Congressional Record, Senate, June 7, 2022 — Amendments to H.R. 3967, Honoring our PACT Act
Summary
This is S2818 of the Congressional Record, Senate, June 7, 2022, in a document titled Amendments to H.R. 3967, Honoring our PACT Act, with interleaved columns. It lists amendments submitted to H.R. 3967, including SA 5051 by Mr. Tester, for himself and Mr. Moran, SA 5048 and SA 5050 by Mr. Lee, SA 5060 by Mr. Paul, SA 5061 and SA 5062 by Ms. Lummis, and SA 5063 and SA 5064 by Mr. Moran. The text of SA 5051 strikes all after the enacting clause, with a table of contents covering expansion of health care eligibility for toxic-exposed veterans, the toxic exposure presumption process, and presumptions of service connection. One amendment text is a sense of the Senate on provision of compensation.
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“Congressional Record, Senate, June 7, 2022 — Amendments to H.R. 3967, Honoring our PACT Act.”
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S2818 CONGRESSIONAL RECORD — SENATE June 7, 2022
amendment SA 5051 submitted by Mr. ‘‘(E) Adenosquamous carcinoma of the that title to alter the table to conform to
TESTER (for himself and Mr. MORAN) and in- lung. the changes made by the amendment.
tended to be proposed to the bill H.R. 3967, ‘‘(F) Large cell carcinoma of the lung. (c) TABLE OF CONTENTS.—The table of con-
supra; which was ordered to lie on the table. ‘‘(G) Salivary gland-type tumors of the tents for this Act is as follows:
SA 5060. Mr. PAUL submitted an amend- lung. Sec. 1. Short title; references to title 38,
ment intended to be proposed to amendment ‘‘(H) Sacromatoid carcinoma of the lung. United States Code; table of
SA 5051 submitted by Mr. TESTER (for him- ‘‘(I) Typical and atypical carcinoid of the contents.
self and Mr . MORAN) and intended to be pro- lung.
TITLE I—EXPANSION OF HEALTH CARE
posed to the bill H.R. 3967, supra; which was ‘‘(3) chronic rhinitis.
ELIGIBILITY
ordered to lie on the table. ‘‘(4) Chronic sinusitis.
SA 5061. Ms. LUMMIS submitted an Subtitle A—Toxic-exposed Veterans
amendment intended to be proposed to SA 5050. Mr. LEE (for himself and Sec. 101. Short title.
amendment SA 5051 submitted by Mr. Mr. ROMNEY) submitted an amendment Sec. 102. Definitions relating to toxic-ex-
TESTER (for himself and Mr. MORAN) and in- intended to be proposed by him to the posed veterans.
tended to be proposed to the bill H.R. 3967, bill H.R. 3967, to improve health care Sec. 103. Expansion of health care for spe-
supra; which was ordered to lie on the table. cific categories of toxic-exposed
and benefits for veterans exposed to
SA 5062. Ms. LUMMIS submitted an veterans and veterans sup-
amendment intended to be proposed to toxic substances, and for other pur-
porting certain overseas contin-
amendment SA 5051 submitted by Mr. poses; which was ordered to lie on the gency operations.
TESTER (for himself and Mr. MORAN) and in- table; as follows: Sec. 104. Assessments of implementation
tended to be proposed to the bill H.R. 3967, Beginning on page 5, strike line 1 and all and operation.
supra; which was ordered to lie on the table. that follows through page 67, line 15. Subtitle B—Certain Veterans of Combat
SA 5063. Mr. MORAN submitted an amend- Beginning on page 86, strike line 1 and all Service and Other Matters
ment intended to be proposed to amendment that follows through page 150, line 16.
SA 5051 submitted by Mr. TESTER (for him- Sec. 111. Expansion of period of eligibility
At the appropriate place, insert the fol- for health care for certain vet-
self and Mr. MORAN) and intended to be pro- lowing:
posed to the bill H.R. 3967, supra; which was erans of combat service.
SEC. lll. SENSE OF THE SENATE ON PROVI-
ordered to lie on the table. SION OF COMPENSATION.
TITLE II—TOXIC EXPOSURE
SA 5064. Mr. MORAN submitted an amend- PRESUMPTION PROCESS
It is the sense of the Senate that, for the
ment intended to be proposed to amendment Sec. 201. Short title.
purposes of section 1110 of title 38, United
SA 5051 submitted by Mr. TESTER (for him- Sec. 202. Improvements to ability of Depart-
States Code, and subject to section 1113 of
self and Mr. MORAN) and intended to be pro- ment of Veterans Affairs to es-
such title, for disabilities where there is af-
posed to the bill H.R. 3967, supra; which was tablish presumptions of service
firmative evidence to establish that a per-
ordered to lie on the table. connection based on toxic expo-
sonal injury suffered or disease contracted in
f line of duty for which there is a recognized sure.
cause, or for aggravation of a preexisting dis- Sec. 203. Outreach to claimants for dis-
TEXT OF AMENDMENTS ability compensation pursuant
ease contracted in line of duty for which
SA 5048. Mr. LEE submitted an there is a recognized cause, in the active to changes in presumptions of
amendment intended to be proposed by military, naval, air, or space service, during service connection.
him to the bill H.R. 3967, to improve a period of war, the United States will pay to Sec. 204. Reevaluation of claims for depend-
any veteran thus disabled and who was dis- ency and indemnity compensa-
health care and benefits for veterans
charged or released under conditions other tion involving presumptions of
exposed to toxic substances, and for service connection.
than dishonorable from the period of service
other purposes; which was ordered to in which said injury or disease was incurred, TITLE III—IMPROVING THE ESTABLISH-
lie on the table; as follows: or preexisting injury or disease was aggra- MENT OF SERVICE CONNECTION PROC-
On page 30, strike lines 4 through 19 and in- vated, compensation, but no compensation ESS FOR TOXIC-EXPOSED VETERANS
sert the following: shall be paid if the disability is a result of Sec. 301. Short title.
‘‘(b) REMOVAL OF PRESUMPTION.—(1) The the veteran’s own willful misconduct or Sec. 302. Presumptions of toxic exposure.
Secretary shall— abuse of alcohol or drugs. Sec. 303. Medical nexus examinations for
‘‘(A) issue a regulation to remove an ill-
toxic exposure risk activities.
ness from a presumption of service connec- SA 5051. Mr. TESTER (for himself
tion previously established pursuant to a TITLE IV—PRESUMPTIONS OF SERVICE
and Mr. MORAN) submitted an amend-
regulation issued under subsection (a) if CONNECTION
ment intended to be proposed by him
there is a lack of evidence establishing a Sec. 401. Treatment of veterans who partici-
to the bill H.R. 3967, to improve health
positive association between the illness and pated in cleanup of Enewetak
the toxic exposure; and care and benefits for veterans exposed Atoll as radiation-exposed vet-
‘‘(B) issue a regulation to remove a pre- to toxic substances, and for other pur- erans for purposes of presump-
sumption of service connection established poses; which was ordered to lie on the tion of service connection of
pursuant to title IV of the Sergeant First table; as follows: certain disabilities by Depart-
Class Heath Robinson Honoring our Promise Strike all after the enacting clause and in- ment of Veterans Affairs.
to Address Comprehensive Toxics Act of 2022 sert the following: Sec. 402. Treatment of veterans who partici-
if there is a lack of evidence establishing a SECTION 1. SHORT TITLE; REFERENCES TO TITLE pated in nuclear response near
positive association between the disease and 38, UNITED STATES CODE; TABLE OF Palomares, Spain, or Thule,
the toxic exposure. CONTENTS. Greenland, as radiation-exposed
(a) SHORT TITLE.—This Act may be cited as veterans for purposes of pre-
SA 5049. Mr. LEE submitted an the ‘‘Sergeant First Class Heath Robinson sumption of service connection
amendment intended to be proposed by Honoring our Promise to Address Com- of certain disabilities by De-
him to the bill H.R. 3967, to improve prehensive Toxics Act of 2022’’ or the ‘‘Hon- partment of Veterans Affairs.
health care and benefits for veterans oring our PACT Act of 2022’’. Sec. 403. Presumptions of service connection
(b) MATTERS RELATING TO AMENDMENTS TO for diseases associated with ex-
exposed to toxic substances, and for TITLE 38, UNITED STATES CODE.— posures to certain herbicide
other purposes; which was ordered to (1) REFERENCES.—Except as otherwise ex- agents for veterans who served
lie on the table; as follows: pressly provided, when in this Act an amend- in certain locations.
Beginning on page 64, strike line 1 and all ment or repeal is expressed in terms of an Sec. 404. Addition of additional diseases as-
that follows through page 65, line 9, and in- amendment to, or repeal of, a section or sociated with exposure to cer-
sert the following: other provision, the reference shall be con- tain herbicide agents for which
‘‘(1) Chronic asthma that was diagnosed sidered to be made to a section or other pro- there is a presumption of serv-
after service of the covered veteran as speci- vision of title 38, United States Code. ice connection for veterans who
fied in subsection (c). (2) AMENDMENTS TO TABLES OF CONTENTS.— served in certain locations.
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‘‘(2) The following types of cancer: Except as otherwise expressly provided, Sec. 405. Improving compensation for dis-
‘‘(A) Squamous cell carcinoma of the lar- when an amendment made by this Act to abilities occurring in Persian
ynx. title 38, United States Code, adds a section Gulf War veterans.
‘‘(B) Squamous cell carcinoma of the tra- or larger organizational unit to that title or Sec. 406. Presumption of service connection
chea. amends the designation or heading of a sec- for certain diseases associated
‘‘(C) Adenocarcinoma of the trachea. tion or larger organizational unit in that with exposure to burn pits and
‘‘(D) Salivary gland-type tumors of the tra- title, that amendment also shall have the ef- other toxins.
chea. fect of amending any table of sections in Sec. 407. Rule of construction.
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2819
TITLE V—RESEARCH MATTERS TITLE IX—IMPROVEMENT OF WORK- (1) EXPANSION.—Subsection (e) of section
Sec. 501. Interagency working group on FORCE OF DEPARTMENT OF VETERANS 1710, as amended by section 102(c), is further
toxic exposure research. AFFAIRS amended—
Sec. 502. Analysis and report on treatment Sec. 901. National rural recruitment and hir- (A) in paragraph (1), by adding at the end
of veterans for medical condi- ing plan for Veterans Health the following new subparagraphs:
tions related to toxic exposure. Administration. ‘‘(G) Beginning not later than the applica-
Sec. 503. Analysis relating to mortality of Sec. 902. Authority to buy out service con- ble date specified in paragraph (6), and sub-
veterans who served in South- tracts for certain health care ject to paragraph (2), a veteran who partici-
west Asia. professionals in exchange for pated in a toxic exposure risk activity while
Sec. 504. Study on health trends of post–9/11 employment at rural or highly serving on active duty, active duty for train-
veterans. rural facilities of Department ing, or inactive duty training is eligible for
Sec. 505. Study on cancer rates among vet- of Veterans Affairs. hospital care (including mental health serv-
erans. Sec. 903. Qualifications for human resources ices and counseling), medical services, and
Sec. 506. Study on health effects of waste re- positions within Department of nursing home care under subsection (a)(2)(F)
lated to Manhattan Project on Veterans Affairs and plan to re- for any illness.
certain veterans. cruit and retain human re- ‘‘(H) Beginning not later than the applica-
Sec. 507. Study on toxic exposure and men- sources employees. ble date specified in paragraph (6), and sub-
tal health outcomes. Sec. 904. Modification of pay cap for certain ject to paragraph (2), a covered veteran (as
Sec. 508. Study on veterans in Territories of employees of Veterans Health defined in section 1119(c) of this title) is eli-
the United States. Administration. gible for hospital care (including mental
Sec. 509. Department of Veterans Affairs Sec. 905. Expansion of opportunities for health services and counseling), medical
public website for toxic expo- housekeeping aides. services, and nursing home care under sub-
Sec. 906. Modification of authority of the section (a)(2)(F) for any illness.
sure research.
Secretary of Veterans Affairs ‘‘(I)(i) Beginning not later than the appli-
Sec. 510. Report on health effects of jet fuels
relating to hours, conditions of cable date specified in paragraph (6), and
used by Armed Forces.
employment, and pay for cer- subject to paragraph (2), a veteran who de-
TITLE VI—IMPROVEMENT OF RE- ployed in support of a contingency operation
SOURCES AND TRAINING REGARDING tain employees of Veterans
specified in clause (ii) is eligible for hospital
TOXIC-EXPOSED VETERANS Health Administration.
Sec. 907. Waiver of pay limitation for cer- care (including mental health services and
Sec. 601. Short title; definitions. tain employees of Department counseling), medical services, and nursing
Sec. 602. Publication of list of resources of home care under subsection (a)(2)(F) for any
of Veterans Affairs.
Department of Veterans Affairs Sec. 908. Elimination of limitation on illness.
for toxic-exposed veterans and ‘‘(ii) A contingency operation specified in
awards and bonus for employees
veterans who report toxic expo- this clause is any of the following:
of Department of Veterans Af-
sures and outreach program for ‘‘(I) Operation Enduring Freedom.
fairs.
such veterans and caregivers Sec. 909. Additional authority of the Sec- ‘‘(II) Operation Freedom’s Sentinel.
and survivors of such veterans. ‘‘(III) Operation Iraqi Freedom.
retary of Veterans Affairs re-
Sec. 603. Incorporation of toxic exposure ‘‘(IV) Operation New Dawn.
lating to recruitment and re-
screening for veterans. ‘‘(V) Operation Inherent Resolve.
tention of personnel.
Sec. 604. Training for personnel of the De- ‘‘(VI) Resolute Support Mission.’’; and
TITLE I—EXPANSION OF HEALTH CARE (B) in paragraph (2)(B)—
partment of Veterans Affairs
ELIGIBILITY (i) by striking ‘‘or (F)’’ and inserting ‘‘(F),
with respect to veterans who
report toxic exposures. Subtitle A—Toxic-exposed Veterans (G), (H), or (I)’’; and
TITLE VII—RESOURCING
SEC. 101. SHORT TITLE. (ii) by striking ‘‘service or testing’’ and in-
This title may be cited as the ‘‘Conceding serting ‘‘service, testing, or activity’’.
Sec. 701. Authority to use appropriations to Our Veterans’ Exposure Now and Necessi- (2) PHASE IN.—Such subsection is further
enhance claims processing ca- tating Training Act of 2022’’ or the ‘‘COV- amended by adding at the end the following
pacity and automation. ENANT Act of 2022’’. new paragraph:
Sec. 702. Authorization of major medical fa- SEC. 102. DEFINITIONS RELATING TO TOXIC-EX- ‘‘(6)(A) The Secretary shall determine the
cility leases of Department of POSED VETERANS. dates in subparagraphs (G), (H), and (I) of
Veterans Affairs for fiscal year (a) IN GENERAL.—Section 1710(a)(2)(F) is paragraph (1) as follows:
2023. amended by striking ‘‘who was exposed to a ‘‘(i) October 1, 2024, with respect to a vet-
Sec. 703. Treatment of major medical facil- toxic substance, radiation, or other condi- eran described in such subparagraph (G) or
ity leases of the Department of tions, as provided in subsection (e)’’ and in- (H) who was discharged or released from the
Veterans Affairs. serting ‘‘who is a toxic-exposed veteran, in active military, naval, air, or space service
Sec. 704. Authority to enter into agreements accordance with subsection (e)’’. during the period beginning on August 2,
with academic affiliates and (b) DEFINITIONS OF TOXIC EXPOSURE AND 1990, and ending on September 11, 2001.
other entities to acquire space TOXIC-EXPOSED VETERAN.—Section 101 is ‘‘(ii) October 1, 2026, with respect to a vet-
for the purpose of providing amended by adding at the end the following eran described in such subparagraph (G) or
health-care resources to vet- new paragraphs: (H) who was discharged or released from the
erans. ‘‘(37) The term ‘toxic exposure’ includes active military, naval, air, or space service
Sec. 705. Modifications to enhanced-use the following:
during the period beginning on September 12,
lease authority of Department ‘‘(A) A toxic exposure risk activity, as de-
2001, and ending on December 31, 2006.
of Veterans Affairs. fined in section 1710(e)(4) of this title.
‘‘(iii) October 1, 2028, with respect to a vet-
Sec. 706. Authority for joint leasing actions ‘‘(B) An exposure to a substance, chemical,
eran described in such subparagraph (G) or
of Department of Defense and or airborne hazard identified in the list
(H) who was discharged or released from the
Department of Veterans Af- under section 1119(b)(2) of this title.
‘‘(38) The term ‘toxic-exposed veteran’ active military, naval, air, or space service
fairs.
means any veteran described in section during the period beginning on January 1,
Sec. 707. Appropriation of amounts for
1710(e)(1) of this title.’’. 2007, and ending on December 31, 2012.
major medical facility leases.
(c) DEFINITION OF TOXIC EXPOSURE RISK AC- ‘‘(iv) October 1, 2030, with respect to a vet-
TITLE VIII—RECORDS AND OTHER eran described in such subparagraph (G) or
TIVITY.—Section 1710(e)(4) is amended by
MATTERS (H) who was discharged or released from the
adding at the end the following new subpara-
Sec. 801. Epidemiological study on Fort graph: active military, naval, air, or space service
McClellan veterans. ‘‘(C) The term ‘toxic exposure risk activ- during the period beginning on January 1,
Sec. 802. Biennial briefing on Individual ity’ means any activity— 2013, and ending on December 31, 2018.
Longitudinal Exposure Record. ‘‘(i) that requires a corresponding entry in ‘‘(v) October 1, 2032, with respect to a vet-
Sec. 803. Correction of exposure records by an exposure tracking record system (as de- eran described in such subparagraph (I).
members of the Armed Forces fined in section 1119(c) of this title) for the ‘‘(B)(i) The Secretary may modify a date
and veterans. veteran who carried out the activity; or specified in subparagraph (A) to an earlier
Sec. 804. Federal cause of action relating to ‘‘(ii) that the Secretary determines quali- date, as the Secretary determines appro-
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water at Camp Lejeune, North fies for purposes of this subsection when tak- priate based on the number of veterans re-
Carolina. ing into account what is reasonably prudent ceiving hospital care, medical services, and
Sec. 805. Cost of War Toxic Exposures Fund. to protect the health of veterans.’’. nursing home care under subparagraphs (G),
Sec. 806. Appropriation for fiscal year 2022. SEC. 103. EXPANSION OF HEALTH CARE FOR SPE- (H), and (I) of paragraph (1) and the resources
Sec. 807. Authorization of electronic notice CIFIC CATEGORIES OF TOXIC-EX- available to the Secretary.
in claims under laws adminis- POSED VETERANS AND VETERANS ‘‘(ii) If the Secretary determines to modify
tered by the Secretary of Vet- SUPPORTING CERTAIN OVERSEAS a date under clause (i), the Secretary shall—
erans Affairs. CONTINGENCY OPERATIONS. ‘‘(I) notify the Committee on Veterans’ Af-
Sec. 808. Burn pit transparency. (a) IN GENERAL.— fairs of the Senate and the Committee on
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S2820 CONGRESSIONAL RECORD — SENATE June 7, 2022
Veterans’ Affairs of the House of Representa- (2) MATTERS.—Each report under para- leased from the active military, naval, air,
tives of the proposed modification; and graph (1) shall include, with respect to the or space service after September 11, 2001, and
‘‘(II) publish such modified date in the Fed- year covered by the report, detailed informa- before October 1, 2013, but did not enroll to
eral Register.’’. tion on the following: receive such hospital care, medical services,
(b) OUTREACH PLANS.—With respect to each (A) The total number of veterans enrolled or nursing home care under such paragraph
of clauses (i) through (v) of section in the patient enrollment system who, dur- pursuant to subparagraph (A) before October
1710(e)(6)(A) of title 38, United States Code ing such year, received hospital care or med- 1, 2022, the one-year period beginning on Oc-
(as added by subsection (a)(2)), not later than ical services furnished by the Secretary tober 1, 2022.’’; and
180 days before the date specified in the under chapter 17 of title 38, United States (3) by striking subparagraph (C).
clause (including a date modified pursuant Code. (b) CLARIFICATION OF COVERAGE.—Section
to such section), the Secretary shall submit (B) Of the veterans specified in subpara- 1710(e)(1)(D) is amended by inserting after
to the Committee on Veterans’ Affairs of the graph (A), the number of such veterans who, ‘‘Persian Gulf War’’ the following: ‘‘(includ-
Senate and the Committee on Veterans’ Af- during the preceding three fiscal years, had ing any veteran who, in connection with
fairs of the House of Representatives a plan not received such care or services. service during such period, received the
to conduct outreach to the veterans de- (C) With respect to the veterans specified Armed Forces Expeditionary Medal, Service
scribed in the clause to notify such veterans in subparagraph (B), the cost of providing Specific Expeditionary Medal, Combat Era
of their eligibility for hospital care, medical health care to such veterans during the year Specific Expeditionary Medal, Campaign
services, or nursing home care under sub- covered by the report, shown in total and Specific Medal, or any other combat theater
paragraph (G), (H), or (I), of section 1710(e)(1) disaggregated by— award established by a Federal statute or an
of such title, as the case may be. (i) the level of care; and Executive order)’’.
SEC. 104. ASSESSMENTS OF IMPLEMENTATION
(ii) whether the care was provided through (c) OUTREACH PLAN.—Not later than De-
AND OPERATION. the Veterans Community Care Program. cember 1, 2022, the Secretary of Veterans Af-
(D) With respect to the number of veterans fairs shall submit to the Committee on Vet-
(a) INITIAL RESOURCE ASSESSMENT AND RE-
described in subparagraphs (G), (H), and (I) of erans’ Affairs of the Senate and the Com-
PORT.—Not later than 180 days after the date
section 1710(e)(1) of title 38, United States mittee on Veterans’ Affairs of the House of
of the enactment of this Act, the Secretary
Code (as added by section 103), the following Representatives a plan to conduct outreach
of Veterans Affairs shall—
(shown in total and disaggregated by medical to veterans described in subparagraph (B) of
(1) complete an assessment to determine—
facility of the Department, as applicable): section 1710(e)(3) of title 38, United States
(A) the personnel and material resources
(i) The number of such veterans who, dur- Code, as amended by subsection (a)(2), to no-
necessary to implement section 103 (includ-
ing the year covered by the report, enrolled tify such veterans of their eligibility for hos-
ing the amendments made by such section); in the patient enrollment system.
and pital care, medical services, or nursing home
(ii) The number of such veterans who ap- care pursuant to such subparagraph.
(B) the total number of covered veterans, plied for, but were denied, such enrollment.
as such term is defined in section 1119(c) of (d) REPORT ON ENROLLMENTS.—Not later
(iii) The number of such veterans who were than January 30, 2024, the Secretary shall
title 38, United States Code (as added by sec- denied hospital care or a medical service fur-
tion 302), who receive hospital care or med- submit to the Committee on Veterans’ Af-
nished by the Secretary that was considered fairs of the Senate and the Committee on
ical services furnished by the Secretary to be medically necessary but not of an
under chapter 17 of such title, disaggregated Veterans’ Affairs of the House of Representa-
emergency nature. tives a report identifying, with respect to
by priority group specified in section 1705(a) (E) The numbers and characteristics of,
of such title; and the one-year period beginning on October 1,
and the type and extent of health care fur- 2022, the number of veterans described in sec-
(2) submit to the Committee on Veterans’ nished by the Secretary to, veterans enrolled
Affairs of the Senate and the Committee on tion 1710(e)(3)(B) of title 38, United States
in the patient enrollment system (shown in Code, as amended by subsection (a)(2), who,
Veterans’ Affairs of the House of Representa- total and disaggregated by medical facility
tives a report containing the findings of the during such period, enrolled in the patient
of the Department). enrollment system of the Department of Vet-
assessment completed under paragraph (1), (F) The numbers and characteristics of,
including a specific determination as to erans Affairs established and operated under
and the type and extent of health care fur- section 1705(a) of such title.
whether the Department has the personnel nished by the Secretary to, veterans not en- (e) EFFECTIVE DATE.—This section and the
and material resources necessary to imple- rolled in the patient enrollment system amendments made by this section shall take
ment section 103. (disaggregated by each class of eligibility for effect on October 1, 2022.
(b) INFORMATION SYSTEMS.—Not later than care under section 1710 of title 38, United
October 1, 2024, the Secretary shall establish TITLE II—TOXIC EXPOSURE
States Code, and further shown as a total per
information systems to assess the implemen- PRESUMPTION PROCESS
class and disaggregated by medical facility
tation of section 103, including the amend- of the Department). SEC. 201. SHORT TITLE.
ments made by such section, and use the re- (G) The specific fiscal impact (shown in This title may be cited as the ‘‘Toxic Expo-
sults of assessments under such systems to total and disaggregated by geographic health sure in the American Military Act of 2022’’ or
inform the reports under subsection (c). care delivery areas) of changes in the deliv- the ‘‘TEAM Act of 2022’’.
(c) ANNUAL REPORTS.— ery patterns of health care furnished by the SEC. 202. IMPROVEMENTS TO ABILITY OF DE-
(1) REPORTS.—Not later than October 1, Secretary under chapter 17 of such title as a PARTMENT OF VETERANS AFFAIRS
2025, and on an annual basis thereafter until TO ESTABLISH PRESUMPTIONS OF
result of the implementation of section 103
SERVICE CONNECTION BASED ON
October 1, 2033, the Secretary shall submit to (including the amendments made by such TOXIC EXPOSURE.
the Committee on Veterans’ Affairs of the section). (a) ADVISORY COMMITTEES, PANELS, AND
Senate and the Committee on Veterans’ Af- (d) DEFINITIONS.—In this section:
BOARDS.—Chapter 11 is amended by adding at
fairs of the House of Representatives a re- (1) PATIENT ENROLLMENT SYSTEM.—The
the end the following new subchapter:
port on the following: term ‘‘patient enrollment system’’ means
(A) The effect of the implementation of, the patient enrollment system of the Depart- ‘‘SUBCHAPTER VII—DETERMINATIONS
and the provision and management of care ment of Veterans Affairs established and op- RELATING TO PRESUMPTIONS OF
under, section 103 (including the amend- erated under section 1705(a) of title 38, SERVICE CONNECTION BASED ON
ments made by such section) on the demand United States Code. TOXIC EXPOSURE
by veterans described in subparagraphs (G), (2) VETERANS COMMUNITY CARE PROGRAM.— ‘‘§ 1171. Procedures to determine presump-
(H), and (I) of section 1710(e)(1) of title 38, The term ‘‘Veterans Community Care Pro- tions of service connection based on toxic
United States Code (as added by such section gram’’ means the program established under exposure; definitions
103) for health care services furnished by the section 1703 of title 38, United States Code. ‘‘(a) PROCEDURES.—The Secretary shall de-
Secretary. Subtitle B—Certain Veterans of Combat termine whether to establish, or to remove,
(B) Any differing patterns of demand for Service and Other Matters presumptions of service connection based on
health care services by such veterans, SEC. 111. EXPANSION OF PERIOD OF ELIGIBILITY toxic exposure pursuant to this subchapter,
disaggregated by factors such as the relative FOR HEALTH CARE FOR CERTAIN whereby—
distance of the veteran from medical facili- VETERANS OF COMBAT SERVICE. ‘‘(1) under section 1172 of this title—
ties of the Department and whether the vet- (a) EXPANDED PERIOD.—Section 1710(e)(3) is ‘‘(A) the Secretary provides—
eran had previously received hospital care or amended— ‘‘(i) public notice regarding what formal
medical services furnished by the Secretary (1) in subparagraph (A)— evaluations the Secretary plans to conduct;
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under chapter 17 of such title. (A) by striking ‘‘January 27, 2003’’ and in- and
(C) The extent to which the Secretary has serting ‘‘September 11, 2001’’; and ‘‘(ii) the public an opportunity to comment
met such demand. (B) by striking ‘‘five-year period’’ and in- on the proposed formal evaluations;
(D) Any changes, during the year covered serting ‘‘10-year period’’; ‘‘(B) the working group established under
by the report, in the delivery patterns of (2) by amending subparagraph (B) to read subsection (b) of such section provides—
health care furnished by the Secretary under as follows: ‘‘(i) advice to the Secretary on toxic-ex-
chapter 17 of such title, and the fiscal impact ‘‘(B) With respect to a veteran described in posed veterans and cases in which veterans
of such changes. paragraph (1)(D) who was discharged or re- who, during active military, naval, air, or
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2821
space service, may have experienced a toxic ‘‘(b) WORKING GROUP.—(1) The Secretary ‘‘§ 1173. Formal evaluation of recommenda-
exposure or their dependents may have expe- shall establish a working group within the tions
rienced a toxic exposure while the veterans Department (in this section referred to as
were serving in the active military, naval, the ‘Working Group’). ‘‘(a) FORMAL EVALUATIONS.—The Secretary
air, or space service; ‘‘(2) The Working Group shall include per- shall establish a process to conduct a formal
‘‘(ii) recommendations to the Secretary on sonnel of the Veterans Health Administra- evaluation with respect to each rec-
corrections needed in the Individual Longi- tion and the Veterans Benefits Administra- ommendation made by the Working Group
tudinal Exposure Record to better reflect tion. under section 1172 of this title.
veterans and dependents described in clause ‘‘(3) The Secretary shall consult with, and ‘‘(b) EVIDENCE, DATA, AND FACTORS.—The
(i); and seek the advice of, the Working Group with Secretary shall ensure that each formal
‘‘(iii) recommendations to the Secretary respect to cases in which— evaluation under subsection (a) covers the
regarding which cases of possible toxic expo- ‘‘(A) a veteran may have, during active following:
sure should be reviewed; military, naval, air, or space service, experi- ‘‘(1) Scientific evidence, based on the re-
‘‘(2) the Secretary provides for formal eval- enced a toxic exposure; or view of available scientific literature, in-
uations of such recommendations under sec- ‘‘(B) a dependent of a veteran may have ex- cluding human, toxicological, animal, and
tion 1173 of this title and takes into account perienced a toxic exposure during the active methodological studies, and other factors.
reports received by the Secretary from the military, naval, air, or space service of the ‘‘(2) Claims data, based on the review of
National Academies of Sciences, Engineer- veteran. claim rate, grant rate, and service connec-
ing, and Medicine under section 1176 of this ‘‘(c) ASSESSMENTS.—(1) The Working Group tion prevalence, and other factors.
title; and shall assess cases of the toxic exposure of ‘‘(3) Other factors the Secretary deter-
‘‘(3) the Secretary issues regulations under veterans and their dependents that occurred mines appropriate, such as—
section 1174 of this title. during active military, naval, air, or space ‘‘(A) the level of disability and mortality
‘‘(b) DEFINITIONS.—In this subchapter: service, including by conducting ongoing caused by the health effects related to the
‘‘(1) The term ‘illness’ includes a disease or surveillance and reviewing such exposure de- case of toxic exposure being evaluated;
other condition affecting the health of an in- scribed in scientific literature, media re- ‘‘(B) the quantity and quality of the infor-
dividual, including mental and physical ports, information from veterans, and infor- mation available and reviewed;
health. mation from Congress. ‘‘(C) the feasibility of and period for gener-
‘‘(2) The term ‘Individual Longitudinal Ex- ‘‘(2) The assessments under paragraph (1) ating relevant information and evidence;
posure Record’ includes— shall cover suspected and known toxic expo- ‘‘(D) whether such health effects are
‘‘(A) service records; sures occurring during active military, combat- or deployment-related;
‘‘(B) any database maintained by the De- naval, air, or space service, including by ‘‘(E) the ubiquity or rarity of the health ef-
partment of Defense and shared with the De- identifying and evaluating new and emerging fects; and
partment of Veterans Affairs to serve as a toxic exposures that are not recognized ‘‘(F) any time frame during which a health
central portal for exposure-related data that under existing presumptions of service con- effect must become manifest.
compiles, collates, presents, and provides nection. ‘‘(c) CONDUCT OF EVALUATIONS.—(1) The
available occupational and environmental ‘‘(3) The Working Group may conduct an Secretary shall ensure that each formal
exposure information to support the needs of assessment under paragraph (1) in response evaluation under subsection (a)—
the Department of Defense and the Depart- to a comment received under paragraph (2) ‘‘(A) reviews scientific evidence in a man-
ment of Veterans Affairs; or or (3) of subsection (a). ner that—
‘‘(C) any successor system to a database ‘‘(4) The Working Group shall, in consulta- ‘‘(i) conforms to principles of scientific and
described in subparagraph (B). tion with the Secretary of Defense, on a peri- data integrity;
‘‘§ 1172. Annual notice and opportunity for odic basis, assess the Individual Longitu- ‘‘(ii) is free from suppression or distortion
public comment dinal Exposure Record to ensure the accu- of scientific or technological findings, data,
‘‘(a) NOTICE REQUIRED.—(1)(A) Not less fre- racy of data collected. information, conclusions, or technical re-
quently than once each year, the Secretary ‘‘(d) DEVELOPMENT OF RECOMMENDATIONS.— sults; and
shall publish in the Federal Register notice (1) Following an assessment of a case of the ‘‘(B)(i) evaluates the likelihood that a posi-
of the formal evaluations that the Secretary toxic exposure of veterans that occurred dur- tive association exists between an illness and
plans to conduct pursuant to section 1173 of ing active military, naval, air, or space serv- a toxic exposure while serving in the active
this title. ice under subsection (c), or their dependents, military, naval, air, or space service; and
‘‘(B) Each notice published under subpara- the Working Group may develop a rec- ‘‘(ii) assesses the toxic exposures and ill-
graph (A) shall include, for each formal eval- ommendation for formal evaluation under nesses and determines whether the evidence
uation referred to in the notice, an expla- section 1173 of this title to conduct a review supports a finding of a positive association
nation as to why the military environmental of the health effects related to the case of ex- between the toxic exposure and the illness.
exposures and adverse health outcomes that posure if the Working Group determines that
the research may change the current under- ‘‘(2) In carrying out paragraph (1)(B)(ii), a
are the subject of the formal evaluation were
standing of the relationship between an ex- formal evaluation under subsection (a) shall
chosen by the Secretary for formal evalua-
posure to an environmental hazard and ad- include reviewing all relevant data to deter-
tion under section 1173 of this title.
verse health outcomes in humans. mine the strength of evidence for a positive
‘‘(2)(A) With each notice published under
‘‘(2) Upon receipt of evidence suggesting association based on the following four cat-
paragraph (1), the Secretary shall seek pub-
that previous findings regarding the periods egories:
lic comment on the military environmental
and locations of exposure covered by an ex- ‘‘(A) The ‘sufficient’ category, where the
exposures and adverse health outcomes that
isting presumption of service connection are evidence is sufficient to conclude that a posi-
are the subject of the formal evaluations re-
no longer supported, the Working Group may tive association exists.
ferred to in the notice.
nominate such evidence for formal evalua- ‘‘(B) The ‘equipoise and above’ category,
‘‘(B) The Secretary shall—
tion under section 1173 of this title to modify where the evidence is sufficient to conclude
‘‘(i) consider all public comment received
the periods and locations. that a positive association is at least as like-
under subparagraph (A); and
‘‘(e) REPORTS BY THE WORKING GROUP.—Not ly as not, but not sufficient to conclude that
‘‘(ii) publish in the Federal Register a re-
less frequently than once each year, the a positive association exists.
sponse to the comments received under sub-
Working Group shall submit to the Sec- ‘‘(C) The ‘below equipoise’ category, where
paragraph (A).
retary, the Committee on Veterans’ Affairs the evidence is not sufficient to conclude
‘‘(3)(A) For each notice published under
of the Senate, and the Committee on Vet- that a positive association is at least as like-
paragraph (1), the Secretary shall hold an
erans’ Affairs of the House of Representa- ly as not, or is not sufficient to make a sci-
open meeting for members of the public to
tives, and make publicly available, a report entifically informed judgment.
voice their comments in response to the no-
on— ‘‘(D) The ‘against’ category, where the evi-
tice.
‘‘(B) To help evaluate presumptions of ‘‘(1) recommendations developed under dence suggests the lack of a positive associa-
service connection, the Secretary shall, not subsection (d), if any; and tion.
less frequently than quarterly, collaborate ‘‘(2) recommendations for such legislative ‘‘(d) RECOMMENDATION FOR ESTABLISHING A
with, partner with, and give weight to the or administrative action as the Working PRESUMPTION OF SERVICE CONNECTION.—Not
advice of veterans service organizations and Group considers necessary for the Working later than 120 days after the date on which a
SSpencer on DSK126QN23PROD with SENATE
such other stakeholders as the Secretary Group to be more effective in carrying out formal evaluation is commenced, the ele-
considers appropriate. the requirements of this section. ment of the Department that conducts the
‘‘(4) Failure to include a military environ- ‘‘(f) RESPONSES BY SECRETARY.—In re- evaluation shall submit to the Secretary a
mental exposure or adverse health effect in a sponse to each report submitted under sub- recommendation with respect to establishing
Federal Register notice published pursuant section (e), the Secretary shall, not later a presumption of service connection for the
to subsection (a) shall not preclude the Sec- than 30 days after receiving the report, ini- toxic exposure and illness, or modifying an
retary from initiating a formal evaluation of tiate a formal evaluation pursuant to section existing presumption of service connection,
such exposure or health effect. 1173 of this title. covered by the evaluation.
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S2822 CONGRESSIONAL RECORD — SENATE June 7, 2022
‘‘§ 1174. Regulations regarding presumptions mits the notice under subsection (b) regard- tween the Secretary and the Academies
of service connection based on toxic expo- ing the modification. under this section, the Academies shall
sure ‘‘(b) NOTICE.—If the Secretary proposes to make any recommendations for additional
‘‘(a) ACTION UPON RECOMMENDATION.—Not modify the process under which the working scientific studies to resolve areas of con-
later than 160 days after the date on which group established under subsection (b) of sec- tinuing scientific uncertainty relating to
the Secretary receives a recommendation to tion 1172 of this title conducts assessments toxic exposures.
establish or modify a presumption of service under such section, the process under which ‘‘(2) In making recommendations under
connection under section 1173 of this title— the Secretary conducts formal evaluations paragraph (1), the Academies shall consider—
‘‘(1) if the Secretary determines, in the dis- under section 1173 of this title, or issues reg- ‘‘(A) the scientific information that is
cretion of the Secretary, that the presump- ulations under section 1174 of this title, the available at the time of the recommenda-
tion, or modification, is warranted, the Sec- Secretary shall submit to the Committee on tion;
retary shall— Veterans’ Affairs of the Senate and the Com- ‘‘(B) the value and relevance of the infor-
‘‘(A) commence issuing regulations in ac- mittee on Veterans’ Affairs of the House of mation that could result from additional
cordance with the provisions of subchapter II Representatives a notice of the proposed studies; and
of chapter 5 of title 5 (commonly referred to modifications containing the following: ‘‘(C) the cost and feasibility of carrying
as the Administrative Procedures Act) set- ‘‘(1) A description of the proposed modi- out such additional studies.
fications. ‘‘(g) REPORTS.—(1)(A) Under an agreement
ting forth the presumption or commence re-
‘‘(2) A description of any exceptions to the between the Secretary and the Academies
vising regulations to carry out such modi- under this section, not later than one year
fication; and requirements of such sections that are pro-
posed because of limited available scientific after the date of the enactment of the Ser-
‘‘(B) include in such regulations any time geant First Class Heath Robinson Honoring
frame during which a health effect must be- evidence, and a description of how such eval-
our Promise to Address Comprehensive
come manifest; or uations will be conducted.
Toxics Act of 2022, the Academies shall sub-
‘‘(2) if the Secretary determines, in the dis- ‘‘§ 1176. Agreement with National Academies mit to the Secretary, the Committee on Vet-
cretion of the Secretary, that the presump- of Sciences, Engineering, and Medicine erans’ Affairs of the Senate, and the Com-
tion, or modification, is not warranted, the concerning toxic exposures mittee on Veterans’ Affairs of the House of
Secretary shall publish in the Federal Reg- ‘‘(a) PURPOSE.—The purpose of this section Representatives an initial report on the ac-
ister a notice of the determination, includ- is to provide for the National Academies of tivities of the Academies under the agree-
ing the reasons supporting the determina- Sciences, Engineering, and Medicine (in this ment.
tion. section referred to as the ‘Academies’), an ‘‘(B) The report submitted under subpara-
‘‘(b) REMOVAL OF PRESUMPTION.—(1)(A) The independent nonprofit scientific organiza- graph (A) shall include the following:
Secretary may— tion with appropriate expertise that is not ‘‘(i) The determinations described in sub-
‘‘(i) issue a regulation to remove an illness part of the Federal Government, to review section (d).
from a presumption of service connection and evaluate the available scientific evi- ‘‘(ii) A full explanation of the scientific
previously established pursuant to a regula- dence regarding associations between dis- evidence and reasoning that led to such de-
tion issued under subsection (a); and eases and toxic exposures. terminations.
‘‘(ii) issue a regulation to remove a pre- ‘‘(b) AGREEMENT.—(1) The Secretary shall ‘‘(iii) Any recommendations of the Acad-
sumption of service connection established seek to enter into a five-year agreement emies under subsection (f).
pursuant to title IV of the Sergeant First with the Academies to perform the services ‘‘(2) Under an agreement between the Sec-
Class Heath Robinson Honoring our Promise covered by this section. retary and the Academies under this section,
to Address Comprehensive Toxics Act of 2022 ‘‘(2) The Secretary shall seek to enter into not less frequently than once every two
if the Secretary concludes that evidence sug- an agreement described in paragraph (1) not years after the date on which the initial re-
gests the lack of a positive association be- later than 60 days after the date of the enact- port is submitted under paragraph (1)(A), the
tween the disease and the toxic exposure. ment of the Sergeant First Class Heath Rob- Academies shall submit to the Secretary, the
‘‘(B) Under subparagraph (A)(ii), the Sec- inson Honoring our Promise to Address Com- Committee on Veterans’ Affairs of the Sen-
retary shall not consider the lack of evidence prehensive Toxics Act of 2022. ate, and the Committee on Veterans’ Affairs
as sufficient to support a decision for re- ‘‘(3) An agreement under this section may of the House of Representatives an updated
moval of a presumption. report on the activities of the Academies
be extended in five-year increments.
‘‘(2) Whenever an illness is removed from under the agreement.
‘‘(c) REVIEW OF SCIENTIFIC EVIDENCE.—
regulations pursuant to paragraph (1), or the ‘‘(h) ALTERNATIVE CONTRACT SCIENTIFIC OR-
Under an agreement between the Secretary GANIZATION.—(1) If the Secretary is unable
periods and locations of exposure covered by and the Academies under this section, the
a presumption of service connection are within the time period prescribed in sub-
Academies shall review and summarize the section (b)(2) to enter into an agreement
modified under subsection (a)— scientific evidence, and assess the strength
‘‘(A) a veteran who was awarded compensa- with the Academies for the purposes of this
thereof, concerning the association between section on terms acceptable to the Sec-
tion under chapter 11 of this title for such toxic exposures during active military,
illness on the basis of the presumption pro- retary, the Secretary shall seek to enter into
naval, air, or space service and each disease an agreement for the purposes of this section
vided under such regulations before the ef- suspected to be associated with such expo-
fective date of the removal or modification with another appropriate scientific organiza-
sure in the human population. tion that—
shall continue to be entitled to receive com- ‘‘(d) SCIENTIFIC DETERMINATIONS CON-
pensation on that basis; ‘‘(A) is not part of the Federal Govern-
CERNING DISEASES.—For each disease re- ment;
‘‘(B) a survivor of a veteran who was viewed under subsection (c), the Academies
awarded dependency and indemnity com- ‘‘(B) operates as a not-for-profit entity;
shall determine, to the extent that available and
pensation under chapter 13 of this title for scientific data permit meaningful determina-
the death of a veteran resulting from such ‘‘(C) has expertise and objectivity com-
tions— parable to that of the Academies.
illness on the basis of such presumption shall ‘‘(1) whether an association exists between ‘‘(2) If the Secretary enters into an agree-
continue to be entitled to receive depend- toxic exposures and the occurrence of the ment with another organization as described
ency and indemnity compensation on such disease, taking into account the strength of in paragraph (1), any reference in this sub-
basis; and the scientific evidence and the appropriate- chapter to the Academies shall be treated as
‘‘(C) no veteran or survivor covered under ness of the statistical and epidemiological a reference to the other organization.’’.
subparagraph (A) or (B) shall have their com- methods used to detect the association; (b) REPORTS AND BRIEFINGS.—
pensation reduced solely because of the re- ‘‘(2) the increased risk of the disease (1) REPORT.—
moval of an illness pursuant to paragraph among those reporting toxic exposures dur- (A) IN GENERAL.—Not later than two years
(1). ing active military, naval, air, or space serv- after the date of the enactment of this Act,
‘‘§ 1175. Authority to modify process; congres- ice; the Secretary of Veterans Affairs shall sub-
sional oversight ‘‘(3) whether there exists a plausible bio- mit to the Committee on Veterans’ Affairs of
‘‘(a) IN GENERAL.—The Secretary may mod- logical mechanism or other evidence of a the Senate and the Committee on Veterans’
ify the process under which the working positive association between the toxic expo- Affairs of the House of Representatives a re-
group established under subsection (b) of sec- sure and the occurrence of the disease; and port on the implementation of, and rec-
tion 1172 of this title conducts assessments ‘‘(4) determine the strength of evidence for ommendations for, subchapter VII of chapter
under such section, the Secretary conducts a positive association based on categories 11 of title 38, United States Code, as added by
SSpencer on DSK126QN23PROD with SENATE
formal evaluations under section 1173 of this furnished under section 1173 of this title. subsection (a).
title, and issues regulations under section ‘‘(e) COOPERATION OF FEDERAL AGENCIES.— (B) CONSULTATION.—The Secretary shall
1174 of this title if— The head of each relevant Federal agency, develop the report under subparagraph (A) in
‘‘(1) such evaluations cover the evidence, including the Secretary of Defense, shall co- consultation with organizations recognized
data, and factors required by subsection (b) operate fully with the Academies in per- by the Secretary for the representation of
of such section 1173; and forming the services covered by this section. veterans under section 5902 of such title and
‘‘(2) a period of 180 days has elapsed fol- ‘‘(f) RECOMMENDATIONS FOR ADDITIONAL SCI- any other entity the Secretary determines
lowing the date on which the Secretary sub- ENTIFIC STUDIES.—(1) Under an agreement be- appropriate.
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2823
(2) BRIEFING.—On a quarterly basis during Secretary from the National Academy of SEC. 204. REEVALUATION OF CLAIMS FOR DE-
the two-year period beginning on the date of Sciences under section 3 of the Agent Orange PENDENCY AND INDEMNITY COM-
the enactment of this Act, the Secretary PENSATION INVOLVING PRESUMP-
Act of 1991 (Public Law 102–4).’’; and
TIONS OF SERVICE CONNECTION.
shall provide to the Committee on Veterans’ (C) by redesignating subsection (f) as sub-
Affairs of the Senate and the Committee on (a) IN GENERAL.—Subchapter I of chapter
section (c);
Veterans’ Affairs of the House of Representa- 13 is amended by adding at the end the fol-
(2) in section 1116B(b)(2)(A), by inserting
tives a briefing on the implementation of lowing new section:
‘‘pursuant to subchapter VII of this chap-
subchapter VII of chapter 11 of such title, as ter,’’ before ‘‘the Secretary determines’’; and ‘‘§ 1305. Reevaluation of dependency and in-
added by subsection (a). (3) in section 1118— demnity compensation determinations pur-
(c) INDEPENDENT ASSESSMENT.— (A) by striking subsections (b) through (e); suant to changes in presumptions of serv-
(1) AGREEMENT.—The Secretary shall seek and ice connection
to enter into an agreement with the Na- (B) by inserting after subsection (a) the ‘‘(a) REEVALUATION.—Whenever a law, in-
tional Academies of Science, Engineering, following new subsection (b): cluding through a regulation or Federal
and Medicine (in this subsection referred to court decision or settlement, establishes or
‘‘(b) The Secretary shall ensure that any
as the ‘‘Academies’’) before the date that is modifies a presumption of service connec-
determination made on or after the date of
90 days after the date of the enactment of tion, the Secretary shall—
the enactment of the Sergeant First Class
this Act to perform the services set forth ‘‘(1) identify all claims for dependency and
Heath Robinson Honoring our Promise to
under paragraph (2). indemnity compensation under this chapter
Address Comprehensive Toxics Act of 2022 re-
(2) ASSESSMENT.— that—
garding a presumption of service connection
(A) IN GENERAL.—Under an agreement be- ‘‘(A) were submitted to the Secretary;
based on a toxic exposure under this section
tween the Secretary and the Academies ‘‘(B) were evaluated and denied by the Sec-
is made pursuant to subchapter VII of this
under paragraph (1), the Academies shall retary before the date on which such provi-
chapter.’’.
conduct an assessment of the implementa- sion of law went into effect; and
tion by the Department of Veterans Affairs SEC. 203. OUTREACH TO CLAIMANTS FOR DIS- ‘‘(C) might have been evaluated differently
of the process established under subchapter ABILITY COMPENSATION PURSUANT
had the establishment or modification been
TO CHANGES IN PRESUMPTIONS OF
VII of chapter 11 of title 38, United States applicable to the claim;
SERVICE CONNECTION.
Code, as added by subsection (a). ‘‘(2) allow for the reevaluation of such
(B) ELEMENTS.—The assessment conducted (a) IN GENERAL.—Subchapter VI of chapter claims at the election of the claimant; and
under subparagraph (A) shall include the fol- 11 is amended by adding at the end the fol- ‘‘(3) notwithstanding section 5110 of this
lowing: lowing new section: title, with respect to claims approved pursu-
(i) An assessment of the Department’s im- ‘‘§ 1167. Outreach pursuant to changes in pre- ant to such reevaluation, provide compensa-
plementation of the process established sumptions of service connection tion under this chapter effective as if the es-
under subsection (a) to determine whether tablishment or modification of the presump-
the process is in accordance with current sci- ‘‘(a) IN GENERAL.—Whenever a law, includ- tion of service connection had been in effect
entific standards for assessing the link be- ing through a regulation or Federal court de- on the date of the submission of the original
tween exposure to environmental hazards cision or settlement, establishes or modifies claim described in paragraph (1).
and the development of health outcomes, a presumption of service connection, the ‘‘(b) OUTREACH.—(1) The Secretary shall
(ii) assess whether the criteria is fair and Secretary shall— conduct outreach to inform relevant claim-
consistent, and ‘‘(1) identify all claims for compensation ants that they may elect to have a claim be
(iii) provide recommendations for improve- under this chapter that— reevaluated in light of the establishment or
ments to the process. ‘‘(A) were submitted to the Secretary; modification of a presumption of service con-
(3) REPORT.—Not later than one year after ‘‘(B) were evaluated and denied by the Sec- nection described in subsection (a).
the date on which the Secretary enters into retary before the date on which such provi- ‘‘(2) Outreach under paragraph (1) shall in-
an agreement under paragraph (1), the Sec- sion of law went into effect; and clude the following:
retary shall submit to the Committee on ‘‘(C) might have been evaluated differently ‘‘(A) The Secretary shall publish on the
Veterans’ Affairs of the Senate and the Com- had the establishment or modification been internet website of the Department a notice
mittee on Veterans’ Affairs of the House of applicable to the claim; and that such claimants may elect to have a
Representatives a report on the findings of ‘‘(2) pursuant to subsection (b), conduct claim so reevaluated.
the Academies pursuant to such agreement. outreach to the claimants. ‘‘(B) The Secretary shall notify, in writing
(4) ALTERNATIVE CONTRACT SCIENTIFIC OR- ‘‘(b) OUTREACH.—(1) The Secretary shall or by electronic means, veterans service or-
GANIZATION.— conduct outreach to inform claimants iden- ganizations of the ability of such claimants
(A) IN GENERAL.—If the Secretary is unable tified under subsection (a) that they may to elect to have a claim so reevaluated.
within the time period prescribed in para- submit a supplemental claim in light of the ‘‘(C) The Secretary shall contact each
graph (1) to enter into an agreement with establishment or modification of a presump- claimant identified under subsection (a) in
the Academies for the purposes of this sub- tion of service connection described in sub- the same manner that the Department last
section on terms acceptable to the Sec- section (a). provided notice of a decision.’’.
retary, the Secretary shall seek to enter into ‘‘(2) Outreach under paragraph (1) shall in- (b) APPLICATION.—Section 1305 of title 38,
an agreement for the purposes of this sub- clude the following: United States Code, as added by subsection
section with another appropriate scientific ‘‘(A) The Secretary shall publish on the (a), shall apply with respect to presumptions
organization that— internet website of the Department a notice of service connection established or modified
(i) is not part of the Federal Government; that such veterans may elect to file a supple- on or after the date of the enactment of this
(ii) operates as a not-for-profit entity; and mental claim. Act, including pursuant to amendments
(iii) has expertise and objectivity com- ‘‘(B) The Secretary shall notify, in writing made by this Act.
parable to that of the Academies. or by electronic means, veterans service or- (c) RULE OF CONSTRUCTION.—Nothing in
(B) TREATMENT.—If the Secretary enters ganizations of the ability of such veterans to this section shall be construed as modifying
into an agreement with another organization file a supplemental claim. the obligations of the Department of Vet-
as described in subparagraph (A), any ref- ‘‘(C) The Secretary shall contact each erans Affairs under Federal court decisions
erence in this subsection to the Academies of claimant identified under subsection (a) in or settlements in effect as of the date of the
Sciences, Engineering, and Medicine shall be the same manner that the Department last enactment of this Act.
treated as a reference to the other organiza- provided notice of a decision.’’. TITLE III—IMPROVING THE ESTABLISH-
tion. (b) APPLICATION.—Section 1167 of title 38, MENT OF SERVICE CONNECTION PROC-
(d) CONFORMING AMENDMENTS.—Chapter 11 ESS FOR TOXIC-EXPOSED VETERANS
United States Code, as added by subsection
is amended— SEC. 301. SHORT TITLE.
(a), shall apply with respect to presumptions
(1) in section 1116— This title may be cited as the ‘‘Veterans
of service connection established or modified
(A) by striking subsections (b), (c), (d), and Burn Pits Exposure Recognition Act of 2022’’.
on or after the date of the enactment of this
(e); SEC. 302. PRESUMPTIONS OF TOXIC EXPOSURE.
Act, including pursuant to amendments
(B) by inserting after subsection (a) the Subchapter II of chapter 11 is amended by
made by this Act.
following new subsection (b): adding at the end the following new section:
‘‘(b) The Secretary shall ensure that any (c) RULE OF CONSTRUCTION.—Nothing in
this section shall be construed as— ‘‘§ 1119. Presumptions of toxic exposure
SSpencer on DSK126QN23PROD with SENATE
determination made on or after the date of
the enactment of the Sergeant First Class (1) modifying the obligations of the De- ‘‘(a) CONSIDERATION OF RECORDS.—If a vet-
Heath Robinson Honoring our Promise to partment of Veterans Affairs under Federal eran submits to the Secretary a claim for
Address Comprehensive Toxics Act of 2022 re- court decisions or settlements in effect as of compensation for a service-connected dis-
garding a presumption of service connection the date of the enactment of this Act; or ability under section 1110 of this title with
based on exposure to an herbicide agent (2) requiring a retroactively applied effec- evidence of a disability and a toxic exposure
under this section is made pursuant to sub- tive date of a supplemental claim earlier that occurred during active military, naval,
chapter VII of this chapter, including with than the date a presumption of service con- air, or space service, the Secretary may, in
respect to assessing reports received by the nection is established or modified. adjudicating such claim, consider—
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S2824 CONGRESSIONAL RECORD — SENATE June 7, 2022
‘‘(1) any record of the veteran in an expo- ‘‘(B) includes the Individual Longitudinal (b) PALOMARES OR THULE.—Section
sure tracking record system; and Exposure Record, or successor system. 1112(c)(3)(B), as amended by section 401, is
‘‘(2) if no record of the veteran in an expo- ‘‘(3) The term ‘toxic exposure risk activity’ further amended by adding at the end the
sure tracking record system indicates that has the meaning given such term in section following new clauses:
the veteran was subject to a toxic exposure 1710(e)(4) of this title.’’. ‘‘(vi) Onsite participation in the response
during active military, naval, air, or space SEC. 303. MEDICAL NEXUS EXAMINATIONS FOR effort following the collision of a United
service, the totality of the circumstances of TOXIC EXPOSURE RISK ACTIVITIES. States Air Force B–52 bomber and refueling
the service of the veteran. Subchapter VI of chapter 11, as amended plane that caused the release of four thermo-
‘‘(b) PRESUMPTION OF SPECIFIC TOXIC EXPO- by section 203, is further amended by adding nuclear weapons in the vicinity of
SURE FOR MEMBERS WHO SERVED IN CERTAIN at the end the following new section: Palomares, Spain, during the period begin-
LOCATIONS.—(1) The Secretary shall, for pur- ‘‘§ 1168. Medical nexus examinations for toxic ning January 17, 1966, and ending March 31,
poses of section 1110 and chapter 17 of this exposure risk activities 1967.
title, presume that any covered veteran was ‘‘(a) MEDICAL EXAMINATIONS AND MEDICAL ‘‘(vii) Onsite participation in the response
exposed to the substances, chemicals, and OPINIONS.—(1) Except as provided in sub- effort following the on-board fire and crash
airborne hazards identified in the list under section (b), if a veteran submits to the Sec- of a United States Air Force B–52 bomber
paragraph (2) during the service of the cov- retary a claim for compensation for a serv- that caused the release of four thermo-
ered veteran specified in subsection (c)(1), ice-connected disability under section 1110 of nuclear weapons in the vicinity of Thule Air
unless there is affirmative evidence to estab- this title with evidence of a disability and Force Base, Greenland, during the period be-
lish that the covered veteran was not ex- evidence of participation in a toxic exposure ginning January 21, 1968, and ending Sep-
posed to any such substances, chemicals, or risk activity during active military, naval, tember 25, 1968.’’.
hazards in connection with such service. air, or space service, and such evidence is not
‘‘(2) The Secretary shall— SEC. 403. PRESUMPTIONS OF SERVICE CONNEC-
sufficient to establish a service connection TION FOR DISEASES ASSOCIATED
‘‘(A) establish and maintain a list that
for the disability, the Secretary shall— WITH EXPOSURES TO CERTAIN HER-
contains an identification of one or more BICIDE AGENTS FOR VETERANS
‘‘(A) provide the veteran with a medical ex-
such substances, chemicals, and airborne WHO SERVED IN CERTAIN LOCA-
amination under section 5103A(d) of this
hazards as the Secretary, in collaboration TIONS.
title; and
with the Secretary of Defense, may deter- (a) SHORT TITLE.—This section may be
‘‘(B) obtain a medical opinion (to be re-
mine appropriate for purposes of this sec- cited as the ‘‘Veterans Agent Orange Expo-
quested by the Secretary in connection with
tion; and sure Equity Act of 2022’’.
the medical examination under subpara-
‘‘(B) determine, using procedures con- (b) IN GENERAL.—Section 1116, as amended
graph (A)) as to whether it is at least as like-
sistent with section 1172 of this title and by section 202, is further amended—
ly as not that there is a nexus between the
through the conduct of a formal evaluation (1) by striking ‘‘, during active military,
disability and the toxic exposure risk activ-
under section 1173 of this title, whether to naval, air, or space service, served in the Re-
establish an end date for a covered veteran ity.
‘‘(2) When providing the Secretary with a public of Vietnam during the period begin-
to qualify for presumptions of exposure ning on January 9, 1962, and ending on May
medical opinion under paragraph (1)(B) for a
under this section, if appropriate, but in no 7, 1975’’ each place it appears and inserting
veteran, the health care provider shall con-
case establish an end date earlier than the sider— ‘‘performed covered service’’;
last day of the period specified in section (2) by striking ‘‘performed active military,
‘‘(A) the total potential exposure through
101(33) for the Persian Gulf War. naval, air, or space service in the Republic of
all applicable military deployments of the
‘‘(3) Beginning not later than two years Vietnam during the period beginning on Jan-
after the date of the enactment of the Ser- veteran; and
‘‘(B) the synergistic, combined effect of all uary 9, 1962, and ending on May 7, 1975’’ each
geant First Class Heath Robinson Honoring place it appears and inserting ‘‘performed
our Promise to Address Comprehensive toxic exposure risk activities of the veteran.
‘‘(3) The requirement under paragraph covered service’’; and
Toxics Act of 2022, and not less frequently (3) by adding at the end the following new
(2)(B) shall not be construed as requiring a
than once every two years thereafter, the subsection:
health care provider to consider the syner-
Secretary shall submit to the Committee on ‘‘(d) In this section, the term ‘covered serv-
gistic, combined effect of each of the sub-
Veterans’ Affairs of the Senate and the Com- ice’ means active military, naval, air, or
stances, chemicals, and airborne hazards
mittee on Veterans’ Affairs of the House of space service—
identified in the list under section 1119(b)(2)
Representatives a report identifying any ad-
of this title. ‘‘(1) performed in the Republic of Vietnam
ditions or removals to the list under para-
‘‘(b) EXCEPTION.—Subsection (a) shall not during the period beginning on January 9,
graph (2) during the period covered by the re-
apply if the Secretary determines there is no 1962, and ending on May 7, 1975;
port.
indication of an association between the dis- ‘‘(2) performed in Thailand at any United
‘‘(c) DEFINITIONS.—In this section:
ability claimed by the veteran and the toxic States or Royal Thai base during the period
‘‘(1) The term ‘covered veteran’ means any
exposure risk activity for which the veteran beginning on January 9, 1962, and ending on
veteran who—
submitted evidence. June 30, 1976, without regard to where on the
‘‘(A) on or after August 2, 1990, performed ‘‘(c) TOXIC EXPOSURE RISK ACTIVITY DE-
active military, naval, air, or space service base the veteran was located or what mili-
FINED.—In this section, the term ‘toxic expo- tary job specialty the veteran performed;
while assigned to a duty station in, including sure risk activity’ has the meaning given
airspace above— ‘‘(3) performed in Laos during the period
that term in section 1710(e)(4) of this title.’’. beginning on December 1, 1965, and ending on
‘‘(i) Bahrain;
TITLE IV—PRESUMPTIONS OF SERVICE September 30, 1969;
‘‘(ii) Iraq;
CONNECTION ‘‘(4) performed in Cambodia at Mimot or
‘‘(iii) Kuwait;
‘‘(iv) Oman; SEC. 401. TREATMENT OF VETERANS WHO PAR- Krek, Kampong Cham Province during the
TICIPATED IN CLEANUP OF period beginning on April 16, 1969, and ending
‘‘(v) Qatar;
ENEWETAK ATOLL AS RADIATION- on April 30, 1969; or
‘‘(vi) Saudi Arabia; EXPOSED VETERANS FOR PURPOSES
‘‘(vii) Somalia; or ‘‘(5) performed on Guam or American
OF PRESUMPTION OF SERVICE CON-
‘‘(viii) United Arab Emirates; or NECTION OF CERTAIN DISABILITIES Samoa, or in the territorial waters thereof,
‘‘(B) on or after September 11, 2001, per- BY DEPARTMENT OF VETERANS AF- during the period beginning on January 9,
formed active military, naval, air, or space FAIRS. 1962, and ending on July 31, 1980, or served on
service while assigned to a duty station in, (a) SHORT TITLE.—This section may be Johnston Atoll or on a ship that called at
including airspace above— cited as the ‘‘Mark Takai Atomic Veterans Johnston Atoll during the period beginning
‘‘(i) Afghanistan; Healthcare Parity Act of 2022’’. on January 1, 1972, and ending on September
‘‘(ii) Djibouti; (b) ENEWETAK ATOLL.—Section 1112(c)(3)(B) 30, 1977.’’.
‘‘(iii) Egypt; is amended by adding at the end the fol- (c) ELIGIBILITY FOR HOSPITAL CARE AND
‘‘(iv) Jordan; lowing new clause: MEDICAL SERVICES.—Section 1710(e)(4), as
‘‘(v) Lebanon; ‘‘(v) Cleanup of Enewetak Atoll during the amended by section 102(c), is further amend-
‘‘(vi) Syria; period beginning on January 1, 1977, and end- ed by striking subparagraph (A) and insert-
‘‘(vii) Yemen; ing on December 31, 1980.’’. ing the following new subparagraph:
‘‘(viii) Uzbekistan; or SEC. 402. TREATMENT OF VETERANS WHO PAR- ‘‘(A) The term ‘Vietnam-era herbicide-ex-
‘‘(ix) any other country determined rel- TICIPATED IN NUCLEAR RESPONSE posed veteran’ means a veteran who—
evant by the Secretary. NEAR PALOMARES, SPAIN, OR ‘‘(i) performed covered service, as defined
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THULE, GREENLAND, AS RADIATION- in section 1116(d) of this title; or
‘‘(2) The term ‘exposure tracking record EXPOSED VETERANS FOR PURPOSES
system’— OF PRESUMPTION OF SERVICE CON-
‘‘(ii) the Secretary finds may have been ex-
‘‘(A) means any system, program, or pilot NECTION OF CERTAIN DISABILITIES posed during active military, naval, air, or
program used by the Secretary of Veterans BY DEPARTMENT OF VETERANS AF- space service to dioxin during the Vietnam
Affairs or the Secretary of Defense to track FAIRS. era, regardless of the geographic area of such
how veterans or members of the Armed (a) SHORT TITLE.—This section may be service, or was exposed during such service
Forces have been exposed to various occupa- cited as the ‘‘Palomares or Thule Veterans to a toxic substance found in a herbicide or
tional or environmental hazards; and Act of 2022’’. defoliant used for military purposes during
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2825
such era, regardless of the geographic area of the Secretary of Veterans Affairs determines title, and subject to section 1113 of this title,
such service.’’. are— a disease specified in subsection (b) becom-
(d) CONFORMING AMENDMENT.—The heading (I) terminally ill; ing manifest in a covered veteran shall be
for section 1116 is amended by striking ‘‘the (II) homeless; considered to have been incurred in or aggra-
Republic of Vietnam’’ and inserting ‘‘certain (III) under extreme financial hardship; vated during active military, naval, air, or
locations’’. (IV) more than 85 years old; or space service, notwithstanding that there is
(e) EFFECTIVE DATE AND APPLICABILITY.— (V) capable of demonstrating other suffi- no record of evidence of such disease during
The amendments made by this section shall cient cause. the period of such service.
take effect on the date of the enactment of (ii) On October 1, 2026, for everyone not de- ‘‘(b) DISEASES SPECIFIED.—The diseases
this Act and shall apply as follows: scribed in subparagraph (A). specified in this subsection are the following:
(1) On the date of the enactment of this (B) RETROACTIVE APPLICATION.—Notwith- ‘‘(1) Asthma that was diagnosed after serv-
Act for claimants for dependency and indem- standing any Federal court decisions or set- ice of the covered veteran as specified in sub-
nity compensation under chapter 13 of title tlements in effect on the day before the date section (c).
38, United States Code, and for veterans of the enactment of this Act, the Secretary ‘‘(2) The following types of cancer:
whom the Secretary of Veterans Affairs de- of Veterans Affairs shall award retroactive ‘‘(A) Head cancer of any type.
termines are— claims for a condition under section ‘‘(B) Neck cancer of any type.
(A) terminally ill; 1116(a)(2)(M) of title 38, United States Code, ‘‘(C) Respiratory cancer of any type.
(B) homeless; as added by subsection (c) of this section, ‘‘(D) Gastrointestinal cancer of any type.
(C) under extreme financial hardship; only to claimants for dependency and indem- ‘‘(E) Reproductive cancer of any type.
(D) more than 85 years old; or nity compensation under chapter 13 of such ‘‘(F) Lymphoma cancer of any type.
(E) capable of demonstrating other suffi- title described in subparagraph (A)(i) of this ‘‘(G) Lymphomatic cancer of any type.
cient cause. paragraph. ‘‘(H) Kidney cancer.
(2) On October 1, 2022, for everyone not de- SEC. 405. IMPROVING COMPENSATION FOR DIS- ‘‘(I) Brain cancer.
scribed in paragraph (1). ABILITIES OCCURRING IN PERSIAN ‘‘(J) Melanoma.
SEC. 404. ADDITION OF ADDITIONAL DISEASES GULF WAR VETERANS. ‘‘(K) Pancreatic cancer.
ASSOCIATED WITH EXPOSURE TO (a) REDUCTION IN THRESHOLD OF ELIGI- ‘‘(3) Chronic bronchitis.
CERTAIN HERBICIDE AGENTS FOR BILITY.—Subsection (a)(1) of section 1117 is ‘‘(4) Chronic obstructive pulmonary dis-
WHICH THERE IS A PRESUMPTION amended by striking ‘‘became manifest—’’ ease.
OF SERVICE CONNECTION FOR VET- and all that follows through the period at ‘‘(5) Constrictive bronchiolitis or oblitera-
ERANS WHO SERVED IN CERTAIN the end and inserting ‘‘became manifest to tive bronchiolitis.
LOCATIONS.
any degree at any time.’’. ‘‘(6) Emphysema.
(a) SHORT TITLE.—This section may be (b) PERMANENT EXTENSION OF PERIOD OF ‘‘(7) Granulomatous disease.
cited as the ‘‘Fair Care for Vietnam Veterans ELIGIBILITY.—Such section is further amend- ‘‘(8) Interstitial lung disease.
Act of 2022’’. ed— ‘‘(9) Pleuritis.
(b) MONOCLONAL GAMMOPATHY OF UNDETER- (1) by striking subsection (b); ‘‘(10) Pulmonary fibrosis.
MINED SIGNIFICANCE.—Section 1116(a)(2) of (2) by redesignating subsections (c) and (d) ‘‘(11) Sarcoidosis.
title 38, United States Code, is amended by as subsections (b) and (c), respectively; and ‘‘(12) Chronic sinusitis.
adding at the end the following new subpara- (3) in subsection (a)(2)(C), by striking ‘‘(13) Chronic rhinitis.
graph: ‘‘under subsection (d)’’ and inserting ‘‘under ‘‘(14) Glioblastoma.
‘‘(L) Monoclonal gammopathy of undeter- subsection (c)’’. ‘‘(15) Any other disease for which the Sec-
mined significance.’’. (c) ESTABLISHING SINGULAR DISABILITY- retary determines, pursuant to regulations
(c) HYPERTENSION.—Such section, as BASED QUESTIONNAIRE.—Such section is fur- prescribed under subchapter VII that a pre-
amended by subsection (b), is further amend- ther amended by inserting after subsection sumption of service connection is warranted
ed by adding at the end the following new (c) (as redesignated by subsection (b)) the based on a positive association with a sub-
subparagraph: following new subsection (d): stance, chemical, or airborne hazard identi-
‘‘(M) Hypertension.’’. ‘‘(d) If a Persian Gulf veteran at a medical
fied in the list under section 1119(b)(2) of this
(d) EFFECTIVE DATES AND APPLICABILITY.— facility of the Department presents with any
title.
(1) MONOCLONAL GAMMOPATHY OF UNDETER- one symptom associated with Gulf War Ill- ‘‘(c) COVERED VETERAN DEFINED.—In this
MINED SIGNIFICANCE.— ness, the Secretary shall ensure that health section, the term ‘covered veteran’ has the
(A) IN GENERAL.—The amendment made by care personnel of the Department use a dis- meaning given that term in section 1119(c) of
subsection (b) shall take effect on the date of ability benefits questionnaire, or successor this title.’’.
the enactment of this Act and shall apply as questionnaire, designed to identify Gulf War (c) CONFORMING AMENDMENT.—Section 1113
follows: Illness, in addition to any other diagnostic is amended by striking ‘‘or 1118’’ each place
(i) On the date of the enactment of this Act actions the personnel determine appro- it appears and inserting ‘‘1118, or 1120’’.
for claimants for dependency and indemnity priate.’’. (d) EFFECTIVE DATE AND APPLICABILITY.—
compensation under chapter 13 of title 38, (d) EXPANSION OF DEFINITION OF PERSIAN The amendments made by this section shall
United States Code, and for veterans whom GULF VETERAN.—Subsection (f) of such sec- take effect on the date of the enactment of
the Secretary of Veterans Affairs determines tion is amended by inserting ‘‘, Afghanistan, this Act and shall apply as follows:
are— Israel, Egypt, Turkey, Syria, or Jordan,’’ (1) On the date of the enactment of this
(I) terminally ill; after ‘‘operations’’. Act for claimants for dependency and indem-
(e) TRAINING.—Such section is further
(II) homeless; nity compensation under chapter 13 of title
amended by adding at the end the following
(III) under extreme financial hardship; 38, United States Code, and veterans whom
new subsection:
(IV) more than 85 years old; or ‘‘(i)(1) The Secretary shall take such ac- the Secretary of Veterans Affairs determines
(V) capable of demonstrating other suffi- tions as may be necessary to ensure that are—
cient cause. health care personnel of the Department are (A) terminally ill;
(ii) On October 1, 2022, for everyone not de- appropriately trained to effectively carry (B) homeless;
scribed in clause (i). out this section. (C) under extreme financial hardship;
(B) RETROACTIVE APPLICATION.—Notwith- ‘‘(2) Not less frequently than once each (D) more than 85 years old; or
standing any Federal court decisions or set- year, the Secretary shall submit to Congress (E) capable of demonstrating other suffi-
tlements in effect on the day before the date a report on the actions taken by the Sec- cient cause.
of the enactment of this Act, the Secretary retary to carry out paragraph (1).’’. (2) On the date of the enactment of this
of Veterans Affairs shall award retroactive SEC. 406. PRESUMPTION OF SERVICE CONNEC- Act for everyone not described in paragraph
claims for a condition under section TION FOR CERTAIN DISEASES ASSO- (1), with respect to paragraphs (1), (2)(C),
1116(a)(2)(L) of title 38, United States Code, CIATED WITH EXPOSURE TO BURN (2)(I), (5), (6), (7), (8), (9), (10), (11), (12), (13),
as added by subsection (b) of this section, PITS AND OTHER TOXINS. and (14), of section 1120(b) of title 38, United
only to claimants for dependency and indem- (a) SHORT TITLE.—This section may be States Code, as added by subsection (b).
nity compensation under chapter 13 of such cited as the ‘‘Presumptive Benefits for War (3) On October 1, 2023, for everyone not de-
title described in subparagraph (A)(i) of this Fighters Exposed to Burn Pits and Other scribed in paragraph (1), with respect to
paragraph. Toxins Act of 2022’’. paragraphs (3) and (4) of section 1120(b) of
(2) HYPERTENSION.— (b) IN GENERAL.—Subchapter II of chapter such title, as so added.
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(A) IN GENERAL.—The amendment made by 11, as amended by section 302, is further (4) On October 1, 2024, for everyone not de-
subsection (c) shall take effect on the date of amended by inserting after section 1119 the scribed in paragraph (1), with respect to sub-
the enactment of this Act and shall apply as following new section: paragraphs (A), (B), (D), (E), (F), (G), and (K)
follows: ‘‘§ 1120. Presumption of service connection of section 1120(b)(2) of such title, as so added.
(i) On the date of the enactment of this Act for certain diseases associated with expo- (5) On October 1, 2025, for everyone not de-
for claimants for dependency and indemnity sure to burn pits and other toxins scribed in paragraph (1), with respect to sub-
compensation under chapter 13 of title 38, ‘‘(a) PRESUMPTION OF SERVICE CONNEC- paragraphs (H) and (J) of section 1120(b)(2) of
United States Code, and for veterans whom TION.—For the purposes of section 1110 of this such title, as so added.
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S2826 CONGRESSIONAL RECORD — SENATE June 7, 2022
SEC. 407. RULE OF CONSTRUCTION. (C) funded by the Federal Government; and (C) Kuwait;
(a) GENERALLY.—Nothing in this Act shall (D) regarding the health consequences of (D) Oman;
be construed to prevent the Secretary of toxic exposures experienced during active (E) Qatar;
Veterans Affairs from processing claims for military, naval, air, or space service. (F) Saudi Arabia;
benefits under title 38, United States Code, (3) TOXIC EXPOSURE.—The term ‘‘toxic ex- (G) Somalia; or
for a condition or disease for which this Act posure’’ has the meaning given such term in (H) the United Arab Emirates; or
establishes a presumption of service connec- section 101 of title 38, United States Code, as (2) on or after September 11, 2001, served on
tion, as a claim for benefits for a condition amended by section 102(b). active duty in—
or disease with direct service connection. SEC. 502. ANALYSIS AND REPORT ON TREATMENT (A) Afghanistan;
(b) EFFECTIVE DATES AND APPLICABILITY.— OF VETERANS FOR MEDICAL CONDI- (B) Djibouti;
The Secretary shall not deny a claim for TIONS RELATED TO TOXIC EXPO- (C) Egypt;
benefits under title 38, United States Code, SURE. (D) Jordan;
for a condition or disease for which this Act (a) IN GENERAL.—The Secretary of Vet- (E) Lebanon;
establishes a presumption of service connec- erans Affairs shall analyze, on a continuous (F) Syria; or
tion because the claimant filed the claim basis, all clinical data that— (G) Yemen.
prior to the effective date or date of applica- (1) is obtained by the Department of Vet- SEC. 504. STUDY ON HEALTH TRENDS OF POST–9/
bility for that particular condition or dis- erans Affairs in connection with hospital 11 VETERANS.
ease. care, medical services, and nursing home The Secretary of Veterans Affairs shall
care furnished under section 1710(a)(2)(F) of conduct an epidemiological study on the
TITLE V—RESEARCH MATTERS
title 38, United States Code; and health trends of veterans who served in the
SEC. 501. INTERAGENCY WORKING GROUP ON (2) is likely to be scientifically useful in
TOXIC EXPOSURE RESEARCH. Armed Forces after September 11, 2001.
determining the association, if any, between SEC. 505. STUDY ON CANCER RATES AMONG VET-
(a) ESTABLISHMENT.— the medical condition of a veteran and a ERANS.
(1) IN GENERAL.—Not later than one year toxic exposure. (a) IN GENERAL.—The Secretary of Vet-
after the date of the enactment of this Act, (b) ANNUAL REPORT.—Not later than one erans Affairs shall conduct a study on the in-
the Secretary of Veterans Affairs shall, in year after the date of the enactment of this cidence of cancer in veterans to determine
collaboration with the heads of the entities Act, and annually thereafter, the Secretary trends in the rates of the incidence of cancer
described in paragraph (2), establish the shall submit to the Committee on Veterans’ in veterans.
Toxic Exposure Research Working Group (in Affairs of the Senate and the Committee on (b) ELEMENTS.—The study required by sub-
this section referred to as the ‘‘Working Veterans’ Affairs of the House of Representa- section (a) shall assess, with respect to each
Group’’). tives a report containing the following: veteran included in the study, the following:
(2) COMPOSITION.—The Working Group shall (1) The aggregate data compiled under sub- (1) The age of the veteran.
consist of employees, selected by the Sec- section (a). (2) The period of service and length of serv-
retary, of the following: (2) An analysis of such data. ice of the veteran in the Armed Forces.
(A) The Department of Veterans Affairs. (3) A description of the types and (3) The military occupational specialty or
(B) The Department of Defense. incidences of medical conditions identified specialties of the veteran.
(C) The Department of Health and Human by the Department under such subsection. (4) The sex of the veteran.
Services. (4) The explanation of the Secretary for (5) The type or types of cancer that the
(D) The Environmental Protection Agency. the incidence of such medical conditions and veteran has.
(E) Other entities of the Federal Govern- other explanations for the incidence of such SEC. 506. STUDY ON HEALTH EFFECTS OF WASTE
ment involved in research activities regard- conditions as the Secretary considers reason- RELATED TO MANHATTAN PROJECT
ing the health consequences of toxic expo- able. ON CERTAIN VETERANS.
sures experienced during active military, (5) The views of the Secretary on the sci- (a) STUDY.—Not later than 180 days after
naval, air, or space service. entific validity of drawing conclusions from the date of the enactment of this Act, the
(b) FUNCTIONS.—The Working Group shall the incidence of such medical conditions, as Secretary of Veterans Affairs shall enter
perform the following functions: evidenced by the data compiled under sub- into an agreement with the National Acad-
(1) Identify collaborative research activi- section (a), regarding any association be- emies of Sciences, Engineering, and Medicine
ties and resources available among entities tween such conditions and toxic exposures. for the conduct of a study on the health
represented by members of the Working (c) TOXIC EXPOSURE DEFINED.—In this sec- trends of veterans who, while serving in the
Group to conduct such collaborative re- tion, the term ‘‘toxic exposure’’ has the active military, naval, air, or space service—
search activities. meaning given such term in section 101 of (1) participated in activities relating to the
(2) Develop a five-year strategic plan for title 38, United States Code, as amended by Manhattan Project (including activities re-
such entities to carry out collaborative re- section 102(b). lating to covered waste) in connection with
search activities. SEC. 503. ANALYSIS RELATING TO MORTALITY OF such service; or
(c) REPORTING.—The Secretary shall sub- VETERANS WHO SERVED IN SOUTH- (2) resided at or near, as determined by the
mit to the Committee on Veterans’ Affairs of WEST ASIA. Secretary, the locations described in sub-
the Senate and the Committee on Veterans’ (a) ANALYSIS.— section (b).
Affairs of the House of Representatives the (1) IN GENERAL.—Not later than 270 days (b) COVERED LOCATIONS.—The locations de-
following: after the date of the enactment of this Act, scribed in this subsection are the following
(1) Not later than one year after the date of the Secretary of Veterans Affairs, in coordi- locations:
the enactment of this Act, a report on the nation with the Secretary of Defense, shall (1) In the county of St. Louis, Missouri, the
establishment of the Working Group under conduct an updated analysis of total and res- following:
subsection (a). piratory disease mortality in covered vet- (A) Coldwater Creek, Missouri.
(2) Not later than two years after the date erans. (B) The St. Louis Airport Site, Missouri.
of the enactment of this Act, a report con- (2) ELEMENTS.—The analysis required by (C) The West Lake Landfill.
taining the collaborative research activities paragraph (1) shall include, to the extent (2) Oak Ridge, Tennessee.
identified, and the strategic plan developed, practicable, the following with respect to (3) Hanford, Washington.
by the Working Group under subsection (b). each covered veteran: (4) Any other location that is proximate to
(3) Not less frequently than annually dur- (A) Metrics of airborne exposures. covered waste, as determined by the Sec-
ing the five-year period covered by the stra- (B) The location and timing of deploy- retary.
tegic plan under subsection (b), a progress ments of the veteran. (c) ELEMENTS.—The study under subsection
report on implementation of the strategic (C) The military occupational specialty of (a) shall assess, with respect to each veteran
plan. the veteran. included in the study, the following:
(d) TERMINATION.—The Working Group (D) The Armed Force in which the veteran (1) The age, sex, and race of the veteran.
shall terminate after submitting the final re- served. (2) The period and location of exposure to
port under subsection (c). (E) Pre-existing health status of the vet- covered waste.
(e) DEFINITIONS.—In this section: eran, including with respect to asthma. (3) Any type of cancer, or other illness as-
(1) ACTIVE MILITARY, NAVAL, AIR, OR SPACE (F) Relevant personal information of the sociated with toxic exposure, that the vet-
SERVICE.—The term ‘‘active military, naval, veteran, including cigarette and e-cigarette eran has.
air, or space service’’ has the meaning given smoking history, diet, sex, gender, age, race, (4) A comparison of the overall health con-
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that term in section 101 of title 38, United and ethnicity. dition of the veteran, including any illness of
States Code. (b) COVERED VETERAN DEFINED.—In this the veteran identified pursuant to paragraph
(2) COLLABORATIVE RESEARCH ACTIVITY.— section, the term ‘‘covered veteran’’ means (3), with the overall health condition of past
The term ‘‘collaborative research activity’’ any veteran who— and present civilian populations residing at
means a research activity— (1) on or after August 2, 1990, served on ac- the same location of exposure, as determined
(A) agreed upon by the Working Group; tive duty in— by the Secretary.
(B) conducted by an entity represented by (A) Bahrain; (d) REPORT.—Not later than three years
a member of the Working Group; (B) Iraq; after the date of the enactment of this Act,
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2827
the Secretary shall submit to the Committee in Territories and Freely Associated States the Comptroller General shall provide to the
on Veterans’ Affairs of the Senate and the of the United States, including deficits in Committee on Veterans’ Affairs of the Sen-
Committee on Veterans’ Affairs of the House the availability and accessibility of such ate and the Committee on Veterans’ Affairs
of Representatives a report on the study benefits and services compared to veterans of the House of Representatives a briefing
under subsection (a) and include in such re- elsewhere in the United States. setting forth the results of the study con-
port an analysis of the data available and (2) ELEMENTS.—The study under paragraph ducted under subsection (a), including any
data reliability. (1) shall include— recommendations developed under paragraph
(e) DEFINITIONS.—In this section: (A) the number of veterans in each Terri- (2)(K) of such subsection.
(1) ACTIVE MILITARY, NAVAL, AIR, OR SPACE tory and Freely Associated State of the (c) DEFINITIONS.—In this section:
SERVICE; TOXIC EXPOSURE.—The terms ‘‘ac- United States; (1) FREELY ASSOCIATED STATE.—The term
tive military, naval, air, or space service’’ (B) the number of veterans in each Terri- ‘‘Freely Associated State’’ includes the Fed-
and ‘‘toxic exposure’’ have the meanings tory and Freely Associated State who are en- erated States of Micronesia, the Republic of
given those terms in section 101 of title 38, rolled in the system of annual patient enroll- the Marshall Islands, and the Republic of
United States Code, as added by section ment of the Department of Veterans Affairs Palau.
102(b). under section 1705(a) of title 38, United (2) TERRITORY.—The term ‘‘Territory’’ in-
(2) COVERED WASTE.—The term ‘‘covered States Code; cludes American Samoa, the Commonwealth
waste’’ means any waste arising from activi- (C) a description of how the Department of the Northern Marianas Islands, Guam,
ties carried out in connection with the Man- estimates the number of veterans in each Puerto Rico, and the Virgin Islands.
hattan Project. Territory and Freely Associated State who (3) VET CENTER.—The term ‘‘Vet Center’’
(3) ILLNESS.—The term ‘‘illness’’ has the are eligible for services under section 1710 of has the meaning given that term in section
meaning given that term in section 1171 of such title but who are not enrolled as de- 1712A(h) of title 38, United States Code.
title 38, United States Code, as added by sec- scribed in subparagraph (B); SEC. 509. DEPARTMENT OF VETERANS AFFAIRS
tion 202. (D) a detailed description of obstacles fac- PUBLIC WEBSITE FOR TOXIC EXPO-
(4) TOXIC EXPOSURE.—The term ‘‘toxic ex- ing veterans in each Territory and Freely SURE RESEARCH.
posure’’ has the meaning given such term in Associated State in accessing health care (a) WEBSITE.—Not later than one year after
section 101 of title 38, United States Code, as services, including those involving the avail- the date of the enactment of this Act, the
amended by section 102(b). ability of such services to veterans in the Secretary of Veterans Affairs shall establish,
Territory or Freely Associated State in and maintain thereafter, a publicly acces-
SEC. 507. STUDY ON TOXIC EXPOSURE AND MEN-
TAL HEALTH OUTCOMES. which the veterans reside, and any distance sible internet website of the Department of
impediments to receiving services at a re- Veterans Affairs that serves as a clearing-
(a) STUDY REQUIRED.—Not later than 180
gional medical center of the Veterans Health house for the publication of all toxic expo-
days after the date of the enactment of this
Administration, a community-based out- sure research carried out or funded by the
Act, the Secretary of Veterans Affairs shall
patient clinic, another full-service medical executive branch of the Federal Government.
enter into an agreement with the National
facility of the Department, or a Vet Center, (b) COORDINATION.—In carrying out sub-
Academies of Sciences, Engineering, and
respectively; section (a), the Secretary shall coordinate
Medicine for the conduct of a study of vet-
(E) a detailed description of obstacles fac- with—
erans to assess possible relationships be- ing veterans in each Territory and Freely (1) the heads of each Federal agency car-
tween toxic exposures experienced during Associated State in accessing readjustment rying out or funding toxic exposure research;
service in the Armed Forces and mental counseling services, including those involv- (2) the War Related Illness and Injury
health conditions, including chronic multi- ing the availability of such services to vet- Study Center of the Department of Veterans
symptom illness, traumatic brain injury, erans in the Territory in which the veterans Affairs, or successor center; and
post-traumatic stress disorder, depression, reside, and any distance impediments to re- (3) any working group of the Department
episodes of psychosis, schizophrenia, bipolar ceiving services at a readjustment coun- of Veterans Affairs or other similar entity
disorder, suicide attempts, and suicide seling services center of the Department; responsible for coordinating toxic exposure
deaths. (F) a detailed description of obstacles fac- research.
(b) ELEMENTS.—For each veteran included ing veterans in each Territory and Freely (c) DEFINITIONS.—In this section:
in the study under subsection (a), the fol- Associated State in accessing non-health (1) TOXIC EXPOSURE.—The term ‘‘toxic ex-
lowing information shall be collected and as- care veterans benefits, including those in- posure’’ has the meaning given that term in
sessed: volving the availability of benefits and serv- section 101 of title 38, United States Code, as
(1) Age. ices to veterans in the Territory or Freely added by section 102(b).
(2) Sex. Associated State in which the veterans re- (2) TOXIC EXPOSURE RESEARCH.—The term
(3) Race and ethnicity. side, and any distance impediments to ac- ‘‘toxic exposure research’’ means research on
(4) Period and length of service in the cessing the nearest office of the Veterans the health consequences of toxic exposures
Armed Forces. Benefits Administration; experienced during service in the Armed
(5) The military occupational specialty or (G) an analysis of the staffing and quality Forces.
specialties of the veteran. of the offices of the Veterans Benefits Ad- SEC. 510. REPORT ON HEALTH EFFECTS OF JET
(6) History of toxic exposure during service ministration and Veterans Health Adminis- FUELS USED BY ARMED FORCES.
in the Armed Forces. tration charged with serving veterans in the (a) INITIAL REPORT.—Not later than one
(7) Any diagnosis of chronic multisymptom Territories and Freely Associated States, in- year after the date of the enactment of this
illness. cluding the availability of the full- and part- Act, the Secretary of Veterans Affairs shall
(8) Any diagnosis of a mental health or time staff of each office to the veterans they submit to the Committee on Veterans’ Af-
cognitive disorder. are charged with serving; fairs of the Senate and the Committee on
(9) Any history of suicide attempt or (H) an analysis of the availability of the Veterans’ Affairs of the House of Representa-
suicidality. Veterans Community Care Program estab- tives, and make publicly available, a report
(10) If the veteran died by suicide. lished under section 1703 of title 38, United on health effects of jet fuels used by the
(11) Any confounding traumatic experi- States Code, to veterans in each Territory Armed Forces.
ences that could affect a veteran’s mental and Freely Associated State; (b) CONTENTS.—The report submitted under
health. (I) an analysis of the economic and health subsection (a) shall include the following:
(c) REPORT.—Not later than three years outcomes for veterans in each Territory or (1) A discussion of the effect of various dif-
after the date of the enactment of this Act, Freely Associated State resulting from ob- ferent types of jet fuels used by the Armed
the Secretary shall submit to the Committee stacles to accessing adequate assistance and Forces on the health of individuals by length
on Veterans’ Affairs of the Senate and the health care at facilities of the Department; of exposure.
Committee on Veterans’ Affairs of the House (J) an analysis of the access to benefit as- (2) An identification of the immediate
of Representatives a report containing the sistance and health care provided to veterans symptoms of jet fuel exposure that may indi-
findings of the National Academies of in the aftermath of major disasters declared cate future health risks.
Sciences, Engineering, and Medicine with re- in each of the Territories and Freely Associ- (3) A chronology of health safeguards im-
spect to the study conducted under sub- ated States since September 4, 2017; and plemented by the Armed Forces intended to
section (a). (K) such recommendations as the Comp- reduce the exposure of members of the
SEC. 508. STUDY ON VETERANS IN TERRITORIES troller General considers appropriate for im- Armed Forces to jet fuel.
OF THE UNITED STATES. (4) An identification of any areas relating
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proving access of veterans in the Territories
(a) GAO STUDY.— and Freely Associated States to benefits and to jet fuel exposure about which new re-
(1) IN GENERAL.—The Comptroller General health care services furnished by the Sec- search needs to be conducted.
of the United States shall conduct a study on retary, and reducing barriers and deficits in (c) FOLLOW-UP REPORT.—Not later than
the state of access and barriers to benefits the availability and accessibility of such five years after the date of the submittal of
and services furnished by the Veterans Bene- benefits and services compared to veterans the report under subsection (a), the Sec-
fits Administration and the Veterans Health elsewhere in the United States. retary shall submit to the committees re-
Administration under laws administered by (b) BRIEFING.—Not later than one year ferred to in such subsection an update to
the Secretary of Veterans Affairs to veterans after the date of the enactment of this Act, such report.
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S2828 CONGRESSIONAL RECORD — SENATE June 7, 2022
TITLE VI—IMPROVEMENT OF RESOURCES cifically designed and manufactured for the the processing and rating of claims by rely-
AND TRAINING REGARDING TOXIC-EX- burning of solid waste. ing on patterns of similar evidence in claim
POSED VETERANS (d) PRINT MATERIAL.—In developing the files.
SEC. 601. SHORT TITLE; DEFINITIONS. screening established under subsection (a), (iv) To the greatest extent possible, auto-
(a) SHORT TITLE.—This title may be cited the Secretary shall ensure that print mate- mation should be carried out by drawing
as the ‘‘Fairly Assessing Service-related rials complementary to such screening that from information in the possession of the De-
Toxic Exposure Residuals Presumptions Act outline related resources for veterans are partment, other Government agencies, and
of 2022’’ or the ‘‘FASTER Presumption Act of available at each medical center of the De- applicants for benefits.
2022’’. partment to veterans who may not have ac- (v) Automation of any claims analysis or
(b) DEFINITIONS.—In this title, the terms cess to the internet. determination process should not be end-to-
‘‘active military, naval, air, or space serv- (e) SCREENING UPDATES.—The Secretary end or lack intermediation.
ice’’, ‘‘toxic exposure’’, and ‘‘toxic-exposed shall consider updates to the content of the (vi) Employees of the Department should
veteran’’ have the meanings given those screening required under subsection (a) not continue to make decisions with respect to
terms in section 101 of title 38, United States less frequently than biennially to ensure the the approval of claims and the granting of
Code, as amended by section 102. screening contains the most current infor- benefits.
SEC. 602. PUBLICATION OF LIST OF RESOURCES mation. (vii) Automation should not be carried out
OF DEPARTMENT OF VETERANS AF- SEC. 604. TRAINING FOR PERSONNEL OF THE DE- in a manner that reduces or infringes upon
FAIRS FOR TOXIC-EXPOSED VET- PARTMENT OF VETERANS AFFAIRS the due process rights of applicants for bene-
ERANS AND VETERANS WHO RE- WITH RESPECT TO VETERANS WHO fits under the laws administered by the Sec-
PORT TOXIC EXPOSURES AND OUT- REPORT TOXIC EXPOSURES. retary; or the duties of the Secretary to as-
REACH PROGRAM FOR SUCH VET- (a) HEALTH CARE PERSONNEL.—The Sec- sist and notify claimants.
ERANS AND CAREGIVERS AND SUR- retary of Veterans Affairs shall provide to
VIVORS OF SUCH VETERANS. (viii) Automation should be carried out
health care personnel of the Department of while taking all necessary measures to pro-
(a) PUBLICATION OF LIST OF RESOURCES.—
Veterans Affairs education and training to tect the privacy of claimants and their per-
(1) IN GENERAL.—Not later than one year
identify, treat, and assess the impact on vet- sonally identifiable information.
after the date of the enactment of this Act,
erans of illnesses related to toxic exposures (ix) Automation of claims processing
and annually thereafter, the Secretary of
and inform such personnel of how to ask for should not eliminate or reduce the workforce
Veterans Affairs shall publish a list of re-
additional information from veterans regard- of the Veterans Benefits Administration.
sources of the Department of Veterans Af-
ing different toxic exposures. (C) An identification of targets, for each
fairs for—
(b) BENEFITS PERSONNEL.— fiscal year, by which the Secretary intends
(A) toxic-exposed veterans and veterans (1) IN GENERAL.—The Secretary shall incor-
who report toxic exposure; to complete the modernization of each infor-
porate a training program for processors of mation system or major component or
(B) families and caregivers of such vet- claims under the laws administered by the
erans; and functionality of such system identified under
Secretary who review claims for disability subparagraph (A).
(C) survivors of such veterans who are re- benefits relating to service-connected dis-
ceiving death benefits under the laws admin- (D) Cost estimates for the modernization of
abilities based on toxic exposures. each information system identified under
istered by the Secretary. (2) ANNUAL TRAINING.—Training provided
(2) UPDATE.—The Secretary shall periodi- paragraph (A) for each fiscal year covered by
to processors under paragraph (1) shall be the plan and in total.
cally update the list published under para-
provided not less frequently than annually. (2) APPROPRIATE CONGRESSIONAL COMMIT-
graph (1).
TITLE VII—RESOURCING TEES.—In this section, the term ‘‘appropriate
(b) OUTREACH.—The Secretary shall de-
velop, with input from the community, an SEC. 701. AUTHORITY TO USE APPROPRIATIONS congressional committees’’ means—
informative outreach program for veterans TO ENHANCE CLAIMS PROCESSING (A) the Committee on Veterans’ Affairs
on illnesses that may be related to toxic ex- CAPACITY AND AUTOMATION. and the Subcommittee on Military Construc-
posures, including outreach with respect to (a) AUTHORITY.—The Secretary of Veterans tion, Veterans Affairs, and Related Agencies
benefits and support programs. Affairs may use, from amounts appropriated of the Committee on Appropriations of the
SEC. 603. INCORPORATION OF TOXIC EXPOSURE to the Cost of War Toxic Exposures Fund es- Senate; and
SCREENING FOR VETERANS. tablished by section 324 of title 38, United (B) the Committee on Veterans’ Affairs
(a) IN GENERAL.—Beginning not later than States Code, as added by section 805 of this and the Subcommittee on Military Construc-
90 days after the date of the enactment of Act, such amounts as may be necessary to tion, Veterans Affairs, and Related Agencies
this Act, the Secretary of Veterans Affairs continue the modernization, development, of the Committee on Appropriations of the
shall incorporate a screening to help deter- and expansion of capabilities and capacity of House of Representatives.
mine potential toxic exposures during active information technology systems and infra- SEC. 702. AUTHORIZATION OF MAJOR MEDICAL
military, naval, air, or space service as part structure of the Veterans Benefits Adminis- FACILITY LEASES OF DEPARTMENT
of a health care screening furnished by the tration, including for claims automation, to OF VETERANS AFFAIRS FOR FISCAL
support expected increased claims processing YEAR 2023.
Department of Veterans Affairs to veterans
enrolled in the system of annual patient en- for newly eligible veterans pursuant to this (a) IN GENERAL.—The Secretary of Vet-
rollment of the Department established and Act. erans Affairs may carry out the following
operated under section 1705 of title 38, United (b) PLAN FOR MODERNIZATION OF VETERANS major medical facility leases in fiscal year
States Code, to improve understanding by BENEFITS ADMINISTRATION INFORMATION 2023:
the Department of toxic exposures while TECHNOLOGY SYSTEMS.— (1) Lease for an outpatient clinic in the vi-
serving in the Armed Forces. (1) IN GENERAL.—Not later than 180 days cinity of Allentown, Pennsylvania, in an es-
(b) TIMING.—The Secretary shall ensure after the date of the enactment of this Act, timated amount of $31,832,000.
that a veteran described in subsection (a) the Secretary of Veterans Affairs shall sub- (2) Lease for a facility for member services
completes the screening required under such mit to the appropriate congressional com- for the Veterans Health Administration in
subsection not less frequently than once mittees a plan for the modernization of the the vicinity of Atlanta, Georgia, in an esti-
every five years. information technology systems of the Vet- mated amount of $27,134,000.
(c) DETERMINATION OF QUESTIONS.— erans Benefits Administration. The plan (3) Lease for an outpatient clinic in the vi-
(1) IN GENERAL.—The questions included in shall cover the first fiscal year that begins cinity of Baltimore, Maryland, in an esti-
the screening required under subsection (a) after the date of the enactment of this Act mated amount of $43,041,000.
shall be determined by the Secretary with and the subsequent four fiscal years and (4) Lease for an outpatient clinic in the vi-
input from medical professionals. shall include each of the following: cinity of Baton Rouge, Louisiana, in an esti-
(2) SPECIFIC QUESTIONS.—At a minimum, (A) An identification of any information mated amount of $29,550,000.
the screening required under subsection (a) system to be modernized or retired, if appli- (5) Lease for an outpatient clinic in the vi-
shall, with respect to a veteran, include— cable, during the period covered by the plan. cinity of Beaufort, South Carolina, in an es-
(A) a question about the potential exposure (B) A description of how the Secretary in- timated amount of $24,254,000.
of the veteran to an open burn pit; and tends to incorporate the following principles (6) Lease for an outpatient clinic in the vi-
(B) a question regarding toxic exposures into the modernization of such information cinity of Beaumont, Texas, in an estimated
that are commonly associated with service systems: amount of $15,632,000.
in the Armed Forces. (i) The purpose of automation should be to (7) Lease for an outpatient clinic in the vi-
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(3) OPEN BURN PIT DEFINED.—In this sub- increase the speed and accuracy of claims cinity of Brainerd, Minnesota, in an esti-
section, the term ‘‘open burn pit’’ means an processing decisions. mated amount of $14,669,000.
area of land that— (ii) Automation should be conducted in a (8) Lease for a facility for research in the
(A) is designated by the Secretary of De- manner that enhances the productivity of vicinity of Buffalo, New York, in an esti-
fense to be used for disposing solid waste by employees of the Department of Veterans Af- mated amount of $11,106,000.
burning in the outdoor air; and fairs. (9) Lease for an outpatient clinic in the vi-
(B) does not contain a commercially manu- (iii) Automation should be carried out in a cinity of Clarksville, Tennessee, in an esti-
factured incinerator or other equipment spe- manner that achieves greater consistency in mated amount of $75,135,000.
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2829
(10) Lease of a facility for research in the (1) by striking ‘‘No funds’’ and inserting five-year period, a ten-year period, and a
vicinity of Columbia, Missouri, in an esti- ‘‘(A) No funds’’; twenty-year period.
mated amount of $20,726,000. (2) by striking ‘‘or any major medical facil- ‘‘(E) A detailed analysis of how the lease is
(11) Lease for an outpatient clinic in the ity lease’’; expected to comply with Office of Manage-
vicinity of Cookeville, Tennessee, in an esti- (3) by striking ‘‘or lease’’; and ment and Budget Circular A–11 and section
mated amount of $10,958,000. (4) by adding at the end the following new 1341 of title 31 (commonly referred to as the
(12) Lease for a residential treatment facil- subparagraph: ‘Anti-Deficiency Act’). Any such analysis
ity in the vicinity of Denver, Colorado, in an ‘‘(B) No funds may be appropriated for any shall include—
estimated amount of $9,133,000. fiscal year, and the Secretary may not obli- ‘‘(i) an analysis of the classification of the
(13) Lease for an outpatient clinic in the gate or expend funds (other than for advance lease as a ‘lease purchase’, a ‘capital lease’,
vicinity of Elizabethtown, Kentucky, in an planning and design), for any major medical or an ‘operating lease’ as those terms are de-
estimated amount of $16,671,000. facility lease unless the Committee on Vet- fined in Office of Management and Budget
(14) Lease for an outpatient clinic in the erans’ Affairs of the Senate and the Com- Circular A–11;
vicinity of Farmington, Missouri, in an esti- mittee on Veterans’ Affairs of the House of ‘‘(ii) an analysis of the obligation of budg-
mated amount of $17,940,000. Representatives each adopt a resolution ap- etary resources associated with the lease;
(15) Lease for an outpatient clinic in the proving the lease.’’. and
vicinity of Hampton, Virginia, in an esti- (b) MODIFICATION OF DEFINITION OF MAJOR ‘‘(iii) an analysis of the methodology used
mated amount of $63,085,000. MEDICAL FACILITY LEASE.—Subparagraph (B) in determining the asset cost, fair market
(16) Lease for an outpatient clinic in the of paragraph (3) of such subsection is amend- value, and cancellation costs of the lease.’’.
vicinity of Jacksonville, North Carolina, in ed to read as follows: (d) INTERIM LEASING ACTIONS.—Such sec-
an estimated amount of $61,450,000. ‘‘(B) The term ‘major medical facility tion is further amended by adding at the end
(17) Lease for an outpatient clinic in the lease’— the following new subsection:
vicinity of Killeen, Texas, in an estimated ‘‘(i) means a lease for space for use as a ‘‘(i)(1) Notwithstanding subsection
amount of $61,030,000. new medical facility approved through the (a)(2)(B), the Secretary may carry out in-
(18) Lease for an outpatient clinic in the General Services Administration under sec- terim leasing actions as the Secretary con-
vicinity of Lawrence, Indiana, in an esti- tion 3307(a) of title 40 at an average annual siders necessary for the following leases:
mated amount of $15,811,000. rent equal to or greater than the appropriate ‘‘(A) Major medical facility leases (as de-
(19) Lease for an outpatient clinic in the dollar threshold described in such section, fined in subsection (a)(3)(B)) approved pursu-
vicinity of Lecanto, Florida, in an estimated which shall be subject to annual adjustment ant to this section and for which a pro-
amount of $15,373,000. in accordance with section 3307(h) of such spectus for a replacement lease has been sub-
(20) Lease for an outpatient clinic in the title; and mitted to Congress pursuant to subsection
vicinity of Nashville, Tennessee, in an esti- ‘‘(ii) does not include a lease for space for (b)(2).
mated amount of $58,038,000. use as a shared Federal medical facility for ‘‘(B) Replacement leases that do not re-
(21) Lease for an outpatient clinic in the which the Department’s estimated share of quire approval under this section and for
vicinity of North Kansas City, Missouri, in the lease costs does not exceed such dollar which a prospectus has been submitted to
an estimated amount of $40,027,000. threshold.’’. Congress pursuant to subsection (b)(2).
(22) Lease for an outpatient clinic in the (c) SEPARATE PROSPECTUS REQUIREMENT ‘‘(2) In this subsection, the term ‘interim
vicinity of Pflugerville, Texas, in an esti- FOR MAJOR MEDICAL FACILITY LEASES.—Sub- leasing actions’ has the meaning given that
mated amount of $16,654,000. section (b) of such section is amended— term by the Administrator of the General
(23) Lease for an outpatient clinic in the (1) by striking paragraph (7); Services Administration.’’.
vicinity of Plano, Texas, in an estimated (2) in paragraph (1), by redesignating sub- (e) PURCHASE OPTIONS.—Such section is
amount of $32,796,000. paragraphs (A) through (E) as clauses (i) further amended by adding at the end the
(24) Lease for an outpatient clinic in the through (v), respectively; following new subsection:
vicinity of Prince George’s County, Mary- (3) in paragraph (6), by redesignating sub- ‘‘(j) The Secretary may obligate and ex-
land, in an estimated amount of $31,754,000. paragraphs (A) through (C) as clauses (i) pend funds to exercise a purchase option in-
(25) Lease for an outpatient clinic in the through (iii), respectively; cluded in any major medical facility lease
vicinity of Rolla, Missouri, in an estimated (4) by redesignating paragraphs (1) through (as defined in subsection (a)(3)(B)).’’.
amount of $21,352,000. (6) as subparagraphs (A) through (F), respec- (f) APPLICABILITY.—The amendments made
(26) Lease for an outpatient clinic in the tively; by this section shall apply with respect to
vicinity of Salt Lake City, Utah, in an esti- (5) in the matter preceding subparagraph any lease that has not been specifically au-
mated amount of $29,466,000. (A), as redesignated by paragraph (4)— thorized by law on or before the date of the
(27) Lease for an outpatient clinic in the (A) by striking ‘‘Whenever the President’’ enactment of this Act.
vicinity of Sarasota, Florida, in an esti- and inserting ‘‘(1) Whenever the President’’; SEC. 704. AUTHORITY TO ENTER INTO AGREE-
mated amount of $36,517,000. MENTS WITH ACADEMIC AFFILIATES
(B) by striking ‘‘the Congress’’ and insert- AND OTHER ENTITIES TO ACQUIRE
(28) Lease for an outpatient clinic in the ing ‘‘Congress’’; and SPACE FOR THE PURPOSE OF PRO-
vicinity of Springfield, Massachusetts, in an (C) by striking ‘‘or a major medical facil- VIDING HEALTH-CARE RESOURCES
estimated amount of $30,918,000. ity lease (as defined in subsection (a)(3)(b))’’; TO VETERANS.
(29) Lease for a community living center in (6) in subparagraph (A), as redesignated by Section 8103 of title 38, United States Code,
the vicinity of Tampa, Florida, in an esti- paragraph (4), by striking ‘‘leased,’’; is amended by adding at the end the fol-
mated amount of $51,682,000. (7) in subparagraph (E), as redesignated by lowing new subsection:
(30) Lease for an outpatient clinic in the paragraph (4)— ‘‘(h)(1) Notwithstanding any other provi-
vicinity of The Villages, Florida, in an esti- (A) by striking ‘‘or lease’’ each place it ap- sion of law requiring the use of competitive
mated amount of $48,267,000. pears; and procedures, including section 2304 of title 10,
(31) Lease for an outpatient clinic in the (B) by striking ‘‘or leases’’; and when the Secretary determines it to be in
vicinity of Tri-Cities, Washington, in an esti- (8) by adding at the end the following new the best interest of the Department, the Sec-
mated amount of $36,136,000. paragraph: retary may enter into a lease with an aca-
(b) TREATMENT OF AUTHORIZATIONS.—The ‘‘(2) Whenever the President or the Sec- demic affiliate or covered entity to acquire
authorization of leases under subsection (a) retary submit to Congress a request for the space for the purpose of providing health-
shall be considered to be a specific author- funding of a major medical facility lease (as care resources to veterans.
ization by law of the funds for such leases for defined in subsection (a)(3)(B)), the Sec- ‘‘(2) In this subsection:
purposes of section 8104(a)(2) of title 38, retary shall submit to each committee, on ‘‘(A) The term ‘academic affiliate’ means
United States Code, as in effect on the day the same day, a prospectus of the proposed an institution or organization described in
before the date of the enactment of this Act. medical facility. Any such prospectus shall section 7302(d) of this title.
(c) AUTHORIZATION OF APPROPRIATIONS.— include the following: ‘‘(B) The term ‘covered entity’ means a
There is authorized to be appropriated to the ‘‘(A) A description of the facility to be unit or subdivision of a State, local, or mu-
Secretary of Veterans Affairs for fiscal year leased. nicipal government, public or nonprofit
2023, or the year in which funds are appro- ‘‘(B) An estimate of the cost to the Federal agency, institution, or organization, or other
priated for the Medical Facilities account, Government of the facility to be leased. institution or organization as the Secretary
$998,137,000 for the leases authorized in sub- ‘‘(C) An estimate of the energy perform- considers appropriate that owns property
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section (a). ance of the proposed lease space, to include controlled by an academic affiliate to be
SEC. 703. TREATMENT OF MAJOR MEDICAL FA- a description of anticipated utilization of re- leased under this subsection.
CILITY LEASES OF THE DEPART- newable energy, energy efficient and climate ‘‘(C) The term ‘health -care resource’ has
MENT OF VETERANS AFFAIRS. resilient elements, and related matters. the meaning given that term in section
(a) CONGRESSIONAL APPROVAL OF MAJOR ‘‘(D) Current and projected workload and 8152(1) of this title.
MEDICAL FACILITY LEASES.—Paragraph (2) of utilization data regarding the facility to be ‘‘(D) The term ‘space’ means any room,
subsection (a) of section 8104 of title 38, leased, including information on projected unit, floor, wing, building, parking facility,
United States Code, is amended— changes in workload and utilization over a or other subdivision of a building or facility
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S2830 CONGRESSIONAL RECORD — SENATE June 7, 2022
owned or controlled by an academic affil- amounts appropriated to the ‘Medical Facili- (2) An analysis of the quality and accuracy
iate.’’. ties’ account of the Department of Veterans of the location data used by the Department
SEC. 705. MODIFICATIONS TO ENHANCED-USE Affairs for the purpose of leasing space for a of Defense in determining potential expo-
LEASE AUTHORITY OF DEPARTMENT shared medical facility if the estimated sures to occupational or environmental haz-
OF VETERANS AFFAIRS. share of the Department of Veterans Affairs ards by members of the Armed Forces and
(a) MODIFICATIONS TO AUTHORITY.—Para- for the lease costs does not exceed the veterans, and recommendations for how to
graph (2) of section 8162(a) of title 38, United amount specified in section 8104(a)(3)(B) of improve the quality of such data if nec-
States Code, is amended to read as follows: this title.’’; and essary.
‘‘(2)(A) The Secretary may enter into an (3) in subsection (c), by adding at the end (c) DEFINITIONS.—In this section:
enhanced-use lease on or after the date of the following new paragraph: (1) APPROPRIATE COMMITTEES OF CON-
the enactment of this paragraph only if the ‘‘(3) Any amount transferred to the Sec- GRESS.—The term ‘‘appropriate committees
Secretary determines— retary of Veterans Affairs by the Secretary of Congress’’ means—
‘‘(i) that the lease will not be inconsistent of Defense for the purpose of leasing space (A) the Committee on Armed Services and
with, and will not adversely affect— for a shared medical facility may be credited the Committee on Veterans’ Affairs of the
‘‘(I) the mission of the Department; or to the ‘Medical Facilities’ account of the De- Senate; and
‘‘(II) the operation of facilities, programs, partment of Veterans Affairs and may be (B) the Committee on Armed Services and
and services of the Department in the area of used for such purpose.’’. the Committee on Veterans’ Affairs of the
the leased property; and SEC. 707. APPROPRIATION OF AMOUNTS FOR House of Representatives.
‘‘(ii) that— MAJOR MEDICAL FACILITY LEASES. (2) INDIVIDUAL LONGITUDINAL EXPOSURE
‘‘(I) the lease will enhance the use of the (a) FISCAL YEAR 2023.—In addition to RECORD.—The term ‘‘Individual Longitudinal
leased property by directly or indirectly ben- amounts otherwise available, there is appro- Exposure Record’’ has the meaning given
efitting veterans; or priated for fiscal year 2023, out of any funds such term in section 1171 of title 38, United
‘‘(II) the leased property will provide sup- in the Treasury not otherwise appropriated, States Code, as added by section 202.
portive housing. $1,880,000,000 for an additional amount for the SEC. 803. CORRECTION OF EXPOSURE RECORDS
‘‘(B) The Secretary shall give priority to Medical Facilities account of the Depart- BY MEMBERS OF THE ARMED
enhanced-use leases that, on the leased prop- ment of Veterans Affairs, to remain avail- FORCES AND VETERANS.
erty— able until expended, for major medical facil- (a) IN GENERAL.—The Secretary of Vet-
‘‘(i) provide supportive housing for vet- ity leases authorized by section 702. erans Affairs shall coordinate with the Sec-
erans; (b) ADDITIONAL YEARS.—In addition to retary of Defense to provide a means for vet-
‘‘(ii) provide direct services or benefits tar- amounts otherwise available, there is appro- erans to update their records as necessary to
geted to veterans; or priated, out of any funds in the Treasury not reflect exposures to occupational or environ-
‘‘(iii) provide services or benefits that indi- otherwise appropriated, for an additional mental hazards by such member or veteran
rectly support veterans.’’. amount for the Medical Facilities account of in the Individual Longitudinal Exposure
(b) EXTENSION OF MAXIMUM TERM OF EN- the Department of Veterans Affairs, to re- Record.
HANCED-USE LEASE.—Section 8162(b)(2) of main available until expended, for major (b) EVIDENCE.—
such title is amended by striking ‘‘75 years’’ medical facility leases authorized by section (1) PROVISION OF EVIDENCE.—To update a
and inserting ‘‘99 years’’. 702 or approved pursuant to subchapter I of record under subsection (a), a veteran shall
(c) MODIFICATION OF USE OF PROCEEDS.— chapter 81 of title 38, United States Code, as provide such evidence as the Secretary of
Section 8165(a)(1) of such title is amended by amended by section 703— Veterans Affairs considers necessary.
striking ‘‘shall be deposited in the Depart- (1) $100,000,000 for fiscal year 2024; (2) REGULATIONS.—The Secretary of Vet-
ment of Veterans Affairs Medical Care Col- (2) $200,000,000 for fiscal year 2025; erans Affairs shall prescribe by regulation
lections Fund established under section (3) $400,000,000 for fiscal year 2026; the evidence considered necessary under
1729A of this title.’’ and inserting ‘‘shall, at (4) $450,000,000 for fiscal year 2027; paragraph (1).
the discretion of the Secretary, be deposited (5) $600,000,000 for fiscal year 2028; (c) DEFINITIONS.—In this section:
in— (6) $610,000,000 for fiscal year 2029; (1) INDIVIDUAL LONGITUDINAL EXPOSURE
‘‘(A) the Department of Veterans Affairs (7) $620,000,000 for fiscal year 2030; and RECORD.—The term ‘‘Individual Longitudinal
Medical Care Collections Fund established (8) $650,000,000 for fiscal year 2031. Exposure Record’’ has the meaning given
under section 1729A of this title; or TITLE VIII—RECORDS AND OTHER such term in section 1171 of title 38, United
‘‘(B) the Medical Facilities or Construc- MATTERS States Code, as added by section 202.
tion, Minor Projects account of the Depart- (2) TOXIC EXPOSURE.—The term ‘‘toxic ex-
SEC. 801. EPIDEMIOLOGICAL STUDY ON FORT
ment to be used to defray the costs of admin- MCCLELLAN VETERANS. posure’’ has the meaning given such term in
istration, maintenance, repair, and related The Secretary of Veterans Affairs shall section 101 of title 38, United States Code, as
expenses incurred by the Department with conduct an epidemiological study on the amended by section 102(b).
respect to property that is owned by or under health trends of veterans who served in the SEC. 804. FEDERAL CAUSE OF ACTION RELATING
the jurisdiction or control of the Depart- Armed Forces at Fort McClellan at any time TO WATER AT CAMP LEJEUNE,
ment.’’. during the period beginning January 1, 1935, NORTH CAROLINA.
(d) REPEAL OF SUNSET.—Section 8169 of and ending on May 20, 1999. (a) SHORT TITLE.—This section may be
such title is repealed. cited as the ‘‘Camp Lejeune Justice Act of
SEC. 802. BIENNIAL BRIEFING ON INDIVIDUAL
(e) APPROPRIATION.—In addition to LONGITUDINAL EXPOSURE RECORD. 2022’’.
amounts otherwise available, there is appro- (b) IN GENERAL.—An individual, including a
(a) IN GENERAL.—Not later than one year
priated for fiscal year 2022, out of any funds veteran (as defined in section 101 of title 38,
after the date on which the Individual Longi-
in the Treasury not otherwise appropriated, United States Code), or the legal representa-
tudinal Exposure Record achieves full oper-
$922,000,000 for an additional amount for the tive of such an individual, who resided,
ational capability, as determined by the Sec-
Department of Veterans Affairs, to remain
retary of Defense, and every two years there- worked, or was otherwise exposed (including
available until expended, to enter into en-
after, the Secretary of Defense, in consulta- in utero exposure) for not less than 30 days
hanced-use leases pursuant to section 8162 of
tion with the Secretary of Veterans Affairs, during the period beginning on August 1,
title 38, United States Code, as amended by
shall provide the appropriate committees of 1953, and ending on December 31, 1987, to
this section.
Congress a briefing on— water at Camp Lejeune, North Carolina, that
SEC. 706. AUTHORITY FOR JOINT LEASING AC-
TIONS OF DEPARTMENT OF DE-
(1) the quality of the databases of the De- was supplied by, or on behalf of, the United
FENSE AND DEPARTMENT OF VET- partment of Defense that provide the infor- States may bring an action in the United
ERANS AFFAIRS. mation presented in such Individual Longi- States District Court for the Eastern Dis-
(a) DEPARTMENT OF DEFENSE.—Section tudinal Exposure Record; and trict of North Carolina to obtain appropriate
1104A of title 10, United States Code, is (2) the usefulness of such Individual Longi- relief for harm that was caused by exposure
amended— tudinal Exposure Record or system in sup- to the water at Camp Lejeune.
(1) by inserting ‘‘, or the leasing,’’ after porting members of the Armed Forces and (c) BURDENS AND STANDARD OF PROOF.—
‘‘design, and construction’’ each place it ap- veterans in receiving health care and bene- (1) IN GENERAL.—The burden of proof shall
pears; and fits from the Department of Defense and the be on the party filing the action to show one
(2) in subsection (c)(2), by inserting ‘‘, or Department of Veterans Affairs. or more relationships between the water at
the leasing,’’ after ‘‘design’’. (b) ELEMENTS.—Each briefing required by Camp Lejeune and the harm.
subsection (a) shall include, for the period (2) STANDARDS.—To meet the burden of
SSpencer on DSK126QN23PROD with SENATE
(b) DEPARTMENT OF VETERANS AFFAIRS.—
Section 8111B of title 38, United States Code, covered by the report, the following: proof described in paragraph (1), a party
is amended— (1) An identification of potential exposures shall produce evidence showing that the rela-
(1) in subsection (a), by inserting ‘‘, or the to occupational or environmental hazards tionship between exposure to the water at
leasing,’’ after ‘‘design, and construction’’; captured by the current systems of the De- Camp Lejeune and the harm is—
(2) in subsection (b), by adding at the end partment of Defense for environmental, oc- (A) sufficient to conclude that a causal re-
the following new paragraph: cupational, and health monitoring, and rec- lationship exists; or
‘‘(3) The Secretary of Veterans Affairs may ommendations for how to improve those sys- (B) sufficient to conclude that a causal re-
transfer to the Department of Defense tems. lationship is at least as likely as not.
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2831
(d) EXCLUSIVE JURISDICTION AND VENUE.— ‘‘(1) the delivery of veterans’ health care priated for fiscal year 2022, out of any funds
The United States District Court for the associated with exposure to environmental in the Treasury not otherwise appropriated,
Eastern District of North Carolina shall have hazards in the active military, naval, air, or $500,000,000 for the Cost of War Toxic Expo-
exclusive jurisdiction over any action filed space service in programs administered by sures Fund, established by section 324 of title
under subsection (b), and shall be the exclu- the Under Secretary for Health; 38, United States Code, as added by section
sive venue for such an action. Nothing in ‘‘(2) any expenses incident to the delivery 805 of this Act, to remain available until
this subsection shall impair the right of any of veterans’ health care and benefits associ- September 30, 2024.
party to a trial by jury. ated with exposure to environmental hazards (b) SPEND PLAN.—Not later than 30 days
(e) EXCLUSIVE REMEDY.— in the active military, naval, air, or space after enactment of this Act, the Secretary of
(1) IN GENERAL.—An individual, or legal service, including administrative expenses, Veterans Affairs shall submit a plan for ex-
representative of an individual, who brings such as information technology and claims pending amounts made available by sub-
an action under this section for a harm de- processing and appeals, and excluding leases section (a) by program, project or activity to
scribed in subsection (b), including a latent as authorized or approved under section 8104 the Committee on Appropriations of the Sen-
disease, may not thereafter bring a tort ac- of this title; and ate and the Committee on Appropriations of
tion against the United States for such harm ‘‘(3) medical and other research relating to the House of Representatives. Funds may
pursuant to any other law. exposure to environmental hazards. not be obligated until such Committees issue
(2) HEALTH AND DISABILITY BENEFITS RELAT- ‘‘(d) BUDGET SCOREKEEPING.—(1) Imme- an approval, or absent a response, a period of
ING TO WATER EXPOSURE.—Any award made to diately upon enactment of the Sergeant 30 days has elapsed.
an individual, or legal representative of an First Class Heath Robinson Honoring our SEC. 807. AUTHORIZATION OF ELECTRONIC NO-
individual, under this section shall be offset Promise to Address Comprehensive Toxics TICE IN CLAIMS UNDER LAWS AD-
by the amount of any disability award, pay- Act of 2022, expenses authorized to be appro- MINISTERED BY THE SECRETARY OF
ment, or benefit provided to the individual, priated to the Fund in subsection (c) shall be VETERANS AFFAIRS.
or legal representative— estimated for fiscal year 2023 and each subse- (a) IN GENERAL.—Title 38, United States
(A) under— quent fiscal year and treated as budget au- Code, is amended as follows:
(i) any program under the laws adminis- thority that is considered to be direct spend- (1) By striking section 5100 and inserting
tered by the Secretary of Veterans Affairs; ing— the following:
(ii) the Medicare program under title XVIII ‘‘(A) in the baseline for purposes of section ‘‘§ 5100. Definitions
of the Social Security Act (42 U.S.C. 1395 et 257 of the Balanced Budget and Emergency
Deficit Control Act of 1985 (2 U.S.C. 907); ‘‘In this chapter:
seq.); or
‘‘(B) by the Chairman of the Committee on ‘‘(1) The term ‘claimant’ means any indi-
(iii) the Medicaid program under title XIX
the Budget of the Senate and the Chair of vidual applying for, or submitting a claim
of the Social Security Act (42 U.S.C. 1396 et
the Committee on the Budget of the House of for, any benefit under the laws administered
seq.); and
Representatives, as appropriate, for purposes by the Secretary.
(B) in connection with health care or a dis-
of budget enforcement in the Senate and the ‘‘(2) The term ‘notice’ means a communica-
ability relating to exposure to the water at
House of Representatives; tion issued through means (including elec-
Camp Lejeune.
(f) IMMUNITY LIMITATION.—The United ‘‘(C) under the Congressional Budget Act of tronic means) prescribed by the Secretary.’’.
States may not assert any claim to immu- 1974 (2 U.S.C. 621 et seq.), including in the re- (2) In section 5104, by adding at the end the
nity in an action under this section that ports required by section 308(b) of such Act (2 following new subsection:
would otherwise be available under section U.S.C. 639); and ‘‘(c) The Secretary may provide notice
2680(a) of title 28, United States Code. ‘‘(D) for purposes of the Statutory Pay-As- under subsection (a) electronically if a
(g) NO PUNITIVE DAMAGES.—Punitive dam- You-Go Act of 2010 (2 U.S.C. 931 et seq.). claimant (or the claimant’s representative)
ages may not be awarded in any action under ‘‘(2) No amount appropriated to the Fund elects to receive such notice electronically.
this section. in fiscal year 2023 or any subsequent fiscal A claimant (or the claimant’s representa-
(h) DISPOSITION BY FEDERAL AGENCY RE- year pursuant to this section shall be count- tive) may revoke such an election at any
QUIRED.—An individual may not bring an ac- ed as discretionary budget authority and time, by means prescribed by the Secretary.
tion under this section before complying outlays or as direct spending for any esti- ‘‘(d) The Secretary shall annually—
with section 2675 of title 28, United States mate of an appropriation Act under the Con- ‘‘(1) solicit recommendations from stake-
Code. gressional Budget and Impoundment Control holders on how to improve notice under this
(i) EXCEPTION FOR COMBATANT ACTIVITIES.— Act of 1974 (2 U.S.C. 621 et seq.) and any section; and
This section does not apply to any claim or other Act. ‘‘(2) publish such recommendations on a
action arising out of the combatant activi- ‘‘(3) Notwithstanding the Budget publicly available website of the Depart-
ties of the Armed Forces. Scorekeeping Guidelines and the accom- ment.’’.
(j) APPLICABILITY; PERIOD FOR FILING.— panying list of programs and accounts set (3) In section 5104B(c), in the matter pre-
(1) APPLICABILITY.—This section shall forth in the joint explanatory statement of ceding paragraph (1) by striking ‘‘in writing’’
apply only to a claim accruing before the the committee of conference accompanying and inserting ‘‘to the claimant (and any rep-
date of enactment of this Act. Conference Report 105–217, and for purposes resentative of such claimant)’’.
(2) STATUTE OF LIMITATIONS.—A claim in an of the Balanced Budget and Emergency Def- (4) In section 5112(b)(6), by striking ‘‘(at
action under this section may not be com- icit Control Act of 1985 (2 U.S.C. 900 et seq.) the payee’s last address of record)’’.
menced after the later of— and the Congressional Budget Act of 1974 (2 (5) In section 7104—
(A) the date that is two years after the U.S.C. 621 et seq.), the Fund shall be treated (A) in the heading, by adding ‘‘; decisions;
date of enactment of this Act; or as if it were an account designated as ‘Ap- notice’’ at the end; and
(B) the date that is 180 days after the date propriated Entitlements and Mandatories for (B) by striking subsection (e) and inserting
on which the claim is denied under section Fiscal Year 1997’ in the joint explanatory the following:
2675 of title 28, United States Code. statement of the committee of conference ‘‘(e) After reaching a decision on an appeal,
(3) INAPPLICABILITY OF OTHER LIMITA- accompanying Conference Report 105–217. the Board shall promptly issue notice (as
TIONS.—Any applicable statute of repose or ‘‘(e) ESTIMATES FOR CONGRESSIONAL CON-
that term is defined in section 5100 of this
statute of limitations, other than under SIDERATION.—The Secretary shall include in
title) of such decision to the following:
paragraph (2), shall not apply to a claim documents submitted to Congress in support
‘‘(1) The appellant.
under this section. of the President’s budget submitted pursuant
‘‘(2) Any other party with a right to notice
to section 1105 of title 31 detailed estimates
SEC. 805. COST OF WAR TOXIC EXPOSURES FUND. of such decision.
of the sums described in subsection (c) for
(a) IN GENERAL.—Chapter 3 is amended by ‘‘(3) Any authorized representative of the
the applicable fiscal year.
adding at the end the following new section: ‘‘(f) PROCEDURES FOR ESTIMATES.—The Sec- appellant or party described in paragraph (2).
‘‘§ 324. Cost of War Toxic Exposures Fund retary may, after consultation with the ‘‘(f)(1) The Secretary may provide notice
‘‘(a) ESTABLISHMENT.—There is hereby es- Committee on Appropriations of the Senate under subsection (e) electronically if a
tablished in the Treasury of the United and the Committee on Appropriations of the claimant (or the claimant’s representative)
States an account to be known as the ‘Cost House of Representatives, establish policies elects to receive such notice electronically.
of War Toxic Exposures Fund’ (the ‘Fund’), and procedures for developing the annual de- ‘‘(2) A claimant (or the claimant’s rep-
to be administered by the Secretary. tailed estimates required by subsection (e).’’. resentative) may revoke such an election at
‘‘(b) DEPOSITS.—There shall be deposited in (b) SEQUESTRATION.—Section 256(h)(4) of any time, by means prescribed by the Sec-
the Fund such amounts as may be appro- retary.’’.
SSpencer on DSK126QN23PROD with SENATE
the Balanced Budget and Emergency Deficit
priated to the Fund pursuant to subsection Control Act of 1985 (2 U.S.C. 906(h)(4)) is (6) In section 7105(b)(1)(A), by striking
(c). amended by adding at the end the following ‘‘mailing’’ and inserting ‘‘issuance’’.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.— new subparagraph: (7) In section 7105A(a), by striking
There is authorized to be appropriated to the ‘‘(G) Cost of War Toxic Exposures Fund.’’. ‘‘mailed’’ and inserting ‘‘issued’’.
Fund for fiscal year 2023 and each subsequent SEC. 806. APPROPRIATION FOR FISCAL YEAR (8) In section 7266(a), by striking ‘‘mailed’’
fiscal year such sums as are necessary to in- 2022. and inserting ‘‘issued’’.
crease funding, over the fiscal year 2021 (a) APPROPRIATION.—In addition to (b) RULE OF CONSTRUCTION.—None of the
level, for investment in— amounts otherwise available, there is appro- amendments made by this section shall be
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S2832 CONGRESSIONAL RECORD — SENATE June 7, 2022
construed to apply section 5104(a) of such ration with the directors of each commu- sional fails for any reason to complete the
title to decisions of the Board of Veterans’ nity-based outpatient clinic and medical period of obligated service of the individual
Appeals under chapter 71 of such title. center of the Department of Veterans Af- under subsection (c), the United States shall
SEC. 808. BURN PIT TRANSPARENCY. fairs, shall develop and implement a national be entitled to recover from the individual an
(a) ANNUAL REPORT ON DISABILITY rural recruitment and hiring plan for the amount equal to—
CLAIMS.— Veterans Health Administration to— (A) the total amount paid under subsection
(1) IN GENERAL.—Not later than 180 days (1) recruit health care professionals for (a) to buy out the non-Department service
after the date of the enactment of this Act, rural and highly rural community-based out- contract of the individual; multiplied by
and annually thereafter, the Secretary of patient clinics and rural and highly rural (B) a fraction—
Veterans Affairs shall submit to the appro- medical centers of the Department; (i) the numerator of which is—
priate congressional committees a report de- (2) determine which such clinics or centers (I) the total number of months in the pe-
tailing the following: have a staffing shortage of health care pro- riod of obligated service of the individual;
(A) The total number of covered veterans. fessionals; minus
(B) The total number of claimed issues for (3) develop best practices and techniques (II) the number of months served by the in-
disability compensation under chapter 11 of for recruiting health care professionals for dividual; and
title 38, United States Code, approved and such clinics and centers; (ii) the denominator of which is the total
the total number denied by the Secretary of (4) not less frequently than annually, pro- number of months in the period of obligated
Veterans Affairs with respect to a covered vide virtually based, on-demand training to service of the individual.
veteran, and a breakdown of the reasons for human resources professionals of the Vet- (2) EXCEPTION.—Liability shall not arise
the denials. erans Health Administration on the best under paragraph (1) in the case of an indi-
(C) A comprehensive list of the top 10 con- practices and techniques developed under vidual covered by that paragraph if the indi-
ditions from each body system for which the paragraph (3); and vidual does not obtain, or fails to maintain,
Secretary awarded service connection for (5) provide recruitment resources, such as employment as an employee of the Depart-
covered veterans. pamphlets and marketing material to— ment due to staffing changes approved by
(D) Any updates or trends with respect to (A) Veterans Integrated Service Networks the Under Secretary for Health.
of the Department; (e) NOT A TAXABLE BENEFIT.—A contract
the information described in subparagraphs
(B) rural and highly rural community- buy out for a covered health care profes-
(A), (B), and (C), that the Secretary deter- sional under subsection (a) shall not be con-
mines appropriate. based outpatient clinics of the Department;
sidered a taxable benefit or event for the
(2) COVERED VETERAN DEFINED.—In this sub- and
covered health care professional.
section, the term ‘‘covered veteran’’ means a (C) rural and highly rural medical centers (f) ANNUAL REPORT.—
veteran who deployed to the Southwest Asia of the Department. (1) IN GENERAL.—Not later than 18 months
theater of operations any time after August (b) ANNUAL REPORT.—Not later than 18 after the date of the enactment of this Act,
1990, or Afghanistan, Syria, Djibouti, or Uz- months after the date of the enactment of and not less frequently than annually there-
bekistan after September 19, 2001, and who this Act, and annually thereafter, the Sec- after, the Secretary of Veterans Affairs shall
submits a claim for disability compensation retary shall submit to the Committee on submit to the Committee on Veterans’ Af-
under chapter 11 of title 38, United States Veterans’ Affairs of the Senate and the Com- fairs of the Senate and the Committee on
Code. mittee on Veterans’ Affairs of the House of Veterans’ Affairs of the House of Representa-
(b) INFORMATION REGARDING THE AIRBORNE Representatives a report that includes— tives a report on the use by the Secretary of
HAZARDS AND OPEN BURN PIT REGISTRY.— (1) the plan developed and implemented the authority under this section.
(1) NOTICE.—The Secretary of Veterans Af- under subsection (a); and (2) ELEMENTS.—Each report required by
fairs shall ensure that a medical professional (2) an assessment of the outcomes related paragraph (1) shall include the following:
of the Department of Veterans Affairs in- to recruitment and retention of employees of (A) The number of health care profes-
forms a veteran of the Airborne Hazards and the Veterans Health Administration at rural sionals for whom a service contract buyout
Open Burn Pit Registry if the veteran pre- and highly rural facilities of the Depart- payment was made under subsection (a) in
sents at a medical facility of the Department ment. the previous fiscal year, disaggregated by oc-
for treatment that the veteran describes as (c) DEFINITIONS.—In this section, the terms cupation or specialty.
being related to, or ancillary to, the expo- ‘‘rural’’ and ‘‘highly rural’’ have the mean- (B) The average, highest, and lowest
sure of the veteran to toxic airborne chemi- ings given those terms under the rural-urban amount of the service contract buyout pay-
cals and fumes caused by open burn pits. commuting areas coding system of the De- ments made under subsection (a) for each oc-
(2) DISPLAY.—In making information pub- partment of Agriculture. cupation or specialty in the previous fiscal
lic regarding the number of participants in SEC. 902. AUTHORITY TO BUY OUT SERVICE CON- year.
the Airborne Hazards and Open Burn Pit TRACTS FOR CERTAIN HEALTH (C) Each location where contract buyout
Registry, the Secretary shall display such CARE PROFESSIONALS IN EX- authority under subsection (a) was utilized
CHANGE FOR EMPLOYMENT AT
numbers by both State and by congressional RURAL OR HIGHLY RURAL FACILI-
and the number of covered health care pro-
district. TIES OF DEPARTMENT OF VET- fessionals who agreed to be employed at such
(c) DEFINITIONS.—In this section: ERANS AFFAIRS. location in the previous fiscal year.
(1) AIRBORNE HAZARDS AND OPEN BURN PIT (a) IN GENERAL.—For any covered health (g) DEFINITIONS.—In this section:
REGISTRY.—The term ‘‘Airborne Hazards and care professional to whom the Secretary of (1) COVERED HEALTH CARE PROFESSIONAL.—
Open Burn Pit Registry’’ means the registry Veterans Affairs has offered employment The term ‘‘covered health care professional’’
established by the Secretary of Veterans Af- with the Department of Veterans Affairs, the means a physician, nurse anesthetist, physi-
fairs under section 201 of the Dignified Burial Secretary may buy out the non-Department cian assistant, or nurse practitioner offered
and Other Veterans’ Benefits Improvement employment with the Department regardless
service contract of such individual in ex-
Act of 2012 (Public Law 112–260; 38 U.S.C. 527 of the authority under which such employ-
change for such individual agreeing to be
note). ment is offered.
employed at a rural or highly rural facility
(2) APPROPRIATE CONGRESSIONAL COMMIT- (2) RURAL; HIGHLY RURAL.—The terms
of the Department for a period of obligated
TEES.—The term ‘‘appropriate congressional ‘‘rural’’ and ‘‘highly rural’’ have the mean-
service specified in subsection (c).
committees’’ means— (b) PAYMENT OF AMOUNTS.— ings given those terms under the rural-urban
(A) the Committee on Veterans’ Affairs (1) IN GENERAL.—Payment of any amounts commuting areas coding system of the De-
and the Committee on Armed Services of the for a buy out of a service contract for a cov- partment of Agriculture.
Senate; and (h) SUNSET.—This section shall terminate
ered health care professional under sub-
(B) The Committee on Veterans’ Affairs on September 30, 2027.
section (a) shall be made directly to the indi-
and the Committee on Armed Services of the SEC. 903. QUALIFICATIONS FOR HUMAN RE-
vidual or entity with respect to which the SOURCES POSITIONS WITHIN DE-
House of Representatives. covered health care professional has a serv- PARTMENT OF VETERANS AFFAIRS
(3) OPEN BURN PIT.—The term ‘‘open burn ice obligation under such contract. AND PLAN TO RECRUIT AND RETAIN
pit’’ has the meaning given that term in sec- (2) LIMITATION ON TOTAL AMOUNT.—The HUMAN RESOURCES EMPLOYEES.
tion 201(c) of the Dignified Burial and Other total amount paid by the Department under (a) ESTABLISHMENT OF QUALIFICATIONS.—
Veterans’ Benefits Improvement Act of 2012 this section shall not exceed $40,000,000 per Not later than 180 days after the date of the
(Public Law 112–260; 38 U.S.C. 527 note). fiscal year. enactment of this Act, the Secretary of Vet-
TITLE IX—IMPROVEMENT OF WORK- (c) OBLIGATED SERVICE.—In exchange for a erans Affairs shall—
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FORCE OF DEPARTMENT OF VETERANS contract buy out under subsection (a), a cov- (1) establish qualifications for each human
AFFAIRS ered health care professional shall agree to resources position within the Department of
SEC. 901. NATIONAL RURAL RECRUITMENT AND be employed for not less than four years at Veterans Affairs in coordination with the Of-
HIRING PLAN FOR VETERANS a rural or highly rural facility of the Depart- fice of Personnel Management;
HEALTH ADMINISTRATION. ment. (2) establish standardized performance
(a) IN GENERAL.—Not later than 18 months (d) LIABILITY.— metrics for each such position; and
after the date of the enactment of this Act, (1) IN GENERAL.—Except as provided in (3) submit to the Committee on Veterans’
the Secretary of Veterans Affairs, in collabo- paragraph (2), if a covered health care profes- Affairs of the Senate and the Committee on
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2833
Veterans’ Affairs of the House of Representa- SEC. 906. MODIFICATION OF AUTHORITY OF THE (B) in subsection (b), by adding at the end
tives a report containing the qualifications SECRETARY OF VETERANS AFFAIRS the following new paragraph:
RELATING TO HOURS, CONDITIONS
and standardized performance metrics estab- ‘‘(9) Any position for which the employee is
OF EMPLOYMENT, AND PAY FOR
lished under paragraphs (1) and (2). CERTAIN EMPLOYEES OF VETERANS appointed under section 7306 or 7401(4) of this
(b) IMPROVEMENT OF HUMAN RESOURCES AC- HEALTH ADMINISTRATION. title.’’.
TIONS.—Not later than 90 days after the date (a) EXPANSION OF ELIGIBILITY OF EMPLOY- (2) ADMINISTRATION OF FULL-TIME EMPLOY-
EES FOR CERTAIN AWARDS.—Section 7404(c) is EES.—Section 7423 is amended—
of the enactment of this Act, the Secretary
shall establish or enhance systems of the De- amended— (A) in subsection (a)(2), by adding at the
(1) by striking ‘‘Notwithstanding’’ and in- end the following new subparagraph:
partment to monitor the hiring and other
human resources actions that occur at the serting ‘‘(1) Notwithstanding’’; ‘‘(D) The Secretary may exclude from the
local, regional, and national levels of the De- (2) by inserting ‘‘or 7401(4)’’ after ‘‘section requirements of paragraph (1) employees
7306’’; hired under section 7306 or 7401(4) of this
partment to improve the performance of
(3) by striking ‘‘who is not eligible for pay title or for a position described in section
those actions.
under subchapter III’’ and inserting ‘‘or in a 7401(1) of this title that the Secretary has de-
(c) REPORT.—Not later than one year after covered executive position under section termined is of equivalent rank to a Senior
the establishment of the qualifications and 7401(1) of this title’’; Executive Service position (as such term is
performance metrics under subsection (a), (4) by striking ‘‘sections 4507 and 5384’’ and defined in section 3132(a) of title 5).’’; and
the Comptroller General of the United States inserting ‘‘section 4507’’; and (B) in subsection (e)(1), by striking
shall submit to the Committee on Veterans’ (5) by adding at the end the following new ‘‘7401(1)’’ and inserting ‘‘7421(b)’’.
Affairs of the Senate and the Committee on paragraph: (3) ADDITIONAL PAY AUTHORITIES.—Section
Veterans’ Affairs of the House of Representa- ‘‘(2) In this subsection, the term ‘covered 7410(a) is amended—
tives a report containing— executive position’ means a position that the (A) by striking ‘‘The Secretary’’ and in-
(1) a description of the implementation of Secretary has determined is of equivalent serting ‘‘(1) The Secretary’’;
such qualifications and performance metrics; rank to a Senior Executive Service position (B) by striking ‘‘the personnel described in
(2) an assessment of the quality of such (as such term is defined in section 3132(a) of paragraph (1) of section 7401 of this title’’
qualifications and performance metrics; title 5) and is subject to an agency perform- and inserting ‘‘personnel appointed under
(3) an assessment of performance and out- ance management system.’’. section 7306 of this title or section 7401(4) of
comes based on such metrics; and (b) AUTHORITY FOR AWARDS PROGRAMS OF this title, or personnel described in section
(4) such other matters as the Comptroller DEPARTMENT OF VETERANS AFFAIRS.— 7401(1) of this title,’’; and
General considers appropriate. (1) IN GENERAL.—Subchapter I of chapter 74 (C) by striking ‘‘in the same manner, and
(d) PLAN TO RECRUIT AND RETAIN HUMAN is amended by inserting after section 7404 subject to the same limitations, as in the
RESOURCES EMPLOYEES.—Not later than one the following new section: case of’’ and inserting ‘‘in a manner con-
year after the date of the enactment of this ‘‘§ 7404A. Awards sistent with’’; and
Act, the Secretary of Veterans Affairs shall (D) by adding at the end the following new
‘‘(a) SUPERIOR ACCOMPLISHMENTS AND PER-
submit to the Committee on Veterans’ Af- paragraph:
FORMANCE AWARDS PROGRAM.—The Secretary
fairs of the Senate and the Committee on ‘‘(2) Payments under paragraph (1) shall
may establish an awards program for per-
Veterans’ Affairs of the House of Representa- not be considered in calculating the limita-
sonnel listed in section 7421(b) of this title
tives a plan for the recruitment and reten- tion under section 7431(e)(4) of this title.’’.
consistent with chapter 45 of title 5, to the
tion of human resources employees within (4) TREATMENT OF PAY AUTHORITY
extent practicable.
the Department of Veterans Affairs. CHANGES.—For the purposes of the amend-
‘‘(b) EXECUTIVE PERFORMANCE AWARDS PRO-
GRAM.—Notwithstanding section 7425 of this
ments made by paragraph (3), the Secretary
SEC. 904. MODIFICATION OF PAY CAP FOR CER- of Veterans Affairs shall treat any award or
TAIN EMPLOYEES OF VETERANS title or any other provision of law, the Sec-
retary may establish a performance awards payment made by the Secretary between
HEALTH ADMINISTRATION.
program consistent with section 5384 of title January 1, 2017, and the date of the enact-
(a) IN GENERAL.—Section 7455(c) is amend- 5 for— ment of this Act to employees appointed
ed— ‘‘(1) personnel appointed under section under sections 7306, 7401(1), and 7401(4) of
(1) in paragraph (1), by striking ‘‘30 per- 7401(1) of this title for a position that the title 38, United States Code, that the Sec-
cent’’ inserting ‘‘50 percent’’; Secretary has determined is of equivalent retary has determined are of equivalent rank
(2) in paragraph (2), by striking ‘‘level IV’’ rank to a Senior Executive Service position to a Senior Executive Service position (as
inserting ‘‘level II’’; and (as such term is defined in section 3132(a) of such term is defined in section 3132(a) of title
(3) by adding at the end the following new title 5) and is subject to an agency perform- 5, United States Code), as if such amend-
paragraph: ance management system; and ments had been in effect at the time of such
‘‘(2) personnel appointed under section 7306 award or payment.
‘‘(3)(A) Notwithstanding section 5304 of
or 7401(4) of this title. (5) TREATMENT OF PRIOR LEAVE BALANCES.—
title 5 or any other provision of law, but sub-
‘‘(c) PAYMENT OF AWARDS.—Awards under Notwithstanding any other provision of law,
ject to the limitation under paragraph (2),
this section may be paid based on criteria es- the Secretary may adjust the leave balance
pursuant to an increase under subsection (a),
tablished by the Secretary and shall not be and carryover leave balance of any employee
the Secretary may pay a special rate or an
considered in calculating the limitation described in section 7421(b)(9) of title 38,
adjusted rate of basic pay in excess of the
under section 7431(e)(4) of this title. United States Code, as amended by para-
rate of basic pay payable for level IV of the
‘‘(d) NOT CONSIDERED BASIC PAY.—Awards graph (1)(B), to ensure any leave accrued or
Executive Schedule.
under this section shall not be considered carried over before the date of the enactment
‘‘(B) If an employee is in receipt of a spe- of this Act remains available to such em-
basic pay for any purpose.
cial rate of pay under subparagraph (A) in ‘‘(e) REGULATIONS.—The Secretary may ployee.
excess of the rate of basic pay payable for prescribe regulations for the administration (d) TREATMENT OF CERTAIN EMPLOYEES AS
level IV of the Executive Schedule with an of this section.’’. APPOINTED UNDER SECTION 7306.—Section 7306
established special rate supplement of great- (2) LIMITATION ON PAST AWARDS.—Notwith- is amended—
er value than a supplement based on the ap- standing any other provision of law, awards (1) in subsection (a), by redesignating the
plicable locality-based comparability pay- made by the Secretary of Veterans Affairs second paragraph (11) as paragraph (12); and
ment percentage under section 5304 of title 5, for any period on or after January 1, 2017, (2) by adding at the end the following new
but a pay adjustment would cause such es- and before the date of the enactment of this subsection:
tablished special rate supplement to be of Act for an employee under section 7306 or ‘‘(g) For purposes of applying any provision
lesser value, the special rate supplement 7401(4) of title 38, United States Code, or for of chapter 74 of this title, including sections
shall be converted to a supplement based on a position described in section 7401(1) of such 7404, 7410, and 7421, or any other provision of
the applicable locality-based comparability title that the Secretary has determined is of law, the Secretary may treat any appoint-
percentage unless the Secretary determines equivalent rank to a Senior Executive Serv- ment for a position under this chapter to be
that some other action is appropriate.’’. ice position (as such term is defined in sec- an appointment under this section.’’.
(b) PAY FOR CRITICAL POSITIONS.—Section tion 3132(a) of title 5, United States Code), (e) CONFORMING AMENDMENT.—Section
7404(a)(1)(B) is amended by inserting ‘‘7306 may be subject to section 7404A of title 38, 7431(e)(4) is amended by striking ‘‘In no
or’’ before ‘‘7401(4)’’. United States Code, as added by paragraph case’’ and inserting ‘‘Except as provided in
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(1). sections 7404A(c) and 7410(a)(2) of this title,
SEC. 905. EXPANSION OF OPPORTUNITIES FOR in no case’’.
(c) MODIFICATION OF EMPLOYEES SUBJECT
HOUSEKEEPING AIDES.
TO REGULATION BY SECRETARY OF VETERANS SEC. 907. WAIVER OF PAY LIMITATION FOR CER-
Section 3310 of title 5, United States Code, AFFAIRS OF HOURS AND CONDITIONS OF EM- TAIN EMPLOYEES OF DEPARTMENT
is amended by inserting ‘‘(other than for po- PLOYMENT AND LEAVES OF ABSENCE.— OF VETERANS AFFAIRS.
sitions of housekeeping aides in the Depart- (1) IN GENERAL.—Section 7421 is amended— Subchapter I of chapter 7 is amended by in-
ment of Veterans Affairs)’’ after ‘‘competi- (A) in subsection (a), by striking ‘‘chapter’’ serting after section 703 the following new
tive service’’. and inserting ‘‘title’’; and section:
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S2834 CONGRESSIONAL RECORD — SENATE June 7, 2022
‘‘§ 704. Waiver of pay limitation for certain ment or relocation bonus under section ‘‘(g) EXPEDITED HIRING AUTHORITY FOR
employees 5753(e) of title 5 without regard to any re- POST-SECONDARY STUDENTS; COMPETITIVE
‘‘(a) EMPLOYEES OF VETERANS HEALTH AD- quirements for certification or approval SERVICE.—(1) Subject to paragraph (2) of this
MINISTRATION IMPACTED BY CLOSURE OR RE- under that section. subsection, the Secretary may expedite hir-
ALIGNMENT.—Notwithstanding any other pro- ‘‘(b) RETENTION BONUSES.—(1) The Sec- ing of post-secondary students under section
vision of law, the Secretary may waive any retary may pay a retention bonus under sec- 3116 of title 5, without regard to subsection
annual premium or aggregate limitation on tion 5754(f) of title 5 without regard to any (d) of such section or any regulations pre-
pay for an employee of the Veterans Health requirement for certification or approval scribed by the Office of Personnel Manage-
Administration for the calendar year during under that subsection. ment for administration of such subsection.
which— ‘‘(2) The Secretary may pay a retention ‘‘(2) The number of employees the Sec-
‘‘(1) the official duty station of the em- bonus as specified in subsection (e)(2) of sec- retary may appoint under section 3116 of
ployee is closed; or tion 5754 of title 5 and may pay the bonus as title 5 may not exceed the number equal to
‘‘(2) the office, facility, activity, or organi- a single lump-sum payment at the beginning 25 percent of the number of students that the
zation of the employee is realigned. of the full period of service required by an Secretary appointed during the previous fis-
‘‘(b) EMPLOYEES PROVIDING CARE TO VET- agreement under subsection (d) of such sec- cal year to a position at the GS–11 level, or
ERANS EXPOSED TO OPEN BURN PITS.— tion. an equivalent level, or below.
‘‘(1) IN GENERAL.—Notwithstanding any ‘‘(c) MERIT AWARDS.—The Secretary may ‘‘(h) PAY AUTHORITY FOR CRITICAL POSI-
other provision of law, the Secretary may grant a cash award under section 4502(b) of TIONS.—(1) Subject to the provisions of this
waive any annual premium or aggregate lim- title 5 without regard to any requirement for subsection, the Secretary may authorize the
itation on pay for an employee of the De- certification or approval under that section. fixing of the rate of pay for a critical posi-
partment whose primary duties include pro- ‘‘(d) INCENTIVES FOR CRITICAL SKILLS.—(1) tion in the Department consistent with the
viding expanded care for veterans exposed to Subject to the provisions of this paragraph, authorities and requirements of section 5377
open burn pits. the Secretary may provide a critical skill in- of title 5 that apply to the Office of Per-
‘‘(2) OPEN BURN PIT DEFINED.—In this sub- centive to an employee in a case in which sonnel Management.
section, the term ‘open burn pit’ has the the Secretary determines— ‘‘(2) The Secretary may fix the rate of pay
meaning given that term in section 201(c) of ‘‘(A) the employee possesses a high-demand for a critical position under this subsection
the Dignified Burial and Other Veterans’ skill or skill that is at a shortage; in excess of the limitation set forth by sec-
Benefits Improvement Act of 2012 (Public ‘‘(B) such skill is directly related to the tion 5377(d)(2) of such title.
Law 112–260; 38 U.S.C. 527 note). duties and responsibilities of the employee’s ‘‘(3) Basic pay may not be fixed under this
‘‘(c) COORDINATION WITH OFFICE OF PER- position; and subsection at a rate greater than the rate
SONNEL MANAGEMENT.—In implementing this ‘‘(C) employment of an individual with payable for the Vice President of the United
section, the Secretary shall coordinate with such skill in such position serves a critical States established under section 104 of title
the Director of the Office of Personnel Man- mission-related need of the Department. 3, except upon written approval of the Presi-
agement. ‘‘(2) An incentive provided to an employee dent.
‘‘(d) REPORTS.— under paragraph (1) may not to exceed 25 ‘‘(4) Notwithstanding section 5377(f) of title
‘‘(1) IN GENERAL.—For each quarter that percent of the basic pay of the employee. 5, the Secretary may authorize the exercise
the Secretary waives a limitation under this ‘‘(3) Provision of an incentive under para- of authority under this subsection with re-
section, the Secretary shall submit to the graph (1) shall be contingent on the em- spect to up to 200 positions at any time.
Committee on Veterans’ Affairs of the Sen- ployee entering into a written agreement to ‘‘(i) RATES OF SPECIAL PAY.—(1) The Sec-
ate, the Committee on Veterans’ Affairs of complete a period of employment with the retary may establish a rate for special pay
the House of Representatives, and the Office Department. under section 5305(a)(1) of title 5.
of Personnel Management a report on the ‘‘(4) An incentive provided under paragraph ‘‘(2) In applying such section to the Sec-
waiver or waivers. (1) shall not be considered basic pay for any retary’s authority under paragraph (1)—
‘‘(2) CONTENTS.—Each report submitted purpose. ‘‘(A) ‘50 percent’ shall be substituted for ‘30
under paragraph (1) with respect to a waiver ‘‘(5) The Secretary may prescribe condi- percent’; and
or waivers shall include the following: tions, including with respect to eligibility, ‘‘(B) ‘level II of the Executive Schedule’
‘‘(A) Where the waiver or waivers were and limitations on provision of incentive shall be substituted for ‘level IV of the Exec-
used, including in which component of the under paragraph (1). utive Schedule’.
‘‘(6) Incentive provided under paragraph (1) ‘‘(j) WAIVER OF LIMITATIONS ON CERTAIN
Department and, as the case may be, which
shall not be included in the calculation of PAYMENTS UNDER PAY COMPARABILITY SYS-
medical center of the Department.
total amount of compensation under section TEM.—The Secretary may waive the limita-
‘‘(B) For how many employees the waiver
7431(e)(4) of this title. tion in section 5307 of title 5 for an employee
or waivers were used, disaggregated by com-
‘‘(e) STUDENT LOAN REPAYMENTS.—(1) Sub- or a payment.
ponent of the Department and, if applicable,
ject to the provisions of this subsection, the ‘‘(k) TERMINATION.—The authorities under
medical center of the Department.
Secretary may repay a student loan pursu- this section shall terminate on September 30,
‘‘(C) The average amount by which each
ant to section 5379(b) of title 5. 2027.’’.
payment exceeded the pay limitation that
‘‘(2) Paragraph (2) of such section shall not
was waived, disaggregated by component of SA 5052. Mr. TESTER submitted an
apply to payment under this subsection.
the Department and, if applicable, medical
‘‘(3) Payment under this subsection shall amendment intended to be proposed by
center of the Department.
‘‘(e) EMPLOYEE DEFINED.—In this section, be made subject to such terms, limitations, him to the bill H.R. 3967, to improve
the term ‘employee’ means any employee re- or conditions as may be mutually agreed to health care and benefits for veterans
gardless of the authority under which the by the Secretary and the employee con- exposed to toxic substances, and for
employee was hired. cerned, except that the amount paid by the
other purposes; which was ordered to
‘‘(f) TERMINATION.—This section shall ter- Secretary under this subsection may not ex-
ceed— lie on the table; as follows:
minate on September 30, 2027.’’.
‘‘(A) $40,000 for any employee in any cal- On page 18, strike lines 17 through 20 and
SEC. 908.ELIMINATION OF LIMITATION ON
AWARDS AND BONUS FOR EMPLOY- endar year; or insert the following:
EES OF DEPARTMENT OF VETERANS ‘‘(B) a total of $100,000 in the case of any SEC. 201. SHORT TITLE.
AFFAIRS. employee. This title may be cited as the ‘‘Toxic Expo-
(a) IN GENERAL.—Section 705(a) of the Vet- ‘‘(f) EXPEDITED HIRING AUTHORITY FOR COL- sure in the American Military Act’’ or the
erans Access, Choice, and Accountability Act LEGE GRADUATES; COMPETITIVE SERVICE.—(1) ‘‘TEAM Act’’.
of 2014 (Public Law 113–146; 38 U.S.C. 703 Subject to paragraph (2) of this subsection,
note) is amended by striking paragraph (3). the Secretary may expedite hiring for col- SA 5053. Mr. TESTER submitted an
(b) APPLICABILITY.—Subsection (a) shall lege graduates under section 3115 of title 5 amendment intended to be proposed by
take effect on the date of the enactment of without regard to subsection (e) of such sec- him to the bill H.R. 3967, to improve
this Act and apply as if such subsection had tion or any regulations prescribed by the Of- health care and benefits for veterans
been enacted on September 30, 2021. fice of Personnel Management for adminis- exposed to toxic substances, and for
SEC. 909. ADDITIONAL AUTHORITY OF THE SEC- tration of such subsection.
RETARY OF VETERANS AFFAIRS RE- ‘‘(2) The number of employees the Sec-
other purposes; which was ordered to
LATING TO RECRUITMENT AND RE- retary may appoint under section 3115 of lie on the table; as follows:
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TENTION OF PERSONNEL. title 5 may not exceed the number equal to On page 47, strike lines 5 through 7 and in-
Subchapter I of chapter 7 is amended by in- 25 percent of individuals that the Secretary sert the following:
serting after section 705 the following new appointed during the previous fiscal year to SEC. 301. SHORT TITLE.
section: a position in the competitive service classi- This title may be cited as the ‘‘Veterans
‘‘§ 706. Additional authority relating to re- fied in a professional or administrative occu- Burn Pits Exposure Recognition Act’’.
cruitment and retention of personnel pational category, at the GS–11 level, or an
‘‘(a) RECRUITMENT AND RELOCATION BO- equivalent level, or below, under a competi- SA 5054. Mr. TESTER submitted an
NUSES.—The Secretary may pay a recruit- tive examining procedure. amendment intended to be proposed by
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2835
him to the bill H.R. 3967, to improve (b) MEDICAL SERVICES DEFINED.—In this program shall be at the election of the vet-
health care and benefits for veterans section, the term ‘‘medical services’’ has the eran.
exposed to toxic substances, and for meaning given that term in section 1701(6) of (f) ADMINISTRATION.—
title 38, United States Code (1) NOTICE TO COVERED VETERANS.—In car-
other purposes; which was ordered to SEC. 122. PILOT PROGRAM ON EXPANSION OF rying out the pilot program, the Secretary
lie on the table; as follows: FURNISHING BY DEPARTMENT OF shall inform all covered veterans of the serv-
At the appropriate place, insert the fol- VETERANS AFFAIRS OF DENTAL
ices and treatment available under the pilot
lowing: CARE TO CERTAIN ENROLLED VET-
ERANS. program.
(a) SHORT TITLE.—This section may be (2) COPAYMENTS.—The Secretary may col-
cited as the ‘‘Fair Care for Vietnam Veterans (a) IN GENERAL.—Commencing not later
than one year after the date of the enact- lect copayments for dental care furnished
Act’’. under the pilot program in accordance with
ment of this Act, the Secretary of Veterans
Affairs shall carry out a pilot program under authorities on the collection of copayments
SA 5055. Mr. JOHNSON submitted an
which the Secretary shall furnish dental care for medical care of veterans under chapter 17
amendment intended to be proposed to of title 38, United States Code.
to all covered veterans who are not eligible
amendment SA 5051 submitted by Mr. for dental services and treatment and related (3) CONTRACTS.—
TESTER (for himself and Mr. MORAN) dental appliances under the laws adminis- (A) IN GENERAL.—Subject to subparagraph
and intended to be proposed to the bill tered by the Secretary as of the date of the (C), in carrying out the pilot program, the
H.R. 3967, to improve health care and enactment of this Act. Secretary may enter into contracts with ap-
benefits for veterans exposed to toxic (b) DURATION.—The pilot program shall be propriate entities for the provision of dental
substances, and for other purposes; carried out during the two-year period begin- care under the pilot program.
ning on the date of the commencement of (B) PERFORMANCE STANDARDS AND
which was ordered to lie on the table; the pilot program. METRICS.—Each contract entered into under
as follows: (c) LOCATIONS.— subparagraph (A) shall specify performance
At the end, add the following: (1) IN GENERAL.—The Secretary shall carry standards and metrics and processes for en-
TITLE XI—OTHER MATTERS out the pilot program at the following loca- suring compliance of the contractor con-
SEC. 1101. OFFSET OF COSTS USING UNOBLI- tions: cerned with such performance standards.
GATED FUNDS FROM THE AMERICAN (A) Each medical center of the Department (C) LIMITATION.—The Secretary may only
RESCUE PLAN ACT OF 2021. with an established dental clinic. enter into contracts under subparagraph (A)
Effective on the date of the enactment of (B) Not fewer than four military medical if the Secretary determines that the Depart-
this Act, of the unobligated balances made treatment facilities of the Department of ment does not employ, and cannot recruit
available under the American Rescue Plan Defense with the capacity to furnish dental and retain, qualified dentists, dental hygien-
Act of 2021 (Public Law 117–2; 135 Stat. 4), or care, which shall be selected in consultation ists, and oral surgeons in the applicable loca-
an amendment made by such Act, there is re- with the Secretary of Defense. tion.
scinded, on a pro rata basis, $270,000,000,000. (C) Not fewer than four community-based (g) REPORTS.—
outpatient clinics with space available for (1) IN GENERAL.—Not later than 90 days be-
SA 5056. Mr. SANDERS submitted an the furnishing of dental care under the pilot fore the completion of the pilot program, and
amendment intended to be proposed to program. not later than 180 days after the completion
amendment SA 5051 submitted by Mr. (D) Not fewer than four Federally Qualified of the pilot program, the Secretary shall
Health Centers.
TESTER (for himself and Mr. MORAN) submit to the Committee on Veterans’ Af-
(E) Not fewer than four facilities of the In-
and intended to be proposed to the bill fairs and the Committee on Armed Services
dian Health Service with established dental
H.R. 3967, to improve health care and of the Senate and the Committee on Vet-
clinics, which shall be selected in consulta-
benefits for veterans exposed to toxic erans’ Affairs and the Committee on Armed
tion with the Secretary of Health and
Services of the House of Representatives a
substances, and for other purposes; Human Services.
report on the pilot program.
which was ordered to lie on the table; (2) CONSIDERATIONS.—In selecting locations
(2) CONTENTS.—Each report under para-
as follows: for the pilot program, the Secretary shall
graph (1) shall include the following:
consider the feasibility and advisability of
At the end of title I, add the following: (A) A description of the implementation
selecting locations in each of the following:
Subtitle C—Other Health Care Matters (A) Rural areas. and operation of the pilot program.
SEC. 121. REQUIREMENT OF DENTAL CLINIC OF (B) Areas that are not in close proximity (B) The number of covered veterans receiv-
DEPARTMENT OF VETERANS AF- to an active duty military installation. ing dental care under the pilot program and
FAIRS IN EACH STATE.
(C) Areas representing different geographic a description of the dental care furnished to
The Secretary of Veterans Affairs shall en- locations, such as census tracts established such veterans.
sure that each State has a dental clinic of by the Bureau of the Census. (C) An analysis of the costs and benefits of
the Department of Veterans Affairs to serv- (3) MOBILE DENTAL CLINICS.—In carrying the pilot program, including a comparison of
ice the needs of the veterans within that out the pilot program, the Secretary shall costs and benefits by location type.
State by not later than September 30, 2024. test the efficacy of mobile dental clinics to (D) An assessment of the impact of the
service rural areas that do not have a popu- pilot program on appointments for care, pre-
SA 5057. Mr. SANDERS submitted an lation base to warrant a full-time clinic but scriptions, hospitalizations, emergency room
amendment intended to be proposed to where there are covered veterans in need of visits, wellness, employability, and satisfac-
amendment SA 5051 submitted by Mr. dental care. tion of patients, and perceived quality of life
TESTER (for himself and Mr. MORAN) (4) HOME BASED DENTAL CARE.—In carrying of covered veterans.
and intended to be proposed to the bill out the pilot program, the Secretary shall (E) An analysis and assessment of the effi-
test the efficacy of portable dental care units cacy of mobile clinics and home based dental
H.R. 3967, to improve health care and care to service the dental needs of covered
benefits for veterans exposed to toxic to service rural veteran in their homes, as
the Secretary considers medically appro- veterans under the pilot program.
substances, and for other purposes; (F) An analysis and assessment of the effi-
priate.
which was ordered to lie on the table; (d) SERVICES.— cacy of dental therapists and tele-dentistry
as follows: (1) SCOPE.—The dental care furnished to to service the dental needs of covered vet-
At the end of title I, add the following: covered veterans under the pilot program erans under the pilot program, to include a
Subtitle C—Expansion of Dental Care for shall be consistent with the dental services cost benefit analysis of such services.
Veterans and treatment furnished by the Secretary to (G) The findings and conclusions of the
veterans with service-connected disabilities Secretary with respect to the pilot program.
SEC. 121. PILOT PROGRAM TO FURNISH DENTAL
CARE FROM THE DEPARTMENT OF rated 100 percent disabling under the laws (H) A comparison of the costs for private
VETERANS AFFAIRS IN THE SAME administered by the Secretary. sector dental care with cost of furnishing
MANNER AS ANY OTHER MEDICAL (2) DENTAL THERAPISTS AND TELE-DEN- dental care from the Department, broken
SERVICE. TISTRY.— down by each locality included in the pilot
(a) IN GENERAL.—Commencing not later (A) IN GENERAL.—In carrying out the pilot program.
than one year after the date of the enact- program, The Secretary shall test the effi- (I) Such recommendations as the Secretary
ment of this Act, the Secretary of Veterans considers appropriate for the expansion of
SSpencer on DSK126QN23PROD with SENATE
cacy of the use of dental therapists and tele-
Affairs shall carry out a pilot program to as- dentistry to service the dental care needs of dental care to all veterans eligible for health
sess the feasibility and advisability of fur- covered veterans. care from the Department.
nishing dental care in the same manner as (B) USE OF TELE-DENTISTRY.—When pro- (h) DEFINITIONS.—In this section:
medical services furnished by the Depart- viding tele-dentistry under subparagraph (1) COVERED VETERAN.—The term ‘‘covered
ment, notwithstanding the limitations on (A), the Secretary shall use Federal employ- veteran’’ means a veteran enrolled in the
the provision of dental care under sections ees to the maximum extent possible. system of annual patient enrollment of the
1710(c) and 1712 of title 38, United States (e) VOLUNTARY PARTICIPATION.—The par- Department of Veterans Affairs established
Code. ticipation of a covered veteran in the pilot and operated under section 1705(a) of title 38,
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S2836 CONGRESSIONAL RECORD — SENATE June 7, 2022
United States Code, pursuant to paragraph (f) EFFECTIVE DATE.—This section shall Subtitle C—Other Health Care Matters
(1) or (2) of such section. take effect on the date that is one year after SEC. 121. EXPANSION OF HEALTH CARE FROM
(2) FEDERALLY QUALIFIED HEALTH CENTER.— the date of the enactment of this Act. DEPARTMENT OF VETERANS AF-
The term ‘‘Federally Qualified Health Cen- SEC. 125. STUDENT LOAN REPAYMENT PROGRAM FAIRS TO INCLUDE MEMBERS OF
ter’’ means a federally-qualified health cen- TO INCENTIVIZE DENTAL TRAINING THE RESERVE COMPONENTS OF THE
ter as defined in section 1905(l)(2)(B) of the AND ENSURE THE DENTAL WORK- ARMED FORCES WHO ARE NOT ON
Social Security Act (42 U.S.C. 1396d(l)(2)(B)). FORCE OF THE DEPARTMENT OF ACTIVE ORDERS.
SEC. 123. REQUIREMENT OF DENTAL CLINIC OF VETERANS AFFAIRS. (a) EXPANSION OF CARE.—
DEPARTMENT OF VETERANS AF- (1) IN GENERAL.—Section 1789 of title 38,
(a) PROGRAM REQUIRED.—The Secretary of
FAIRS IN EACH STATE. United States Code, is amended to read as
Veterans Affairs, to ensure that the Depart-
(a) IN GENERAL.—The Secretary of Vet- follows:
ment of Veterans Affairs has sufficient staff
erans Affairs shall ensure that each State to provide dental service to veterans, shall ‘‘§ 1789. Health care for members of the re-
has a dental clinic of the Department of Vet- implement a loan reimbursement program serve components of the Armed Forces
erans Affairs to service the needs of the vet- ‘‘(a) IN GENERAL.—The Secretary (subject
for qualified dentists, dental therapists, den-
erans within that State. to subsection (c)) shall furnish hospital care
(b) EFFECTIVE DATE.—This section shall tal hygienists, and oral surgeons who agree—
(1) to be appointed by the Secretary as a and medical services to any member of the
take effect on the date that is one year after
dentist, dental therapist, dental hygienist, reserve components of the Armed Forces
the date of the enactment of this Act.
or oral surgeon, as the case may be, under during any period in which the member is
SEC. 124. PROGRAM ON EDUCATION TO PROMOTE
DENTAL HEALTH IN VETERANS. section 7401 of title 38, United States Code; not entitled to health care furnished by the
(a) PROGRAM REQUIRED.—The Secretary of and Secretary of Defense.
Veterans Affairs shall carry out a program of (2) to serve as a dentist, dental therapist, ‘‘(b) MENTAL HEALTH CARE.—The Secretary
education to promote dental health for vet- dental hygienist, or oral surgeon, as the case may furnish mental health services to mem-
erans who are enrolled in the system of an- may be, of the Department pursuant to such bers of the reserve components of the Armed
nual patient enrollment of the Department appointment at a dental clinic of the Depart- Forces.
of Veterans Affairs established and operated ment for a period of not less than five years. ‘‘(c) LIMITATION.—The requirement in sub-
under section 1705(a) of title 38, United (b) MAXIMUM AMOUNT.— section (a) shall be effective in any fiscal
States Code. (1) IN GENERAL.—Except as provided in year only to the extent and in the amount
(b) ELEMENTS.—The program required by paragraph (2), the Secretary may reimburse provided in advance in appropriations Acts
subsection (a) shall provide education for not more than— for such purpose.
veterans on the following: (A) $75,000 for each dentist participating in ‘‘(d) CONSULTATION WITH SECRETARY OF DE-
(1) The association between dental health FENSE.—The Secretary shall carry out this
the program under subsection (a);
and overall health and well-being. (B) $20,000 for each dental therapist partici- section in consultation with the Secretary of
(2) Proper techniques for dental care. pating in such program; Defense.’’.
(3) Signs and symptoms of commonly oc- (C) $10,000 for each dental hygienist par- (2) CLERICAL AMENDMENT.—The table of
curring dental conditions. ticipating in such program; and sections at the beginning of subchapter VIII
(4) Treatment options for commonly occur- (D) $20,000 for each credentialed doctor of of chapter 17 of such title is amended by
ring dental issues. medicine in dentistry serving as an oral sur- striking the item relating to section 1789 and
(5) Options for obtaining access to dental geon and participating in such program. inserting the following new item:
care, including information on eligibility for (2) DUAL ELIGIBILITY.—The Secretary may ‘‘1789. Health care for members of the reserve
dental care through the Department. reimburse an individual serving in multiple components of the Armed
(6) Available and accessible options for ob- positions described in subparagraphs (A) Forces.’’.
taining low or no-cost dental care, including through (D) of paragraph (1) not more than (b) ENROLLMENT IN PATIENT ENROLLMENT
through dental schools and Federally Quali- $95,000. SYSTEM.—
fied Health Centers. (1) PRIORITY FOR ENROLLMENT.—Section
(c) SELECTION OF LOCATIONS.—The Sec-
(7) Such other matters relating to dental 1705(a) of title 38, United States Code, is
retary shall monitor demand among veterans
health as the Secretary considers appro- amended—
priate. for dental care and require participants in
(A) in the matter preceding paragraph (1),
(c) DELIVERY OF EDUCATIONAL MATE- the program under subsection (a) to choose
by striking ‘‘enrollment of veterans’’ and in-
RIALS.— from dental clinics of the Department with
serting ‘‘enrollment of individuals under
(1) IN GENERAL.—The Secretary shall pro- the greatest need for dentists, dental hygien-
such system’’; and
vide educational materials to veterans under ists, or oral surgeons, as the case may be, ac-
(B) in paragraph (7)—
the program required by subsection (a) cording to facility enrollment and patient
(i) by striking ‘‘Veterans’’ and inserting
through a variety of mechanisms, including demand.
‘‘(A) Veterans’’; and
the following: SEC. 126. EDUCATIONAL AND TRAINING PART- (ii) by adding at the end the following new
(A) The availability and distribution of NERSHIPS FOR DENTISTS, DENTAL
subparagraph:
print materials at facilities of the Depart- THERAPISTS, DENTAL HYGIENISTS
AND ORAL SURGEONS. ‘‘(B) Members of the reserve components of
ment (including at medical centers, clinics, the Armed Forces for purposes of furnishing
Vet Centers, and readjustment counseling The Secretary of Veterans Affairs shall hospital care and medical services under sec-
centers) and to providers (including members enter into educational and training partner- tion 1789(a) of this title.’’.
of Patient Aligned Care Teams). ships with dental schools to provide training (2) INITIAL ENROLLMENT.—The Secretary of
(B) The availability and distribution of and employment opportunities for dentists, Veterans Affairs shall enroll all members of
materials over the Internet, including dental therapists, dental hygienists, and oral the reserve components of the Armed Forces
through webinars, My HealtheVet, and surgeons. in the patient enrollment system by not
VA.gov. SEC. 127. AUTHORIZATION OF APPROPRIATIONS. later than December 31, 2022.
(C) Presentations by the dental program (3) ONGOING ENROLLMENT.—After December
office of the Department of information, in- (a) IN GENERAL.—There is authorized to be
appropriated for the Department of Veterans 31, 2022, the Secretary shall automatically
cluding both small group and large group enroll in the patient enrollment system all
presentations, and distribution of such infor- Affairs for fiscal year 2023 such sums as may
be necessary to carry out this subtitle. new members of the reserve components of
mation to all locations in which the program the Armed Forces upon those members join-
is being carried out. (b) AVAILABILITY.—The amount authorized
to be appropriated under subsection (a) shall ing the reserve components.
(2) SELECTION OF MECHANISMS.—In selecting (4) CONSULTATION WITH SECRETARY OF DE-
mechanisms under paragraph (1), the Sec- be available for obligation for the eight-year
FENSE.—The Secretary shall carry out this
retary shall select mechanisms designed to period beginning on the date that is one year
after the date of the enactment of this Act. subsection and the amendments made by
maximize the number of veterans who re- this subsection in consultation with the Sec-
ceive education under the program. retary of Defense.
(d) CONSTRUCTION.—Nothing in this section SA 5058. Mr. SANDERS submitted an (5) PATIENT ENROLLMENT SYSTEM DEFINED.—
shall be construed to alter or revise the eligi- amendment intended to be proposed to In this subsection, the term ‘‘patient enroll-
bility of any veteran for dental care under
the laws administered by the Secretary. amendment SA 5051 submitted by Mr. ment system’’ means the system of annual
(e) DEFINITIONS.—In this section TESTER (for himself and Mr. MORAN) patient enrollment of the Department of
SSpencer on DSK126QN23PROD with SENATE
(1) FEDERALLY QUALIFIED HEALTH CENTER.— and intended to be proposed to the bill Veterans Affairs established and operated
The term ‘‘Federally Qualified Health Cen- H.R. 3967, to improve health care and under section 1705(a) of title 38, United
ter’’ means a federally-qualified health cen- States Code.
benefits for veterans exposed to toxic
ter as defined in section 1905(l)(2)(B) of the substances, and for other purposes;
Social Security Act (42 U.S.C. 1396d(l)(2)(B)).’ SA 5059. Mr. SANDERS submitted an
which was ordered to lie on the table; amendment intended to be proposed to
(2) VET CENTER.—The term ‘‘Vet Center’’
has the meaning given that term in section as follows: amendment SA 5051 submitted by Mr.
1712A(h) of title 38, United States Code. At the end of title I, add the following: TESTER (for himself and Mr. MORAN)
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June 7, 2022 CONGRESSIONAL RECORD — SENATE S2837
and intended to be proposed to the bill H.R. 3967, to improve health care and Beginning on page 117, strike line 22 and
H.R. 3967, to improve health care and benefits for veterans exposed to toxic all that follows through page 121, line 12.
benefits for veterans exposed to toxic substances, and for other purposes; SA 5064. Mr. MORAN submitted an
substances, and for other purposes; which was ordered to lie on the table; amendment intended to be proposed to
which was ordered to lie on the table; as follows: amendment SA 5051 submitted by Mr.
as follows: At the appropriate place, insert the fol-
TESTER (for himself and Mr. MORAN)
At the end of title I, add the following: lowing:
SEC. ll. OFFSET THROUGH TEMPORARY RE-
and intended to be proposed to the bill
Subtitle C—Other Health Care Matters DUCTION IN FOREIGN ASSISTANCE H.R. 3967, to improve health care and
SEC. 121. MODIFICATION OF DETERMINATION OF PROGRAMS. benefits for veterans exposed to toxic
ELIGIBILITY OF VETERANS FOR During the 10-year period beginning on Oc- substances, and for other purposes;
TREATMENT AS A LOW-INCOME FAM- tober 1, 2022, no Federal funds may be ex-
ILY FOR PURPOSES OF ENROLL- which was ordered to lie on the table;
pended by the United States Agency for as follows:
MENT IN THE PATIENT ENROLL-
MENT SYSTEM OF THE DEPARTMENT
International Development other than funds
At the end of title I, add the following:
OF VETERANS AFFAIRS. that have been appropriated for Israel.
Subtitle C—Other Health Care Matters
(a) AREAS OF RESIDENCE.—The Secretary of
SA 5061. Ms. LUMMIS submitted an SEC. 121. MODIFICATION TO STANDARDS FOR AC-
Veterans Affairs shall modify the areas in CESS TO HEALTH CARE FROM DE-
which veterans reside as specified for pur- amendment intended to be proposed to
PARTMENT OF VETERANS AFFAIRS
poses of determining whether veterans qual- amendment SA 5051 submitted by Mr. AND NON-DEPARTMENT PROVIDERS.
ify for treatment as low-income families for TESTER (for himself and Mr. MORAN) (a) IN GENERAL.—Section 1703B of title 38,
enrollment in the patient enrollment system and intended to be proposed to the bill United States Code, is amended—
of the Department of Veterans Affairs under H.R. 3967, to improve health care and (1) by striking subsections (a) through (e)
section 1705(a)(7) of title 38, United States benefits for veterans exposed to toxic and inserting the following new subsections:
Code, to meet the requirements as follows: substances, and for other purposes; ‘‘(a) THRESHOLD ELIGIBILITY STANDARDS
(1) Any area so specified shall be within which was ordered to lie on the table; FOR ACCESS TO COMMUNITY CARE.—(1) A cov-
only one State. as follows: ered veteran may elect to receive non-De-
(2) Any area so specified shall be coexten- partment hospital care, medical services, or
Beginning on page 58, strike line 19 and all
sive with one or more counties (or similar extended care services through the Veterans
that follows through page 61, line 11, and in-
political subdivisions) in the State con- Community Care Program under section 1703
sert the following:
cerned. of this title pursuant to subsection (d)(1)(D)
(c) EFFECTIVE DATES AND APPLICABILITY.—
(b) VARIABLE INCOME THRESHOLDS.—The of such section using the following eligi-
(1) IN GENERAL.—The amendment made by
Secretary shall modify the thresholds for in- bility access standards:
subsection (b) shall take effect on the date of
come as specified for purposes of deter- ‘‘(A) With respect to primary care, mental
the enactment of this Act and shall apply as
mining whether veterans qualify for treat- health care, or non-institutional extended
follows:
ment as low-income families for enrollment care services, if the Department cannot
(A) On the date of the enactment of this
in the patient enrollment system referred to schedule an appointment for the covered vet-
Act for claimants for dependency and indem-
in subsection (a) to meet the requirements as eran with a health care provider of the De-
nity compensation under chapter 13 of title
follows: partment—
38, United States Code, and for veterans
(1) There shall be one income threshold for ‘‘(i) within 30 minutes average driving time
whom the Secretary of Veterans Affairs de-
each State, equal to 100 percent of the high- from the residence of the veteran; and
termines are—
est income threshold among— ‘‘(ii) within 20 days of the date of request
(i) terminally ill;
(A) the counties or metropolitan statis- for such an appointment unless a later date
(ii) homeless;
tical areas within such State; and has been agreed to by the veteran in con-
(iii) under extreme financial hardship;
(B) any metropolitan statistical area that sultation with the health care provider.
(iv) more than 85 years old; or
encompasses territory of such State and one ‘‘(B) With respect to specialty care or spe-
(v) capable of demonstrating other suffi-
or more other States. cialty services, if the Department cannot
cient cause.
(2) The calculation of the highest income schedule an appointment for the covered vet-
(B) On October 1, 2022, for everyone not de-
threshold of a county or metropolitan statis- eran with a health care provider of the De-
scribed in subparagraph (A).
tical area shall be consistent with the cal- partment—
(2) RETROACTIVE APPLICATION.—Notwith-
culation used for purposes of section 3(b) of ‘‘(i) within 60 minutes average driving time
standing any Federal court decisions or set-
the United States Housing Act of 1937 (42 from the residence of the veteran; and
tlements in effect on the day before the date
U.S.C. 1437a(b)). ‘‘(ii) within 28 days of the date of request
of the enactment of this Act, the Secretary
(3) The timing and methodology for imple- for such an appointment unless a later date
of Veterans Affairs shall award retroactive
menting any modifications in geographic in- has been agreed to by the veteran in con-
claims for a condition under section
come thresholds pursuant to paragraph (1) sultation with the health care provider.
1116(a)(2)(L) of title 38, United States Code, ‘‘(2) For the purposes of determining the
shall be determined by the Secretary in such as added by subsection (b) of this section,
a manner as to permit the Department to eligibility of a covered veteran for care or
only to claimants for dependency and indem- services under paragraph (1), the Secretary
build capacity for enrolling such additional nity compensation under chapter 13 of such
veterans in the patient enrollment system of shall not take into consideration the avail-
title described in paragraph (1)(A) of this ability of telehealth appointments from the
the Department as become eligible for en- subsection.
rollment as a result of such modifications, Department when determining whether the
except that all required modifications shall Department is able to furnish such care or
SA 5062. Ms. LUMMIS submitted an services in a manner that complies with the
be completed not later than five years after amendment intended to be proposed to
date of the enactment of this Act. eligibility access standards under such para-
(c) METROPOLITAN STATISTICAL AREA.—In
amendment SA 5051 submitted by Mr. graph.
this section, the term ‘‘metropolitan statis- TESTER (for himself and Mr. MORAN) ‘‘(b) ACCESS TO CARE STANDARDS FOR COM-
tical area’’ has the meaning given that term and intended to be proposed to the bill MUNITY CARE.—(1) Subject to subsection (c),
by the Office of Management and Budget. H.R. 3967, to improve health care and the Secretary shall meet the following ac-
benefits for veterans exposed to toxic cess to care standards when furnishing non-
SEC. 122. GUARANTEE OF HEALTH CARE BENE-
Department hospital care, medical services,
FITS FOR ENROLLED VETERANS. substances, and for other purposes;
or extended care services to a covered vet-
The Secretary of Veterans Affairs shall en- which was ordered to lie on the table; eran through the Veterans Community Care
sure that all veterans, once enrolled in the as follows: Program under section 1703 of this title:
patient enrollment system of the Depart- Beginning on page 58, strike line 5 and all ‘‘(A) With respect to an appointment for
ment of Veterans Affairs under section that follows through page 61, line 11. primary care, mental health care, or non-in-
1705(a) of title 38, United States Code, remain
stitutional extended care services—
enrolled in such system and may continue
SA 5063. Mr. MORAN submitted an ‘‘(i) within 30 minutes average driving time
receiving health care furnished by the De-
amendment intended to be proposed to from the residence of the veteran unless a
partment if they choose, subject to such
longer driving time has been agreed to by
SSpencer on DSK126QN23PROD with SENATE
cost-sharing requirements as may apply to amendment SA 5051 submitted by Mr.
TESTER (for himself and Mr. MORAN) the veteran; and
the veteran under existing provisions of law.
and intended to be proposed to the bill ‘‘(ii) within 20 days of the date of request
for such an appointment unless a later date
SA 5060. Mr. PAUL submitted an H.R. 3967, to improve health care and has been agreed to by the veteran.
amendment intended to be proposed to benefits for veterans exposed to toxic ‘‘(B) With respect to an appointment for
amendment SA 5051 submitted by Mr. substances, and for other purposes; specialty care or specialty services—
TESTER (for himself and Mr. MORAN) which was ordered to lie on the table; ‘‘(i) within 60 minutes average driving time
and intended to be proposed to the bill as follows: from the residence of the veteran unless a
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S2838 CONGRESSIONAL RECORD — SENATE June 7, 2022
longer driving time has been agreed to by (a), the Secretary shall measure from the AUTHORITY FOR COMMITTEES TO
the veteran; and date of request for the appointment unless a MEET
‘‘(ii) within 28 days of the date of request later date has been agreed to by the veteran
for such an appointment unless a later date in consultation with a health care provider Mr. DURBIN. Mr. President, I have
has been agreed to by the veteran. of the Department to the first next available eight requests for committees to meet
‘‘(2) The Secretary shall ensure that— appointment date in the clinic schedule rel- during today’s session of the Senate.
‘‘(A) health care providers specified under evant to the requested medical service. They have the approval of the Majority
section 1703(c) of this title are able to com- ‘‘(e) PERIODIC REVIEW OF ACCESS STAND-
ARDS.—Not later than three years after the
and Minority Leaders.
ply with the applicable access to care stand-
date of the enactment of the Sergeant First Pursuant to rule XXVI, paragraph
ards under paragraph (1) for such providers;
and Class Heath Robinson Honoring our Promise 5(a), of the Standing Rules of the Sen-
‘‘(B) meeting such standards is reflected in to Address Comprehensive Toxics Act of 2022, ate, the following committees are au-
the contractual requirements of third-party and not less frequently than once every thorized to meet during today’s session
administrators. three years thereafter, the Secretary shall— of the Senate:
‘‘(c) WAIVERS TO ACCESS TO CARE STAND- ‘‘(1) conduct a review of the eligibility ac-
COMMITTEE ON FINANCE
ARDS FOR COMMUNITY CARE PROVIDERS.—(1) A cess standards under subsection (a) and the
third-party administrator may request a access to care standards under subsection (b) The Committee on Finance is author-
waiver to the requirement to meet the access in consultation with— ized to meet during the session of the
to care standards under subsection (b) if— ‘‘(A) such Federal entities as the Secretary Senate on Tuesday, June 7, 2022, at 10
‘‘(A)(i) the scarcity of available providers considers appropriate, including the Depart- a.m., to conduct a hearing.
or facilities in the region precludes the ment of Defense, the Department of Health
COMMITTEE ON FOREIGN RELATIONS
third-party administrator from meeting and Human Services, and the Centers for
Medicare & Medicaid Services; The Committee on Foreign Relations
those access standards; or
‘‘(ii) the landscape of providers or facilities ‘‘(B) entities in the private sector; and is authorized to meet during the ses-
has changed and certain providers or facili- ‘‘(C) other entities that are not part of the sion of the Senate on Tuesday, June 7,
ties are not available such that the third- Federal Government; and 2022, at 10 a.m., to conduct a closed
party administrator is not able to meet ‘‘(2) submit to the appropriate committees briefing.
those access standards; and of Congress a report on—
COMMITTEE ON FOREIGN RELATIONS
‘‘(B) to address the scarcity of available ‘‘(A) the findings of the Secretary with re-
spect to the review conducted under para- The Committee on Foreign Relations
providers or the change in the provider or fa-
cility landscape, as the case may be, the graph (1); and is authorized to meet during the ses-
third-party administrator has contracted ‘‘(B) such recommendations as the Sec- sion of the Senate on Tuesday, June 7,
retary may have with respect to the eligi- 2022, at 3 p.m., to conduct a hearing on
with other providers or facilities that may
bility access standards under subsection (a) nominations.
not meet those access standards, but are the
and the access to care standards under sub-
currently available providers or facilities COMMITTEE ON HOMELAND SECURITY AND
section (b).’’;
most accessible to veterans within the re- GOVERNMENTAL AFFAIRS
(2) in subsection (f), by striking ‘‘The Sec-
gion of responsibility of the third-party ad-
retary’’ and inserting ‘‘COMPLIANCE BY COM- The Committee on Homeland Secu-
ministrator.
‘‘(2) Any waiver requested by a third-party MUNITY CARE PROVIDERS.—The Secretary’’; rity and Governmental Affairs is au-
administrator under paragraph (1) must be (3) by striking subsection (g) and inserting thorized to meet during the session of
the following new subsection (g): the Senate on Tuesday, June 7, 2022, at
requested in writing and submitted to the
‘‘(g) PUBLICATION OF ACCESS STANDARDS.—
Office of Community Care of the Department The Secretary shall publish in the Federal 10 a.m., to conduct a hearing.
for approval by that office. Register and on a publicly available internet COMMITTEE ON THE JUDICIARY
‘‘(3) As part of any waiver request under
website of the Department— The Committee on the Judiciary is
paragraph (1), a third-party administrator
‘‘(1) the eligibility access standards estab- authorized to meet during the session
must include conclusive evidence and docu-
lished under subsection (a); and of the Senate on Tuesday, June 7, 2022,
mentation that the access to care standards
‘‘(2) the access to care standards estab-
under subsection (b) cannot be met because lished under subsection (b).’’; at 10 a.m., to conduct a hearing.
of scarcity of available providers or changes (4) in subsection (h)(1), by striking ‘‘(1) SUBCOMMITTEE ON CONSERVATION, CLIMATE,
to the landscape of providers or facilities. Consistent with’’ and inserting ‘‘REQUESTS FORESTRY, AND NATURAL RESOURCES
‘‘(4) In evaluating a waiver request under
FOR DETERMINATIONS.—(1) Consistent with’’; The Subcommittee on Conservation,
paragraph (1), the Secretary shall consider
and Climate, Forestry, and Natural Re-
the following:
(5) in subsection (i)— sources of the Committee on Agri-
‘‘(A) The number and geographic distribu-
(A) by striking ‘‘In this section’’ and in-
tion of eligible health care providers avail- serting ‘‘DEFINITIONS.—In this section’’; and
culture, Nutrition, and Forestry is au-
able within the geographic area and spe- (B) by adding at the end the following new thorized to meet during the session of
cialty referenced in the waiver request. paragraphs: the Senate on Tuesday, June 7, 2022, at
‘‘(B) The prevailing market conditions ‘‘(3) The term ‘inability to contract’, with 10 a.m., to conduct a hearing.
within the geographic area and specialty ref- respect to a third-party administrator, SUBCOMMITTEE ON PUBLIC LANDS, FORESTS,
erenced in the waiver request, which shall means the inability of the third-party ad- AND MINING
include the number and distribution of ministrator to successfully negotiate and es-
health care providers contracting with other The Subcommittee on Public Lands,
tablish a community care network contract
health care plans (including commercial with a provider or facility.
Forests, and Mining of the Committee
plans and the Medicare program under title ‘‘(4) The term ‘third-party administrator’ on Energy and Natural Resources is au-
XVIII of the Social Security Act (42 U.S.C. means an entity that manages a provider thorized to meet during the session of
1395 et seq.)) operating in the geographic network and performs administrative serv- the Senate on Tuesday, June 7, 2022, at
area and specialty referenced in the waiver ices related to such network within the Vet- 3 p.m., to conduct a hearing.
request. erans Community Care Program under sec-
‘‘(C) Whether the service area is comprised SUBCOMMITTEE ON TOURISM, TRADE, AND
tion 1703 of this title.’’. EXPORT PROMOTION
of highly rural, rural, or urban areas or some (b) PREVENTION OF SUSPENSION OF VET-
combination of such areas. ERANS COMMUNITY CARE PROGRAM.—Section The Subcommittee on Tourism,
‘‘(D) How significantly the waiver request 1703(a) of such title is amended by adding at Trade, and Export Promotion of the
differs from the access to care standards the end the following new paragraph: Committee on Commerce, Science, and
under subsection (b). ‘‘(4) Nothing in this section shall be con- Transportation is authorized to meet
‘‘(E) The rates offered to providers in the strued to authorize the Secretary to suspend during the session of the Senate on
geographic area covered by the waiver. the program established under paragraph
‘‘(5) The Secretary shall not consider in- (1).’’.
Tuesday, June 7, 2022, at 3 p.m., to con-
ability to contract as a valid sole rationale (c) ESTABLISHMENT OF REQUIREMENTS FOR duct a hearing.
for granting a waiver under paragraph (1). DOCUMENTATION OF POSTPONEMENT OF AP- f
‘‘(d) CALCULATION OF DRIVING TIMES AND
SSpencer on DSK126QN23PROD with SENATE
POINTMENT DATE.—Not later than 180 days
WAIT TIMES.—(1) For purposes of calculating after the date of the enactment of this Act, PRIVILEGES OF THE FLOOR
average driving time from the residence of the Secretary of Veterans Affairs shall es- Ms. MURKOWSKI. Mr. President, I
the veteran under subsections (a) and (b), the tablish a process and requirements for facili- ask unanimous consent that privileges
Secretary shall use geographic information ties of the Department of Veterans Affairs to
system software. document the agreement of a veteran to
of the floor be granted to my first ses-
‘‘(2) For purposes of calculating the wait postpone an appointment as specified under sion summer interns for the month of
time for a veteran to schedule an appoint- section 1703B of title 38, United States Code, June; that is Harold Monroe, Gracelyn
ment with the Department under subsection as amended by subsection (a). Gohr, Charlee Korthuis, Dustin Lozano,
VerDate Sep 11 2014 03:21 Jun 08, 2022 Jkt 029060 PO 00000 Frm 00044 Fmt 4624 Sfmt 0634 E:\CR\FM\A07JN6.026 S07JNPT1
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