S 3373 — Honoring our PACT Act of 2022

Deadline.

Notification.>> 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.

ASSESSMENTS<<NOTE: OF IMPLEMENTATION AND OPERATION.

(a)Deadlines. 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-- (1) complete an assessment to determine-- (A) the personnel and material resources necessary to implement section 103 (including the amendments made by such section);

and38 (B)USC the1710 totalnote.>> numberASSESSMENTS ofOF coveredIMPLEMENTATION veterans,AND asOPERATION. 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;

(a) <<NOTE:

Determinations.>> 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-- (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 [[Page 136 STAT.

1764]] (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;

(B) Of<<NOTE: 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)Time Withperiod.>> respectOf to the veterans specified in subparagraph (B),(A), the costnumber of providing health care to such veterans who, during the yearpreceding coveredthree byfiscal theyears, report,had shownnot inreceived totalsuch andcare disaggregatedor by--services. (i) the level of care;

and(C) (ii)<<NOTE: whether the care was provided through the Veterans Community Care Program.

Costs.>> 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 [[Page 136 STAT.

1765]] (ii) whether the care was provided through the Veterans Community Care Program.

(a) Expanded Period.--Section 1710(e)(3) is<<NOTE: amended-- (1) in subparagraph (A)-- (A) by striking ``January 27, 2003'' and inserting ``September 11, 2001'';

38 USC 1710.>> is amended-- (1) in subparagraph (A)-- (A) by striking ``January 27, 2003'' and inserting ``September 11, 2001'';

``(B)[[Page With136 respectSTAT. 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.'';

1766]] ``(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.'';

(b) Clarification of Coverage.--Section 1710(e)(1)(D) is<<NOTE: amended by inserting after ``Persian Gulf War'' the following:

38 USC 1710.>> is amended by inserting after ``Persian Gulf War'' the following:

(c) Outreach<<NOTE: 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.

Deadline.

Notification.>> 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.

(e) Effective<<NOTE: Date.--This section and the amendments made by this section shall take effect on October 1, 2022.

TITLE38 II--TOXICUSC EXPOSURE1710 PRESUMPTIONnote.>> PROCESSEffective SEC.Date.--This section and the amendments made by this section shall take effect on October 1, 2022.

TITLE II-- <<NOTE:

Toxic Exposure in the American Military Act of 2022.>> TOXIC EXPOSURE PRESUMPTION PROCESS SEC.

SHORT<<NOTE: TITLE.

38 USC 101 note.>> SHORT TITLE.

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

``SUBCHAPTER38 VII--DETERMINATIONSUSC RELATING1101 TOprec.>> PRESUMPTIONSis OFamended SERVICEby CONNECTIONadding BASEDat ONthe TOXICend EXPOSUREthe ``Sec.following new subchapter:

[[Page 136 STAT.

1767]] ``SUBCHAPTER VII <<NOTE:

38 USC 1171 prec.>> --DETERMINATIONS RELATING TO PRESUMPTIONS OF SERVICE CONNECTION BASED ON TOXIC EXPOSURE ``Sec.

Procedures<<NOTE: to determine presumptions of service connection based on toxic exposure;

definitions38 ``(a)USC Procedures.--The1171.>> SecretaryProcedures shallto determine whether to establish, or to remove, presumptions of service connection based on toxic exposureexposure; 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;

anddefinitions ``(ii)``(a) theProcedures.--The publicSecretary anshall opportunitydetermine whether to commentestablish, 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 proposedSecretary formalprovides-- evaluations;``(i) <<NOTE:

``(B)Notice.>> thepublic workingnotice groupregarding establishedwhat underformal subsectionevaluations (b) of such section provides-- ``(i) advice to the Secretary onplans toxic-to exposedconduct; 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;

and ``(ii) <<NOTE:

Public comment.>> the public an opportunity to comment on the proposed formal evaluations;

``(B) <<NOTE:

Recommenda- tions.>> 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;

``(2) the<<NOTE: 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 of this title;

Evaluations.>> the Secretary provides for formal evaluations of such recommendations under section 1173 of this title and ``(3)takes into account reports received by the Secretary issuesfrom regulationsthe National Academies of Sciences, Engineering, and Medicine under section 11741176 of this title.title;

and ``(3) <<NOTE:

Regulations.>> the Secretary issues regulations under section 1174 of this title.

``Sec.[[Page 136 STAT.

1768]] ``Sec.

Annual<<NOTE: 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.

38 USC 1172.>> Annual notice and opportunity for public comment ``(a) <<NOTE:

Federal Register, publications.>> 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) To<<NOTE: 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.

Evaluation.

Time period.>> 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.

``(b) Working<<NOTE: Group.--(1) The Secretary shall establish a working group within the Department (in this section referred to as the `Working Group').

Establishment.>> Working Group.--(1) The Secretary shall establish a working group within the Department (in this section referred to as the `Working Group').

``(3) The<<NOTE: 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;

Consultation.>> 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;

``(3)[[Page The136 WorkingSTAT. Group may conduct an assessment under paragraph (1) in response to a comment received under paragraph (2) or (3) of subsection (a).

``(4)1769]] ``(3) The Working Group shall,may inconduct consultationan withassessment theunder Secretaryparagraph of(1) Defense,in onresponse to a periodiccomment basis,received assessunder theparagraph Individual(2) Longitudinalor Exposure(3) Record to ensure the accuracy of datasubsection collected.(a).

``(d)``(4) Development<<NOTE: 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.

Consultation.>> 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) <<NOTE:

Determination.>> 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.

``(e) Reports<<NOTE: 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;

Time period.

Public information.

Recommenda- tions.>> 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;

``(f) Responses<<NOTE: 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 of this title.

Deadline.

Evaluation.>> 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.

Formal<<NOTE: 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.

Reviews.

Determinations.

38 USC 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)[[Page the136 quantitySTAT. and quality of the information available and reviewed;

1770]] ``(B) the quantity and quality of the information available and reviewed;

and ``(ii) assesses<<NOTE: 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)Assessments.>> Inassesses carryingthe outtoxic paragraphexposures (1)(B)(ii),and aillnesses formaland evaluationdetermines underwhether subsectionthe (a)evidence shallsupports includea reviewingfinding all relevant data to determine the strength of evidence for a positive association basedbetween on the followingtoxic fourexposure categories:and the illness.

``(2) <<NOTE:

Data.>> 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:

``(d) Recommendation for Establishing a Presumption of Service Connection.--NotConnection.-- later<<NOTE: 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.

Deadline.>> 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.

Regulations<<NOTE: 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;

38 USC 1174.>> Regulations regarding presumptions of service connection based on toxic exposure ``(a) <<NOTE:

Deadline.

Determinations.>> 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-- [[Page 136 STAT.

1771]] ``(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;

or ``(2) if<<NOTE: 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.

Federal Register, publication.

Notice.>> 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.

Authority<<NOTE: to modify process;

38 USC 1175.>> Authority to modify process;

and ``(2) a<<NOTE: period of 180 days has elapsed following the date on which the Secretary submits the notice under subsection (b) regarding the modification.

``(b)Time Notice.--Ifperiod.>> thea Secretaryperiod proposes to modify the process under which the working group established under subsection (b) of section180 1172days ofhas thiselapsed titlefollowing conducts assessments under such section, the processdate underon which the Secretary conductssubmits 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 ofunder thesubsection proposed(b) modificationsregarding containing the following:modification.

``(b) Notice.--If the Secretary proposes to modify the process under which the working group established under subsection (b) [[Page 136 STAT.

1772]] 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:

Agreement<<NOTE: 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)38 Agreement.--(1)USC The1176.>> SecretaryAgreement shall seek to enter into a five-year agreement with theNational Academies toof performSciences, theEngineering, servicesand coveredMedicine byconcerning thistoxic section.exposures ``(a) <<NOTE:

``(2)Reviews. 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)Evaluations.>> AnPurpose.--The agreementpurpose underof this section mayis beto extendedprovide infor five-yearthe increments.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.

``(c)``(b) Review<<NOTE: 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.

Time periods.>> 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) <<NOTE:

Deadline.>> 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) <<NOTE:

Extension authority.>> An agreement under this section may be extended in five-year increments.

``(c) <<NOTE:

Summary.

Assessment.>> 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.

``(e)[[Page Cooperation136 ofSTAT. 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.

1773]] ``(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.

``(i) The<<NOTE: determinations described in subsection (d).

Determinations.>> The determinations described in subsection (d).

``(iii) Any<<NOTE: recommendations of the Academies under subsection (f).

``(2)Recommenda- Undertions.>> anAny agreementrecommendations 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 thesubsection agreement.(f).

``(2) <<NOTE:

Time period.

Update.>> 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.

(b) Reports and Briefings.-- (1)[[Page Report.--136 (A)STAT. 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).

1774]] (1) Report.-- (A) <<NOTE:

Recommenda- tions.>> 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).

(2) Briefing.--On<<NOTE: 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)Time Independentperiods.>> Assessment.--Briefing.--On (1)a Agreement.--Thequarterly Secretarybasis shallduring seekthe totwo-year enterperiod intobeginning anon agreementthe withdate of the Nationalenactment Academies of Science,this Engineering,Act, andthe MedicineSecretary (inshall thisprovide subsectionto referredthe toCommittee ason theVeterans' ``Academies'')Affairs beforeof the dateSenate thatand isthe 90Committee dayson afterVeterans' Affairs of the dateHouse of Representatives a briefing on the enactmentimplementation of thissubchapter ActVII toof performchapter the11 servicesof setsuch forthtitle, underas paragraphadded (2).by subsection (a).

(c) Independent Assessment.-- (1) <<NOTE:

Deadline.>> 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).

(i) An<<NOTE: 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.

Determination.>> 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) <<NOTE:

Recommenda- tions.>> provide recommendations for improvements to the process.

(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[[Page on136 termsSTAT. 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;

1775]] 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;

(d) Conforming<<NOTE: Amendments.--Chapter 11 is amended-- (1) in section 1116-- (A) by striking subsections (b), (c), (d), and (e);

Determinations.>> Conforming Amendments.--Chapter 11 is amended-- (1) <<NOTE:

38 USC 1116.>> in section 1116-- (A) by striking subsections (b), (c), (d), and (e);

``(b) The<<NOTE: 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 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).'';

Assessments.>> 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).'';

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

38 USC 1101 prec.>> is amended by adding at the end the following new section:

Outreach<<NOTE: 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)38 wereUSC evaluated1167.>> andOutreach deniedpursuant byto 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 beforeshall-- the``(1) dateidentify onall whichclaims suchfor provisioncompensation ofunder lawthis wentchapter intothat-- effect;``(A) were submitted to the Secretary;

[[Page 136 STAT.

1776]] ``(B) were evaluated and denied by the Secretary before the date on which such provision of law went into effect;

``(A) The<<NOTE: Secretary shall publish on the internet website of the Department a notice that such veterans may elect to file a supplemental claim.

``(B)Web Theposting. Secretary shall notify, in writing or by electronic means, veterans service organizations of the ability of such veterans to file a supplemental claim.

Notice.>> The Secretary shall publish on the internet website of the Department a notice that such veterans may elect to file a supplemental claim.

``(B) <<NOTE:

Notification.>> The Secretary shall notify, in writing or by electronic means, veterans service organizations of the ability of such veterans to file a supplemental claim.

(b) Application.--Section<<NOTE: 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)38 RuleUSC of1167 Construction.--Nothingnote.>> inApplication.--Section this1167 sectionof shalltitle be38, construedUnited as--States (1)Code, modifyingas theadded obligationsby ofsubsection the(a), Departmentshall ofapply Veteranswith Affairsrespect underto Federalpresumptions courtof decisionsservice orconnection settlementsestablished inor effectmodified ason ofor after the date of the enactment of this Act;Act, including pursuant to amendments made by this Act.

(c) <<NOTE:

38 USC 1167 note.>> 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;

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

38 USC 1301 prec.>> is amended by adding at the end the following new section:

Reevaluation<<NOTE: 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;

38 USC 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;

``(2)[[Page allow136 forSTAT. the reevaluation of such claims at the election of the claimant;

1777]] ``(2) allow for the reevaluation of such claims at the election of the claimant;

``(A) The<<NOTE: Secretary shall publish on the internet website of the Department a notice that such claimants may elect to have a claim so reevaluated.

``(B)Web Theposting. 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.

Notice.>> 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) <<NOTE:

Notification.>> 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.

(b) Application.--Section<<NOTE: 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)38 RuleUSC of1305 Construction.--Nothingnote.>> inApplication.--Section this1305 sectionof shalltitle be38, construedUnited States Code, as modifyingadded theby obligationssubsection of(a), theshall Departmentapply ofwith Veteransrespect Affairsto underpresumptions Federalof courtservice decisionsconnection established or settlementsmodified inon effector asafter of the date of the enactment of this Act, including pursuant to amendments made by this Act.

TITLE(c) III--IMPROVING<<NOTE: THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS FOR TOXIC-EXPOSED VETERANS SEC.

38 USC 1305 note.>> 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--I <<NOTE:

Veterans Burn Pits Exposure Recognition Act of 2022.>> MPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS FOR TOXIC-EXPOSED VETERANS SEC.

SHORT<<NOTE: TITLE.

38 USC 101 note.>> SHORT TITLE.

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

38 USC 1101 prec.>> amended by adding at the end the following new section:

Presumptions<<NOTE: 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;

and38 ``(2)USC if1119.>> noPresumptions recordof toxic exposure ``(a) Consideration of theRecords.--If a veteran insubmits anto exposurethe trackingSecretary recorda systemclaim indicatesfor thatcompensation thefor veterana wasservice-connected subjectdisability tounder 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 totalitySecretary ofmay, thein circumstancesadjudicating ofsuch theclaim, serviceconsider-- ``(1) any record of the veteran.veteran in an exposure tracking record system;

and [[Page 136 STAT.

1778]] ``(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.

``(2) The<<NOTE: 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;

andDeterminations.>> ``(B)The determine,Secretary usingshall-- procedures``(A) consistent<<NOTE: with section 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)List.>> Beginningestablish notand latermaintain thana twolist yearsthat aftercontains thean dateidentification of theone enactmentor ofmore thesuch Sergeantsubstances, Firstchemicals, Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022, and notairborne lesshazards frequentlyas thanthe onceSecretary, everyin twocollaboration yearswith thereafter, the Secretary shall submit to the Committee on Veterans' Affairs of theDefense, Senatemay anddetermine theappropriate Committeefor onpurposes Veterans' Affairs of thethis Housesection; of Representatives a report identifying any additions or removals to the list under paragraph (2) during the period covered by the report.

and ``(B) <<NOTE:

Evaluation.>> 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) <<NOTE:

Reports.

Time period.>> 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.

``(1) The<<NOTE: 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;

Effective dates.>> 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;

``(vii)[[Page Yemen;136 STAT.

1779]] ``(vii) Yemen;

or ``(ix) any<<NOTE: other country determined relevant by the Secretary.

Determination.>> any other country determined relevant by the Secretary.

Medical<<NOTE: 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 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;

38 USC 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 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;

``(b) Exception.--Subsection<<NOTE: (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.

Determination.>> 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.

TITLE[[Page IV--PRESUMPTIONS136 OFSTAT. SERVICE CONNECTION SEC.

1780]] TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION SEC.

TREATMENT<<NOTE: 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)Mark ShortTakai Title.--ThisAtomic sectionVeterans mayHealthcare beParity citedAct asof the2022.>> ``MarkTREATMENT TakaiOF AtomicVETERANS VeteransWHO HealthcarePARTICIPATED ParityIN ActCLEANUP ofOF 2022''.ENEWETAK ATOLL AS RADIATION-EXPOSED VETERANS FOR PURPOSES OF PRESUMPTION OF SERVICE CONNECTION OF CERTAIN DISABILITIES BY DEPARTMENT OF VETERANS AFFAIRS.

(b)(a) Enewetak<<NOTE: Atoll.--Section 1112(c)(3)(B) is amended by adding at the end the following new clause:

``(v)38 CleanupUSC of101 Enewetaknote.>> AtollShort duringTitle.--This thesection periodmay beginningbe oncited Januaryas 1,the 1977,``Mark andTakai endingAtomic onVeterans DecemberHealthcare 31,Parity 1980.''.Act of 2022''.

(b) Enewetak Atoll.--Section 1112(c)(3)(B) <<NOTE:

38 USC 1112.>> is amended by adding at the end the following new clause:

``(v) <<NOTE:

Time period.>> Cleanup of Enewetak Atoll during the period beginning on January 1, 1977, and ending on December 31, 1980.''.

TREATMENT<<NOTE: 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)Palomares Shortor Title.--ThisThule sectionVeterans mayAct beof cited2022.>> asTREATMENT theOF ``PalomaresVETERANS orWHO ThulePARTICIPATED VeteransIN ActNUCLEAR ofRESPONSE 2022''.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.

(b)(a) Palomares<<NOTE: or Thule.--Section 1112(c)(3)(B), as amended by section 401, is further amended by adding at the end the following new clauses:

38 USC 101 note.>> Short Title.--This section may be cited as the ``Palomares or Thule Veterans Act of 2022''.

(b) <<NOTE:

Time periods.>> 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:

PRESUMPTIONS<<NOTE: OF SERVICE CONNECTION FOR DISEASES ASSOCIATED WITH EXPOSURES TO CERTAIN HERBICIDE AGENTS FOR VETERANS WHO SERVED IN CERTAIN LOCATIONS.

(a)Veterans ShortAgent Title.--ThisOrange sectionExposure mayEquity beAct citedof as2022.>> thePRESUMPTIONS ``VeteransOF AgentSERVICE OrangeCONNECTION ExposureFOR EquityDISEASES ActASSOCIATED ofWITH 2022''.EXPOSURES TO CERTAIN HERBICIDE AGENTS FOR VETERANS WHO SERVED IN CERTAIN LOCATIONS.

(b)(a) In<<NOTE: 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)38 byUSC striking101 ``performednote.>> activeShort military,Title.--This naval,section air,may orbe spacecited serviceas in the Republic``Veterans ofAgent VietnamOrange duringExposure theEquity periodAct beginningof on2022''. January 9, 1962, and ending on May 7, 1975'' each place it appears and inserting ``performed covered service'';

(b) <<NOTE:

Time periods.>> 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'' [[Page 136 STAT.

1781]] each place it appears and inserting ``performed covered service'';

``(d) In<<NOTE: 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;

Definition.>> 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;

(c) Eligibility for Hospital Care and Medical Services.--Section 1710(e)(4), as amended by section 102(c), is<<NOTE: further amended by striking subparagraph (A) and inserting the following new subparagraph:

``(A)38 TheUSC term1710.>> `Vietnam-erais herbicide-exposedfurther veteran'amended meansby astriking veteransubparagraph who--(A) ``(i)and performedinserting coveredthe service,following asnew definedsubparagraph: in section 1116(d) of this title;

``(A) <<NOTE:

Definition.>> The term `Vietnam-era herbicide-exposed veteran' means a veteran who-- ``(i) performed covered service, as defined in section 1116(d) of this title;

(d) Conforming Amendment.--The heading for section 1116 is<<NOTE: amended by striking ``the Republic of Vietnam'' and inserting ``certain locations''.

(e)38 EffectiveUSC Date1101 andprec, Applicability.--The1116.>> amendmentsis madeamended by thisstriking section``the shallRepublic take effect on the date of theVietnam'' enactment of this Act and shallinserting apply``certain aslocations''. follows:

(1)(e) On<<NOTE: 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;

38 USC 1116 note.>> 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) <<NOTE:

Determination.>> 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;

SEC.[[Page 136 STAT.

1782]] SEC.

ADDITION<<NOTE: 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)Fair ShortCare Title.--Thisfor sectionVietnam mayVeterans beAct citedof as2022.>> theADDITION ``FairOF CareADDITIONAL forDISEASES VietnamASSOCIATED VeteransWITH ActEXPOSURE ofTO 2022''.CERTAIN HERBICIDE AGENTS FOR WHICH THERE IS A PRESUMPTION OF SERVICE CONNECTION FOR VETERANS WHO SERVED IN CERTAIN LOCATIONS.

(b)(a) Monoclonal<<NOTE: 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:

38 USC 101 note.>> 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 <<NOTE:

38 USC 1116.>> States Code, is amended by adding at the end the following new subparagraph:

(d) Effective<<NOTE: 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)38 OnUSC the1116 datenote.>> ofEffective theDates enactmentand ofApplicability.-- this(1) ActMonoclonal forgammopathy claimantsof forundetermined dependencysignificance.-- and(A) indemnityIn compensationgeneral.--The underamendment chaptermade 13by ofsubsection title(b) 38,shall Unitedtake Stateseffect Code,on andthe fordate veteransof whom the Secretaryenactment of Veteransthis AffairsAct determinesand are--shall (I)apply terminallyas ill;follows:

(i) <<NOTE:

Determination.>> 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;

(B) Retroactive<<NOTE: 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.

Claims.>> 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.

(i) On<<NOTE: 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;

Determination.>> 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;

or (V)[[Page capable136 ofSTAT. demonstrating other sufficient cause.

1783]] (V) capable of demonstrating other sufficient cause.

(B) Retroactive<<NOTE: 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.

Claims.>> 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.

(a) Reduction in Threshold of Eligibility.--Subsection (a)(1) of section 1117 is<<NOTE: 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.''.

38 USC 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.''.

``(2) Not<<NOTE: 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).''.

Reports.>> 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).''.

PRESUMPTION<<NOTE: OF SERVICE CONNECTION FOR CERTAIN DISEASES ASSOCIATED WITH EXPOSURE TO BURN PITS AND OTHER TOXINS.

(a)Presumptive Short Title.--This section may be cited as the ``Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2022''.2022.>> PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN DISEASES ASSOCIATED WITH EXPOSURE TO BURN PITS AND OTHER TOXINS.

(b)(a) In<<NOTE: General.--Subchapter II of chapter 11, as amended by section 302, is further amended by inserting after section 1119 the following new section:

38 USC 101 note.>> Short Title.--This section may be cited as the ``Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2022''.

[[Page 136 STAT.

1784]] (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:

Presumption<<NOTE: 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.

38 USC 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.

``(15) Any<<NOTE: 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.

Determination.>> 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) Conforming Amendment.--Section 1113 is<<NOTE: amended by striking ``or 1118'' each place it appears and inserting ``1118, or 1120''.

(d)38 EffectiveUSC Date1113.>> andis Applicability.--Theamended amendments made by thisstriking section``or shall1118'' takeeach effectplace onit theappears date of the enactment of this Act and shallinserting apply``1118, asor follows:1120''.

(1)(d) On<<NOTE: 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;

38 USC 1120 note.>> 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:

[[Page 136 STAT.

1785]] (1) <<NOTE:

Determination.>> 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;

RULE<<NOTE: OF CONSTRUCTION.

38 USC 101 note.>> RULE OF CONSTRUCTION.

(a) Establishment.-- (1) In<<NOTE: 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'').

Deadline.>> 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'').

(E)[[Page Other136 entitiesSTAT. of the Federal Government involved in research activities regarding the health consequences of toxic exposures experienced during active military, naval, air, or space service.

1786]] (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.

(2) Develop<<NOTE: a five-year strategic plan for such entities to carry out collaborative research activities.

Time period.

Strategic plan.>> Develop a five- year strategic plan for such entities to carry out collaborative research activities.

ANALYSIS<<NOTE: AND REPORT ON TREATMENT OF VETERANS FOR MEDICAL CONDITIONS RELATED TO TOXIC EXPOSURE.

(a)38 InUSC General.--The527 Secretarynote.>> ofANALYSIS VeteransAND AffairsREPORT shallON analyze,TREATMENT onOF aVETERANS continuousFOR basis,MEDICAL allCONDITIONS clinicalRELATED dataTO that--TOXIC (1)EXPOSURE. 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;

(a) <<NOTE:

Data.>> 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;

(b) Annual Report.--Not later than one year after the date of the enactment of this Act, and annually thereafter, the Secretary shall[[Page submit136 toSTAT. the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report containing the following:

1787]] 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:

(a) Analysis.-- (1) In<<NOTE: 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.

Deadline.

Coordination.

Update.>> 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.

(b) Covered<<NOTE: 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;

Effective dates.>> 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;

(D)[[Page Jordan;136 STAT.

1788]] (D) Jordan;

STUDY<<NOTE: ON HEALTH TRENDS OF POST-9/11 VETERANS.

Time period.>> STUDY ON HEALTH TRENDS OF POST- 9/11 VETERANS.

(a) In<<NOTE: 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.

Determination.>> 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.

(a) Study.--Not<<NOTE: 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;

orDeadline. (2) resided at or near, as determined by the Secretary, the locations described in subsection (b).

(b)Contracts.>> CoveredStudy.--Not Locations.--Thelater locationsthan described180 indays after the date of the enactment of this subsectionAct, arethe Secretary of Veterans Affairs shall enter into an agreement with the followingNational locations: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) <<NOTE:

Determination.>> resided at or near, as determined by the Secretary, the locations described in subsection (b).

(b) <<NOTE:

State listing.>> Covered Locations.--The locations described in this subsection are the following locations:

(4) Any<<NOTE: other location that is proximate to covered waste, as determined by the Secretary.

(c)Determination.>> Elements.--TheAny studyother underlocation subsectionthat (a)is shallproximate assess, with respect to eachcovered veteranwaste, includedas indetermined theby study, the following:Secretary.

(c) <<NOTE:

Assessments.>> Elements.--The study under subsection (a) shall assess, with respect to each veteran included in the study, the following:

(4) A<<NOTE: 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)Determination.>> Report.--NotA latercomparison thanof three years after the dateoverall ofhealth thecondition enactment of this Act, the Secretaryveteran, shallincluding submitany toillness the Committee on Veterans' Affairs of the Senateveteran andidentified thepursuant Committeeto onparagraph Veterans'(3), Affairswith of the Houseoverall ofhealth Representativescondition a report on the study under subsection (a) and include in such report an analysis of thepast data[[Page available136 andSTAT. data reliability.

1789]] and present civilian populations residing at the same location of exposure, as determined by the Secretary.

(d) <<NOTE:

Analysis.

Data.>> 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.

(a) Study<<NOTE: 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.

Deadline.

Contracts.

Assessment.>> 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.

(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[[Page of136 theSTAT. National Academies of Sciences, Engineering, and Medicine with respect to the study conducted under subsection (a).

1790]] findings of the National Academies of Sciences, Engineering, and Medicine with respect to the study conducted under subsection (a).

(G) an<<NOTE: 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)Analysis.>> an analysis of the availabilitystaffing and quality of the Veteransoffices Communityof Carethe ProgramVeterans establishedBenefits underAdministration sectionand 1703Veterans ofHealth titleAdministration 38,charged Unitedwith Statesserving Code, to veterans in eachthe TerritoryTerritories and Freely Associated State;States, including the [[Page 136 STAT.

(I)1791]] anavailability analysis of the economicfull- and healthpart-time outcomesstaff forof veterans in each Territoryoffice or Freely Associated State resulting from obstacles to accessingthe adequateveterans assistancethey andare healthcharged carewith atserving; facilities of the Department;

(J)(H) an<<NOTE: 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;

andAnalysis.>> (K)an suchanalysis recommendationsof as the Comptrolleravailability General considers appropriate for improving access of veterans in the TerritoriesVeterans andCommunity FreelyCare AssociatedProgram Statesestablished tounder benefitssection and1703 healthof caretitle services38, furnishedUnited byStates theCode, Secretary,to andveterans reducing barriers and deficits in theeach availabilityTerritory and accessibilityFreely ofAssociated suchState; benefits and services compared to veterans elsewhere in the United States.

(b)(I) Briefing.--Not<<NOTE: 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.

Analysis.>> 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) <<NOTE:

Analysis.

Time period.>> 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) <<NOTE:

Recommenda- tions.>> 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) <<NOTE:

Deadline.

Recommenda- tions.>> 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.

DEPARTMENT<<NOTE: OF VETERANS AFFAIRS PUBLIC WEBSITE FOR TOXIC EXPOSURE RESEARCH.

(a)38 Website.--NotUSC later527 thannote.>> oneDEPARTMENT yearOF afterVETERANS theAFFAIRS datePUBLIC ofWEBSITE theFOR enactmentTOXIC ofEXPOSURE thisRESEARCH. 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.

(a) <<NOTE:

Deadline.>> 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.

(1)[[Page Toxic136 exposure.--TheSTAT. term ``toxic exposure'' has the meaning given that term in section 101 of title 38, United States Code, as added by section 102(b).

1792]] (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).

(a) Initial<<NOTE: 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.

Public information.>> 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.

(c) Follow-up<<NOTE: 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.

TITLEUpdate.>> VI--IMPROVEMENTFollow-up OFReport.--Not RESOURCESlater ANDthan TRAININGfive REGARDINGyears TOXIC-EXPOSEDafter VETERANSthe SEC.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 <<NOTE:

Fairly Assessing Service-related Toxic Exposure Residuals Presumptions Act of 2022.>> --IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED VETERANS SEC.

SHORT<<NOTE: TITLE;

38 USC 1101 note prec.>> SHORT TITLE;

PUBLICATION<<NOTE: 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)38 PublicationUSC of1101 Listnote ofprec.>> Resources.--PUBLICATION (1)OF InLIST general.--NotOF laterRESOURCES thanOF oneDEPARTMENT yearOF afterVETERANS theAFFAIRS dateFOR ofTOXIC-EXPOSED theVETERANS enactmentAND ofVETERANS thisWHO Act,REPORT andTOXIC annuallyEXPOSURES thereafter,AND theOUTREACH SecretaryPROGRAM ofFOR VeteransSUCH AffairsVETERANS shallAND publishCAREGIVERS aAND listSURVIVORS ofOF resourcesSUCH ofVETERANS. the Department of Veterans Affairs for-- (A) toxic-exposed veterans and veterans who report toxic exposure;

(a) Publication of List of Resources.-- (1) <<NOTE:

Deadline.

Time period.>> 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-- [[Page 136 STAT.

1793]] (A) toxic-exposed veterans and veterans who report toxic exposure;

INCORPORATION<<NOTE: OF TOXIC EXPOSURE SCREENING FOR VETERANS.

(a)38 InUSC General.--Beginning1101 notnote laterprec.>> thanINCORPORATION 90OF daysTOXIC afterEXPOSURE theSCREENING dateFOR ofVETERANS. 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.

(a) <<NOTE:

Deadline.

Determination.>> 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.

(e) Screening<<NOTE: 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.Time period.>> 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.

[[Page 136 STAT.

1794]] SEC.

TRAINING<<NOTE: FOR PERSONNEL OF THE DEPARTMENT OF VETERANS AFFAIRS WITH RESPECT TO VETERANS WHO REPORT TOXIC EXPOSURES.

38 USC 1101 note prec.>> TRAINING FOR PERSONNEL OF THE DEPARTMENT OF VETERANS AFFAIRS WITH RESPECT TO VETERANS WHO REPORT TOXIC EXPOSURES.

(a) Authority.--The<<NOTE: 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.

(b)38 PlanUSC for324 Modernizationnote.>> Authority.--The Secretary of Veterans BenefitsAffairs Administrationmay Informationuse, Technologyfrom Systems.--amounts (1)appropriated Into general.--Notthe laterCost thanof 180War daysToxic afterExposures theFund dateestablished by section 324 of thetitle enactment38, United States Code, as added by section 805 of this Act, thesuch Secretaryamounts ofas Veteransmay Affairsbe shallnecessary submit to continue the appropriatemodernization, congressionaldevelopment, committeesand aexpansion planof forcapabilities theand modernizationcapacity of the information technology systems and infrastructure of the Veterans Benefits Administration.Administration, including for claims automation, to support expected increased claims processing for newly eligible veterans pursuant to this Act.

The(b) planPlan shallfor coverModernization the first fiscal year that begins after the date of theVeterans enactmentBenefits ofAdministration thisInformation ActTechnology andSystems.-- the(1) subsequent<<NOTE: four fiscal years and shall include each of the following:

Deadline.>> 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.

<<NOTE:

Time periods.>> 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:

(iii) Automation should be carried out in a manner that achieves greater consistency in the processing and rating[[Page of136 claimsSTAT. by relying on patterns of similar evidence in claim files.

1795]] rating of claims by relying on patterns of similar evidence in claim files.

(D) Cost<<NOTE: estimates for the modernization of each information system identified under paragraph (A) for each fiscal year covered by the plan and in total.

(2)Cost Appropriateestimates.>> congressionalCost committees.--Inestimates thisfor section, the termmodernization ``appropriateof congressionaleach committees''information means--system (A)identified theunder Committeeparagraph on(A) Veterans'for Affairseach andfiscal theyear Subcommitteecovered onby Militarythe Construction,plan Veterans Affairs, and Relatedin Agenciestotal. of the Committee on Appropriations of the Senate;

(2) <<NOTE:

Definition.>> 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;

(a) In<<NOTE: General.--The Secretary of Veterans Affairs may carry out the following major medical facility leases in fiscal year 2023:

State listing.>> In General.--The Secretary of Veterans Affairs may carry out the following major medical facility leases in fiscal year 2023:

(5)[[Page Lease136 forSTAT. an outpatient clinic in the vicinity of Beaufort, South Carolina, in an estimated amount of $24,254,000.

1796]] (5) Lease for an outpatient clinic in the vicinity of Beaufort, South Carolina, in an estimated amount of $24,254,000.

(b)[[Page Treatment136 ofSTAT. 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.

1797]] (b) Treatment of <<NOTE:

Effective date.>> 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.

and (C)[[Page by136 strikingSTAT. ``or a major medical facility lease (as defined in subsection (a)(3)(b))'';

1798]] (C) by striking ``or a major medical facility lease (as defined in subsection (a)(3)(b))'';

``(B) An<<NOTE: estimate of the cost to the Federal Government of the facility to be leased.

``(C)Cost estimate.>> An estimate of the energycost performanceto of the proposedFederal leaseGovernment space, to include a description of anticipatedthe utilizationfacility ofto renewablebe energy,leased. energy efficient and climate resilient elements, and related matters.

``(D)``(C) Current<<NOTE: 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)Estimate.>> AAn detailedestimate analysis of how the leaseenergy isperformance expectedof tothe complyproposed withlease Officespace, ofto Managementinclude anda Budgetdescription Circularof A-11anticipated andutilization section 1341 of titlerenewable 31energy, (commonlyenergy referredefficient toand asclimate theresilient `Anti-elements, Deficiencyand Act').related matters.

``(D) <<NOTE:

Data.

Time periods.>> 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) <<NOTE:

Analyses.

Compliance.>> 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').

``(2) In<<NOTE: this subsection, the term `interim leasing actions' has the meaning given that term by the Administrator of the General Services Administration.''.

Definition.>> In this subsection, the term `interim leasing actions' has the meaning given that term by the Administrator of the General Services Administration.''.

``(j)[[Page The136 SecretarySTAT. 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)1799]] Applicability.--The``(j) amendmentsThe madeSecretary bymay thisobligate sectionand shallexpend applyfunds with respect to anyexercise leasea thatpurchase hasoption notincluded beenin specificallyany authorizedmajor bymedical lawfacility onlease or(as beforedefined thein datesubsection of(a)(3)(B)).''. the enactment of this Act.

(f) <<NOTE:

38 USC 8104 note.>> 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.

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

``(h)(1) Notwithstanding<<NOTE: 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)Determination.>> InNotwithstanding thisany subsection: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) <<NOTE:

Definitions.>> In this subsection:

``(2)(A) The<<NOTE: 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;

Determination.>> 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;

``(ii)[[Page provide136 directSTAT. services or benefits targeted to veterans;

1800]] ``(ii) provide direct services or benefits targeted to veterans;

(b) Extension of Maximum Term of Enhanced-use Lease.--Section 8162(b)(2) of such title is<<NOTE: amended by striking ``75 years'' and inserting ``99 years''.

38 USC 8162.>> is amended by striking ``75 years'' and inserting ``99 years''.

(d) Repeal<<NOTE: of Sunset.--Section 8169 of such title is repealed.

(e)38 Appropriation.--InUSC addition8101 toprec.>> amountsRepeal otherwise available, there is appropriated for fiscal year 2022, out of anySunset.--Section funds8169 in the Treasury not otherwise appropriated, $922,000,000 for an additional amount for the Department of Veteranssuch Affairs, to remain available until expended, to enter into enhanced-use leases pursuant to section of title 38,is Unitedrepealed. States Code, as amended by this section.

(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.

``(3) The<<NOTE: 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.'';

Transfer authority.>> 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.'';

``(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[[Page of136 theSTAT. Department of Veterans Affairs and may be used for such purpose.''.

1801]] account of the Department of Veterans Affairs and may be used for such purpose.''.

(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;

The Secretary<<NOTE: 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.

Time period.>> 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.

BIENNIAL<<NOTE: BRIEFING ON INDIVIDUAL LONGITUDINAL EXPOSURE RECORD.

(a)10 InUSC General.--Not1071 laternote.>> thanBIENNIAL oneBRIEFING yearON afterINDIVIDUAL theLONGITUDINAL dateEXPOSURE onRECORD. 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;

(a) <<NOTE:

Deadline.

Determination.

Consultation.>> 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;

(b) Elements.--Each<<NOTE: briefing required by subsection (a) shall include, for the period covered by the report, the following:

(1)Recommenda- Antions.>> identificationElements.--Each ofbriefing potentialrequired exposuresby tosubsection occupational(a) orshall environmentalinclude, hazardsfor captured by the currentperiod systemscovered ofby the Departmentreport, ofthe Defensefollowing: for environmental, occupational, and health monitoring, and recommendations for how to improve those systems.

(2)(1) An analysisidentification of the quality and accuracy of the location data used by the Department of Defense in determining potential exposures to occupational or environmental hazards captured by members of the Armedcurrent Forcessystems andof veterans,the andDepartment recommendationsof Defense for howenvironmental, tooccupational, improve[[Page the136 qualitySTAT. of such data if necessary.

1802]] and health monitoring, and recommendations for how to improve those systems.

(2) <<NOTE:

Analysis.

Determination.>> 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.

CORRECTION<<NOTE: OF EXPOSURE RECORDS BY MEMBERS OF THE ARMED FORCES AND VETERANS.

(a)38 InUSC General.--The1171 Secretarynote.>> ofCORRECTION VeteransOF AffairsEXPOSURE shallRECORDS coordinateBY withMEMBERS theOF SecretaryTHE ofARMED DefenseFORCES toAND provideVETERANS. 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.

(a) <<NOTE:

Coordination.

Update.>> 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.

FEDERAL<<NOTE: CAUSE OF ACTION RELATING TO WATER AT CAMP LEJEUNE, NORTH CAROLINA.

Camp Lejeune Justice Act of 2022.

28 USC 2671 note prec.>> FEDERAL CAUSE OF ACTION RELATING TO WATER AT CAMP LEJEUNE, NORTH CAROLINA.

(b) In<<NOTE: 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)Time Burdensperiods.>> andIn StandardGeneral.--An ofindividual, Proof.--including (1)a Inveteran general.--The(as burdendefined in section 101 of prooftitle shall38, beUnited onStates Code), or the partylegal filingrepresentative theof actionsuch toan showindividual, onewho resided, worked, or morewas relationshipsotherwise betweenexposed (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 LejeuneLejeune, andNorth Carolina, that was supplied by, or on behalf of, the harm.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.-- [[Page 136 STAT.

1803]] (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.

(h) Disposition<<NOTE: 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.

Compliance.>> 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.

(j) Applicability;<<NOTE:

Claims.>> Applicability;

or (B)[[Page the136 dateSTAT. that is 180 days after the date on which the claim is denied under section 2675 of title 28, United States Code.

1804]] (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.

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

38 USC 301 prec.>> is amended by adding at the end the following new section:

Cost<<NOTE: 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.