Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 or the Honoring our PACT Act of 2022
This bill addresses health care, presumption of service-connection, research, resources, and other matters related to veterans who were exposed to toxic substances during military service.
TITLE I--EXPANSION OF HEALTH CARE ELIGIBILITY
Conceding Our Veterans' Exposure Now and Necessitating Training Act of 2022 or the COVENANT Act of 2022
Subtitle A--Toxic-Exposed Veterans
(Sec. 103) This section provides eligibility for Department of Veterans Affairs (VA) medical care, including mental health services and counseling, to veterans who (1) participated in a toxic exposure risk activity (e.g., a qualifying activity that requires a corresponding entry in an exposure tracking record system, such as the Individual Longitudinal Exposure Record); (2) served in specified locations on specified dates; or (3) deployed in support of a specified contingency operation.
(Sec. 104) The VA must complete an assessment to determine (1) the personnel and material resources necessary to implement the expanded provision of care to the veterans specified in Section 103 of this bill (e.g., veterans who participated in a toxic exposure risk activity), and (2) the total number of veterans who served in specified locations on specified dates and receive hospital care or medical services from the VA, disaggregated by priority group.
Subtitle B--Certain Veterans Of Combat Service And Other Matters
(Sec. 111) This section extends the eligibility period for VA hospital care, medical services, and nursing home care for combat veterans who served after September 11, 2001, and are toxic-exposed veterans, including those who did not enroll to receive VA care during the eligibility period.
TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS
Toxic Exposure in the American Military Act of 2022 or the TEAM Act of 2022
(Sec. 202) This section prescribes the procedures for establishing or removing presumptions of service-connection based on toxic exposure, including by providing for public notice and comment periods and the establishment of a working group to advise and make recommendations regarding toxic exposures during military service.
(Sec. 203) The VA must conduct outreach to certain claimants when a law establishes or modifies a presumption of service-connection. Specifically, the VA must identify and conduct outreach for all claims for compensation for a service-connected disability that (1) were submitted to the VA, (2) were evaluated and denied before the new law went into effect, and (3) might have been evaluated differently if the modification had been applicable to the claim.
(Sec. 204) The VA must conduct outreach to certain claimants when a law establishes or modifies a presumption of service-connection in relation to dependency and indemnity compensation. Specifically, the VA must identify and conduct outreach for all claims for dependency and indemnity compensation related to service-connected conditions that (1) were submitted to the VA, (2) were evaluated and denied before the new law went into effect, and (3) might have been evaluated differently if the modification had been applicable to the claim.
TITLE III--IMPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS FOR TOXIC-EXPOSED VETERANS
Veterans Burn Pits Exposure Recognition Act of 2022
(Sec. 302) This section establishes a presumption that veterans were exposed to certain substances, chemicals, and airborne hazards during military service in specified locations in specified time frames (e.g., on or after August 2, 1990, in Bahrain).
(Sec. 303) The VA must provide a veteran with a medical examination regarding the nexus between a disability and toxic exposure risk activity if a veteran submits a disability compensation claim for a service-connected disability with insufficient evidence.
TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION
Mark Takai Atomic Veterans Healthcare Parity Act of 2022
(Sec. 401) This section includes veterans who participated in the cleanup of Enewetak Atoll in the Marshall Islands between January 1, 1977, and December 31, 1980, as radiation-exposed veterans for purposes of the VA presumption of service-connection for specified cancers.
Palomares or Thule Veterans Act of 2022
(Sec. 402) This section includes veterans who participated in the cleanup of radioactive materials at Palomares, Spain, or in the response effort following the on-board fire and crash of a U.S. Air Force B-52 bomber in the vicinity of Thule Air Force Base, Greenland, as radiation-exposed veterans for purposes of the presumption of service-connection for specified cancers.
Veterans Agent Orange Exposure Equity Act of 2022
(Sec. 403) This section expands the presumption of service-connection for diseases associated with exposure to certain herbicide agents for veterans who served in Vietnam between January 9, 1962, and May 7, 1975. Specifically, the bill expands the presumption to cover veterans who served during specified time frames in Thailand at any U.S. or Royal Thai bases, Laos, Cambodia, Guam or American Samoa or the waters thereof, or on Johnson Atoll. Under the bill, such veterans are eligible for VA hospital care, medical services, and nursing home care.
Fair Care for Vietnam Veterans Act of 2022
(Sec. 404) This section provides a presumption of service-connection for hypertension and monoclonal gammopathy of undetermined significance (MGUS) for veterans who performed service specified in Section 403 of this bill (e.g., in Thailand).
(Sec. 405) This section addresses disability compensation and care issues for Persian Gulf War veterans, including by expanding who qualifies as a Persian Gulf Veteran.
Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2022
(Sec. 406) This section establishes a presumption of service-connection for specified diseases associated with exposure to specified substances, chemicals, or airborne hazards becoming manifest in veterans who served in specified locations during specified times (e.g., Iraq on or after August 2, 1990).
TITLE V--RESEARCH MATTERS
(Sec. 501) The VA must collaborate with various entities, such as the Department of Defense (DOD), to establish the Toxic Exposure Research Working Group to (1) identify collaborative research activities and resources and conduct such research related to health consequences of toxic exposure during military service, and (2) develop a five-year strategic plan for collaborative research activities.
(Sec. 502) The VA must continually analyze all clinical data obtained in connection with its provision of hospital care, medical services, and nursing home care for toxic-exposed veterans that is likely to be scientifically useful in determining the association between a veteran's medical condition and a toxic exposure.
(Sec. 503) The VA must conduct an updated analysis of total and respiratory disease mortality in veterans who served in specified locations at specified times, such as in Kuwait on or after August 2, 1990.
(Sec. 504) The VA must conduct an epidemiological study on the health trends of veterans who served in the Armed Forces after September 11, 2001.
(Sec. 505) The VA must study the incidence of cancer in veterans to determine trends in the rates of incidence of cancer in veterans.
(Sec. 506) The VA must enter into an agreement with the National Academies of Sciences, Engineering, and Medicine (NASEM) to study the health trends of veterans who, during active service, participated in activities relating to the Manhattan Project or resided near specified locations proximate to waste arising from activities in connection with the Manhattan Project.
(Sec. 507) The VA must enter an agreement with NASEM to study possible relationships between toxic exposures experienced during service in the Armed Forces and mental health conditions.
(Sec. 508) The Government Accountability Office must study the state of access and barriers to benefits and services furnished by the Veterans Benefits Administration (VBA) and the Veterans Health Administration (VHA) to veterans in territories and Freely Associated States of the United States.
(Sec. 509) The VA must establish and maintain a publicly accessible website to serve as a clearinghouse for the publication of all toxic exposure research carried out or funded by the executive branch of the federal government.
(Sec. 510) The VA must report to Congress on the health effects of jet fuels used by the Armed Forces.
TITLE VI--IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED VETERANS
Fairly Assessing Service-related Toxic Exposure Residuals Presumptions Act of 2022 or the FASTER Presumption Act of 2022
(Sec. 602) The VA must publish a list of its resources for toxic-exposed veterans and veterans who report toxic exposure, families and caregivers of such veterans, and survivors of such veterans who are receiving death benefits. The VA must also develop an informative outreach program for veterans on illnesses that may be related to toxic exposures.
(Sec. 603) The VA must incorporate a screening to help determine potential toxic exposures during active military service as part of the health care screening furnished to veterans enrolled in the VA health care system.
(Sec. 604) The VA must provide its health care personnel with education and training to identify, treat, and assess the impact on veterans of illnesses related to toxic exposures. Additionally, the VA must incorporate an annual training program for processors of claims for disability benefits relating to service-connected disabilities based on toxic exposures.
TITLE VII--RESOURCING
(Sec. 701) The VA is authorized to use funds appropriated to the Cost of War Toxic Exposures Fund to continue the modernization, development, and expansion of capabilities and capacity of information technology systems and infrastructure of the VBA to support expected increased claims processing for newly eligible veterans. The VA must submit a plan to Congress for the modernization of the information technology systems of the VBA.
(Sec. 702) This section authorizes the VA to carry out various medical facility leases at specified amounts in FY2023 (e.g., an outpatient clinic in Allentown, Pennsylvania).
(Sec. 703) This section prohibits funds from being appropriated, obligated, or expended for any major VA medical facility lease unless the congressional veterans affairs committees each adopt a resolution approving the lease.
Additionally, this section (1) modifies the requirements for the prospectus that must be submitted regarding a request for funding a major medical facility lease, and (2) authorizes the VA to carry out interim leasing actions as it considers necessary for approved major medical facility leases and replacement leases that do not require approval.
(Sec. 704) The VA may enter into a lease with an academic affiliate or other specified entity to acquire space for the purpose of providing health care resources to veterans.
(Sec. 705) This section modifies the enhanced-use lease authority of the VA, including by permanently authorizing such authority and extending the maximum term of such leases from 75 to 99 years. This section also provides appropriations for entering into enhanced-used leases and authorizes the VA to deposit unutilized funds received under an enhanced-use lease in the Medical Facilities or the Construction, Minor Projects accounts.
(Sec. 706) This section prescribes the authority for joint leasing actions between DOD and the VA.
(Sec. 707) This section provides specified appropriations for major medical facility leases through FY2031.
TITLE VIII--RECORDS AND OTHER MATTERS
(Sec. 801) The VA must conduct an epidemiological study on the health trends of veterans who served at Fort McClellan at any time between January 1, 1935, and May 20, 1999.
(Sec. 802) DOD must brief Congress on the quality of its databases that provide the information presented in the Individual Longitudinal Exposure Record and the usefulness of the record in supporting members of the Armed Forces and veterans in receiving health care and benefits.
(Sec. 803) The VA must provide a means for veterans to update their records as necessary to reflect exposures to occupational or environmental hazards in the Individual Longitudinal Exposure Record.
Camp Lejeune Justice Act of 2022
(Sec. 804) This section provides a federal cause of action for individuals who resided, worked, or were otherwise exposed (including in utero) for not less than 30 days to water at Camp Lejeune, North Carolina, between August 1, 1953, and December 31, 1987.
(Sec. 805) This section establishes the Cost of War Toxic Exposures Fund in the Treasury to be administered by the VA to invest in the delivery of veterans' health care and benefits associated with exposures to environmental hazards during military services and medical and other research relating to exposure to environmental hazards.
(Sec. 806) This section provides appropriations to the Cost of War Toxic Exposures Fund to remain available through FY2024. The VA must submit a plan for expending such amounts.
(Sec. 807) This section authorizes the VA to provide notice related to claims in an electronic format upon the election of the claimant, including for decisions by the Board of Veterans' Appeals.
(Sec. 808) The VA must annually submit a report related to veterans who submit a disability claim for a service-connected disability and were deployed at specified locations at specified times. Additionally, the VA must ensure that VA medical professionals inform a veteran of the Airborne Hazards and Open Burn Pit Registry if a veteran seeks treatment at a VA medical facility for issues related to, or ancillary to, the exposure to toxic airborne chemicals and fumes caused by open burn pits.
TITLE IX--IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS
(Sec. 901) The VA must develop and implement a national rural recruitment and hiring plan for the VHA to, among other purposes, recruit health care professionals for rural and highly rural community-based outpatient clinics and medical centers.
(Sec. 902) The VA may buy out a non-VA service contract of certain health care professionals to whom the VA has offered employment in exchange for the individual agreeing to be employed at a rural or highly rural facility for at least four years.
(Sec. 903) The VA must establish qualifications for each of its human resources positions and establish standardized performance metrics for such positions. The VA must also establish or enhance its systems to monitor human resources actions that occur at local, regional, and national levels to improve performance of those actions. The VA must also submit a plan to Congress for the recruitment and retention of human resources employees within the VA.
(Sec. 904) This section increases the pay cap for certain employees of the VHA.
(Sec. 905) This section expands employment opportunities for housekeeping aides by removing the requirement that competition for VA housekeeping aide positions is restricted to preference eligibles.
(Sec. 906) This section modifies the authority of the VA related to hours, conditions and employment, and pay for certain employees of the VHA, specifically certain appointees and Senior Executive Service positions. Additionally, the section authorizes the VA to establish an awards program for certain appointed personnel, such as physicians.
(Sec. 907) The VA is authorized to waive any annual premium or aggregate limitation on pay for an employee of the VHA during the calendar year in which the official duty station of the employee is closed or the office, facility, activity, or organization of the employee is realigned. Similarly, the VA may waive any annual premium or aggregate limitation on pay for an employee whose primary duties include providing expanded care for veterans exposed to open burn pits.
(Sec. 908) This section eliminates the limitation on aggregate amounts for awards and bonuses for employees of the VA.
(Sec. 909) Among other elements, this section provides additional authority for the VA to provide recruitment and relocation bonuses, retention bonuses, merit awards, incentives for critical skills, and student loan repayments. The section increases the cap on the number of college graduates and post-secondary students the VA may hire through an expedited process. The VA may authorize the fixing of the rate of pay for critical positions in the VA, with some limitations. Additionally, the VA may establish a rate for special pay and may waive the limitation on certain payments, such as bonuses.
In the Senate of the United States,

                                                         June 16, 2022.
    Resolved, That the bill from the House of Representatives (H.R. 
3967) entitled ``An Act to improve health care and benefits for 
veterans exposed to toxic substances, and for other purposes.'', do 
pass with the following

                               AMENDMENT:

             Strike all after the enacting clause and insert the 
      following:

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

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

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

             TITLE I--EXPANSION OF HEALTH CARE ELIGIBILITY

                   Subtitle A--Toxic-exposed Veterans

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

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

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

              TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS

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

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

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

              TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION

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

                       TITLE V--RESEARCH MATTERS

Sec. 501. Interagency working group on toxic exposure research.
Sec. 502. Analysis and report on treatment of veterans for medical 
                            conditions related to toxic exposure.
Sec. 503. Analysis relating to mortality of veterans who served in 
                            Southwest Asia.
Sec. 504. Study on health trends of post-9/11 veterans.
Sec. 505. Study on cancer rates among veterans.
Sec. 506. Study on health effects of waste related to Manhattan Project 
                            on certain veterans.
Sec. 507. Study on toxic exposure and mental health outcomes.
Sec. 508. Study on veterans in Territories of the United States.
Sec. 509. Department of Veterans Affairs public website for toxic 
                            exposure research.
Sec. 510. Report on health effects of jet fuels used by Armed Forces.

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

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

                         TITLE VII--RESOURCING

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

                 TITLE VIII--RECORDS AND OTHER MATTERS

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

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

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

             TITLE I--EXPANSION OF HEALTH CARE ELIGIBILITY

                   Subtitle A--Toxic-exposed Veterans

SEC. 101. SHORT TITLE.

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

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

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

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

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

SEC. 104. ASSESSMENTS OF IMPLEMENTATION AND OPERATION.

    (a) Initial Resource Assessment and Report.--Not later than 180 
days after the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall--
            (1) complete an assessment to determine--
                    (A) the personnel and material resources necessary 
                to implement section 103 (including the amendments made 
                by such section); and
                    (B) the total number of covered veterans, as such 
                term is defined in section 1119(c) of title 38, United 
                States Code (as added by section 302), who receive 
                hospital care or medical services furnished by the 
                Secretary under chapter 17 of such title, disaggregated 
                by priority group specified in section 1705(a) of such 
                title; and
            (2) submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report containing the findings of the 
        assessment completed under paragraph (1), including a specific 
        determination as to whether the Department has the personnel 
        and material resources necessary to implement section 103.
    (b) Information Systems.--Not later than October 1, 2024, the 
Secretary shall establish information systems to assess the 
implementation of section 103, including the amendments made by such 
section, and use the results of assessments under such systems to 
inform the reports under subsection (c).
    (c) Annual Reports.--
            (1) Reports.--Not later than October 1, 2025, and on an 
        annual basis thereafter until October 1, 2033, the Secretary 
        shall submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report on the following:
                    (A) The effect of the implementation of, and the 
                provision and management of care under, section 103 
                (including the amendments made by such section) on the 
                demand by veterans described in subparagraphs (G), (H), 
                and (I) of section 1710(e)(1) of title 38, United 
                States Code (as added by such section 103) for health 
                care services furnished by the Secretary.
                    (B) Any differing patterns of demand for health 
                care services by such veterans, disaggregated by 
                factors such as the relative distance of the veteran 
                from medical facilities of the Department and whether 
                the veteran had previously received hospital care or 
                medical services furnished by the Secretary under 
                chapter 17 of such title.
                    (C) The extent to which the Secretary has met such 
                demand.
                    (D) Any changes, during the year covered by the 
                report, in the delivery patterns of health care 
                furnished by the Secretary under chapter 17 of such 
                title, and the fiscal impact of such changes.
            (2) Matters.--Each report under paragraph (1) shall 
        include, with respect to the year covered by the report, 
        detailed information on the following:
                    (A) The total number of veterans enrolled in the 
                patient enrollment system who, during such year, 
                received hospital care or medical services furnished by 
                the Secretary under chapter 17 of title 38, United 
                States Code.
                    (B) Of the veterans specified in subparagraph (A), 
                the number of such veterans who, during the preceding 
                three fiscal years, had not received such care or 
                services.
                    (C) With respect to the veterans specified in 
                subparagraph (B), the cost of providing health care to 
                such veterans during the year covered by the report, 
                shown in total and disaggregated by--
                            (i) the level of care; and
                            (ii) whether the care was provided through 
                        the Veterans Community Care Program.
                    (D) With respect to the number of veterans 
                described in subparagraphs (G), (H), and (I) of section 
                1710(e)(1) of title 38, United States Code (as added by 
                section 103), the following (shown in total and 
                disaggregated by medical facility of the Department, as 
                applicable):
                            (i) The number of such veterans who, during 
                        the year covered by the report, enrolled in the 
                        patient enrollment system.
                            (ii) The number of such veterans who 
                        applied for, but were denied, such enrollment.
                            (iii) The number of such veterans who were 
                        denied hospital care or a medical service 
                        furnished by the Secretary that was considered 
                        to be medically necessary but not of an 
                        emergency nature.
                    (E) The numbers and characteristics of, and the 
                type and extent of health care furnished by the 
                Secretary to, veterans enrolled in the patient 
                enrollment system (shown in total and disaggregated by 
                medical facility of the Department).
                    (F) The numbers and characteristics of, and the 
                type and extent of health care furnished by the 
                Secretary to, veterans not enrolled in the patient 
                enrollment system (disaggregated by each class of 
                eligibility for care under section 1710 of title 38, 
                United States Code, and further shown as a total per 
                class and disaggregated by medical facility of the 
                Department).
                    (G) The specific fiscal impact (shown in total and 
                disaggregated by geographic health care delivery areas) 
                of changes in the delivery patterns of health care 
                furnished by the Secretary under chapter 17 of such 
                title as a result of the implementation of section 103 
                (including the amendments made by such section).
    (d) Definitions.--In this section:
            (1) Patient enrollment system.--The term ``patient 
        enrollment system'' means the patient enrollment system of the 
        Department of Veterans Affairs established and operated under 
        section 1705(a) of title 38, United States Code.
            (2) Veterans community care program.--The term ``Veterans 
        Community Care Program'' means the program established under 
        section 1703 of title 38, United States Code.

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

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

    (a) Expanded Period.--Section 1710(e)(3) is amended--
            (1) in subparagraph (A)--
                    (A) by striking ``January 27, 2003'' and inserting 
                ``September 11, 2001''; and
                    (B) by striking ``five-year period'' and inserting 
                ``10-year period'';
            (2) by amending subparagraph (B) to read as follows:
            ``(B) With respect to a veteran described in paragraph 
        (1)(D) who was discharged or released from the active military, 
        naval, air, or space service after September 11, 2001, and 
        before October 1, 2013, but did not enroll to receive such 
        hospital care, medical services, or nursing home care under 
        such paragraph pursuant to subparagraph (A) before October 1, 
        2022, the one-year period beginning on October 1, 2022.''; and
            (3) by striking subparagraph (C).
    (b) Clarification of Coverage.--Section 1710(e)(1)(D) is amended by 
inserting after ``Persian Gulf War'' the following: ``(including any 
veteran who, in connection with service during such period, received 
the Armed Forces Expeditionary Medal, Service Specific Expeditionary 
Medal, Combat Era Specific Expeditionary Medal, Campaign Specific 
Medal, or any other combat theater award established by a Federal 
statute or an Executive order)''.
    (c) Outreach Plan.--Not later than December 1, 2022, the Secretary 
of Veterans Affairs shall submit to the Committee on Veterans' Affairs 
of the Senate and the Committee on Veterans' Affairs of the House of 
Representatives a plan to conduct outreach to veterans described in 
subparagraph (B) of section 1710(e)(3) of title 38, United States Code, 
as amended by subsection (a)(2), to notify such veterans of their 
eligibility for hospital care, medical services, or nursing home care 
pursuant to such subparagraph.
    (d) Report on Enrollments.--Not later than January 30, 2024, the 
Secretary shall submit to the Committee on Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report identifying, with respect to the one-year 
period beginning on October 1, 2022, the number of veterans described 
in section 1710(e)(3)(B) of title 38, United States Code, as amended by 
subsection (a)(2), who, during such period, enrolled in the patient 
enrollment system of the Department of Veterans Affairs established and 
operated under section 1705(a) of such title.
    (e) Effective Date.--This section and the amendments made by this 
section shall take effect on October 1, 2022.

              TITLE II--TOXIC EXPOSURE PRESUMPTION PROCESS

SEC. 201. SHORT TITLE.

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

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

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

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

``Sec. 1171. Procedures to determine presumptions of service connection 
              based on toxic exposure; definitions
    ``(a) Procedures.--The Secretary shall determine whether to 
establish, or to remove, presumptions of service connection based on 
toxic exposure pursuant to this subchapter, whereby--
            ``(1) under section 1172 of this title--
                    ``(A) the Secretary provides--
                            ``(i) public notice regarding what formal 
                        evaluations the Secretary plans to conduct; and
                            ``(ii) the public an opportunity to comment 
                        on the proposed formal evaluations;
                    ``(B) the working group established under 
                subsection (b) of such section provides--
                            ``(i) advice to the Secretary on toxic-
                        exposed veterans and cases in which veterans 
                        who, during active military, naval, air, or 
                        space service, may have experienced a toxic 
                        exposure or their dependents may have 
                        experienced a toxic exposure while the veterans 
                        were serving in the active military, naval, 
                        air, or space service;
                            ``(ii) recommendations to the Secretary on 
                        corrections needed in the Individual 
                        Longitudinal Exposure Record to better reflect 
                        veterans and dependents described in clause 
                        (i); and
                            ``(iii) recommendations to the Secretary 
                        regarding which cases of possible toxic 
                        exposure should be reviewed;
            ``(2) the Secretary provides for formal evaluations of such 
        recommendations under section 1173 of this title and takes into 
        account reports received by the Secretary from the National 
        Academies of Sciences, Engineering, and Medicine under section 
        1176 of this title; and
            ``(3) the Secretary issues regulations under section 1174 
        of this title.
    ``(b) Definitions.--In this subchapter:
            ``(1) The term `illness' includes a disease or other 
        condition affecting the health of an individual, including 
        mental and physical health.
            ``(2) The term `Individual Longitudinal Exposure Record' 
        includes--
                    ``(A) service records;
                    ``(B) any database maintained by the Department of 
                Defense and shared with the Department of Veterans 
                Affairs to serve as a central portal for exposure-
                related data that compiles, collates, presents, and 
                provides available occupational and environmental 
                exposure information to support the needs of the 
                Department of Defense and the Department of Veterans 
                Affairs; or
                    ``(C) any successor system to a database described 
                in subparagraph (B).
``Sec. 1172. Annual notice and opportunity for public comment
    ``(a) Notice Required.--(1)(A) Not less frequently than once each 
year, the Secretary shall publish in the Federal Register notice of the 
formal evaluations that the Secretary plans to conduct pursuant to 
section 1173 of this title.
    ``(B) Each notice published under subparagraph (A) shall include, 
for each formal evaluation referred to in the notice, an explanation as 
to why the military environmental exposures and adverse health outcomes 
that are the subject of the formal evaluation were chosen by the 
Secretary for formal evaluation under section 1173 of this title.
    ``(2)(A) With each notice published under paragraph (1), the 
Secretary shall seek public comment on the military environmental 
exposures and adverse health outcomes that are the subject of the 
formal evaluations referred to in the notice.
    ``(B) The Secretary shall--
            ``(i) consider all public comment received under 
        subparagraph (A); and
            ``(ii) publish in the Federal Register a response to the 
        comments received under subparagraph (A).
    ``(3)(A) For each notice published under paragraph (1), the 
Secretary shall hold an open meeting for members of the public to voice 
their comments in response to the notice.
    ``(B) To help evaluate presumptions of service connection, the 
Secretary shall, not less frequently than quarterly, collaborate with, 
partner with, and give weight to the advice of veterans service 
organizations and such other stakeholders as the Secretary considers 
appropriate.
    ``(4) Failure to include a military environmental exposure or 
adverse health effect in a Federal Register notice published pursuant 
to subsection (a) shall not preclude the Secretary from initiating a 
formal evaluation of such exposure or health effect.
    ``(b) Working Group.--(1) The Secretary shall establish a working 
group within the Department (in this section referred to as the 
`Working Group').
    ``(2) The Working Group shall include personnel of the Veterans 
Health Administration and the Veterans Benefits Administration.
    ``(3) The Secretary shall consult with, and seek the advice of, the 
Working Group with respect to cases in which--
            ``(A) a veteran may have, during active military, naval, 
        air, or space service, experienced a toxic exposure; or
            ``(B) a dependent of a veteran may have experienced a toxic 
        exposure during the active military, naval, air, or space 
        service of the veteran.
    ``(c) Assessments.--(1) The Working Group shall assess cases of the 
toxic exposure of veterans and their dependents that occurred during 
active military, naval, air, or space service, including by conducting 
ongoing surveillance and reviewing such exposure described in 
scientific literature, media reports, information from veterans, and 
information from Congress.
    ``(2) The assessments under paragraph (1) shall cover suspected and 
known toxic exposures occurring during active military, naval, air, or 
space service, including by identifying and evaluating new and emerging 
toxic exposures that are not recognized under existing presumptions of 
service connection.
    ``(3) The Working Group may conduct an assessment under paragraph 
(1) in response to a comment received under paragraph (2) or (3) of 
subsection (a).
    ``(4) The Working Group shall, in consultation with the Secretary 
of Defense, on a periodic basis, assess the Individual Longitudinal 
Exposure Record to ensure the accuracy of data collected.
    ``(d) Development of Recommendations.--(1) Following an assessment 
of a case of the toxic exposure of veterans that occurred during active 
military, naval, air, or space service under subsection (c), or their 
dependents, the Working Group may develop a recommendation for formal 
evaluation under section 1173 of this title to conduct a review of the 
health effects related to the case of exposure if the Working Group 
determines that the research may change the current understanding of 
the relationship between an exposure to an environmental hazard and 
adverse health outcomes in humans.
    ``(2) Upon receipt of evidence suggesting that previous findings 
regarding the periods and locations of exposure covered by an existing 
presumption of service connection are no longer supported, the Working 
Group may nominate such evidence for formal evaluation under section 
1173 of this title to modify the periods and locations.
    ``(e) Reports by the Working Group.--Not less frequently than once 
each year, the Working Group shall submit to the Secretary, the 
Committee on Veterans' Affairs of the Senate, and the Committee on 
Veterans' Affairs of the House of Representatives, and make publicly 
available, a report on--
            ``(1) recommendations developed under subsection (d), if 
        any; and
            ``(2) recommendations for such legislative or 
        administrative action as the Working Group considers necessary 
        for the Working Group to be more effective in carrying out the 
        requirements of this section.
    ``(f) Responses by Secretary.--In response to each report submitted 
under subsection (e), the Secretary shall, not later than 30 days after 
receiving the report, initiate a formal evaluation pursuant to section 
1173 of this title.
``Sec. 1173. Formal evaluation of recommendations
    ``(a) Formal Evaluations.--The Secretary shall establish a process 
to conduct a formal evaluation with respect to each recommendation made 
by the Working Group under section 1172 of this title.
    ``(b) Evidence, Data, and Factors.--The Secretary shall ensure that 
each formal evaluation under subsection (a) covers the following:
            ``(1) Scientific evidence, based on the review of available 
        scientific literature, including human, toxicological, animal, 
        and methodological studies, and other factors.
            ``(2) Claims data, based on the review of claim rate, grant 
        rate, and service connection prevalence, and other factors.
            ``(3) Other factors the Secretary determines appropriate, 
        such as--
                    ``(A) the level of disability and mortality caused 
                by the health effects related to the case of toxic 
                exposure being evaluated;
                    ``(B) the quantity and quality of the information 
                available and reviewed;
                    ``(C) the feasibility of and period for generating 
                relevant information and evidence;
                    ``(D) whether such health effects are combat- or 
                deployment-related;
                    ``(E) the ubiquity or rarity of the health effects; 
                and
                    ``(F) any time frame during which a health effect 
                must become manifest.
    ``(c) Conduct of Evaluations.--(1) The Secretary shall ensure that 
each formal evaluation under subsection (a)--
            ``(A) reviews scientific evidence in a manner that--
                    ``(i) conforms to principles of scientific and data 
                integrity;
                    ``(ii) is free from suppression or distortion of 
                scientific or technological findings, data, 
                information, conclusions, or technical results; and
            ``(B)(i) evaluates the likelihood that a positive 
        association exists between an illness and a toxic exposure 
        while serving in the active military, naval, air, or space 
        service; and
            ``(ii) assesses the toxic exposures and illnesses and 
        determines whether the evidence supports a finding of a 
        positive association between the toxic exposure and the 
        illness.
    ``(2) In carrying out paragraph (1)(B)(ii), a formal evaluation 
under subsection (a) shall include reviewing all relevant data to 
determine the strength of evidence for a positive association based on 
the following four categories:
            ``(A) The `sufficient' category, where the evidence is 
        sufficient to conclude that a positive association exists.
            ``(B) The `equipoise and above' category, where the 
        evidence is sufficient to conclude that a positive association 
        is at least as likely as not, but not sufficient to conclude 
        that a positive association exists.
            ``(C) The `below equipoise' category, where the evidence is 
        not sufficient to conclude that a positive association is at 
        least as likely as not, or is not sufficient to make a 
        scientifically informed judgment.
            ``(D) The `against' category, where the evidence suggests 
        the lack of a positive association.
    ``(d) Recommendation for Establishing a Presumption of Service 
Connection.--Not later than 120 days after the date on which a formal 
evaluation is commenced, the element of the Department that conducts 
the evaluation shall submit to the Secretary a recommendation with 
respect to establishing a presumption of service connection for the 
toxic exposure and illness, or modifying an existing presumption of 
service connection, covered by the evaluation.
``Sec. 1174. Regulations regarding presumptions of service connection 
              based on toxic exposure
    ``(a) Action Upon Recommendation.--Not later than 160 days after 
the date on which the Secretary receives a recommendation to establish 
or modify a presumption of service connection under section 1173 of 
this title--
            ``(1) if the Secretary determines, in the discretion of the 
        Secretary, that the presumption, or modification, is warranted, 
        the Secretary shall--
                    ``(A) commence issuing regulations in accordance 
                with the provisions of subchapter II of chapter 5 of 
                title 5 (commonly referred to as the Administrative 
                Procedures Act) setting forth the presumption or 
                commence revising regulations to carry out such 
                modification; and
                    ``(B) include in such regulations any time frame 
                during which a health effect must become manifest; or
            ``(2) if the Secretary determines, in the discretion of the 
        Secretary, that the presumption, or modification, is not 
        warranted, the Secretary shall publish in the Federal Register 
        a notice of the determination, including the reasons supporting 
        the determination.
    ``(b) Removal of Presumption.--(1)(A) The Secretary may--
            ``(i) issue a regulation to remove an illness from a 
        presumption of service connection previously established 
        pursuant to a regulation issued under subsection (a); and
            ``(ii) issue a regulation to remove a presumption of 
        service connection established pursuant to title IV of the 
        Sergeant First Class Heath Robinson Honoring our Promise to 
        Address Comprehensive Toxics Act of 2022 if the Secretary 
        concludes that evidence suggests the lack of a positive 
        association between the disease and the toxic exposure.
    ``(B) Under subparagraph (A)(ii), the Secretary shall not consider 
the lack of evidence as sufficient to support a decision for removal of 
a presumption.
    ``(2) Whenever an illness is removed from regulations pursuant to 
paragraph (1), or the periods and locations of exposure covered by a 
presumption of service connection are modified under subsection (a)--
            ``(A) a veteran who was awarded compensation under chapter 
        11 of this title for such illness on the basis of the 
        presumption provided under such regulations before the 
        effective date of the removal or modification shall continue to 
        be entitled to receive compensation on that basis;
            ``(B) a survivor of a veteran who was awarded dependency 
        and indemnity compensation under chapter 13 of this title for 
        the death of a veteran resulting from such illness on the basis 
        of such presumption shall continue to be entitled to receive 
        dependency and indemnity compensation on such basis; and
            ``(C) no veteran or survivor covered under subparagraph (A) 
        or (B) shall have their compensation reduced solely because of 
        the removal of an illness pursuant to paragraph (1).
``Sec. 1175. Authority to modify process; congressional oversight
    ``(a) In General.--The Secretary may modify the process under which 
the working group established under subsection (b) of section 1172 of 
this title conducts assessments under such section, the Secretary 
conducts formal evaluations under section 1173 of this title, and 
issues regulations under section 1174 of this title if--
            ``(1) such evaluations cover the evidence, data, and 
        factors required by subsection (b) of such section 1173; and
            ``(2) a period of 180 days has elapsed following the date 
        on which the Secretary submits the notice under subsection (b) 
        regarding the modification.
    ``(b) Notice.--If the Secretary proposes to modify the process 
under which the working group established under subsection (b) of 
section 1172 of this title conducts assessments under such section, the 
process under which the Secretary conducts formal evaluations under 
section 1173 of this title, or issues regulations under section 1174 of 
this title, the Secretary shall submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of the 
House of Representatives a notice of the proposed modifications 
containing the following:
            ``(1) A description of the proposed modifications.
            ``(2) A description of any exceptions to the requirements 
        of such sections that are proposed because of limited available 
        scientific evidence, and a description of how such evaluations 
        will be conducted.
``Sec. 1176. Agreement with National Academies of Sciences, 
              Engineering, and Medicine concerning toxic exposures
    ``(a) Purpose.--The purpose of this section is to provide for the 
National Academies of Sciences, Engineering, and Medicine (in this 
section referred to as the `Academies'), an independent nonprofit 
scientific organization with appropriate expertise that is not part of 
the Federal Government, to review and evaluate the available scientific 
evidence regarding associations between diseases and toxic exposures.
    ``(b) Agreement.--(1) The Secretary shall seek to enter into a 
five-year agreement with the Academies to perform the services covered 
by this section.
    ``(2) The Secretary shall seek to enter into an agreement described 
in paragraph (1) not later than 60 days after the date of the enactment 
of the Sergeant First Class Heath Robinson Honoring our Promise to 
Address Comprehensive Toxics Act of 2022.
    ``(3) An agreement under this section may be extended in five-year 
increments.
    ``(c) Review of Scientific Evidence.--Under an agreement between 
the Secretary and the Academies under this section, the Academies shall 
review and summarize the scientific evidence, and assess the strength 
thereof, concerning the association between toxic exposures during 
active military, naval, air, or space service and each disease 
suspected to be associated with such exposure in the human population.
    ``(d) Scientific Determinations Concerning Diseases.--For each 
disease reviewed under subsection (c), the Academies shall determine, 
to the extent that available scientific data permit meaningful 
determinations--
            ``(1) whether an association exists between toxic exposures 
        and the occurrence of the disease, taking into account the 
        strength of the scientific evidence and the appropriateness of 
        the statistical and epidemiological methods used to detect the 
        association;
            ``(2) the increased risk of the disease among those 
        reporting toxic exposures during active military, naval, air, 
        or space service;
            ``(3) whether there exists a plausible biological mechanism 
        or other evidence of a positive association between the toxic 
        exposure and the occurrence of the disease; and
            ``(4) determine the strength of evidence for a positive 
        association based on categories furnished under section 1173 of 
        this title.
    ``(e) Cooperation of Federal Agencies.--The head of each relevant 
Federal agency, including the Secretary of Defense, shall cooperate 
fully with the Academies in performing the services covered by this 
section.
    ``(f) Recommendations for Additional Scientific Studies.--(1) Under 
an agreement between the Secretary and the Academies under this 
section, the Academies shall make any recommendations for additional 
scientific studies to resolve areas of continuing scientific 
uncertainty relating to toxic exposures.
    ``(2) In making recommendations under paragraph (1), the Academies 
shall consider--
            ``(A) the scientific information that is available at the 
        time of the recommendation;
            ``(B) the value and relevance of the information that could 
        result from additional studies; and
            ``(C) the cost and feasibility of carrying out such 
        additional studies.
    ``(g) Reports.--(1)(A) Under an agreement between the Secretary and 
the Academies under this section, not later than one year after the 
date of the enactment of the Sergeant First Class Heath Robinson 
Honoring our Promise to Address Comprehensive Toxics Act of 2022, the 
Academies shall submit to the Secretary, the Committee on Veterans' 
Affairs of the Senate, and the Committee on Veterans' Affairs of the 
House of Representatives an initial report on the activities of the 
Academies under the agreement.
    ``(B) The report submitted under subparagraph (A) shall include the 
following:
            ``(i) The determinations described in subsection (d).
            ``(ii) A full explanation of the scientific evidence and 
        reasoning that led to such determinations.
            ``(iii) Any recommendations of the Academies under 
        subsection (f).
    ``(2) Under an agreement between the Secretary and the Academies 
under this section, not less frequently than once every two years after 
the date on which the initial report is submitted under paragraph 
(1)(A), the Academies shall submit to the Secretary, the Committee on 
Veterans' Affairs of the Senate, and the Committee on Veterans' Affairs 
of the House of Representatives an updated report on the activities of 
the Academies under the agreement.
    ``(h) Alternative Contract Scientific Organization.--(1) If the 
Secretary is unable within the time period prescribed in subsection 
(b)(2) to enter into an agreement with the Academies for the purposes 
of this section on terms acceptable to the Secretary, the Secretary 
shall seek to enter into an agreement for the purposes of this section 
with another appropriate scientific organization that--
            ``(A) is not part of the Federal Government;
            ``(B) operates as a not-for-profit entity; and
            ``(C) has expertise and objectivity comparable to that of 
        the Academies.
    ``(2) If the Secretary enters into an agreement with another 
organization as described in paragraph (1), any reference in this 
subchapter to the Academies shall be treated as a reference to the 
other organization.''.
    (b) Reports and Briefings.--
            (1) Report.--
                    (A) In general.--Not later than two years after the 
                date of the enactment of this Act, the Secretary of 
                Veterans Affairs shall submit to the Committee on 
                Veterans' Affairs of the Senate and the Committee on 
                Veterans' Affairs of the House of Representatives a 
                report on the implementation of, and recommendations 
                for, subchapter VII of chapter 11 of title 38, United 
                States Code, as added by subsection (a).
                    (B) Consultation.--The Secretary shall develop the 
                report under subparagraph (A) in consultation with 
                organizations recognized by the Secretary for the 
                representation of veterans under section 5902 of such 
                title and any other entity the Secretary determines 
                appropriate.
            (2) Briefing.--On a quarterly basis during the two-year 
        period beginning on the date of the enactment of this Act, the 
        Secretary shall provide to the Committee on Veterans' Affairs 
        of the Senate and the Committee on Veterans' Affairs of the 
        House of Representatives a briefing on the implementation of 
        subchapter VII of chapter 11 of such title, as added by 
        subsection (a).
    (c) Independent Assessment.--
            (1) Agreement.--The Secretary shall seek to enter into an 
        agreement with the National Academies of Science, Engineering, 
        and Medicine (in this subsection referred to as the 
        ``Academies'') before the date that is 90 days after the date 
        of the enactment of this Act to perform the services set forth 
        under paragraph (2).
            (2) Assessment.--
                    (A) In general.--Under an agreement between the 
                Secretary and the Academies under paragraph (1), the 
                Academies shall conduct an assessment of the 
                implementation by the Department of Veterans Affairs of 
                the process established under subchapter VII of chapter 
                11 of title 38, United States Code, as added by 
                subsection (a).
                    (B) Elements.--The assessment conducted under 
                subparagraph (A) shall include the following:
                            (i) An assessment of the Department's 
                        implementation of the process established under 
                        subsection (a) to determine whether the process 
                        is in accordance with current scientific 
                        standards for assessing the link between 
                        exposure to environmental hazards and the 
                        development of health outcomes,
                            (ii) assess whether the criteria is fair 
                        and consistent, and
                            (iii) provide recommendations for 
                        improvements to the process.
            (3) Report.--Not later than one year after the date on 
        which the Secretary enters into an agreement under paragraph 
        (1), the Secretary shall submit to the Committee on Veterans' 
        Affairs of the Senate and the Committee on Veterans' Affairs of 
        the House of Representatives a report on the findings of the 
        Academies pursuant to such agreement.
            (4) Alternative contract scientific organization.--
                    (A) In general.--If the Secretary is unable within 
                the time period prescribed in paragraph (1) to enter 
                into an agreement with the Academies for the purposes 
                of this subsection on terms acceptable to the 
                Secretary, the Secretary shall seek to enter into an 
                agreement for the purposes of this subsection with 
                another appropriate scientific organization that--
                            (i) is not part of the Federal Government;
                            (ii) operates as a not-for-profit entity; 
                        and
                            (iii) has expertise and objectivity 
                        comparable to that of the Academies.
                    (B) Treatment.--If the Secretary enters into an 
                agreement with another organization as described in 
                subparagraph (A), any reference in this subsection to 
                the Academies of Sciences, Engineering, and Medicine 
                shall be treated as a reference to the other 
                organization.
    (d) Conforming Amendments.--Chapter 11 is amended--
            (1) in section 1116--
                    (A) by striking subsections (b), (c), (d), and (e);
                    (B) by inserting after subsection (a) the following 
                new subsection (b):
    ``(b) The Secretary shall ensure that any determination made on or 
after the date of the enactment of the Sergeant First Class Heath 
Robinson Honoring our Promise to Address Comprehensive Toxics Act of 
2022 regarding a presumption of service connection based on exposure to 
an herbicide agent under this section is made pursuant to subchapter 
VII of this chapter, including with respect to assessing reports 
received by the Secretary from the National Academy of Sciences under 
section 3 of the Agent Orange Act of 1991 (Public Law 102-4).''; and
                    (C) by redesignating subsection (f) as subsection 
                (c);
            (2) in section 1116B(b)(2)(A), by inserting ``pursuant to 
        subchapter VII of this chapter,'' before ``the Secretary 
        determines''; and
            (3) in section 1118--
                    (A) by striking subsections (b) through (e); and
                    (B) by inserting after subsection (a) the following 
                new subsection (b):
    ``(b) The Secretary shall ensure that any determination made on or 
after the date of the enactment of the Sergeant First Class Heath 
Robinson Honoring our Promise to Address Comprehensive Toxics Act of 
2022 regarding a presumption of service connection based on a toxic 
exposure under this section is made pursuant to subchapter VII of this 
chapter.''.

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

    (a) In General.--Subchapter VI of chapter 11 is amended by adding 
at the end the following new section:
``Sec. 1167. Outreach pursuant to changes in presumptions of service 
              connection
    ``(a) In General.--Whenever a law, including through a regulation 
or Federal court decision or settlement, establishes or modifies a 
presumption of service connection, the Secretary shall--
            ``(1) identify all claims for compensation under this 
        chapter that--
                    ``(A) were submitted to the Secretary;
                    ``(B) were evaluated and denied by the Secretary 
                before the date on which such provision of law went 
                into effect; and
                    ``(C) might have been evaluated differently had the 
                establishment or modification been applicable to the 
                claim; and
            ``(2) pursuant to subsection (b), conduct outreach to the 
        claimants.
    ``(b) Outreach.--(1) The Secretary shall conduct outreach to inform 
claimants identified under subsection (a) that they may submit a 
supplemental claim in light of the establishment or modification of a 
presumption of service connection described in subsection (a).
    ``(2) Outreach under paragraph (1) shall include the following:
            ``(A) The Secretary shall publish on the internet website 
        of the Department a notice that such veterans may elect to file 
        a supplemental claim.
            ``(B) The Secretary shall notify, in writing or by 
        electronic means, veterans service organizations of the ability 
        of such veterans to file a supplemental claim.
            ``(C) The Secretary shall contact each claimant identified 
        under subsection (a) in the same manner that the Department 
        last provided notice of a decision.''.
    (b) Application.--Section 1167 of title 38, United States Code, as 
added by subsection (a), shall apply with respect to presumptions of 
service connection established or modified on or after the date of the 
enactment of this Act, including pursuant to amendments made by this 
Act.
    (c) Rule of Construction.--Nothing in this section shall be 
construed as--
            (1) modifying the obligations of the Department of Veterans 
        Affairs under Federal court decisions or settlements in effect 
        as of the date of the enactment of this Act; or
            (2) requiring a retroactively applied effective date of a 
        supplemental claim earlier than the date a presumption of 
        service connection is established or modified.

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

    (a) In General.--Subchapter I of chapter 13 is amended by adding at 
the end the following new section:
``Sec. 1305. Reevaluation of dependency and indemnity compensation 
              determinations pursuant to changes in presumptions of 
              service connection
    ``(a) Reevaluation.--Whenever a law, including through a regulation 
or Federal court decision or settlement, establishes or modifies a 
presumption of service connection, the Secretary shall--
            ``(1) identify all claims for dependency and indemnity 
        compensation under this chapter that--
                    ``(A) were submitted to the Secretary;
                    ``(B) were evaluated and denied by the Secretary 
                before the date on which such provision of law went 
                into effect; and
                    ``(C) might have been evaluated differently had the 
                establishment or modification been applicable to the 
                claim;
            ``(2) allow for the reevaluation of such claims at the 
        election of the claimant; and
            ``(3) notwithstanding section 5110 of this title, with 
        respect to claims approved pursuant to such reevaluation, 
        provide compensation under this chapter effective as if the 
        establishment or modification of the presumption of service 
        connection had been in effect on the date of the submission of 
        the original claim described in paragraph (1).
    ``(b) Outreach.--(1) The Secretary shall conduct outreach to inform 
relevant claimants that they may elect to have a claim be reevaluated 
in light of the establishment or modification of a presumption of 
service connection described in subsection (a).
    ``(2) Outreach under paragraph (1) shall include the following:
            ``(A) The Secretary shall publish on the internet website 
        of the Department a notice that such claimants may elect to 
        have a claim so reevaluated.
            ``(B) The Secretary shall notify, in writing or by 
        electronic means, veterans service organizations of the ability 
        of such claimants to elect to have a claim so reevaluated.
            ``(C) The Secretary shall contact each claimant identified 
        under subsection (a) in the same manner that the Department 
        last provided notice of a decision.''.
    (b) Application.--Section 1305 of title 38, United States Code, as 
added by subsection (a), shall apply with respect to presumptions of 
service connection established or modified on or after the date of the 
enactment of this Act, including pursuant to amendments made by this 
Act.
    (c) Rule of Construction.--Nothing in this section shall be 
construed as modifying the obligations of the Department of Veterans 
Affairs under Federal court decisions or settlements in effect as of 
the date of the enactment of this Act.

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

SEC. 301. SHORT TITLE.

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

SEC. 302. PRESUMPTIONS OF TOXIC EXPOSURE.

    Subchapter II of chapter 11 is amended by adding at the end the 
following new section:
``Sec. 1119. Presumptions of toxic exposure
    ``(a) Consideration of Records.--If a veteran submits to the 
Secretary a claim for compensation for a service-connected disability 
under section 1110 of this title with evidence of a disability and a 
toxic exposure that occurred during active military, naval, air, or 
space service, the Secretary may, in adjudicating such claim, 
consider--
            ``(1) any record of the veteran in an exposure tracking 
        record system; and
            ``(2) if no record of the veteran in an exposure tracking 
        record system indicates that the veteran was subject to a toxic 
        exposure during active military, naval, air, or space service, 
        the totality of the circumstances of the service of the 
        veteran.
    ``(b) Presumption of Specific Toxic Exposure for Members Who Served 
in Certain Locations.--(1) The Secretary shall, for purposes of section 
1110 and chapter 17 of this title, presume that any covered veteran was 
exposed to the substances, chemicals, and airborne hazards identified 
in the list under paragraph (2) during the service of the covered 
veteran specified in subsection (c)(1), unless there is affirmative 
evidence to establish that the covered veteran was not exposed to any 
such substances, chemicals, or hazards in connection with such service.
    ``(2) The Secretary shall--
            ``(A) establish and maintain a list that contains an 
        identification of one or more such substances, chemicals, and 
        airborne hazards as the Secretary, in collaboration with the 
        Secretary of Defense, may determine appropriate for purposes of 
        this section; and
            ``(B) determine, using procedures consistent with section 
        1172 of this title and through the conduct of a formal 
        evaluation under section 1173 of this title, whether to 
        establish an end date for a covered veteran to qualify for 
        presumptions of exposure under this section, if appropriate, 
        but in no case establish an end date earlier than the last day 
        of the period specified in section 101(33) for the Persian Gulf 
        War.
    ``(3) Beginning not later than two years after the date of the 
enactment of the Sergeant First Class Heath Robinson Honoring our 
Promise to Address Comprehensive Toxics Act of 2022, and not less 
frequently than once every two years thereafter, the Secretary shall 
submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
identifying any additions or removals to the list under paragraph (2) 
during the period covered by the report.
    ``(c) Definitions.--In this section:
            ``(1) The term `covered veteran' means any veteran who--
                    ``(A) on or after August 2, 1990, performed active 
                military, naval, air, or space service while assigned 
                to a duty station in, including airspace above--
                            ``(i) Bahrain;
                            ``(ii) Iraq;
                            ``(iii) Kuwait;
                            ``(iv) Oman;
                            ``(v) Qatar;
                            ``(vi) Saudi Arabia;
                            ``(vii) Somalia; or
                            ``(viii) United Arab Emirates; or
                    ``(B) on or after September 11, 2001, performed 
                active military, naval, air, or space service while 
                assigned to a duty station in, including airspace 
                above--
                            ``(i) Afghanistan;
                            ``(ii) Djibouti;
                            ``(iii) Egypt;
                            ``(iv) Jordan;
                            ``(v) Lebanon;
                            ``(vi) Syria;
                            ``(vii) Yemen;
                            ``(viii) Uzbekistan; or
                            ``(ix) any other country determined 
                        relevant by the Secretary.
            ``(2) The term `exposure tracking record system'--
                    ``(A) means any system, program, or pilot program 
                used by the Secretary of Veterans Affairs or the 
                Secretary of Defense to track how veterans or members 
                of the Armed Forces have been exposed to various 
                occupational or environmental hazards; and
                    ``(B) includes the Individual Longitudinal Exposure 
                Record, or successor system.
            ``(3) The term `toxic exposure risk activity' has the 
        meaning given such term in section 1710(e)(4) of this title.''.

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

    Subchapter VI of chapter 11, as amended by section 203, is further 
amended by adding at the end the following new section:
``Sec. 1168. Medical nexus examinations for toxic exposure risk 
              activities
    ``(a) Medical Examinations and Medical Opinions.--(1) Except as 
provided in subsection (b), if a veteran submits to the Secretary a 
claim for compensation for a service-connected disability under section 
1110 of this title with evidence of a disability and evidence of 
participation in a toxic exposure risk activity during active military, 
naval, air, or space service, and such evidence is not sufficient to 
establish a service connection for the disability, the Secretary 
shall--
            ``(A) provide the veteran with a medical examination under 
        section 5103A(d) of this title; and
            ``(B) obtain a medical opinion (to be requested by the 
        Secretary in connection with the medical examination under 
        subparagraph (A)) as to whether it is at least as likely as not 
        that there is a nexus between the disability and the toxic 
        exposure risk activity.
    ``(2) When providing the Secretary with a medical opinion under 
paragraph (1)(B) for a veteran, the health care provider shall 
consider--
            ``(A) the total potential exposure through all applicable 
        military deployments of the veteran; and
            ``(B) the synergistic, combined effect of all toxic 
        exposure risk activities of the veteran.
    ``(3) The requirement under paragraph (2)(B) shall not be construed 
as requiring a health care provider to consider the synergistic, 
combined effect of each of the substances, chemicals, and airborne 
hazards identified in the list under section 1119(b)(2) of this title.
    ``(b) Exception.--Subsection (a) shall not apply if the Secretary 
determines there is no indication of an association between the 
disability claimed by the veteran and the toxic exposure risk activity 
for which the veteran submitted evidence.
    ``(c) Toxic Exposure Risk Activity Defined.--In this section, the 
term `toxic exposure risk activity' has the meaning given that term in 
section 1710(e)(4) of this title.''.

              TITLE IV--PRESUMPTIONS OF SERVICE CONNECTION

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

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

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

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

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

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

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

    (a) Short Title.--This section may be cited as the ``Fair Care for 
Vietnam Veterans Act of 2022''.
    (b) Monoclonal Gammopathy of Undetermined Significance.--Section 
1116(a)(2) of title 38, United States Code, is amended by adding at the 
end the following new subparagraph:
            ``(L) Monoclonal gammopathy of undetermined 
        significance.''.
    (c) Hypertension.--Such section, as amended by subsection (b), is 
further amended by adding at the end the following new subparagraph:
            ``(M) Hypertension.''.
    (d) Effective Dates and Applicability.--
            (1) Monoclonal gammopathy of undetermined significance.--
                    (A) In general.--The amendment made by subsection 
                (b) shall take effect on the date of the enactment of 
                this Act and shall apply as follows:
                            (i) On the date of the enactment of this 
                        Act for claimants for dependency and indemnity 
                        compensation under chapter 13 of title 38, 
                        United States Code, and for veterans whom the 
                        Secretary of Veterans Affairs determines are--
                                    (I) terminally ill;
                                    (II) homeless;
                                    (III) under extreme financial 
                                hardship;
                                    (IV) more than 85 years old; or
                                    (V) capable of demonstrating other 
                                sufficient cause.
                            (ii) On October 1, 2022, for everyone not 
                        described in clause (i).
                    (B) Retroactive application.--Notwithstanding any 
                Federal court decisions or settlements in effect on the 
                day before the date of the enactment of this Act, the 
                Secretary of Veterans Affairs shall award retroactive 
                claims for a condition under section 1116(a)(2)(L) of 
                title 38, United States Code, as added by subsection 
                (b) of this section, only to claimants for dependency 
                and indemnity compensation under chapter 13 of such 
                title described in subparagraph (A)(i) of this 
                paragraph.
            (2) Hypertension.--
                    (A) In general.--The amendment made by subsection 
                (c) shall take effect on the date of the enactment of 
                this Act and shall apply as follows:
                            (i) On the date of the enactment of this 
                        Act for claimants for dependency and indemnity 
                        compensation under chapter 13 of title 38, 
                        United States Code, and for veterans whom the 
                        Secretary of Veterans Affairs determines are--
                                    (I) terminally ill;
                                    (II) homeless;
                                    (III) under extreme financial 
                                hardship;
                                    (IV) more than 85 years old; or
                                    (V) capable of demonstrating other 
                                sufficient cause.
                            (ii) On October 1, 2026, for everyone not 
                        described in subparagraph (A).
                    (B) Retroactive application.--Notwithstanding any 
                Federal court decisions or settlements in effect on the 
                day before the date of the enactment of this Act, the 
                Secretary of Veterans Affairs shall award retroactive 
                claims for a condition under section 1116(a)(2)(M) of 
                title 38, United States Code, as added by subsection 
                (c) of this section, only to claimants for dependency 
                and indemnity compensation under chapter 13 of such 
                title described in subparagraph (A)(i) of this 
                paragraph.

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

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

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

    (a) Short Title.--This section may be cited as the ``Presumptive 
Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 
2022''.
    (b) In General.--Subchapter II of chapter 11, as amended by section 
302, is further amended by inserting after section 1119 the following 
new section:
``Sec. 1120. Presumption of service connection for certain diseases 
              associated with exposure to burn pits and other toxins
    ``(a) Presumption of Service Connection.--For the purposes of 
section 1110 of this title, and subject to section 1113 of this title, 
a disease specified in subsection (b) becoming manifest in a covered 
veteran shall be considered to have been incurred in or aggravated 
during active military, naval, air, or space service, notwithstanding 
that there is no record of evidence of such disease during the period 
of such service.
    ``(b) Diseases Specified.--The diseases specified in this 
subsection are the following:
            ``(1) Asthma that was diagnosed after service of the 
        covered veteran as specified in subsection (c).
            ``(2) The following types of cancer:
                    ``(A) Head cancer of any type.
                    ``(B) Neck cancer of any type.
                    ``(C) Respiratory cancer of any type.
                    ``(D) Gastrointestinal cancer of any type.
                    ``(E) Reproductive cancer of any type.
                    ``(F) Lymphoma cancer of any type.
                    ``(G) Lymphomatic cancer of any type.
                    ``(H) Kidney cancer.
                    ``(I) Brain cancer.
                    ``(J) Melanoma.
                    ``(K) Pancreatic cancer.
            ``(3) Chronic bronchitis.
            ``(4) Chronic obstructive pulmonary disease.
            ``(5) Constrictive bronchiolitis or obliterative 
        bronchiolitis.
            ``(6) Emphysema.
            ``(7) Granulomatous disease.
            ``(8) Interstitial lung disease.
            ``(9) Pleuritis.
            ``(10) Pulmonary fibrosis.
            ``(11) Sarcoidosis.
            ``(12) Chronic sinusitis.
            ``(13) Chronic rhinitis.
            ``(14) Glioblastoma.
            ``(15) Any other disease for which the Secretary 
        determines, pursuant to regulations prescribed under subchapter 
        VII that a presumption of service connection is warranted based 
        on a positive association with a substance, chemical, or 
        airborne hazard identified in the list under section 1119(b)(2) 
        of this title.
    ``(c) Covered Veteran Defined.--In this section, the term `covered 
veteran' has the meaning given that term in section 1119(c) of this 
title.''.
    (c) Conforming Amendment.--Section 1113 is amended by striking ``or 
1118'' each place it appears and inserting ``1118, or 1120''.
    (d) Effective Date and Applicability.--The amendments made by this 
section shall take effect on the date of the enactment of this Act and 
shall apply as follows:
            (1) On the date of the enactment of this Act for claimants 
        for dependency and indemnity compensation under chapter 13 of 
        title 38, United States Code, and veterans whom the Secretary 
        of Veterans Affairs determines are--
                    (A) terminally ill;
                    (B) homeless;
                    (C) under extreme financial hardship;
                    (D) more than 85 years old; or
                    (E) capable of demonstrating other sufficient 
                cause.
            (2) On the date of the enactment of this Act for everyone 
        not described in paragraph (1), with respect to paragraphs (1), 
        (2)(C), (2)(I), (5), (6), (7), (8), (9), (10), (11), (12), 
        (13), and (14), of section 1120(b) of title 38, United States 
        Code, as added by subsection (b).
            (3) On October 1, 2023, for everyone not described in 
        paragraph (1), with respect to paragraphs (3) and (4) of 
        section 1120(b) of such title, as so added.
            (4) On October 1, 2024, for everyone not described in 
        paragraph (1), with respect to subparagraphs (A), (B), (D), 
        (E), (F), (G), and (K) of section 1120(b)(2) of such title, as 
        so added.
            (5) On October 1, 2025, for everyone not described in 
        paragraph (1), with respect to subparagraphs (H) and (J) of 
        section 1120(b)(2) of such title, as so added.

SEC. 407. RULE OF CONSTRUCTION.

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

                       TITLE V--RESEARCH MATTERS

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

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

SEC. 502. ANALYSIS AND REPORT ON TREATMENT OF VETERANS FOR MEDICAL 
              CONDITIONS RELATED TO TOXIC EXPOSURE.

    (a) In General.--The Secretary of Veterans Affairs shall analyze, 
on a continuous basis, all clinical data that--
            (1) is obtained by the Department of Veterans Affairs in 
        connection with hospital care, medical services, and nursing 
        home care furnished under section 1710(a)(2)(F) of title 38, 
        United States Code; and
            (2) is likely to be scientifically useful in determining 
        the association, if any, between the medical condition of a 
        veteran and a toxic exposure.
    (b) Annual Report.--Not later than one year after the date of the 
enactment of this Act, and annually thereafter, the Secretary shall 
submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
containing the following:
            (1) The aggregate data compiled under subsection (a).
            (2) An analysis of such data.
            (3) A description of the types and incidences of medical 
        conditions identified by the Department under such subsection.
            (4) The explanation of the Secretary for the incidence of 
        such medical conditions and other explanations for the 
        incidence of such conditions as the Secretary considers 
        reasonable.
            (5) The views of the Secretary on the scientific validity 
        of drawing conclusions from the incidence of such medical 
        conditions, as evidenced by the data compiled under subsection 
        (a), regarding any association between such conditions and 
        toxic exposures.
    (c) Toxic Exposure Defined.--In this section, the term ``toxic 
exposure'' has the meaning given such term in section 101 of title 38, 
United States Code, as amended by section 102(b).

SEC. 503. ANALYSIS RELATING TO MORTALITY OF VETERANS WHO SERVED IN 
              SOUTHWEST ASIA.

    (a) Analysis.--
            (1) In general.--Not later than 270 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs, 
        in coordination with the Secretary of Defense, shall conduct an 
        updated analysis of total and respiratory disease mortality in 
        covered veterans.
            (2) Elements.--The analysis required by paragraph (1) shall 
        include, to the extent practicable, the following with respect 
        to each covered veteran:
                    (A) Metrics of airborne exposures.
                    (B) The location and timing of deployments of the 
                veteran.
                    (C) The military occupational specialty of the 
                veteran.
                    (D) The Armed Force in which the veteran served.
                    (E) Pre-existing health status of the veteran, 
                including with respect to asthma.
                    (F) Relevant personal information of the veteran, 
                including cigarette and e-cigarette smoking history, 
                diet, sex, gender, age, race, and ethnicity.
    (b) Covered Veteran Defined.--In this section, the term ``covered 
veteran'' means any veteran who--
            (1) on or after August 2, 1990, served on active duty in--
                    (A) Bahrain;
                    (B) Iraq;
                    (C) Kuwait;
                    (D) Oman;
                    (E) Qatar;
                    (F) Saudi Arabia;
                    (G) Somalia; or
                    (H) the United Arab Emirates; or
            (2) on or after September 11, 2001, served on active duty 
        in--
                    (A) Afghanistan;
                    (B) Djibouti;
                    (C) Egypt;
                    (D) Jordan;
                    (E) Lebanon;
                    (F) Syria; or
                    (G) Yemen.

SEC. 504. STUDY ON HEALTH TRENDS OF POST-9/11 VETERANS.

    The Secretary of Veterans Affairs shall conduct an epidemiological 
study on the health trends of veterans who served in the Armed Forces 
after September 11, 2001.

SEC. 505. STUDY ON CANCER RATES AMONG VETERANS.

    (a) In General.--The Secretary of Veterans Affairs shall conduct a 
study on the incidence of cancer in veterans to determine trends in the 
rates of the incidence of cancer in veterans.
    (b) Elements.--The study required by subsection (a) shall assess, 
with respect to each veteran included in the study, the following:
            (1) The age of the veteran.
            (2) The period of service and length of service of the 
        veteran in the Armed Forces.
            (3) The military occupational specialty or specialties of 
        the veteran.
            (4) The sex of the veteran.
            (5) The type or types of cancer that the veteran has.

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

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

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

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

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

    (a) GAO Study.--
            (1) In general.--The Comptroller General of the United 
        States shall conduct a study on the state of access and 
        barriers to benefits and services furnished by the Veterans 
        Benefits Administration and the Veterans Health Administration 
        under laws administered by the Secretary of Veterans Affairs to 
        veterans in Territories and Freely Associated States of the 
        United States, including deficits in the availability and 
        accessibility of such benefits and services compared to 
        veterans elsewhere in the United States.
            (2) Elements.--The study under paragraph (1) shall 
        include--
                    (A) the number of veterans in each Territory and 
                Freely Associated State of the United States;
                    (B) the number of veterans in each Territory and 
                Freely Associated State who are enrolled in the system 
                of annual patient enrollment of the Department of 
                Veterans Affairs under section 1705(a) of title 38, 
                United States Code;
                    (C) a description of how the Department estimates 
                the number of veterans in each Territory and Freely 
                Associated State who are eligible for services under 
                section 1710 of such title but who are not enrolled as 
                described in subparagraph (B);
                    (D) a detailed description of obstacles facing 
                veterans in each Territory and Freely Associated State 
                in accessing health care services, including those 
                involving the availability of such services to veterans 
                in the Territory or Freely Associated State in which 
                the veterans reside, and any distance impediments to 
                receiving services at a regional medical center of the 
                Veterans Health Administration, a community-based 
                outpatient clinic, another full-service medical 
                facility of the Department, or a Vet Center, 
                respectively;
                    (E) a detailed description of obstacles facing 
                veterans in each Territory and Freely Associated State 
                in accessing readjustment counseling services, 
                including those involving the availability of such 
                services to veterans in the Territory in which the 
                veterans reside, and any distance impediments to 
                receiving services at a readjustment counseling 
                services center of the Department;
                    (F) a detailed description of obstacles facing 
                veterans in each Territory and Freely Associated State 
                in accessing non-health care veterans benefits, 
                including those involving the availability of benefits 
                and services to veterans in the Territory or Freely 
                Associated State in which the veterans reside, and any 
                distance impediments to accessing the nearest office of 
                the Veterans Benefits Administration;
                    (G) an analysis of the staffing and quality of the 
                offices of the Veterans Benefits Administration and 
                Veterans Health Administration charged with serving 
                veterans in the Territories and Freely Associated 
                States, including the availability of the full- and 
                part-time staff of each office to the veterans they are 
                charged with serving;
                    (H) an analysis of the availability of the Veterans 
                Community Care Program established under section 1703 
                of title 38, United States Code, to veterans in each 
                Territory and Freely Associated State;
                    (I) an analysis of the economic and health outcomes 
                for veterans in each Territory or Freely Associated 
                State resulting from obstacles to accessing adequate 
                assistance and health care at facilities of the 
                Department;
                    (J) an analysis of the access to benefit assistance 
                and health care provided to veterans in the aftermath 
                of major disasters declared in each of the Territories 
                and Freely Associated States since September 4, 2017; 
                and
                    (K) such recommendations as the Comptroller General 
                considers appropriate for improving access of veterans 
                in the Territories and Freely Associated States to 
                benefits and health care services furnished by the 
                Secretary, and reducing barriers and deficits in the 
                availability and accessibility of such benefits and 
                services compared to veterans elsewhere in the United 
                States.
    (b) Briefing.--Not later than one year after the date of the 
enactment of this Act, the Comptroller General shall provide to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a briefing setting 
forth the results of the study conducted under subsection (a), 
including any recommendations developed under paragraph (2)(K) of such 
subsection.
    (c) Definitions.--In this section:
            (1) Freely associated state.--The term ``Freely Associated 
        State'' includes the Federated States of Micronesia, the 
        Republic of the Marshall Islands, and the Republic of Palau.
            (2) Territory.--The term ``Territory'' includes American 
        Samoa, the Commonwealth of the Northern Marianas Islands, Guam, 
        Puerto Rico, and the Virgin Islands.
            (3) Vet center.--The term ``Vet Center'' has the meaning 
        given that term in section 1712A(h) of title 38, United States 
        Code.

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

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

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

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

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

SEC. 601. SHORT TITLE; DEFINITIONS.

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

SEC. 602. PUBLICATION OF LIST OF RESOURCES OF DEPARTMENT OF VETERANS 
              AFFAIRS FOR TOXIC-EXPOSED VETERANS AND VETERANS WHO 
              REPORT TOXIC EXPOSURES AND OUTREACH PROGRAM FOR SUCH 
              VETERANS AND CAREGIVERS AND SURVIVORS OF SUCH VETERANS.

    (a) Publication of List of Resources.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, and annually thereafter, the 
        Secretary of Veterans Affairs shall publish a list of resources 
        of the Department of Veterans Affairs for--
                    (A) toxic-exposed veterans and veterans who report 
                toxic exposure;
                    (B) families and caregivers of such veterans; and
                    (C) survivors of such veterans who are receiving 
                death benefits under the laws administered by the 
                Secretary.
            (2) Update.--The Secretary shall periodically update the 
        list published under paragraph (1).
    (b) Outreach.--The Secretary shall develop, with input from the 
community, an informative outreach program for veterans on illnesses 
that may be related to toxic exposures, including outreach with respect 
to benefits and support programs.

SEC. 603. INCORPORATION OF TOXIC EXPOSURE SCREENING FOR VETERANS.

    (a) In General.--Beginning not later than 90 days after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall 
incorporate a screening to help determine potential toxic exposures 
during active military, naval, air, or space service as part of a 
health care screening furnished by the Department of Veterans Affairs 
to veterans enrolled in the system of annual patient enrollment of the 
Department established and operated under section 1705 of title 38, 
United States Code, to improve understanding by the Department of toxic 
exposures while serving in the Armed Forces.
    (b) Timing.--The Secretary shall ensure that a veteran described in 
subsection (a) completes the screening required under such subsection 
not less frequently than once every five years.
    (c) Determination of Questions.--
            (1) In general.--The questions included in the screening 
        required under subsection (a) shall be determined by the 
        Secretary with input from medical professionals.
            (2) Specific questions.--At a minimum, the screening 
        required under subsection (a) shall, with respect to a veteran, 
        include--
                    (A) a question about the potential exposure of the 
                veteran to an open burn pit; and
                    (B) a question regarding toxic exposures that are 
                commonly associated with service in the Armed Forces.
            (3) Open burn pit defined.--In this subsection, the term 
        ``open burn pit'' means an area of land that--
                    (A) is designated by the Secretary of Defense to be 
                used for disposing solid waste by burning in the 
                outdoor air; and
                    (B) does not contain a commercially manufactured 
                incinerator or other equipment specifically designed 
                and manufactured for the burning of solid waste.
    (d) Print Material.--In developing the screening established under 
subsection (a), the Secretary shall ensure that print materials 
complementary to such screening that outline related resources for 
veterans are available at each medical center of the Department to 
veterans who may not have access to the internet.
    (e) Screening Updates.--The Secretary shall consider updates to the 
content of the screening required under subsection (a) not less 
frequently than biennially to ensure the screening contains the most 
current information.

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

    (a) Health Care Personnel.--The Secretary of Veterans Affairs shall 
provide to health care personnel of the Department of Veterans Affairs 
education and training to identify, treat, and assess the impact on 
veterans of illnesses related to toxic exposures and inform such 
personnel of how to ask for additional information from veterans 
regarding different toxic exposures.
    (b) Benefits Personnel.--
            (1) In general.--The Secretary shall incorporate a training 
        program for processors of claims under the laws administered by 
        the Secretary who review claims for disability benefits 
        relating to service-connected disabilities based on toxic 
        exposures.
            (2) Annual training.--Training provided to processors under 
        paragraph (1) shall be provided not less frequently than 
        annually.

                         TITLE VII--RESOURCING

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

    (a) Authority.--The Secretary of Veterans Affairs may use, from 
amounts appropriated to the Cost of War Toxic Exposures Fund 
established by section 324 of title 38, United States Code, as added by 
section 805 of this Act, such amounts as may be necessary to continue 
the modernization, development, and expansion of capabilities and 
capacity of information technology systems and infrastructure of the 
Veterans Benefits Administration, including for claims automation, to 
support expected increased claims processing for newly eligible 
veterans pursuant to this Act.
    (b) Plan for Modernization of Veterans Benefits Administration 
Information Technology Systems.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall submit to the appropriate congressional committees a plan 
        for the modernization of the information technology systems of 
        the Veterans Benefits Administration. The plan shall cover the 
        first fiscal year that begins after the date of the enactment 
        of this Act and the subsequent four fiscal years and shall 
        include each of the following:
                    (A) An identification of any information system to 
                be modernized or retired, if applicable, during the 
                period covered by the plan.
                    (B) A description of how the Secretary intends to 
                incorporate the following principles into the 
                modernization of such information systems:
                            (i) The purpose of automation should be to 
                        increase the speed and accuracy of claims 
                        processing decisions.
                            (ii) Automation should be conducted in a 
                        manner that enhances the productivity of 
                        employees of the Department of Veterans 
                        Affairs.
                            (iii) Automation should be carried out in a 
                        manner that achieves greater consistency in the 
                        processing and rating of claims by relying on 
                        patterns of similar evidence in claim files.
                            (iv) To the greatest extent possible, 
                        automation should be carried out by drawing 
                        from information in the possession of the 
                        Department, other Government agencies, and 
                        applicants for benefits.
                            (v) Automation of any claims analysis or 
                        determination process should not be end-to-end 
                        or lack intermediation.
                            (vi) Employees of the Department should 
                        continue to make decisions with respect to the 
                        approval of claims and the granting of 
                        benefits.
                            (vii) Automation should not be carried out 
                        in a manner that reduces or infringes upon the 
                        due process rights of applicants for benefits 
                        under the laws administered by the Secretary; 
                        or the duties of the Secretary to assist and 
                        notify claimants.
                            (viii) Automation should be carried out 
                        while taking all necessary measures to protect 
                        the privacy of claimants and their personally 
                        identifiable information.
                            (ix) Automation of claims processing should 
                        not eliminate or reduce the workforce of the 
                        Veterans Benefits Administration.
                    (C) An identification of targets, for each fiscal 
                year, by which the Secretary intends to complete the 
                modernization of each information system or major 
                component or functionality of such system identified 
                under subparagraph (A).
                    (D) Cost estimates for the modernization of each 
                information system identified under paragraph (A) for 
                each fiscal year covered by the plan and in total.
            (2) Appropriate congressional committees.--In this section, 
        the term ``appropriate congressional committees'' means--
                    (A) the Committee on Veterans' Affairs and the 
                Subcommittee on Military Construction, Veterans 
                Affairs, and Related Agencies of the Committee on 
                Appropriations of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Subcommittee on Military Construction, Veterans 
                Affairs, and Related Agencies of the Committee on 
                Appropriations of the House of Representatives.

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

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

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

    (a) Congressional Approval of Major Medical Facility Leases.--
Paragraph (2) of subsection (a) of section 8104 of title 38, United 
States Code, is amended--
            (1) by striking ``No funds'' and inserting ``(A) No 
        funds'';
            (2) by striking ``or any major medical facility lease'';
            (3) by striking ``or lease''; and
            (4) by adding at the end the following new subparagraph:
            ``(B) No funds may be appropriated for any fiscal year, and 
        the Secretary may not obligate or expend funds (other than for 
        advance planning and design), for any major medical facility 
        lease unless the Committee on Veterans' Affairs of the Senate 
        and the Committee on Veterans' Affairs of the House of 
        Representatives each adopt a resolution approving the lease.''.
    (b) Modification of Definition of Major Medical Facility Lease.--
Subparagraph (B) of paragraph (3) of such subsection is amended to read 
as follows:
            ``(B) The term `major medical facility lease'--
                    ``(i) means a lease for space for use as a new 
                medical facility approved through the General Services 
                Administration under section 3307(a) of title 40 at an 
                average annual rent equal to or greater than the 
                appropriate dollar threshold described in such section, 
                which shall be subject to annual adjustment in 
                accordance with section 3307(h) of such title; and
                    ``(ii) does not include a lease for space for use 
                as a shared Federal medical facility for which the 
                Department's estimated share of the lease costs does 
                not exceed such dollar threshold.''.
    (c) Separate Prospectus Requirement for Major Medical Facility 
Leases.--Subsection (b) of such section is amended--
            (1) by striking paragraph (7);
            (2) in paragraph (1), by redesignating subparagraphs (A) 
        through (E) as clauses (i) through (v), respectively;
            (3) in paragraph (6), by redesignating subparagraphs (A) 
        through (C) as clauses (i) through (iii), respectively;
            (4) by redesignating paragraphs (1) through (6) as 
        subparagraphs (A) through (F), respectively;
            (5) in the matter preceding subparagraph (A), as 
        redesignated by paragraph (4)--
                    (A) by striking ``Whenever the President'' and 
                inserting ``(1) Whenever the President'';
                    (B) by striking ``the Congress'' and inserting 
                ``Congress''; and
                    (C) by striking ``or a major medical facility lease 
                (as defined in subsection (a)(3)(b))'';
            (6) in subparagraph (A), as redesignated by paragraph (4), 
        by striking ``leased,'';
            (7) in subparagraph (E), as redesignated by paragraph (4)--
                    (A) by striking ``or lease'' each place it appears; 
                and
                    (B) by striking ``or leases''; and
            (8) by adding at the end the following new paragraph:
    ``(2) Whenever the President or the Secretary submit to Congress a 
request for the funding of a major medical facility lease (as defined 
in subsection (a)(3)(B)), the Secretary shall submit to each committee, 
on the same day, a prospectus of the proposed medical facility. Any 
such prospectus shall include the following:
            ``(A) A description of the facility to be leased.
            ``(B) An estimate of the cost to the Federal Government of 
        the facility to be leased.
            ``(C) An estimate of the energy performance of the proposed 
        lease space, to include a description of anticipated 
        utilization of renewable energy, energy efficient and climate 
        resilient elements, and related matters.
            ``(D) Current and projected workload and utilization data 
        regarding the facility to be leased, including information on 
        projected changes in workload and utilization over a five-year 
        period, a ten-year period, and a twenty-year period.
            ``(E) A detailed analysis of how the lease is expected to 
        comply with Office of Management and Budget Circular A-11 and 
        section 1341 of title 31 (commonly referred to as the `Anti-
        Deficiency Act'). Any such analysis shall include--
                    ``(i) an analysis of the classification of the 
                lease as a `lease purchase', a `capital lease', or an 
                `operating lease' as those terms are defined in Office 
                of Management and Budget Circular A-11;
                    ``(ii) an analysis of the obligation of budgetary 
                resources associated with the lease; and
                    ``(iii) an analysis of the methodology used in 
                determining the asset cost, fair market value, and 
                cancellation costs of the lease.''.
    (d) Interim Leasing Actions.--Such section is further amended by 
adding at the end the following new subsection:
    ``(i)(1) Notwithstanding subsection (a)(2)(B), the Secretary may 
carry out interim leasing actions as the Secretary considers necessary 
for the following leases:
            ``(A) Major medical facility leases (as defined in 
        subsection (a)(3)(B)) approved pursuant to this section and for 
        which a prospectus for a replacement lease has been submitted 
        to Congress pursuant to subsection (b)(2).
            ``(B) Replacement leases that do not require approval under 
        this section and for which a prospectus has been submitted to 
        Congress pursuant to subsection (b)(2).
    ``(2) In this subsection, the term `interim leasing actions' has 
the meaning given that term by the Administrator of the General 
Services Administration.''.
    (e) Purchase Options.--Such section is further amended by adding at 
the end the following new subsection:
    ``(j) The Secretary may obligate and expend funds to exercise a 
purchase option included in any major medical facility lease (as 
defined in subsection (a)(3)(B)).''.
    (f) Applicability.--The amendments made by this section shall apply 
with respect to any lease that has not been specifically authorized by 
law on or before the date of the enactment of this Act.

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

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

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

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

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

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

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

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

                 TITLE VIII--RECORDS AND OTHER MATTERS

SEC. 801. EPIDEMIOLOGICAL STUDY ON FORT MCCLELLAN VETERANS.

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

SEC. 802. BIENNIAL BRIEFING ON INDIVIDUAL LONGITUDINAL EXPOSURE RECORD.

    (a) In General.--Not later than one year after the date on which 
the Individual Longitudinal Exposure Record achieves full operational 
capability, as determined by the Secretary of Defense, and every two 
years thereafter, the Secretary of Defense, in consultation with the 
Secretary of Veterans Affairs, shall provide the appropriate committees 
of Congress a briefing on--
            (1) the quality of the databases of the Department of 
        Defense that provide the information presented in such 
        Individual Longitudinal Exposure Record; and
            (2) the usefulness of such Individual Longitudinal Exposure 
        Record or system in supporting members of the Armed Forces and 
        veterans in receiving health care and benefits from the 
        Department of Defense and the Department of Veterans Affairs.
    (b) Elements.--Each briefing required by subsection (a) shall 
include, for the period covered by the report, the following:
            (1) An identification of potential exposures to 
        occupational or environmental hazards captured by the current 
        systems of the Department of Defense for environmental, 
        occupational, and health monitoring, and recommendations for 
        how to improve those systems.
            (2) An analysis of the quality and accuracy of the location 
        data used by the Department of Defense in determining potential 
        exposures to occupational or environmental hazards by members 
        of the Armed Forces and veterans, and recommendations for how 
        to improve the quality of such data if necessary.
    (c) Definitions.--In this section:
            (1) Appropriate committees of congress.--The term 
        ``appropriate committees of Congress'' means--
                    (A) the Committee on Armed Services and the 
                Committee on Veterans' Affairs of the Senate; and
                    (B) the Committee on Armed Services and the 
                Committee on Veterans' Affairs of the House of 
                Representatives.
            (2) Individual longitudinal exposure record.--The term 
        ``Individual Longitudinal Exposure Record'' has the meaning 
        given such term in section 1171 of title 38, United States 
        Code, as added by section 202.

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

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

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

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

SEC. 805. COST OF WAR TOXIC EXPOSURES FUND.

    (a) In General.--Chapter 3 is amended by adding at the end the 
following new section:
``Sec. 324. Cost of War Toxic Exposures Fund
    ``(a) Establishment.--There is hereby established in the Treasury 
of the United States an account to be known as the `Cost of War Toxic 
Exposures Fund' (the `Fund'), to be administered by the Secretary.
    ``(b) Deposits.--There shall be deposited in the Fund such amounts 
as may be appropriated to the Fund pursuant to subsection (c).
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to the Fund for fiscal year 2023 and each subsequent 
fiscal year such sums as are necessary to increase funding, over the 
fiscal year 2021 level, for investment in--
            ``(1) the delivery of veterans' health care associated with 
        exposure to environmental hazards in the active military, 
        naval, air, or space service in programs administered by the 
        Under Secretary for Health;
            ``(2) any expenses incident to the delivery of veterans' 
        health care and benefits associated with exposure to 
        environmental hazards in the active military, naval, air, or 
        space service, including administrative expenses, such as 
        information technology and claims processing and appeals, and 
        excluding leases as authorized or approved under section 8104 
        of this title; and
            ``(3) medical and other research relating to exposure to 
        environmental hazards.
    ``(d) Budget Scorekeeping.--(1) Immediately upon enactment of the 
Sergeant First Class Heath Robinson Honoring our Promise to Address 
Comprehensive Toxics Act of 2022, expenses authorized to be 
appropriated to the Fund in subsection (c) shall be estimated for 
fiscal year 2023 and each subsequent fiscal year and treated as budget 
authority that is considered to be direct spending--
            ``(A) in the baseline for purposes of section 257 of the 
        Balanced Budget and Emergency Deficit Control Act of 1985 (2 
        U.S.C. 907);
            ``(B) by the Chairman of the Committee on the Budget of the 
        Senate and the Chair of the Committee on the Budget of the 
        House of Representatives, as appropriate, for purposes of 
        budget enforcement in the Senate and the House of 
        Representatives;
            ``(C) under the Congressional Budget Act of 1974 (2 U.S.C. 
        621 et seq.), including in the reports required by section 
        308(b) of such Act (2 U.S.C. 639); and
            ``(D) for purposes of the Statutory Pay-As-You-Go Act of 
        2010 (2 U.S.C. 931 et seq.).
    ``(2) No amount appropriated to the Fund in fiscal year 2023 or any 
subsequent fiscal year pursuant to this section shall be counted as 
discretionary budget authority and outlays or as direct spending for 
any estimate of an appropriation Act under the Congressional Budget and 
Impoundment Control Act of 1974 (2 U.S.C. 621 et seq.) and any other 
Act.
    ``(3) Notwithstanding the Budget Scorekeeping Guidelines and the 
accompanying list of programs and accounts set forth in the joint 
explanatory statement of the committee of conference accompanying 
Conference Report 105-217, and for purposes of the Balanced Budget and 
Emergency Deficit Control Act of 1985 (2 U.S.C. 900 et seq.) and the 
Congressional Budget Act of 1974 (2 U.S.C. 621 et seq.), the Fund shall 
be treated as if it were an account designated as `Appropriated 
Entitlements and Mandatories for Fiscal Year 1997' in the joint 
explanatory statement of the committee of conference accompanying 
Conference Report 105-217.
    ``(e) Estimates for Congressional Consideration.--The Secretary 
shall include in documents submitted to Congress in support of the 
President's budget submitted pursuant to section 1105 of title 31 
detailed estimates of the sums described in subsection (c) for the 
applicable fiscal year.
    ``(f) Procedures for Estimates.--The Secretary may, after 
consultation with the Committee on Appropriations of the Senate and the 
Committee on Appropriations of the House of Representatives, establish 
policies and procedures for developing the annual detailed estimates 
required by subsection (e).''.
    (b) Sequestration.--Section 256(h)(4) of the Balanced Budget and 
Emergency Deficit Control Act of 1985 (2 U.S.C. 906(h)(4)) is amended 
by adding at the end the following new subparagraph:
                    ``(G) Cost of War Toxic Exposures Fund.''.

SEC. 806. APPROPRIATION FOR FISCAL YEAR 2022.

    (a) Appropriation.--In addition to amounts otherwise available, 
there is appropriated for fiscal year 2022, out of any funds in the 
Treasury not otherwise appropriated, $500,000,000 for the Cost of War 
Toxic Exposures Fund, established by section 324 of title 38, United 
States Code, as added by section 805 of this Act, to remain available 
until September 30, 2024.
    (b) Spend Plan.--Not later than 30 days after enactment of this 
Act, the Secretary of Veterans Affairs shall submit a plan for 
expending amounts made available by subsection (a) by program, project 
or activity to the Committee on Appropriations of the Senate and the 
Committee on Appropriations of the House of Representatives. Funds may 
not be obligated until such Committees issue an approval, or absent a 
response, a period of 30 days has elapsed.

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

    (a) In General.--Title 38, United States Code, is amended as 
follows:
            (1) By striking section 5100 and inserting the following:
``Sec. 5100. Definitions
    ``In this chapter:
            ``(1) The term `claimant' means any individual applying 
        for, or submitting a claim for, any benefit under the laws 
        administered by the Secretary.
            ``(2) The term `notice' means a communication issued 
        through means (including electronic means) prescribed by the 
        Secretary.''.
            (2) In section 5104, by adding at the end the following new 
        subsection:
    ``(c) The Secretary may provide notice under subsection (a) 
electronically if a claimant (or the claimant's representative) elects 
to receive such notice electronically. A claimant (or the claimant's 
representative) may revoke such an election at any time, by means 
prescribed by the Secretary.
    ``(d) The Secretary shall annually--
            ``(1) solicit recommendations from stakeholders on how to 
        improve notice under this section; and
            ``(2) publish such recommendations on a publicly available 
        website of the Department.''.
            (3) In section 5104B(c), in the matter preceding paragraph 
        (1) by striking ``in writing'' and inserting ``to the claimant 
        (and any representative of such claimant)''.
            (4) In section 5112(b)(6), by striking ``(at the payee's 
        last address of record)''.
            (5) In section 7104--
                    (A) in the heading, by adding ``; decisions; 
                notice'' at the end; and
                    (B) by striking subsection (e) and inserting the 
                following:
    ``(e) After reaching a decision on an appeal, the Board shall 
promptly issue notice (as that term is defined in section 5100 of this 
title) of such decision to the following:
            ``(1) The appellant.
            ``(2) Any other party with a right to notice of such 
        decision.
            ``(3) Any authorized representative of the appellant or 
        party described in paragraph (2).
    ``(f)(1) The Secretary may provide notice under subsection (e) 
electronically if a claimant (or the claimant's representative) elects 
to receive such notice electronically.
    ``(2) A claimant (or the claimant's representative) may revoke such 
an election at any time, by means prescribed by the Secretary.''.
            (6) In section 7105(b)(1)(A), by striking ``mailing'' and 
        inserting ``issuance''.
            (7) In section 7105A(a), by striking ``mailed'' and 
        inserting ``issued''.
            (8) In section 7266(a), by striking ``mailed'' and 
        inserting ``issued''.
    (b) Rule of Construction.--None of the amendments made by this 
section shall be construed to apply section 5104(a) of such title to 
decisions of the Board of Veterans' Appeals under chapter 71 of such 
title.

SEC. 808. BURN PIT TRANSPARENCY.

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

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

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

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

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

    (a) In General.--For any covered health care professional to whom 
the Secretary of Veterans Affairs has offered employment with the 
Department of Veterans Affairs, the Secretary may buy out the non-
Department service contract of such individual in exchange for such 
individual agreeing to be employed at a rural or highly rural facility 
of the Department for a period of obligated service specified in 
subsection (c).
    (b) Payment of Amounts.--
            (1) In general.--Payment of any amounts for a buy out of a 
        service contract for a covered health care professional under 
        subsection (a) shall be made directly to the individual or 
        entity with respect to which the covered health care 
        professional has a service obligation under such contract.
            (2) Limitation on total amount.--The total amount paid by 
        the Department under this section shall not exceed $40,000,000 
        per fiscal year.
    (c) Obligated Service.--In exchange for a contract buy out under 
subsection (a), a covered health care professional shall agree to be 
employed for not less than four years at a rural or highly rural 
facility of the Department.
    (d) Liability.--
            (1) In general.--Except as provided in paragraph (2), if a 
        covered health care professional fails for any reason to 
        complete the period of obligated service of the individual 
        under subsection (c), the United States shall be entitled to 
        recover from the individual an amount equal to--
                    (A) the total amount paid under subsection (a) to 
                buy out the non-Department service contract of the 
                individual; multiplied by
                    (B) a fraction--
                            (i) the numerator of which is--
                                    (I) the total number of months in 
                                the period of obligated service of the 
                                individual; minus
                                    (II) the number of months served by 
                                the individual; and
                            (ii) the denominator of which is the total 
                        number of months in the period of obligated 
                        service of the individual.
            (2) Exception.--Liability shall not arise under paragraph 
        (1) in the case of an individual covered by that paragraph if 
        the individual does not obtain, or fails to maintain, 
        employment as an employee of the Department due to staffing 
        changes approved by the Under Secretary for Health.
    (e) Not a Taxable Benefit.--A contract buy out for a covered health 
care professional under subsection (a) shall not be considered a 
taxable benefit or event for the covered health care professional.
    (f) Annual Report.--
            (1) In general.--Not later than 18 months after the date of 
        the enactment of this Act, and not less frequently than 
        annually thereafter, the Secretary of Veterans Affairs shall 
        submit to the Committee on Veterans' Affairs of the Senate and 
        the Committee on Veterans' Affairs of the House of 
        Representatives a report on the use by the Secretary of the 
        authority under this section.
            (2) Elements.--Each report required by paragraph (1) shall 
        include the following:
                    (A) The number of health care professionals for 
                whom a service contract buyout payment was made under 
                subsection (a) in the previous fiscal year, 
                disaggregated by occupation or specialty.
                    (B) The average, highest, and lowest amount of the 
                service contract buyout payments made under subsection 
                (a) for each occupation or specialty in the previous 
                fiscal year.
                    (C) Each location where contract buyout authority 
                under subsection (a) was utilized and the number of 
                covered health care professionals who agreed to be 
                employed at such location in the previous fiscal year.
    (g) Definitions.--In this section:
            (1) Covered health care professional.--The term ``covered 
        health care professional'' means a physician, nurse 
        anesthetist, physician assistant, or nurse practitioner offered 
        employment with the Department regardless of the authority 
        under which such employment is offered.
            (2) Rural; highly rural.--The terms ``rural'' and ``highly 
        rural'' have the meanings given those terms under the rural-
        urban commuting areas coding system of the Department of 
        Agriculture.
    (h) Sunset.--This section shall terminate on September 30, 2027.

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

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

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

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

SEC. 905. EXPANSION OF OPPORTUNITIES FOR HOUSEKEEPING AIDES.

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

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

    (a) Expansion of Eligibility of Employees for Certain Awards.--
Section 7404(c) is amended--
            (1) by striking ``Notwithstanding'' and inserting ``(1) 
        Notwithstanding'';
            (2) by inserting ``or 7401(4)'' after ``section 7306'';
            (3) by striking ``who is not eligible for pay under 
        subchapter III'' and inserting ``or in a covered executive 
        position under section 7401(1) of this title'';
            (4) by striking ``sections 4507 and 5384'' and inserting 
        ``section 4507''; and
            (5) by adding at the end the following new paragraph:
    ``(2) In this subsection, the term `covered executive position' 
means a position that the Secretary has determined is of equivalent 
rank to a Senior Executive Service position (as such term is defined in 
section 3132(a) of title 5) and is subject to an agency performance 
management system.''.
    (b) Authority for Awards Programs of Department of Veterans 
Affairs.--
            (1) In general.--Subchapter I of chapter 74 is amended by 
        inserting after section 7404 the following new section:
``Sec. 7404A. Awards
    ``(a) Superior Accomplishments and Performance Awards Program.--The 
Secretary may establish an awards program for personnel listed in 
section 7421(b) of this title consistent with chapter 45 of title 5, to 
the extent practicable.
    ``(b) Executive Performance Awards Program.--Notwithstanding 
section 7425 of this title or any other provision of law, the Secretary 
may establish a performance awards program consistent with section 5384 
of title 5 for--
            ``(1) personnel appointed under section 7401(1) of this 
        title for a position that the Secretary has determined is of 
        equivalent rank to a Senior Executive Service position (as such 
        term is defined in section 3132(a) of title 5) and is subject 
        to an agency performance management system; and
            ``(2) personnel appointed under section 7306 or 7401(4) of 
        this title.
    ``(c) Payment of Awards.--Awards under this section may be paid 
based on criteria established by the Secretary and shall not be 
considered in calculating the limitation under section 7431(e)(4) of 
this title.
    ``(d) Not Considered Basic Pay.--Awards under this section shall 
not be considered basic pay for any purpose.
    ``(e) Regulations.--The Secretary may prescribe regulations for the 
administration of this section.''.
            (2) Limitation on past awards.--Notwithstanding any other 
        provision of law, awards made by the Secretary of Veterans 
        Affairs for any period on or after January 1, 2017, and before 
        the date of the enactment of this Act for an employee under 
        section 7306 or 7401(4) of title 38, United States Code, or for 
        a position described in section 7401(1) of such title that the 
        Secretary has determined is of equivalent rank to a Senior 
        Executive Service position (as such term is defined in section 
        3132(a) of title 5, United States Code), may be subject to 
        section 7404A of title 38, United States Code, as added by 
        paragraph (1).
    (c) Modification of Employees Subject to Regulation by Secretary of 
Veterans Affairs of Hours and Conditions of Employment and Leaves of 
Absence.--
            (1) In general.--Section 7421 is amended--
                    (A) in subsection (a), by striking ``chapter'' and 
                inserting ``title''; and
                    (B) in subsection (b), by adding at the end the 
                following new paragraph:
            ``(9) Any position for which the employee is appointed 
        under section 7306 or 7401(4) of this title.''.
            (2) Administration of full-time employees.--Section 7423 is 
        amended--
                    (A) in subsection (a)(2), by adding at the end the 
                following new subparagraph:
    ``(D) The Secretary may exclude from the requirements of paragraph 
(1) employees hired under section 7306 or 7401(4) of this title or for 
a position described in section 7401(1) of this title that the 
Secretary has determined is of equivalent rank to a Senior Executive 
Service position (as such term is defined in section 3132(a) of title 
5).''; and
                    (B) in subsection (e)(1), by striking ``7401(1)'' 
                and inserting ``7421(b)''.
            (3) Additional pay authorities.--Section 7410(a) is 
        amended--
                    (A) by striking ``The Secretary'' and inserting 
                ``(1) The Secretary'';
                    (B) by striking ``the personnel described in 
                paragraph (1) of section 7401 of this title'' and 
                inserting ``personnel appointed under section 7306 of 
                this title or section 7401(4) of this title, or 
                personnel described in section 7401(1) of this 
                title,''; and
                    (C) by striking ``in the same manner, and subject 
                to the same limitations, as in the case of'' and 
                inserting ``in a manner consistent with''; and
                    (D) by adding at the end the following new 
                paragraph:
    ``(2) Payments under paragraph (1) shall not be considered in 
calculating the limitation under section 7431(e)(4) of this title.''.
            (4) Treatment of pay authority changes.--For the purposes 
        of the amendments made by paragraph (3), the Secretary of 
        Veterans Affairs shall treat any award or payment made by the 
        Secretary between January 1, 2017, and the date of the 
        enactment of this Act to employees appointed under sections 
        7306, 7401(1), and 7401(4) of title 38, United States Code, 
        that the Secretary has determined are of equivalent rank to a 
        Senior Executive Service position (as such term is defined in 
        section 3132(a) of title 5, United States Code), as if such 
        amendments had been in effect at the time of such award or 
        payment.
            (5) Treatment of prior leave balances.--Notwithstanding any 
        other provision of law, the Secretary may adjust the leave 
        balance and carryover leave balance of any employee described 
        in section 7421(b)(9) of title 38, United States Code, as 
        amended by paragraph (1)(B), to ensure any leave accrued or 
        carried over before the date of the enactment of this Act 
        remains available to such employee.
    (d) Treatment of Certain Employees as Appointed Under Section 
7306.--Section 7306 is amended--
            (1) in subsection (a), by redesignating the second 
        paragraph (11) as paragraph (12); and
            (2) by adding at the end the following new subsection:
    ``(g) For purposes of applying any provision of chapter 74 of this 
title, including sections 7404, 7410, and 7421, or any other provision 
of law, the Secretary may treat any appointment for a position under 
this chapter to be an appointment under this section.''.
    (e) Conforming Amendment.--Section 7431(e)(4) is amended by 
striking ``In no case'' and inserting ``Except as provided in sections 
7404A(c) and 7410(a)(2) of this title, in no case''.

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

    Subchapter I of chapter 7 is amended by inserting after section 703 
the following new section:
``Sec. 704. Waiver of pay limitation for certain employees
    ``(a) Employees of Veterans Health Administration Impacted by 
Closure or Realignment.--Notwithstanding any other provision of law, 
the Secretary may waive any annual premium or aggregate limitation on 
pay for an employee of the Veterans Health Administration for the 
calendar year during which--
            ``(1) the official duty station of the employee is closed; 
        or
            ``(2) the office, facility, activity, or organization of 
        the employee is realigned.
    ``(b) Employees Providing Care to Veterans Exposed to Open Burn 
Pits.--
            ``(1) In general.--Notwithstanding any other provision of 
        law, the Secretary may waive any annual premium or aggregate 
        limitation on pay for an employee of the Department whose 
        primary duties include providing expanded care for veterans 
        exposed to open burn pits.
            ``(2) Open burn pit defined.--In this subsection, the term 
        `open burn pit' has the meaning given that term in section 
        201(c) of the Dignified Burial and Other Veterans' Benefits 
        Improvement Act of 2012 (Public Law 112-260; 38 U.S.C. 527 
        note).
    ``(c) Coordination With Office of Personnel Management.--In 
implementing this section, the Secretary shall coordinate with the 
Director of the Office of Personnel Management.
    ``(d) Reports.--
            ``(1) In general.--For each quarter that the Secretary 
        waives a limitation under this section, the Secretary shall 
        submit to the Committee on Veterans' Affairs of the Senate, the 
        Committee on Veterans' Affairs of the House of Representatives, 
        and the Office of Personnel Management a report on the waiver 
        or waivers.
            ``(2) Contents.--Each report submitted under paragraph (1) 
        with respect to a waiver or waivers shall include the 
        following:
                    ``(A) Where the waiver or waivers were used, 
                including in which component of the Department and, as 
                the case may be, which medical center of the 
                Department.
                    ``(B) For how many employees the waiver or waivers 
                were used, disaggregated by component of the Department 
                and, if applicable, medical center of the Department.
                    ``(C) The average amount by which each payment 
                exceeded the pay limitation that was waived, 
                disaggregated by component of the Department and, if 
                applicable, medical center of the Department.
    ``(e) Employee Defined.--In this section, the term `employee' means 
any employee regardless of the authority under which the employee was 
hired.
    ``(f) Termination.--This section shall terminate on September 30, 
2027.''.

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

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

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

    Subchapter I of chapter 7 is amended by inserting after section 705 
the following new section:
``Sec. 706. Additional authority relating to recruitment and retention 
              of personnel
    ``(a) Recruitment and Relocation Bonuses.--The Secretary may pay a 
recruitment or relocation bonus under section 5753(e) of title 5 
without regard to any requirements for certification or approval under 
that section.
    ``(b) Retention Bonuses.--(1) The Secretary may pay a retention 
bonus under section 5754(f) of title 5 without regard to any 
requirement for certification or approval under that subsection.
    ``(2) The Secretary may pay a retention bonus as specified in 
subsection (e)(2) of section 5754 of title 5 and may pay the bonus as a 
single lump-sum payment at the beginning of the full period of service 
required by an agreement under subsection (d) of such section.
    ``(c) Merit Awards.--The Secretary may grant a cash award under 
section 4502(b) of title 5 without regard to any requirement for 
certification or approval under that section.
    ``(d) Incentives for Critical Skills.--(1) Subject to the 
provisions of this paragraph, the Secretary may provide a critical 
skill incentive to an employee in a case in which the Secretary 
determines--
            ``(A) the employee possesses a high-demand skill or skill 
        that is at a shortage;
            ``(B) such skill is directly related to the duties and 
        responsibilities of the employee's position; and
            ``(C) employment of an individual with such skill in such 
        position serves a critical mission-related need of the 
        Department.
    ``(2) An incentive provided to an employee under paragraph (1) may 
not to exceed 25 percent of the basic pay of the employee.
    ``(3) Provision of an incentive under paragraph (1) shall be 
contingent on the employee entering into a written agreement to 
complete a period of employment with the Department.
    ``(4) An incentive provided under paragraph (1) shall not be 
considered basic pay for any purpose.
    ``(5) The Secretary may prescribe conditions, including with 
respect to eligibility, and limitations on provision of incentive under 
paragraph (1).
    ``(6) Incentive provided under paragraph (1) shall not be included 
in the calculation of total amount of compensation under section 
7431(e)(4) of this title.
    ``(e) Student Loan Repayments.--(1) Subject to the provisions of 
this subsection, the Secretary may repay a student loan pursuant to 
section 5379(b) of title 5.
    ``(2) Paragraph (2) of such section shall not apply to payment 
under this subsection.
    ``(3) Payment under this subsection shall be made subject to such 
terms, limitations, or conditions as may be mutually agreed to by the 
Secretary and the employee concerned, except that the amount paid by 
the Secretary under this subsection may not exceed--
            ``(A) $40,000 for any employee in any calendar year; or
            ``(B) a total of $100,000 in the case of any employee.
    ``(f) Expedited Hiring Authority for College Graduates; Competitive 
Service.--(1) Subject to paragraph (2) of this subsection, the 
Secretary may expedite hiring for college graduates under section 3115 
of title 5 without regard to subsection (e) of such section or any 
regulations prescribed by the Office of Personnel Management for 
administration of such subsection.
    ``(2) The number of employees the Secretary may appoint under 
section 3115 of title 5 may not exceed the number equal to 25 percent 
of individuals that the Secretary appointed during the previous fiscal 
year to a position in the competitive service classified in a 
professional or administrative occupational category, at the GS-11 
level, or an equivalent level, or below, under a competitive examining 
procedure.
    ``(g) Expedited Hiring Authority for Post-secondary Students; 
Competitive Service.--(1) Subject to paragraph (2) of this subsection, 
the Secretary may expedite hiring of post-secondary students under 
section 3116 of title 5, without regard to subsection (d) of such 
section or any regulations prescribed by the Office of Personnel 
Management for administration of such subsection.
    ``(2) The number of employees the Secretary may appoint under 
section 3116 of title 5 may not exceed the number equal to 25 percent 
of the number of students that the Secretary appointed during the 
previous fiscal year to a position at the GS-11 level, or an equivalent 
level, or below.
    ``(h) Pay Authority for Critical Positions.--(1) Subject to the 
provisions of this subsection, the Secretary may authorize the fixing 
of the rate of pay for a critical position in the Department consistent 
with the authorities and requirements of section 5377 of title 5 that 
apply to the Office of Personnel Management.
    ``(2) The Secretary may fix the rate of pay for a critical position 
under this subsection in excess of the limitation set forth by section 
5377(d)(2) of such title.
    ``(3) Basic pay may not be fixed under this subsection at a rate 
greater than the rate payable for the Vice President of the United 
States established under section 104 of title 3, except upon written 
approval of the President.
    ``(4) Notwithstanding section 5377(f) of title 5, the Secretary may 
authorize the exercise of authority under this subsection with respect 
to up to 200 positions at any time.
    ``(i) Rates of Special Pay.--(1) The Secretary may establish a rate 
for special pay under section 5305(a)(1) of title 5.
    ``(2) In applying such section to the Secretary's authority under 
paragraph (1)--
            ``(A) `50 percent' shall be substituted for `30 percent'; 
        and
            ``(B) `level II of the Executive Schedule' shall be 
        substituted for `level IV of the Executive Schedule'.
    ``(j) Waiver of Limitations on Certain Payments Under Pay 
Comparability System.--The Secretary may waive the limitation in 
section 5307 of title 5 for an employee or a payment.
    ``(k) Termination.--The authorities under this section shall 
terminate on September 30, 2027.''.

            Attest:

                                                             Secretary.
117th CONGRESS

  2d Session

                               H.R. 3967

_______________________________________________________________________

                               AMENDMENT
Honoring our PACT Act of 2022
To improve health care and benefits for veterans exposed to toxic substances, and for other purposes.
Honoring our PACT Act of 2021
Honoring our Promise to Address Comprehensive Toxics Act of 2021
Honoring our PACT Act of 2021
Honoring our Promise to Address Comprehensive Toxics Act of 2021
COVENANT Act
Conceding Our Veterans' Exposures Now And Necessitating Training Act
FASTER Presumptions Act
Fair Care for Vietnam Veterans Act
Fairly Assessing Service-related Toxic Exposure Residuals Presumptions Act
Mark Takai Atomic Veterans Healthcare Parity Act
Palomares or Thule Veterans Act
Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act
SFC Heath Robinson Burn Pit Transparency Act
TEAM Act
Toxic Exposure in the American Military Act
Veterans Agent Orange Exposure Equity Act
Veterans Burn Pits Exposure Recognition Act
COVENANT Act
Conceding Our Veterans’ Exposures Now And Necessitating Training Act
Fair Care for Vietnam Veterans Act
Mark Takai Atomic Veterans Healthcare Parity Act
Palomares or Thule Veterans Act
Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act
SFC Heath Robinson Burn Pit Transparency Act
TEAM Act
Toxic Exposure in the American Military Act
Veterans Agent Orange Exposure Equity Act
Veterans Burn Pits Exposure Recognition Act
Honoring our PACT Act of 2021
Honoring our Promise to Address Comprehensive Toxics Act of 2021
COVENANT Act
Conceding Our Veterans’ Exposures Now And Necessitating Training Act
FASTER Presumptions Act
Fair Care for Vietnam Veterans Act
Fairly Assessing Service-related Toxic Exposure Residuals Presumptions Act
Mark Takai Atomic Veterans Healthcare Parity Act
Palomares Veterans Act
Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act
TEAM Act
Toxic Exposure in the American Military Act
Veterans Agent Orange Exposure Equity Act
Veterans Burn Pits Exposure Recognition Act
Honoring our PACT Act of 2021
Honoring our Promise to Address Comprehensive Toxics Act of 2021
COVENANT Act
Conceding Our Veterans’ Exposures Now And Necessitating Training Act
FASTER Presumptions Act
Fair Care for Vietnam Veterans Act
Fairly Assessing Service-related Toxic Exposure Residuals Presumptions Act
Mark Takai Atomic Veterans Healthcare Parity Act
Palomares Veterans Act
Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act
TEAM Act
Toxic Exposure in the American Military Act
Veterans Agent Orange Exposure Equity Act
Veterans Burn Pits Exposure Recognition Act
Rep. Takano, Mark