 of title 38,
United States Code, is amended by adding at the end the
following new section:
``Sec. 7330D. Interagency working group on toxic exposure research
``(a) Establishment.--(1) The Secretary shall establish the
Toxic Exposure Research Working Group (in this section referred
to as the `Working Group').
``(2) The Working Group shall consist of employees, selected
by the Secretary, of the following:
``(A) The Department.
``(B) The Department of Defense.
``(C) The Department of Health and Human Services.
``(D) The Environmental Protection Agency.
``(E) Other Federal entities 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 5-year strategic plan for Federal
entities represented in the Working Group to carry out
collaborative research activities.
``(c) Reporting.--The Secretary shall submit, to the
Committees on Veterans' Affairs of the Senate and House of
Representatives, the following:
``(1) Not later than one year after the date of the
enactment of the Act, a report on the establishment of
the Working Group under subsection (a).
``(2) Not later than two years after the date of
enactment of the Act, a report containing the
collaborative research activities identified, and the
Strategic Plan developed, by the Working Group, under
subsection (b).
``(3) Annually during the 5-year period covered by
the strategic plan under subsection (b), a progress
reports on implementation of the Strategic Plan under
subsection (b).
``(d) Termination.--The Working Group shall terminate after
submitting the final report under subsection (c).
``(e) Definitions.--For purposes of this section--
``(1) The term `Act' means the Honoring our Promise
to Address Comprehensive Toxics Act of 2021.
``(2) The term `collaborative research activity'
means a research activity--
``(A) conducted by an entity represented by a
member of the Working Group;
``(B) funded by the Federal Government; and
``(C) regarding the health consequences of
toxic exposures experienced during active
military, naval, air, or space service.''.
(b) Clerical Amendment.--The table of sections at the
beginning of such subchapter is amended by inserting after the
item relating to section 7330C the following new item:
``7330D. Interagency working group on toxic exposure research.''.
(c) Implementation.--The Secretary of Veterans Affairs shall
establish the Working Group under section 7330D of such title,
as added by subsection (a), not later than one year after the
date of the enactment of this Act
----------
26. An Amendment To Be Offered by Representative Spanberger of Virginia
or Her Designee, Debatable for 10 Minutes
Add at the end of title V the following new section:
SEC. 5__. BIENNIAL REPORT ON HEALTH EFFECTS OF JET FUELS USED BY ARMED
FORCES.
Not later than one year after the date of the enactment of
this Act, and biennially thereafter during the subsequent
eight-year period, the Secretary of Veterans Affairs shall
submit to the Committees on Veterans' Affairs of the House of
Representatives and the Senate, and make publicly available, a
report that includes--
(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 Foces to jet fuel; and
(4) an identification of any areas relating to jet
fuel exposure about which new research needs to be
conducted.
----------
27. An Amendment To Be Offered by Representative Torres of California
or Her Designee, Debatable for 10 Minutes
Page 61, after line 15, insert the following:
``(3) Languages.--The Secretary shall publish the
list under paragraph (1) in languages including the
following:
``(A) English.
``(B) Spanish.
``(C) Chinese.
``(D) The seven other most commonly spoken
languages in the United States.''.
----------
28. An Amendment To Be Offered by Representative Torres of California
or Her Designee, Debatable for 10 Minutes
Page 55, line 14, strike ``veterans to'' and insert
``veterans, to''.
Page 55, line 16, strike ``veterans.'' and insert ``veterans,
and on available early detection diagnostics, to determine the
feasibility and advisability of including such diagnostics as
part of the health care furnished to veterans by the
Secretary.''.