,i #aafth ,,congress #b;d ,session ,h4 ,r4 #eieg ,,in ,,the ,,house ,,of ,,representatives ,february #be1 #bjbj,mr4 ,green of ,tennessee 7for himself and ,mr4 ,lynch7 introduced the following bill2 which was referred to the ,committee on ,veterans' ,affairs1 and in addition to the ,committee on ,armed ,services1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to direct the ,secretary of ,defense to conduct a study regarding toxic exposure by members of the ,armed ,forces deployed to ,karshi ,khanabad ,air ,base1 ,uzbekistan1 to direct the ,secretary of ,veterans ,affairs to establish a registry regarding such exposure1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,k#b ,veterans ,toxic ,exposure ,accountability ,act of #bjbj4 #b4 ,study on toxic exposure at ,karshi ,khanabad ,air ,base1 ,uzbekistan 7a7 ,study 7#a7 ,in general ,the ,secretary of ,defense shall conduct a study on toxic exposure by members of the ,armed ,forces deployed to ,karshi ,khanabad ,air ,base1 ,uzbekistan1 at any time during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje4 7#b7 ,matters included ,the study under paragraph 7#a7 shall include the following3 7,a7 ,an assessment regarding the conditions of ,karshi ,khanabad ,air ,base1 ,uzbekistan1 during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje1 including an identification of toxic substances contaminating the ,air ,base during such period4 7,b7 ,an epidemiological study of the health consequences of a member of the ,armed ,forces deployed to the ,air ,base during such period4 7,c7 ,an assessment of any association between exposure to toxic substances identified under subparagraph 7,a7 and the health consequences studied under subparagraph 7,b74 7b7 ,report ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,defense and the ,secretary of ,veterans ,affairs shall jointly submit to the appropriate congressional committees a report containing-- 7#a7 the study under subsection 7a72 and 7#b7 a description of-- 7,a7 the benefits administered by the ,secretary of ,veterans ,affairs that a veteran may be eligible to receive by reason of being exposed to toxic substances at ,karshi ,khanabad ,air ,base1 ,uzbekistan1 while serving in the ,armed ,forces2 and 7,b7 the outreach conducted by the ,secretary to inform such veterans of such benefits4 #c4 ,establishment of ,k#b toxic exposure registry 7a7 ,establishment of registry 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7,a7 establish and maintain a registry for eligible individuals who may have been exposed to toxic substances at ,karshi ,khanabad ,air ,base1 ,uzbekistan1 at any time during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje2 7,b7 include any information in such registry that the ,secretary of ,veterans ,affairs determines necessary to ascertain and monitor the health effects of the exposure of members to such substances2 7,c7 develop a public information campaign to inform eligible individuals about the registry1 including how to register and the benefits of registering2 and 7,d7 periodically notify eligible individuals of significant developments in the study and treatment of conditions associated with such exposure4 7#b7 ,updates ,the ,secretary shall take actions necessary to ensure that the registry may be updated with the cause of death of a deceased registered individual by-- 7,a7 an individual designated by such deceased registered individual2 or 7,b7 if no such individual is designated1 an immediate family member of such deceased registered individual4 7#c7 ,coordination ,the ,secretary of ,veterans ,affairs shall coordinate with the ,secretary of ,defense in carrying out paragraph 7#a74 7b7 ,report to ,congress 7#a7 ,reports by independent scientific organization ,the ,secretary of ,veterans ,affairs shall enter into an agreement with an independent scientific organization to prepare reports as follows3 7,a7 ,not later than two years after the date on which the registry under subsection 7a7 is established1 an initial report containing the following3 7i7 ,an assessment of the effectiveness of actions taken by the ,secretaries to collect and maintain information on the health effects of exposure to toxic substances at ,karshi ,khanabad ,air ,base1 ,uzbekistan4 7ii7 ,recommendations to improve the collection and maintenance of such information4 7iii7 ,using established and previously published epidemiological studies1 recommendations regarding the most effective and prudent means of addressing the medical needs of eligible individuals with respect to conditions that are likely to result from such exposure4 7,b7 ,not later than five years after completing the initial report described in subparagraph 7,a71 a follow-up report containing the following3 7i7 ,an update to the initial report described in subparagraph 7,a74 7ii7 ,an assessment of whether and to what degree the content of the registry established under subsection 7a7 is current and scientifically up-to-date4 7#b7 ,submittal to ,congress 7,a7 ,initial report ,not later than two years after the date on which the registry under subsection 7a7 is established1 the ,secretary of ,veterans ,affairs shall submit to ,congress the initial report prepared under paragraph 7#a77;,a74 7,b7 ,follow-up report ,not later than five years after submitting the report under subparagraph 7,a71 the ,secretary of ,veterans ,affairs shall submit to ,congress the follow-up report prepared under paragraph 7#a77;,b74 7c7 ,definitions ,in this section3 7#a7 ,the term eligible individual means any individual who was deployed as a member of the ,armed ,forces to ,karshi ,khanabad ,air ,base1 ,uzbekistan1 at any time during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje4 7#b7 ,the term immediate family member1 with respect to a deceased individual1 means-- 7,a7 the spouse1 parent1 brother1 sister1 or adult child of the individual2 7,b7 an adult person to whom the individual stands in loco parentis2 or 7,c7 any other adult person-- 7i7 living in the household of the individual at the time of the death of the individual2 and 7ii7 related to the individual by blood or marriage4 7#c7 ,the term registered individual means an individual registered with the registry under subsection 7a74 #d4 ,determination of presumptions of service connection for illnesses associated with ,k#b exposure 7a7 ,in general 7#a7 ,determination required ,not later than #fj days after the date on which the ,secretary of ,veterans ,affairs receives the results of a covered study1 the ,secretary shall make a determination whether a positive association exists between-- 7,a7 the exposure of humans to toxic substances at ,karshi ,khanabad ,air ,base1 ,uzbekistan1 at any time during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje2 and 7,b7 the occurrence of a diagnosed illness in humans4 7#b7 ,bases of determination ,in making a determination under paragraph 7#a71 the ,secretary shall consider-- 7,a7 whether the evidence is statistically significant1 capable of replication1 and able to withstand peer review demonstrating that there is positive association between the exposure and the occurrence of a diagnosed illness2 7,b7 the results of a covered study2 and 7,c7 all other sound medical and scientific evidence available to the ,secretary4 7#c7 ,presumption ,if the ,secretary determines that a positive association exists between exposure and a diagnosed illness pursuant to paragraph 7#a71 the ,secretary shall prescribe regulations providing that-- 7,a7 a presumption of service connection is warranted for the illness covered by that determination if the illness first becomes manifest within the period1 if any1 prescribed in such regulations in a covered veteran2 and 7,b7 such covered veteran shall be presumed to have been exposed to toxic substances at ,karshi ,khanabad ,air ,base1 ,uzbekistan1 at any time during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje1 unless there is conclusive evidence to establish that-- 7i7 the covered veteran was not exposed to toxic substances in the course of such service in the ,armed ,forces2 or 7ii7 the illness first became manifest prior to the covered veteran's exposure4 7#d7 ,submission ,upon the date on which the ,secretary makes the determination under paragraph 7#a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an explanation of such determination4 7b7 ,regulations 7#a7 ,proposed regulations 7,a7 ,timing ,if the ,secretary determines under subsection 7a77#a7 that a presumption of service connection is warranted for an illness1 the ,secretary shall1 not later than #ahj days after making such determination-- 7i7 issue proposed regulations setting forth the determination2 or 7ii7 submit the initial report under subparagraph 7,b74 7,b7 ,reports ,if the ,secretary does not issue proposed regulations by the deadline established in subparagraph 7,a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the status of such proposed regulations4 ,on a quarterly basis thereafter until the date on which the ,secretary issues such proposed regulations1 the ,secretary shall submit to such committees an update on such status4 7#b7 ,final regulations ,not later than #ahj days after the date on which the ,secretary issues any proposed regulations under this subsection1 the ,secretary shall prescribe final regulations4 ,such regulations shall be effective on the date of issuance4 7#c7 ,presumption not warranted 7,a7 ,publication ,if the ,secretary determines under subsection 7a7 that a presumption of service connection is not warranted for an illness1 or proposes to remove a previously established presumption1 the ,secretary shall publish in the ,federal ,register a notice of that determination not later than #ahj days after making the determination4 ,the notice shall include an explanation of the evidence and scientific basis for that determination4 7,b7 ,removal of previous presumption ,if an illness already presumed to be service connected under this section is subject to a notice published under subparagraph 7,a71 the ,secretary shall issue proposed regulations removing the presumption for the illness not later than #ahj days after publication of such notice4 7#d7 ,effect of removal ,whenever the presumption of service connection for an illness under this section is removed under this subsection-- 7,a7 a veteran who was awarded compensation for the illness on the basis of the presumption before the effective date of the removal of the presumption shall continue to be entitled to receive compensation on that basis2 and 7,b7 a survivor of a veteran who was awarded dependency and indemnity compensation for the death of a veteran resulting from the illness on the basis of the presumption before that date shall continue to be entitled to receive dependency and indemnity compensation on that basis4 7c7 ,effective date of benefit awards ,the effective date of any benefit awarded by reason of this section shall be determined in accordance with section #eaaj of title #ch1 ,united ,states ,code1 but shall in no case be earlier than the effective date of the final regulations prescribed pursuant to subsection 7b77#b74 7d7 ,definitions ,in this section3 7#a7 ,the term covered study includes-- 7,a7 the study conducted under section #b2 and 7,b7 any subsequent study or any study conducted by the ,national ,academies of ,sciences1 ,engineering1 and ,medicine regarding the effects of exposure of humans to toxic substances at ,karshi ,khanabad ,air ,base1 ,uzbekistan1 at any time during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje4 7#b7 ,the term covered veteran means a veteran who was deployed as a member of the ,armed ,forces to ,karshi ,khanabad ,air ,base1 ,uzbekistan1 at any time during the period beginning ,october #a1 #bjja1 and ending ,december #ca1 #bjje4 #e4 ,access of the ,national ,academies of ,sciences1 ,engineering1 and ,medicine to information from the ,department of ,defense ,upon request by the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7in this section referred to as the ,academies71 the ,secretary of ,defense shall provide to the ,academies information in the possession of the ,department of ,defense that the ,academies determine useful in performing a covered study1 as that term is defined in section #d7;d74 ,such information includes1 at a minimum1 all environmental sampling data relative to any location included in the study4