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:
(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.
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.
Sec. 111. Expansion of period of eligibility for health care for certain veterans of combat service.
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.
Sec. 301. Short title.
Sec. 302. Presumptions of toxic exposure.
Sec. 303. Medical nexus examinations for toxic exposure risk activities.
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.
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.
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.
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.
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.
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.
This title may be cited as the “Conceding Our Veterans’ Exposure Now and Necessitating Training Act of 2022” or the “COVENANT Act of 2022”.
(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:
(c) Definition of toxic exposure risk activity.—Section 1710(e)(4) is amended by adding at the end the following new subparagraph:
(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.
(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.
“(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.
(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.
(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.
(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—
(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):
(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).
(a) Expanded period.—Section 1710(e)(3) is amended—
(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
(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.
This title may be cited as the “Toxic Exposure in the American Military Act of 2022” or the “TEAM Act of 2022”.
(a) Advisory committees, panels, and boards.—Chapter 11 is amended by adding at the end the following new subchapter:
Ҥ 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—
“(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;
“(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—
“(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
Ҥ 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) 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.
“(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.
“(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.
Ҥ 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.
“(c) Conduct of evaluations.— (1) The Secretary shall ensure that each formal evaluation under subsection (a)—
“(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
“(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.
“(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.
Ҥ 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) 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;
Ҥ 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—
“(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:
Ҥ 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.
“(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;
“(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.
“(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.
“(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—
(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).
(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:
(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—
(d) Conforming amendments.—Chapter 11 is amended—
(1) in section 1116—
(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
(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—
(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.”.
(a) In general.—Subchapter VI of chapter 11 is amended by adding at the end the following new section:
Ҥ 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—
“(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) 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.
(a) In general.—Subchapter I of chapter 13 is amended by adding at the end the following new section:
Ҥ 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—
“(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.
This title may be cited as the “Veterans Burn Pits Exposure Recognition Act of 2022”.
Subchapter II of chapter 11 is amended by adding at the end the following new section:
Ҥ 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—
“(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—
Subchapter VI of chapter 11, as amended by section 203, is further amended by adding at the end the following new section:
Ҥ 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—
“(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.
(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.”.
(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—
“(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—
(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:
(c) Hypertension.—Such section, as amended by subsection (b), is further amended by adding at the end the following new subparagraph:
(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—
(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—
(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.
(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.”.
(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”.
(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:
Ҥ 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:
“(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) 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—
(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.
(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.
(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”).
(b) Functions.—The Working Group shall perform the following functions:
(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).
(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.
(a) In general.—The Secretary of Veterans Affairs shall analyze, on a continuous basis, all clinical data that—
(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:
(3) A description of the types and incidences of medical conditions identified by the Department under such subsection.
(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.
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.
(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.
(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—
(b) Covered locations.—The locations described in this subsection are the following locations:
(c) Elements.—The study under subsection (a) shall assess, with respect to each veteran included in the study, the following:
(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.
(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:
(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).
(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—
(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.
(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—
(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.
(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—
(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.
(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.
(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.
(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.
(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.
(a) Congressional approval of major medical facility leases.—Paragraph (2) of subsection (a) of section 8104 of title 38, United States Code, is amended—
(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
(c) Separate prospectus requirement for major medical facility leases.—Subsection (b) of such section is amended—
(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;
(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:
“(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—
(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).
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.
(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—
(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.”.
(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.
(b) Department of Veterans Affairs.—Section 8111B of title 38, United States Code, is amended—
(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
(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—
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.
(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—
(b) Elements.—Each briefing required by subsection (a) shall include, for the period covered by the report, the following:
(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.—
(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.
(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—
(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
(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.
(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.
(a) In general.—Chapter 3 is amended by adding at the end the following new section:
Ҥ 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
“(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.
(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:
(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.
(a) In general.—Title 38, United States Code, is amended as follows:
(1) By striking section 5100 and inserting the following:
(2) In section 5104, by adding at the end the following new subsection:
(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)”.
(5) In section 7104—
(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:
(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:
(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.
(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.
(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).
(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).
(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;
(3) develop best practices and techniques for recruiting health care professionals for such clinics and centers;
(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.—
(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
(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.
(g) Definitions.—In this section:
(a) Establishment of qualifications.—Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall—
(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—
(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.
(a) In general.—Section 7455(c) is amended—
(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.”.
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”.
(a) Expansion of eligibility of employees for certain awards.—Section 7404(c) is amended—
(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”;
(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:
“(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—
“(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.
(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.—
(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
(3) ADDITIONAL PAY AUTHORITIES.—Section 7410(a) is amended—
(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
(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.
Subchapter I of chapter 7 is amended by inserting after section 703 the following new section:
Ҥ 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—
“(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.
(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).
Subchapter I of chapter 7 is amended by inserting after section 705 the following new section:
Ҥ 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.
“(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—
“(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.
“(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.
“(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.
“(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.
“(i) Rates of special pay.— (1) The Secretary may establish a rate for special pay under section 5305(a)(1) of title 5.
Attest:
Secretary
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