,in the ,senate of the ,united ,states1 ,june #af1 #bjbb4 ,amendment3 ,that the bill from the ,house of ,representatives 7,h4,r4 #cifg7 entitled ,an ,act to improve health care and benefits for veterans exposed to toxic substances1 and for other purposes41 do pass with the following ,strike all after the enacting clause and insert the following3 #a4 ,short title2 references to title #ch1 ,united ,states ,code2 table of contents 7a7 ,short title ,this ,act may be cited as the ,sergeant ,first ,class ,heath ,robinson ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjbb or the ,honoring our ,,pact ,act of #bjbb4 7b7 ,matters relating to amendments to title #ch1 ,united ,states ,code 7#a7 ,references ,except as otherwise expressly provided1 when in this ,act an amendment or repeal is expressed in terms of an amendment to1 or repeal of1 a section or other provision1 the reference shall be considered to be made to a section or other provision of title #ch1 ,united ,states ,code4 7#b7 ,amendments to tables of contents ,except as otherwise expressly provided1 when an amendment made by this ,act to title #ch1 ,united ,states ,code1 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 title1 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 amendment4 7c7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 references to title #ch1 ,united ,states ,code2 table of contents4,,title ,i--,expansion of health care eligibility,subtitle ,a--,toxic-exposed veterans,sec4 #aja4 ,short title4,sec4 #ajb4 ,definitions relating to toxic-exposed veterans4,sec4 #ajc4 ,expansion of health care for specific categories of toxic-exposed veterans and veterans supporting certain overseas contingency operations4,sec4 #ajd4 ,assessments of implementation and operation4,subtitle ,b--,certain veterans of combat service and other matters,sec4 #aaa4 ,expansion of period of eligibility for health care for certain veterans of combat service4,,title ,,ii--,toxic exposure presumption process,sec4 #bja4 ,short title4,sec4 #bjb4 ,improvements to ability of ,department of ,veterans ,affairs to establish presumptions of service connection based on toxic exposure4,sec4 #bjc4 ,outreach to claimants for disability compensation pursuant to changes in presumptions of service connection4,sec4 #bjd4 ,reevaluation of claims for dependency and indemnity compensation involving presumptions of service connection4,,title ,,iii--,improving the establishment of service connection process for toxic-exposed veterans,sec4 #cja4 ,short title4,sec4 #cjb4 ,presumptions of toxic exposure4,sec4 #cjc4 ,medical nexus examinations for toxic exposure risk activities4,,title ,,iv--,presumptions of service connection,sec4 #dja4 ,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 ,affairs4,sec4 #djb4 ,treatment of veterans who participated in nuclear response near ,palomares1 ,spain1 or ,thule1 ,greenland1 as radiation-exposed veterans for purposes of presumption of service connection of certain disabilities by ,department of ,veterans ,affairs4,sec4 #djc4 ,presumptions of service connection for diseases associated with exposures to certain herbicide agents for veterans who served in certain locations4,sec4 #djd4 ,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 locations4,sec4 #dje4 ,improving compensation for disabilities occurring in ,persian ,gulf ,war veterans4,sec4 #djf4 ,presumption of service connection for certain diseases associated with exposure to burn pits and other toxins4,sec4 #djg4 ,rule of construction4,,title ,v--,research matters,sec4 #eja4 ,interagency working group on toxic exposure research4,sec4 #ejb4 ,analysis and report on treatment of veterans for medical conditions related to toxic exposure4,sec4 #ejc4 ,analysis relating to mortality of veterans who served in ,southwest ,asia4,sec4 #ejd4 ,study on health trends of post-#i_/aa veterans4,sec4 #eje4 ,study on cancer rates among veterans4,sec4 #ejf4 ,study on health effects of waste related to ,manhattan ,project on certain veterans4,sec4 #ejg4 ,study on toxic exposure and mental health outcomes4,sec4 #ejh4 ,study on veterans in ,territories of the ,united ,states4,sec4 #eji4 ,department of ,veterans ,affairs public website for toxic exposure research4,sec4 #eaj4 ,report on health effects of jet fuels used by ,armed ,forces4,,title ,,vi--,improvement of resources and training regarding toxic-exposed veterans,sec4 #fja4 ,short title2 definitions4,sec4 #fjb4 ,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 veterans4,sec4 #fjc4 ,incorporation of toxic exposure screening for veterans4,sec4 #fjd4 ,training for personnel of the ,department of ,veterans ,affairs with respect to veterans who report toxic exposures4,,title ,,vii--,resourcing,sec4 #gja4 ,authority to use appropriations to enhance claims processing capacity and automation4,sec4 #gjb4 ,authorization of major medical facility leases of ,department of ,veterans ,affairs for fiscal year #bjbc4,sec4 #gjc4 ,treatment of major medical facility leases of the ,department of ,veterans ,affairs4,sec4 #gjd4 ,authority to enter into agreements with academic affiliates and other entities to acquire space for the purpose of providing health-care resources to veterans4,sec4 #gje4 ,modifications to enhanced-use lease authority of ,department of ,veterans ,affairs4,sec4 #gjf4 ,authority for joint leasing actions of ,department of ,defense and ,department of ,veterans ,affairs4,sec4 #gjg4 ,appropriation of amounts for major medical facility leases4,,title ,,viii--,records and other matters,sec4 #hja4 ,epidemiological study on ,fort ,mc,clellan veterans4,sec4 #hjb4 ,biennial briefing on ,individual ,longitudinal ,exposure ,record4,sec4 #hjc4 ,correction of exposure records by members of the ,armed ,forces and veterans4,sec4 #hjd4 ,federal cause of action relating to water at ,camp ,lejeune1 ,north ,carolina4,sec4 #hje4 ,cost of ,war ,toxic ,exposures ,fund4,sec4 #hjf4 ,appropriation for fiscal year #bjbb4,sec4 #hjg4 ,authorization of electronic notice in claims under laws administered by the ,secretary of ,veterans ,affairs4,sec4 #hjh4 ,burn pit transparency4,,title ,,ix--,improvement of workforce of ,department of ,veterans ,affairs,sec4 #ija4 ,national rural recruitment and hiring plan for ,veterans ,health ,administration4,sec4 #ijb4 ,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 ,affairs4,sec4 #ijc4 ,qualifications for human resources positions within ,department of ,veterans ,affairs and plan to recruit and retain human resources employees4,sec4 #ijd4 ,modification of pay cap for certain employees of ,veterans ,health ,administration4,sec4 #ije4 ,expansion of opportunities for housekeeping aides4,sec4 #ijf4 ,modification of authority of the ,secretary of ,veterans ,affairs relating to hours1 conditions of employment1 and pay for certain employees of ,veterans ,health ,administration4,sec4 #ijg4 ,waiver of pay limitation for certain employees of ,department of ,veterans ,affairs4,sec4 #ijh4 ,elimination of limitation on awards and bonus for employees of ,department of ,veterans ,affairs4,sec4 #iji4 ,additional authority of the ,secretary of ,veterans ,affairs relating to recruitment and retention of personnel4 ,i ,expansion of health care eligibility ,a ,toxic-exposed veterans #aja4 ,short title ,this title may be cited as the ,conceding ,our ,veterans' ,exposure ,now and ,necessitating ,training ,act of #bjbb or the ,,covenant ,act of #bjbb4 #ajb4 ,definitions relating to toxic-exposed veterans 7a7 ,in general ,section #agaj7;a77#b77;,f7 is amended by striking who was exposed to a toxic substance1 radiation1 or other conditions1 as provided in subsection 7e7 and inserting who is a toxic-exposed veteran1 in accordance with subsection 7e74 7b7 ,definitions of toxic exposure and toxic-exposed veteran ,section #aja is amended by adding at the end the following new paragraphs3 7#cg7 ,the term toxic exposure includes the following3 7,a7 ,a toxic exposure risk activity1 as defined in section #agaj7;e77#d7 of this title4 7,b7 ,an exposure to a substance1 chemical1 or airborne hazard identified in the list under section #aaai7;b77#b7 of this title4 7#ch7 ,the term toxic-exposed veteran means any veteran described in section #agaj7;e77#a7 of this title4 4 7c7 ,definition of toxic exposure risk activity ,section #agaj7;e77#d7 is amended by adding at the end the following new subparagraph3 7,c7 ,the term toxic exposure risk activity means any activity-- 7i7 that requires a corresponding entry in an exposure tracking record system 7as defined in section #aaai7;c7 of this title7 for the veteran who carried out the activity2 or 7ii7 that the ,secretary determines qualifies for purposes of this subsection when taking into account what is reasonably prudent to protect the health of veterans4 4 #ajc4 ,expansion of health care for specific categories of toxic-exposed veterans and veterans supporting certain overseas contingency operations 7a7 ,in general 7#a7 ,expansion ,subsection 7e7 of section #agaj1 as amended by section #ajb7;c71 is further amended-- 7,a7 in paragraph 7#a71 by adding at the end the following new subparagraphs3 7,g7 ,beginning not later than the applicable date specified in paragraph 7#f71 and subject to paragraph 7#b71 a veteran who participated in a toxic exposure risk activity while serving on active duty1 active duty for training1 or inactive duty training is eligible for hospital care 7including mental health services and counseling71 medical services1 and nursing home care under subsection 7a77#b77;,f7 for any illness4 7,h7 ,beginning not later than the applicable date specified in paragraph 7#f71 and subject to paragraph 7#b71 a covered veteran 7as defined in section #aaai7;c7 of this title7 is eligible for hospital care 7including mental health services and counseling71 medical services1 and nursing home care under subsection 7a77#b77;,f7 for any illness4 7,i7 7i7 ,beginning not later than the applicable date specified in paragraph 7#f71 and subject to paragraph 7#b71 a veteran who deployed in support of a contingency operation specified in clause 7ii7 is eligible for hospital care 7including mental health services and counseling71 medical services1 and nursing home care under subsection 7a77#b77;,f7 for any illness4 7ii7 ,a contingency operation specified in this clause is any of the following3 7,i7 ,operation ,enduring ,freedom4 7,,ii7 ,operation ,freedom's ,sentinel4 7,,iii7 ,operation ,iraqi ,freedom4 7,,iv7 ,operation ,new ,dawn4 7,v7 ,operation ,inherent ,resolve4 7,,vi7 ,resolute ,support ,mission4 2 and 7,b7 in paragraph 7#b77;,b7-- 7i7 by striking or 7,f7 and inserting 7,f71 7,g71 7,h71 or 7,i72 and 7ii7 by striking service or testing and inserting service1 testing1 or activity4 7#b7 ,phase in ,such subsection is further amended by adding at the end the following new paragraph3 7#f7 7,a7 ,the ,secretary shall determine the dates in subparagraphs 7,g71 7,h71 and 7,i7 of paragraph 7#a7 as follows3 7i7 ,october #a1 #bjbd1 with respect to a veteran described in such subparagraph 7,g7 or 7,h7 who was discharged or released from the active military1 naval1 air1 or space service during the period beginning on ,august #b1 #aiij1 and ending on ,september #aa1 #bjja4 7ii7 ,october #a1 #bjbf1 with respect to a veteran described in such subparagraph 7,g7 or 7,h7 who was discharged or released from the active military1 naval1 air1 or space service during the period beginning on ,september #ab1 #bjja1 and ending on ,december #ca1 #bjjf4 7iii7 ,october #a1 #bjbh1 with respect to a veteran described in such subparagraph 7,g7 or 7,h7 who was discharged or released from the active military1 naval1 air1 or space service during the period beginning on ,january #a1 #bjjg1 and ending on ,december #ca1 #bjab4 7iv7 ,october #a1 #bjcj1 with respect to a veteran described in such subparagraph 7,g7 or 7,h7 who was discharged or released from the active military1 naval1 air1 or space service during the period beginning on ,january #a1 #bjac1 and ending on ,december #ca1 #bjah4 7v7 ,october #a1 #bjcb1 with respect to a veteran described in such subparagraph 7,i74 7,b7 7i7 ,the ,secretary may modify a date specified in subparagraph 7,a7 to an earlier date1 as the ,secretary determines appropriate based on the number of veterans receiving hospital care1 medical services1 and nursing home care under subparagraphs 7,g71 7,h71 and 7,i7 of paragraph 7#a7 and the resources available to the ,secretary4 7ii7 ,if the ,secretary determines to modify a date under clause 7i71 the ,secretary shall-- 7,i7 notify the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives of the proposed modification2 and 7,,ii7 publish such modified date in the ,federal ,register4 4 7b7 ,outreach plans ,with respect to each of clauses 7i7 through 7v7 of section #agaj7;e77#f77;,a7 of title #ch1 ,united ,states ,code 7as added by subsection 7a77#b771 not later than #ahj days before the date specified in the clause 7including a date modified pursuant to such section71 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 care1 medical services1 or nursing home care under subparagraph 7,g71 7,h71 or 7,i71 of section #agaj7;e77#a7 of such title1 as the case may be4 #ajd4 ,assessments of implementation and operation 7a7 ,initial resource assessment and report ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7#a7 complete an assessment to determine-- 7,a7 the personnel and material resources necessary to implement section #ajc 7including the amendments made by such section72 and 7,b7 the total number of covered veterans1 as such term is defined in section #aaai7;c7 of title #ch1 ,united ,states ,code 7as added by section #cjb71 who receive hospital care or medical services furnished by the ,secretary under chapter #ag of such title1 disaggregated by priority group specified in section #agje7;a7 of such title2 and 7#b7 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 7#a71 including a specific determination as to whether the ,department has the personnel and material resources necessary to implement section #ajc4 7b7 ,information systems ,not later than ,october #a1 #bjbd1 the ,secretary shall establish information systems to assess the implementation of section #ajc1 including the amendments made by such section1 and use the results of assessments under such systems to inform the reports under subsection 7c74 7c7 ,annual reports 7#a7 ,reports ,not later than ,october #a1 #bjbe1 and on an annual basis thereafter until ,october #a1 #bjcc1 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 following3 7,a7 ,the effect of the implementation of1 and the provision and management of care under1 section #ajc 7including the amendments made by such section7 on the demand by veterans described in subparagraphs 7,g71 7,h71 and 7,i7 of section #agaj7;e77#a7 of title #ch1 ,united ,states ,code 7as added by such section #ajc7 for health care services furnished by the ,secretary4 7,b7 ,any differing patterns of demand for health care services by such veterans1 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 #ag of such title4 7,c7 ,the extent to which the ,secretary has met such demand4 7,d7 ,any changes1 during the year covered by the report1 in the delivery patterns of health care furnished by the ,secretary under chapter #ag of such title1 and the fiscal impact of such changes4 7#b7 ,matters ,each report under paragraph 7#a7 shall include1 with respect to the year covered by the report1 detailed information on the following3 7,a7 ,the total number of veterans enrolled in the patient enrollment system who1 during such year1 received hospital care or medical services furnished by the ,secretary under chapter #ag of title #ch1 ,united ,states ,code4 7,b7 ,of the veterans specified in subparagraph 7,a71 the number of such veterans who1 during the preceding three fiscal years1 had not received such care or services4 7,c7 ,with respect to the veterans specified in subparagraph 7,b71 the cost of providing health care to such veterans during the year covered by the report1 shown in total and disaggregated by-- 7i7 the level of care2 and 7ii7 whether the care was provided through the ,veterans ,community ,care ,program4 7,d7 ,with respect to the number of veterans described in subparagraphs 7,g71 7,h71 and 7,i7 of section #agaj7;e77#a7 of title #ch1 ,united ,states ,code 7as added by section #ajc71 the following 7shown in total and disaggregated by medical facility of the ,department1 as applicable73 7i7 ,the number of such veterans who1 during the year covered by the report1 enrolled in the patient enrollment system4 7ii7 ,the number of such veterans who applied for1 but were denied1 such enrollment4 7iii7 ,the number of such veterans who were denied hospital care or a medical service furnished by the ,secretary that was considered to be medically necessary but not of an emergency nature4 7,e7 ,the numbers and characteristics of1 and the type and extent of health care furnished by the ,secretary to1 veterans enrolled in the patient enrollment system 7shown in total and disaggregated by medical facility of the ,department74 7,f7 ,the numbers and characteristics of1 and the type and extent of health care furnished by the ,secretary to1 veterans not enrolled in the patient enrollment system 7disaggregated by each class of eligibility for care under section #agaj of title #ch1 ,united ,states ,code1 and further shown as a total per class and disaggregated by medical facility of the ,department74 7,g7 ,the specific fiscal impact 7shown in total and disaggregated by geographic health care delivery areas7 of changes in the delivery patterns of health care furnished by the ,secretary under chapter #ag of such title as a result of the implementation of section #ajc 7including the amendments made by such section74 7d7 ,definitions ,in this section3 7#a7 ,patient enrollment system ,the term patient enrollment system means the patient enrollment system of the ,department of ,veterans ,affairs established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code4 7#b7 ,veterans ,community ,care ,program ,the term ,veterans ,community ,care ,program means the program established under section #agjc of title #ch1 ,united ,states ,code4 ,b ,certain veterans of combat service and other matters #aaa4 ,expansion of period of eligibility for health care for certain veterans of combat service 7a7 ,expanded period ,section #agaj7;e77#c7 is amended-- 7#a7 in subparagraph 7,a7-- 7,a7 by striking ,january #bg1 #bjjc and inserting ,september #aa1 #bjja2 and 7,b7 by striking five-year period and inserting #aj-year period2 7#b7 by amending subparagraph 7,b7 to read as follows3 7,b7 ,with respect to a veteran described in paragraph 7#a77;,d7 who was discharged or released from the active military1 naval1 air1 or space service after ,september #aa1 #bjja1 and before ,october #a1 #bjac1 but did not enroll to receive such hospital care1 medical services1 or nursing home care under such paragraph pursuant to subparagraph 7,a7 before ,october #a1 #bjbb1 the one-year period beginning on ,october #a1 #bjbb4 2 and 7#c7 by striking subparagraph 7,c74 7b7 ,clarification of coverage ,section #agaj7;e77#a77;,d7 is amended by inserting after ,persian ,gulf ,war the following3 7including any veteran who1 in connection with service during such period1 received the ,armed ,forces ,expeditionary ,medal1 ,service ,specific ,expeditionary ,medal1 ,combat ,era ,specific ,expeditionary ,medal1 ,campaign ,specific ,medal1 or any other combat theater award established by a ,federal statute or an ,executive order74 7c7 ,outreach plan ,not later than ,december #a1 #bjbb1 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 7,b7 of section #agaj7;e77#c7 of title #ch1 ,united ,states ,code1 as amended by subsection 7a77#b71 to notify such veterans of their eligibility for hospital care1 medical services1 or nursing home care pursuant to such subparagraph4 7d7 ,report on enrollments ,not later than ,january #cj1 #bjbd1 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 identifying1 with respect to the one-year period beginning on ,october #a1 #bjbb1 the number of veterans described in section #agaj7;e77#c77;,b7 of title #ch1 ,united ,states ,code1 as amended by subsection 7a77#b71 who1 during such period1 enrolled in the patient enrollment system of the ,department of ,veterans ,affairs established and operated under section #agje7;a7 of such title4 7e7 ,effective date ,this section and the amendments made by this section shall take effect on ,october #a1 #bjbb4 ,,ii ,toxic exposure presumption process #bja4 ,short title ,this title may be cited as the ,toxic ,exposure in the ,american ,military ,act of #bjbb or the ,,team ,act of #bjbb4 #bjb4 ,improvements to ability of ,department of ,veterans ,affairs to establish presumptions of service connection based on toxic exposure 7a7 ,advisory committees1 panels1 and boards ,chapter #aa is amended by adding at the end the following new subchapter3 ,,vii ,determinations relating to presumptions of service connection based on toxic exposure #aaga4 ,procedures to determine presumptions of service connection based on toxic exposure2 definitions 7a7 ,procedures ,the ,secretary shall determine whether to establish1 or to remove1 presumptions of service connection based on toxic exposure pursuant to this subchapter1 whereby-- 7#a7 under section #aagb of this title-- 7,a7 the ,secretary provides-- 7i7 public notice regarding what formal evaluations the ,secretary plans to conduct2 and 7ii7 the public an opportunity to comment on the proposed formal evaluations2 7,b7 the working group established under subsection 7b7 of such section provides-- 7i7 advice to the ,secretary on toxic-exposed veterans and cases in which veterans who1 during active military1 naval1 air1 or space service1 may have experienced a toxic exposure or their dependents may have experienced a toxic exposure while the veterans were serving in the active military1 naval1 air1 or space service2 7ii7 recommendations to the ,secretary on corrections needed in the ,individual ,longitudinal ,exposure ,record to better reflect veterans and dependents described in clause 7i72 and 7iii7 recommendations to the ,secretary regarding which cases of possible toxic exposure should be reviewed2 7#b7 the ,secretary provides for formal evaluations of such recommendations under section #aagc of this title and takes into account reports received by the ,secretary from the ,national ,academies of ,sciences1 ,engineering1 and ,medicine under section #aagf of this title2 and 7#c7 the ,secretary issues regulations under section #aagd of this title4 7b7 ,definitions ,in this subchapter3 7#a7 ,the term illness includes a disease or other condition affecting the health of an individual1 including mental and physical health4 7#b7 ,the term ,individual ,longitudinal ,exposure ,record includes-- 7,a7 service records2 7,b7 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 compiles1 collates1 presents1 and provides available occupational and environmental exposure information to support the needs of the ,department of ,defense and the ,department of ,veterans ,affairs2 or 7,c7 any successor system to a database described in subparagraph 7,b74 #aagb4 ,annual notice and opportunity for public comment 7a7 ,notice required 7#a7 7,a7 ,not less frequently than once each year1 the ,secretary shall publish in the ,federal ,register notice of the formal evaluations that the ,secretary plans to conduct pursuant to section #aagc of this title4 7,b7 ,each notice published under subparagraph 7,a7 shall include1 for each formal evaluation referred to in the notice1 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 #aagc of this title4 7#b7 7,a7 ,with each notice published under paragraph 7#a71 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 notice4 7,b7 ,the ,secretary shall-- 7i7 consider all public comment received under subparagraph 7,a72 and 7ii7 publish in the ,federal ,register a response to the comments received under subparagraph 7,a74 7#c7 7,a7 ,for each notice published under paragraph 7#a71 the ,secretary shall hold an open meeting for members of the public to voice their comments in response to the notice4 7,b7 ,to help evaluate presumptions of service connection1 the ,secretary shall1 not less frequently than quarterly1 collaborate with1 partner with1 and give weight to the advice of veterans service organizations and such other stakeholders as the ,secretary considers appropriate4 7#d7 ,failure to include a military environmental exposure or adverse health effect in a ,federal ,register notice published pursuant to subsection 7a7 shall not preclude the ,secretary from initiating a formal evaluation of such exposure or health effect4 7b7 ,working ,group 7#a7 ,the ,secretary shall establish a working group within the ,department 7in this section referred to as the ,working ,group74 7#b7 ,the ,working ,group shall include personnel of the ,veterans ,health ,administration and the ,veterans ,benefits ,administration4 7#c7 ,the ,secretary shall consult with1 and seek the advice of1 the ,working ,group with respect to cases in which-- 7,a7 a veteran may have1 during active military1 naval1 air1 or space service1 experienced a toxic exposure2 or 7,b7 a dependent of a veteran may have experienced a toxic exposure during the active military1 naval1 air1 or space service of the veteran4 7c7 ,assessments 7#a7 ,the ,working ,group shall assess cases of the toxic exposure of veterans and their dependents that occurred during active military1 naval1 air1 or space service1 including by conducting ongoing surveillance and reviewing such exposure described in scientific literature1 media reports1 information from veterans1 and information from ,congress4 7#b7 ,the assessments under paragraph 7#a7 shall cover suspected and known toxic exposures occurring during active military1 naval1 air1 or space service1 including by identifying and evaluating new and emerging toxic exposures that are not recognized under existing presumptions of service connection4 7#c7 ,the ,working ,group may conduct an assessment under paragraph 7#a7 in response to a comment received under paragraph 7#b7 or 7#c7 of subsection 7a74 7#d7 ,the ,working ,group shall1 in consultation with the ,secretary of ,defense1 on a periodic basis1 assess the ,individual ,longitudinal ,exposure ,record to ensure the accuracy of data collected4 7d7 ,development of recommendations 7#a7 ,following an assessment of a case of the toxic exposure of veterans that occurred during active military1 naval1 air1 or space service under subsection 7c71 or their dependents1 the ,working ,group may develop a recommendation for formal evaluation under section #aagc 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 humans4 7#b7 ,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 supported1 the ,working ,group may nominate such evidence for formal evaluation under section #aagc of this title to modify the periods and locations4 7e7 ,reports by the ,working ,group ,not less frequently than once each year1 the ,working ,group shall submit to the ,secretary1 the ,committee on ,veterans' ,affairs of the ,senate1 and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 and make publicly available1 a report on-- 7#a7 recommendations developed under subsection 7d71 if any2 and 7#b7 recommendations for such legislative or administrative action as the ,working ,group considers necessary for the ,working ,group to be more effective in carrying out the requirements of this section4 7f7 ,responses by ,secretary ,in response to each report submitted under subsection 7e71 the ,secretary shall1 not later than #cj days after receiving the report1 initiate a formal evaluation pursuant to section #aagc of this title4 #aagc4 ,formal evaluation of recommendations 7a7 ,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 #aagb of this title4 7b7 ,evidence1 data1 and factors ,the ,secretary shall ensure that each formal evaluation under subsection 7a7 covers the following3 7#a7 ,scientific evidence1 based on the review of available scientific literature1 including human1 toxicological1 animal1 and methodological studies1 and other factors4 7#b7 ,claims data1 based on the review of claim rate1 grant rate1 and service connection prevalence1 and other factors4 7#c7 ,other factors the ,secretary determines appropriate1 such as-- 7,a7 the level of disability and mortality caused by the health effects related to the case of toxic exposure being evaluated2 7,b7 the quantity and quality of the information available and reviewed2 7,c7 the feasibility of and period for generating relevant information and evidence2 7,d7 whether such health effects are combat- or deployment-related2 7,e7 the ubiquity or rarity of the health effects2 and 7,f7 any time frame during which a health effect must become manifest4 7c7 ,conduct of evaluations 7#a7 ,the ,secretary shall ensure that each formal evaluation under subsection 7a7-- 7,a7 reviews scientific evidence in a manner that-- 7i7 conforms to principles of scientific and data integrity2 7ii7 is free from suppression or distortion of scientific or technological findings1 data1 information1 conclusions1 or technical results2 and 7,b7 7i7 evaluates the likelihood that a positive association exists between an illness and a toxic exposure while serving in the active military1 naval1 air1 or space service2 and 7ii7 assesses the toxic exposures and illnesses and determines whether the evidence supports a finding of a positive association between the toxic exposure and the illness4 7#b7 ,in carrying out paragraph 7#a77;,b77ii71 a formal evaluation under subsection 7a7 shall include reviewing all relevant data to determine the strength of evidence for a positive association based on the following four categories3 7,a7 ,the sufficient category1 where the evidence is sufficient to conclude that a positive association exists4 7,b7 ,the equipoise and above category1 where the evidence is sufficient to conclude that a positive association is at least as likely as not1 but not sufficient to conclude that a positive association exists4 7,c7 ,the below equipoise category1 where the evidence is not sufficient to conclude that a positive association is at least as likely as not1 or is not sufficient to make a scientifically informed judgment4 7,d7 ,the against category1 where the evidence suggests the lack of a positive association4 7d7 ,recommendation for establishing a presumption of service connection ,not later than #abj days after the date on which a formal evaluation is commenced1 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 illness1 or modifying an existing presumption of service connection1 covered by the evaluation4 #aagd4 ,regulations regarding presumptions of service connection based on toxic exposure 7a7 ,action upon recommendation ,not later than #afj days after the date on which the ,secretary receives a recommendation to establish or modify a presumption of service connection under section #aagc of this title-- 7#a7 if the ,secretary determines1 in the discretion of the ,secretary1 that the presumption1 or modification1 is warranted1 the ,secretary shall-- 7,a7 commence issuing regulations in accordance with the provisions of subchapter ,,ii of chapter #e of title #e 7commonly referred to as the ,administrative ,procedures ,act7 setting forth the presumption or commence revising regulations to carry out such modification2 and 7,b7 include in such regulations any time frame during which a health effect must become manifest2 or 7#b7 if the ,secretary determines1 in the discretion of the ,secretary1 that the presumption1 or modification1 is not warranted1 the ,secretary shall publish in the ,federal ,register a notice of the determination1 including the reasons supporting the determination4 7b7 ,removal of presumption 7#a7 7,a7 ,the ,secretary may-- 7i7 issue a regulation to remove an illness from a presumption of service connection previously established pursuant to a regulation issued under subsection 7a72 and 7ii7 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 #bjbb if the ,secretary concludes that evidence suggests the lack of a positive association between the disease and the toxic exposure4 7,b7 ,under subparagraph 7,a77ii71 the ,secretary shall not consider the lack of evidence as sufficient to support a decision for removal of a presumption4 7#b7 ,whenever an illness is removed from regulations pursuant to paragraph 7#a71 or the periods and locations of exposure covered by a presumption of service connection are modified under subsection 7a7-- 7,a7 a veteran who was awarded compensation under chapter #aa 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 basis2 7,b7 a survivor of a veteran who was awarded dependency and indemnity compensation under chapter #ac of this title for the death of a veteran resulting from such illness on the basis of such presumption shall continue to be entitled to receive dependency and indemnity compensation on such basis2 and 7,c7 no veteran or survivor covered under subparagraph 7,a7 or 7,b7 shall have their compensation reduced solely because of the removal of an illness pursuant to paragraph 7#a74 #aage4 ,authority to modify process2 congressional oversight 7a7 ,in general ,the ,secretary may modify the process under which the working group established under subsection 7b7 of section #aagb of this title conducts assessments under such section1 the ,secretary conducts formal evaluations under section #aagc of this title1 and issues regulations under section #aagd of this title if-- 7#a7 such evaluations cover the evidence1 data1 and factors required by subsection 7b7 of such section #aagc2 and 7#b7 a period of #ahj days has elapsed following the date on which the ,secretary submits the notice under subsection 7b7 regarding the modification4 7b7 ,notice ,if the ,secretary proposes to modify the process under which the working group established under subsection 7b7 of section #aagb of this title conducts assessments under such section1 the process under which the ,secretary conducts formal evaluations under section #aagc of this title1 or issues regulations under section #aagd of this title1 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 following3 7#a7 ,a description of the proposed modifications4 7#b7 ,a description of any exceptions to the requirements of such sections that are proposed because of limited available scientific evidence1 and a description of how such evaluations will be conducted4 #aagf4 ,agreement with ,national ,academies of ,sciences1 ,engineering1 and ,medicine concerning toxic exposures 7a7 ,purpose ,the purpose of this section is to provide for the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7in this section referred to as the ,academies71 an independent nonprofit scientific organization with appropriate expertise that is not part of the ,federal ,government1 to review and evaluate the available scientific evidence regarding associations between diseases and toxic exposures4 7b7 ,agreement 7#a7 ,the ,secretary shall seek to enter into a five-year agreement with the ,academies to perform the services covered by this section4 7#b7 ,the ,secretary shall seek to enter into an agreement described in paragraph 7#a7 not later than #fj days after the date of the enactment of the ,sergeant ,first ,class ,heath ,robinson ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjbb4 7#c7 ,an agreement under this section may be extended in five-year increments4 7c7 ,review of scientific evidence ,under an agreement between the ,secretary and the ,academies under this section1 the ,academies shall review and summarize the scientific evidence1 and assess the strength thereof1 concerning the association between toxic exposures during active military1 naval1 air1 or space service and each disease suspected to be associated with such exposure in the human population4 7d7 ,scientific determinations concerning diseases ,for each disease reviewed under subsection 7c71 the ,academies shall determine1 to the extent that available scientific data permit meaningful determinations-- 7#a7 whether an association exists between toxic exposures and the occurrence of the disease1 taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association2 7#b7 the increased risk of the disease among those reporting toxic exposures during active military1 naval1 air1 or space service2 7#c7 whether there exists a plausible biological mechanism or other evidence of a positive association between the toxic exposure and the occurrence of the disease2 and 7#d7 determine the strength of evidence for a positive association based on categories furnished under section #aagc of this title4 7e7 ,cooperation of ,federal agencies ,the head of each relevant ,federal agency1 including the ,secretary of ,defense1 shall cooperate fully with the ,academies in performing the services covered by this section4 7f7 ,recommendations for additional scientific studies 7#a7 ,under an agreement between the ,secretary and the ,academies under this section1 the ,academies shall make any recommendations for additional scientific studies to resolve areas of continuing scientific uncertainty relating to toxic exposures4 7#b7 ,in making recommendations under paragraph 7#a71 the ,academies shall consider-- 7,a7 the scientific information that is available at the time of the recommendation2 7,b7 the value and relevance of the information that could result from additional studies2 and 7,c7 the cost and feasibility of carrying out such additional studies4 7g7 ,reports 7#a7 7,a7 ,under an agreement between the ,secretary and the ,academies under this section1 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 #bjbb1 the ,academies shall submit to the ,secretary1 the ,committee on ,veterans' ,affairs of the ,senate1 and the ,committee on ,veterans' ,affairs of the ,house of ,representatives an initial report on the activities of the ,academies under the agreement4 7,b7 ,the report submitted under subparagraph 7,a7 shall include the following3 7i7 ,the determinations described in subsection 7d74 7ii7 ,a full explanation of the scientific evidence and reasoning that led to such determinations4 7iii7 ,any recommendations of the ,academies under subsection 7f74 7#b7 ,under an agreement between the ,secretary and the ,academies under this section1 not less frequently than once every two years after the date on which the initial report is submitted under paragraph 7#a77;,a71 the ,academies shall submit to the ,secretary1 the ,committee on ,veterans' ,affairs of the ,senate1 and the ,committee on ,veterans' ,affairs of the ,house of ,representatives an updated report on the activities of the ,academies under the agreement4 7h7 ,alternative contract scientific organization 7#a7 ,if the ,secretary is unable within the time period prescribed in subsection 7b77#b7 to enter into an agreement with the ,academies for the purposes of this section on terms acceptable to the ,secretary1 the ,secretary shall seek to enter into an agreement for the purposes of this section with another appropriate scientific organization that-- 7,a7 is not part of the ,federal ,government2 7,b7 operates as a not-for-profit entity2 and 7,c7 has expertise and objectivity comparable to that of the ,academies4 7#b7 ,if the ,secretary enters into an agreement with another organization as described in paragraph 7#a71 any reference in this subchapter to the ,academies shall be treated as a reference to the other organization4 4 7b7 ,reports and briefings 7#a7 ,report 7,a7 ,in general ,not later than two years after the date of the enactment of this ,act1 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 of1 and recommendations for1 subchapter ,,vii of chapter #aa of title #ch1 ,united ,states ,code1 as added by subsection 7a74 7,b7 ,consultation ,the ,secretary shall develop the report under subparagraph 7,a7 in consultation with organizations recognized by the ,secretary for the representation of veterans under section #eijb of such title and any other entity the ,secretary determines appropriate4 7#b7 ,briefing ,on a quarterly basis during the two-year period beginning on the date of the enactment of this ,act1 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 #aa of such title1 as added by subsection 7a74 7c7 ,independent assessment 7#a7 ,agreement ,the ,secretary shall seek to enter into an agreement with the ,national ,academies of ,science1 ,engineering1 and ,medicine 7in this subsection referred to as the ,academies7 before the date that is #ij days after the date of the enactment of this ,act to perform the services set forth under paragraph 7#b74 7#b7 ,assessment 7,a7 ,in general ,under an agreement between the ,secretary and the ,academies under paragraph 7#a71 the ,academies shall conduct an assessment of the implementation by the ,department of ,veterans ,affairs of the process established under subchapter ,,vii of chapter #aa of title #ch1 ,united ,states ,code1 as added by subsection 7a74 7,b7 ,elements ,the assessment conducted under subparagraph 7,a7 shall include the following3 7i7 ,an assessment of the ,department's implementation of the process established under subsection 7a7 to determine whether the process is in accordance with current scientific standards for assessing the link between exposure to environmental hazards and the development of health outcomes1 7ii7 assess whether the criteria is fair and consistent1 and 7iii7 provide recommendations for improvements to the process4 7#c7 ,report ,not later than one year after the date on which the ,secretary enters into an agreement under paragraph 7#a71 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 agreement4 7#d7 ,alternative contract scientific organization 7,a7 ,in general ,if the ,secretary is unable within the time period prescribed in paragraph 7#a7 to enter into an agreement with the ,academies for the purposes of this subsection on terms acceptable to the ,secretary1 the ,secretary shall seek to enter into an agreement for the purposes of this subsection with another appropriate scientific organization that-- 7i7 is not part of the ,federal ,government2 7ii7 operates as a not-for-profit entity2 and 7iii7 has expertise and objectivity comparable to that of the ,academies4 7,b7 ,treatment ,if the ,secretary enters into an agreement with another organization as described in subparagraph 7,a71 any reference in this subsection to the ,academies of ,sciences1 ,engineering1 and ,medicine shall be treated as a reference to the other organization4 7d7 ,conforming amendments ,chapter #aa is amended-- 7#a7 in section #aaaf-- 7,a7 by striking subsections 7b71 7c71 7d71 and 7e72 7,b7 by inserting after subsection 7a7 the following new subsection 7b73 7b7 ,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 #bjbb regarding a presumption of service connection based on exposure to an herbicide agent under this section is made pursuant to subchapter ,,vii of this chapter1 including with respect to assessing reports received by the ,secretary from the ,national ,academy of ,sciences under section #c of the ,agent ,orange ,act of #aiia 7,public ,law #ajb-d74 2 and 7,c7 by redesignating subsection 7f7 as subsection 7c72 7#b7 in section #aaaf;,b7b77#b77;,a71 by inserting pursuant to subchapter ,,vii of this chapter1 before the ,secretary determines2 and 7#c7 in section #aaah-- 7,a7 by striking subsections 7b7 through 7e72 and 7,b7 by inserting after subsection 7a7 the following new subsection 7b73 7b7 ,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 #bjbb regarding a presumption of service connection based on a toxic exposure under this section is made pursuant to subchapter ,,vii of this chapter4 4 #bjc4 ,outreach to claimants for disability compensation pursuant to changes in presumptions of service connection 7a7 ,in general ,subchapter ,,vi of chapter #aa is amended by adding at the end the following new section3 #aafg4 ,outreach pursuant to changes in presumptions of service connection 7a7 ,in general ,whenever a law1 including through a regulation or ,federal court decision or settlement1 establishes or modifies a presumption of service connection1 the ,secretary shall-- 7#a7 identify all claims for compensation under this chapter that-- 7,a7 were submitted to the ,secretary2 7,b7 were evaluated and denied by the ,secretary before the date on which such provision of law went into effect2 and 7,c7 might have been evaluated differently had the establishment or modification been applicable to the claim2 and 7#b7 pursuant to subsection 7b71 conduct outreach to the claimants4 7b7 ,outreach 7#a7 ,the ,secretary shall conduct outreach to inform claimants identified under subsection 7a7 that they may submit a supplemental claim in light of the establishment or modification of a presumption of service connection described in subsection 7a74 7#b7 ,outreach under paragraph 7#a7 shall include the following3 7,a7 ,the ,secretary shall publish on the internet website of the ,department a notice that such veterans may elect to file a supplemental claim4 7,b7 ,the ,secretary shall notify1 in writing or by electronic means1 veterans service organizations of the ability of such veterans to file a supplemental claim4 7,c7 ,the ,secretary shall contact each claimant identified under subsection 7a7 in the same manner that the ,department last provided notice of a decision4 4 7b7 ,application ,section #aafg of title #ch1 ,united ,states ,code1 as added by subsection 7a71 shall apply with respect to presumptions of service connection established or modified on or after the date of the enactment of this ,act1 including pursuant to amendments made by this ,act4 7c7 ,rule of construction ,nothing in this section shall be construed as-- 7#a7 modifying the obligations of the ,department of ,veterans ,affairs under ,federal court decisions or settlements in effect as of the date of the enactment of this ,act2 or 7#b7 requiring a retroactively applied effective date of a supplemental claim earlier than the date a presumption of service connection is established or modified4 #bjd4 ,reevaluation of claims for dependency and indemnity compensation involving presumptions of service connection 7a7 ,in general ,subchapter ,i of chapter #ac is amended by adding at the end the following new section3 #acje4 ,reevaluation of dependency and indemnity compensation determinations pursuant to changes in presumptions of service connection 7a7 ,reevaluation ,whenever a law1 including through a regulation or ,federal court decision or settlement1 establishes or modifies a presumption of service connection1 the ,secretary shall-- 7#a7 identify all claims for dependency and indemnity compensation under this chapter that-- 7,a7 were submitted to the ,secretary2 7,b7 were evaluated and denied by the ,secretary before the date on which such provision of law went into effect2 and 7,c7 might have been evaluated differently had the establishment or modification been applicable to the claim2 7#b7 allow for the reevaluation of such claims at the election of the claimant2 and 7#c7 notwithstanding section #eaaj of this title1 with respect to claims approved pursuant to such reevaluation1 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 7#a74 7b7 ,outreach 7#a7 ,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 7a74 7#b7 ,outreach under paragraph 7#a7 shall include the following3 7,a7 ,the ,secretary shall publish on the internet website of the ,department a notice that such claimants may elect to have a claim so reevaluated4 7,b7 ,the ,secretary shall notify1 in writing or by electronic means1 veterans service organizations of the ability of such claimants to elect to have a claim so reevaluated4 7,c7 ,the ,secretary shall contact each claimant identified under subsection 7a7 in the same manner that the ,department last provided notice of a decision4 4 7b7 ,application ,section #acje of title #ch1 ,united ,states ,code1 as added by subsection 7a71 shall apply with respect to presumptions of service connection established or modified on or after the date of the enactment of this ,act1 including pursuant to amendments made by this ,act4 7c7 ,rule of construction ,nothing in this section shall be construed as modifying the obligations of the ,department of ,veterans ,affairs under ,federal court decisions or settlements in effect as of the date of the enactment of this ,act4 ,,iii ,improving the establishment of service connection process for toxic-exposed veterans #cja4 ,short title ,this title may be cited as the ,veterans ,burn ,pits ,exposure ,recognition ,act of #bjbb4 #cjb4 ,presumptions of toxic exposure ,subchapter ,,ii of chapter #aa is amended by adding at the end the following new section3 #aaai4 ,presumptions of toxic exposure 7a7 ,consideration of records ,if a veteran submits to the ,secretary a claim for compensation for a service-connected disability under section #aaaj of this title with evidence of a disability and a toxic exposure that occurred during active military1 naval1 air1 or space service1 the ,secretary may1 in adjudicating such claim1 consider-- 7#a7 any record of the veteran in an exposure tracking record system2 and 7#b7 if no record of the veteran in an exposure tracking record system indicates that the veteran was subject to a toxic exposure during active military1 naval1 air1 or space service1 the totality of the circumstances of the service of the veteran4 7b7 ,presumption of specific toxic exposure for members who served in certain locations 7#a7 ,the ,secretary shall1 for purposes of section #aaaj and chapter #ag of this title1 presume that any covered veteran was exposed to the substances1 chemicals1 and airborne hazards identified in the list under paragraph 7#b7 during the service of the covered veteran specified in subsection 7c77#a71 unless there is affirmative evidence to establish that the covered veteran was not exposed to any such substances1 chemicals1 or hazards in connection with such service4 7#b7 ,the ,secretary shall-- 7,a7 establish and maintain a list that contains an identification of one or more such substances1 chemicals1 and airborne hazards as the ,secretary1 in collaboration with the ,secretary of ,defense1 may determine appropriate for purposes of this section2 and 7,b7 determine1 using procedures consistent with section #aagb of this title and through the conduct of a formal evaluation under section #aagc of this title1 whether to establish an end date for a covered veteran to qualify for presumptions of exposure under this section1 if appropriate1 but in no case establish an end date earlier than the last day of the period specified in section #aja7cc7 for the ,persian ,gulf ,war4 7#c7 ,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 #bjbb1 and not less frequently than once every two years thereafter1 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 7#b7 during the period covered by the report4 7c7 ,definitions ,in this section3 7#a7 ,the term covered veteran means any veteran who-- 7,a7 on or after ,august #b1 #aiij1 performed active military1 naval1 air1 or space service while assigned to a duty station in1 including airspace above-- 7i7 ,bahrain2 7ii7 ,iraq2 7iii7 ,kuwait2 7iv7 ,oman2 7v7 ,qatar2 7vi7 ,saudi ,arabia2 7vii7 ,somalia2 or 7viii7 ,united ,arab ,emirates2 or 7,b7 on or after ,september #aa1 #bjja1 performed active military1 naval1 air1 or space service while assigned to a duty station in1 including airspace above-- 7i7 ,afghanistan2 7ii7 ,djibouti2 7iii7 ,egypt2 7iv7 ,jordan2 7v7 ,lebanon2 7vi7 ,syria2 7vii7 ,yemen2 7viii7 ,uzbekistan2 or 7ix7 any other country determined relevant by the ,secretary4 7#b7 ,the term exposure tracking record system-- 7,a7 means any system1 program1 or pilot program used by the ,secretary of ,veterans ,affairs or the ,secretary of ,defense to track how veterans or members of the ,armed ,forces have been exposed to various occupational or environmental hazards2 and 7,b7 includes the ,individual ,longitudinal ,exposure ,record1 or successor system4 7#c7 ,the term toxic exposure risk activity has the meaning given such term in section #agaj7;e77#d7 of this title4 4 #cjc4 ,medical nexus examinations for toxic exposure risk activities ,subchapter ,,vi of chapter #aa1 as amended by section #bjc1 is further amended by adding at the end the following new section3 #aafh4 ,medical nexus examinations for toxic exposure risk activities 7a7 ,medical examinations and medical opinions 7#a7 ,except as provided in subsection 7b71 if a veteran submits to the ,secretary a claim for compensation for a service-connected disability under section #aaaj of this title with evidence of a disability and evidence of participation in a toxic exposure risk activity during active military1 naval1 air1 or space service1 and such evidence is not sufficient to establish a service connection for the disability1 the ,secretary shall-- 7,a7 provide the veteran with a medical examination under section #eajc;,a7d7 of this title2 and 7,b7 obtain a medical opinion 7to be requested by the ,secretary in connection with the medical examination under subparagraph 7,a77 as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity4 7#b7 ,when providing the ,secretary with a medical opinion under paragraph 7#a77;,b7 for a veteran1 the health care provider shall consider-- 7,a7 the total potential exposure through all applicable military deployments of the veteran2 and 7,b7 the synergistic1 combined effect of all toxic exposure risk activities of the veteran4 7#c7 ,the requirement under paragraph 7#b77;,b7 shall not be construed as requiring a health care provider to consider the synergistic1 combined effect of each of the substances1 chemicals1 and airborne hazards identified in the list under section #aaai7;b77#b7 of this title4 7b7 ,exception ,subsection 7a7 shall not apply if the ,secretary determines there is no indication of an association between the disability claimed by the veteran and the toxic exposure risk activity for which the veteran submitted evidence4 7c7 ,toxic exposure risk activity defined ,in this section1 the term toxic exposure risk activity has the meaning given that term in section #agaj7;e77#d7 of this title4 4 ,,iv ,presumptions of service connection #dja4 ,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 7a7 ,short title ,this section may be cited as the ,mark ,takai ,atomic ,veterans ,healthcare ,parity ,act of #bjbb4 7b7 ,enewetak ,atoll ,section #aaab7;c77#c77;,b7 is amended by adding at the end the following new clause3 7v7 ,cleanup of ,enewetak ,atoll during the period beginning on ,january #a1 #aigg1 and ending on ,december #ca1 #aihj4 4 #djb4 ,treatment of veterans who participated in nuclear response near ,palomares1 ,spain1 or ,thule1 ,greenland1 as radiation-exposed veterans for purposes of presumption of service connection of certain disabilities by ,department of ,veterans ,affairs 7a7 ,short title ,this section may be cited as the ,palomares or ,thule ,veterans ,act of #bjbb4 7b7 ,palomares or ,thule ,section #aaab7;c77#c77;,b71 as amended by section #dja1 is further amended by adding at the end the following new clauses3 7vi7 ,onsite participation in the response effort following the collision of a ,united ,states ,air ,force ,b-#eb bomber and refueling plane that caused the release of four thermonuclear weapons in the vicinity of ,palomares1 ,spain1 during the period beginning ,january #ag1 #aiff1 and ending ,march #ca1 #aifg4 7vii7 ,onsite participation in the response effort following the on-board fire and crash of a ,united ,states ,air ,force ,b-#eb bomber that caused the release of four thermonuclear weapons in the vicinity of ,thule ,air ,force ,base1 ,greenland1 during the period beginning ,january #ba1 #aifh1 and ending ,september #be1 #aifh4 4 #djc4 ,presumptions of service connection for diseases associated with exposures to certain herbicide agents for veterans who served in certain locations 7a7 ,short title ,this section may be cited as the ,veterans ,agent ,orange ,exposure ,equity ,act of #bjbb4 7b7 ,in general ,section #aaaf1 as amended by section #bjb1 is further amended-- 7#a7 by striking 1 during active military1 naval1 air1 or space service1 served in the ,republic of ,vietnam during the period beginning on ,january #i1 #aifb1 and ending on ,may #g1 #aige each place it appears and inserting performed covered service2 7#b7 by striking performed active military1 naval1 air1 or space service in the ,republic of ,vietnam during the period beginning on ,january #i1 #aifb1 and ending on ,may #g1 #aige each place it appears and inserting performed covered service2 and 7#c7 by adding at the end the following new subsection3 7d7 ,in this section1 the term covered service means active military1 naval1 air1 or space service-- 7#a7 performed in the ,republic of ,vietnam during the period beginning on ,january #i1 #aifb1 and ending on ,may #g1 #aige2 7#b7 performed in ,thailand at any ,united ,states or ,royal ,thai base during the period beginning on ,january #i1 #aifb1 and ending on ,june #cj1 #aigf1 without regard to where on the base the veteran was located or what military job specialty the veteran performed2 7#c7 performed in ,laos during the period beginning on ,december #a1 #aife1 and ending on ,september #cj1 #aifi2 7#d7 performed in ,cambodia at ,mimot or ,krek1 ,kampong ,cham ,province during the period beginning on ,april #af1 #aifi1 and ending on ,april #cj1 #aifi2 or 7#e7 performed on ,guam or ,american ,samoa1 or in the territorial waters thereof1 during the period beginning on ,january #i1 #aifb1 and ending on ,july #ca1 #aihj1 or served on ,johnston ,atoll or on a ship that called at ,johnston ,atoll during the period beginning on ,january #a1 #aigb1 and ending on ,september #cj1 #aigg4 4 7c7 ,eligibility for hospital care and medical services ,section #agaj7;e77#d71 as amended by section #ajb7;c71 is further amended by striking subparagraph 7,a7 and inserting the following new subparagraph3 7,a7 ,the term ,vietnam-era herbicide-exposed veteran means a veteran who-- 7i7 performed covered service1 as defined in section #aaaf7;d7 of this title2 or 7ii7 the ,secretary finds may have been exposed during active military1 naval1 air1 or space service to dioxin during the ,vietnam era1 regardless of the geographic area of such service1 or was exposed during such service to a toxic substance found in a herbicide or defoliant used for military purposes during such era1 regardless of the geographic area of such service4 4 7d7 ,conforming amendment ,the heading for section #aaaf is amended by striking the ,republic of ,vietnam and inserting certain locations4 7e7 ,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 follows3 7#a7 ,on the date of the enactment of this ,act for claimants for dependency and indemnity compensation under chapter #ac of title #ch1 ,united ,states ,code1 and for veterans whom the ,secretary of ,veterans ,affairs determines are-- 7,a7 terminally ill2 7,b7 homeless2 7,c7 under extreme financial hardship2 7,d7 more than #he years old2 or 7,e7 capable of demonstrating other sufficient cause4 7#b7 ,on ,october #a1 #bjbb1 for everyone not described in paragraph 7#a74 #djd4 ,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 7a7 ,short title ,this section may be cited as the ,fair ,care for ,vietnam ,veterans ,act of #bjbb4 7b7 ,monoclonal gammopathy of undetermined significance ,section #aaaf7;a77#b7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subparagraph3 7,l7 ,monoclonal gammopathy of undetermined significance4 4 7c7 ,hypertension ,such section1 as amended by subsection 7b71 is further amended by adding at the end the following new subparagraph3 7,m7 ,hypertension4 4 7d7 ,effective dates and applicability 7#a7 ,monoclonal gammopathy of undetermined significance 7,a7 ,in general ,the amendment made by subsection 7b7 shall take effect on the date of the enactment of this ,act and shall apply as follows3 7i7 ,on the date of the enactment of this ,act for claimants for dependency and indemnity compensation under chapter #ac of title #ch1 ,united ,states ,code1 and for veterans whom the ,secretary of ,veterans ,affairs determines are-- 7,i7 terminally ill2 7,,ii7 homeless2 7,,iii7 under extreme financial hardship2 7,,iv7 more than #he years old2 or 7,v7 capable of demonstrating other sufficient cause4 7ii7 ,on ,october #a1 #bjbb1 for everyone not described in clause 7i74 7,b7 ,retroactive application ,notwithstanding any ,federal court decisions or settlements in effect on the day before the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall award retroactive claims for a condition under section #aaaf7;a77#b77,l7 of title #ch1 ,united ,states ,code1 as added by subsection 7b7 of this section1 only to claimants for dependency and indemnity compensation under chapter #ac of such title described in subparagraph 7,a77i7 of this paragraph4 7#b7 ,hypertension 7,a7 ,in general ,the amendment made by subsection 7c7 shall take effect on the date of the enactment of this ,act and shall apply as follows3 7i7 ,on the date of the enactment of this ,act for claimants for dependency and indemnity compensation under chapter #ac of title #ch1 ,united ,states ,code1 and for veterans whom the ,secretary of ,veterans ,affairs determines are-- 7,i7 terminally ill2 7,,ii7 homeless2 7,,iii7 under extreme financial hardship2 7,,iv7 more than #he years old2 or 7,v7 capable of demonstrating other sufficient cause4 7ii7 ,on ,october #a1 #bjbf1 for everyone not described in subparagraph 7,a74 7,b7 ,retroactive application ,notwithstanding any ,federal court decisions or settlements in effect on the day before the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall award retroactive claims for a condition under section #aaaf7;a77#b77,m7 of title #ch1 ,united ,states ,code1 as added by subsection 7c7 of this section1 only to claimants for dependency and indemnity compensation under chapter #ac of such title described in subparagraph 7,a77i7 of this paragraph4 #dje4 ,improving compensation for disabilities occurring in ,persian ,gulf ,war veterans 7a7 ,reduction in threshold of eligibility ,subsection 7a77#a7 of section #aaag 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 time44 7b7 ,permanent extension of period of eligibility ,such section is further amended-- 7#a7 by striking subsection 7b72 7#b7 by redesignating subsections 7c7 and 7d7 as subsections 7b7 and 7c71 respectively2 and 7#c7 in subsection 7a77#b77;,c71 by striking under subsection 7d7 and inserting under subsection 7c74 7c7 ,establishing singular disability-based questionnaire ,such section is further amended by inserting after subsection 7c7 7as redesignated by subsection 7b77 the following new subsection 7d73 7d7 ,if a ,persian ,gulf veteran at a medical facility of the ,department presents with any one symptom associated with ,gulf ,war ,illness1 the ,secretary shall ensure that health care personnel of the ,department use a disability benefits questionnaire1 or successor questionnaire1 designed to identify ,gulf ,war ,illness1 in addition to any other diagnostic actions the personnel determine appropriate4 4 7d7 ,expansion of definition of ,persian ,gulf veteran ,subsection 7f7 of such section is amended by inserting 1 ,afghanistan1 ,israel1 ,egypt1 ,turkey1 ,syria1 or ,jordan1 after operations4 7e7 ,training ,such section is further amended by adding at the end the following new subsection3 7i7 7#a7 ,the ,secretary shall take such actions as may be necessary to ensure that health care personnel of the ,department are appropriately trained to effectively carry out this section4 7#b7 ,not less frequently than once each year1 the ,secretary shall submit to ,congress a report on the actions taken by the ,secretary to carry out paragraph 7#a74 4 #djf4 ,presumption of service connection for certain diseases associated with exposure to burn pits and other toxins 7a7 ,short title ,this section may be cited as the ,presumptive ,benefits for ,war ,fighters ,exposed to ,burn ,pits and ,other ,toxins ,act of #bjbb4 7b7 ,in general ,subchapter ,,ii of chapter #aa1 as amended by section #cjb1 is further amended by inserting after section #aaai the following new section3 #aabj4 ,presumption of service connection for certain diseases associated with exposure to burn pits and other toxins 7a7 ,presumption of service connection ,for the purposes of section #aaaj of this title1 and subject to section #aaac of this title1 a disease specified in subsection 7b7 becoming manifest in a covered veteran shall be considered to have been incurred in or aggravated during active military1 naval1 air1 or space service1 notwithstanding that there is no record of evidence of such disease during the period of such service4 7b7 ,diseases specified ,the diseases specified in this subsection are the following3 7#a7 ,asthma that was diagnosed after service of the covered veteran as specified in subsection 7c74 7#b7 ,the following types of cancer3 7,a7 ,head cancer of any type4 7,b7 ,neck cancer of any type4 7,c7 ,respiratory cancer of any type4 7,d7 ,gastrointestinal cancer of any type4 7,e7 ,reproductive cancer of any type4 7,f7 ,lymphoma cancer of any type4 7,g7 ,lymphomatic cancer of any type4 7,h7 ,kidney cancer4 7,i7 ,brain cancer4 7,j7 ,melanoma4 7,k7 ,pancreatic cancer4 7#c7 ,chronic bronchitis4 7#d7 ,chronic obstructive pulmonary disease4 7#e7 ,constrictive bronchiolitis or obliterative bronchiolitis4 7#f7 ,emphysema4 7#g7 ,granulomatous disease4 7#h7 ,interstitial lung disease4 7#i7 ,pleuritis4 7#aj7 ,pulmonary fibrosis4 7#aa7 ,sarcoidosis4 7#ab7 ,chronic sinusitis4 7#ac7 ,chronic rhinitis4 7#ad7 ,glioblastoma4 7#ae7 ,any other disease for which the ,secretary determines1 pursuant to regulations prescribed under subchapter ,,vii that a presumption of service connection is warranted based on a positive association with a substance1 chemical1 or airborne hazard identified in the list under section #aaai7;b77#b7 of this title4 7c7 ,covered veteran defined ,in this section1 the term covered veteran has the meaning given that term in section #aaai7;c7 of this title4 4 7c7 ,conforming amendment ,section #aaac is amended by striking or #aaah each place it appears and inserting #aaah1 or #aabj4 7d7 ,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 follows3 7#a7 ,on the date of the enactment of this ,act for claimants for dependency and indemnity compensation under chapter #ac of title #ch1 ,united ,states ,code1 and veterans whom the ,secretary of ,veterans ,affairs determines are-- 7,a7 terminally ill2 7,b7 homeless2 7,c7 under extreme financial hardship2 7,d7 more than #he years old2 or 7,e7 capable of demonstrating other sufficient cause4 7#b7 ,on the date of the enactment of this ,act for everyone not described in paragraph 7#a71 with respect to paragraphs 7#a71 7#b77;,c71 7#b77;,i71 7#e71 7#f71 7#g71 7#h71 7#i71 7#aj71 7#aa71 7#ab71 7#ac71 and 7#ad71 of section #aabj7;b7 of title #ch1 ,united ,states ,code1 as added by subsection 7b74 7#c7 ,on ,october #a1 #bjbc1 for everyone not described in paragraph 7#a71 with respect to paragraphs 7#c7 and 7#d7 of section #aabj7;b7 of such title1 as so added4 7#d7 ,on ,october #a1 #bjbd1 for everyone not described in paragraph 7#a71 with respect to subparagraphs 7,a71 7,b71 7,d71 7,e71 7,f71 7,g71 and 7,k7 of section #aabj7;b77#b7 of such title1 as so added4 7#e7 ,on ,october #a1 #bjbe1 for everyone not described in paragraph 7#a71 with respect to subparagraphs 7,h7 and 7,j7 of section #aabj7;b77#b7 of such title1 as so added4 #djg4 ,rule of construction 7a7 ,generally ,nothing in this ,act shall be construed to prevent the ,secretary of ,veterans ,affairs from processing claims for benefits under title #ch1 ,united ,states ,code1 for a condition or disease for which this ,act establishes a presumption of service connection1 as a claim for benefits for a condition or disease with direct service connection4 7b7 ,effective dates and applicability ,the ,secretary shall not deny a claim for benefits under title #ch1 ,united ,states ,code1 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 disease4 ,v ,research matters #eja4 ,interagency working group on toxic exposure research 7a7 ,establishment 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall1 in collaboration with the heads of the entities described in paragraph 7#b71 establish the ,toxic ,exposure ,research ,working ,group 7in this section referred to as the ,working ,group74 7#b7 ,composition ,the ,working ,group shall consist of employees1 selected by the ,secretary1 of the following3 7,a7 ,the ,department of ,veterans ,affairs4 7,b7 ,the ,department of ,defense4 7,c7 ,the ,department of ,health and ,human ,services4 7,d7 ,the ,environmental ,protection ,agency4 7,e7 ,other entities of the ,federal ,government involved in research activities regarding the health consequences of toxic exposures experienced during active military1 naval1 air1 or space service4 7b7 ,functions ,the ,working ,group shall perform the following functions3 7#a7 ,identify collaborative research activities and resources available among entities represented by members of the ,working ,group to conduct such collaborative research activities4 7#b7 ,develop a five-year strategic plan for such entities to carry out collaborative research activities4 7c7 ,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 following3 7#a7 ,not later than one year after the date of the enactment of this ,act1 a report on the establishment of the ,working ,group under subsection 7a74 7#b7 ,not later than two years after the date of the enactment of this ,act1 a report containing the collaborative research activities identified1 and the strategic plan developed1 by the ,working ,group under subsection 7b74 7#c7 ,not less frequently than annually during the five-year period covered by the strategic plan under subsection 7b71 a progress report on implementation of the strategic plan4 7d7 ,termination ,the ,working ,group shall terminate after submitting the final report under subsection 7c74 7e7 ,definitions ,in this section3 7#a7 ,active military1 naval1 air1 or space service ,the term active military1 naval1 air1 or space service has the meaning given that term in section #aja of title #ch1 ,united ,states ,code4 7#b7 ,collaborative research activity ,the term collaborative research activity means a research activity-- 7,a7 agreed upon by the ,working ,group2 7,b7 conducted by an entity represented by a member of the ,working ,group2 7,c7 funded by the ,federal ,government2 and 7,d7 regarding the health consequences of toxic exposures experienced during active military1 naval1 air1 or space service4 7#c7 ,toxic exposure ,the term toxic exposure has the meaning given such term in section #aja of title #ch1 ,united ,states ,code1 as amended by section #ajb7;b74 #ejb4 ,analysis and report on treatment of veterans for medical conditions related to toxic exposure 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall analyze1 on a continuous basis1 all clinical data that-- 7#a7 is obtained by the ,department of ,veterans ,affairs in connection with hospital care1 medical services1 and nursing home care furnished under section #agaj7;a77#b77;,f7 of title #ch1 ,united ,states ,code2 and 7#b7 is likely to be scientifically useful in determining the association1 if any1 between the medical condition of a veteran and a toxic exposure4 7b7 ,annual report ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 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 following3 7#a7 ,the aggregate data compiled under subsection 7a74 7#b7 ,an analysis of such data4 7#c7 ,a description of the types and incidences of medical conditions identified by the ,department under such subsection4 7#d7 ,the explanation of the ,secretary for the incidence of such medical conditions and other explanations for the incidence of such conditions as the ,secretary considers reasonable4 7#e7 ,the views of the ,secretary on the scientific validity of drawing conclusions from the incidence of such medical conditions1 as evidenced by the data compiled under subsection 7a71 regarding any association between such conditions and toxic exposures4 7c7 ,toxic exposure defined ,in this section1 the term toxic exposure has the meaning given such term in section #aja of title #ch1 ,united ,states ,code1 as amended by section #ajb7;b74 #ejc4 ,analysis relating to mortality of veterans who served in ,southwest ,asia 7a7 ,analysis 7#a7 ,in general ,not later than #bgj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in coordination with the ,secretary of ,defense1 shall conduct an updated analysis of total and respiratory disease mortality in covered veterans4 7#b7 ,elements ,the analysis required by paragraph 7#a7 shall include1 to the extent practicable1 the following with respect to each covered veteran3 7,a7 ,metrics of airborne exposures4 7,b7 ,the location and timing of deployments of the veteran4 7,c7 ,the military occupational specialty of the veteran4 7,d7 ,the ,armed ,force in which the veteran served4 7,e7 ,pre-existing health status of the veteran1 including with respect to asthma4 7,f7 ,relevant personal information of the veteran1 including cigarette and e-cigarette smoking history1 diet1 sex1 gender1 age1 race1 and ethnicity4 7b7 ,covered veteran defined ,in this section1 the term covered veteran means any veteran who-- 7#a7 on or after ,august #b1 #aiij1 served on active duty in-- 7,a7 ,bahrain2 7,b7 ,iraq2 7,c7 ,kuwait2 7,d7 ,oman2 7,e7 ,qatar2 7,f7 ,saudi ,arabia2 7,g7 ,somalia2 or 7,h7 the ,united ,arab ,emirates2 or 7#b7 on or after ,september #aa1 #bjja1 served on active duty in-- 7,a7 ,afghanistan2 7,b7 ,djibouti2 7,c7 ,egypt2 7,d7 ,jordan2 7,e7 ,lebanon2 7,f7 ,syria2 or 7,g7 ,yemen4 #ejd4 ,study on health trends of post-#i_/aa 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 #aa1 #bjja4 #eje4 ,study on cancer rates among veterans 7a7 ,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 veterans4 7b7 ,elements ,the study required by subsection 7a7 shall assess1 with respect to each veteran included in the study1 the following3 7#a7 ,the age of the veteran4 7#b7 ,the period of service and length of service of the veteran in the ,armed ,forces4 7#c7 ,the military occupational specialty or specialties of the veteran4 7#d7 ,the sex of the veteran4 7#e7 ,the type or types of cancer that the veteran has4 #ejf4 ,study on health effects of waste related to ,manhattan ,project on certain veterans 7a7 ,study ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine for the conduct of a study on the health trends of veterans who1 while serving in the active military1 naval1 air1 or space service-- 7#a7 participated in activities relating to the ,manhattan ,project 7including activities relating to covered waste7 in connection with such service2 or 7#b7 resided at or near1 as determined by the ,secretary1 the locations described in subsection 7b74 7b7 ,covered locations ,the locations described in this subsection are the following locations3 7#a7 ,in the county of ,st4 ,louis1 ,missouri1 the following3 7,a7 ,coldwater ,creek1 ,missouri4 7,b7 ,the ,st4 ,louis ,airport ,site1 ,missouri4 7,c7 ,the ,west ,lake ,landfill4 7#b7 ,oak ,ridge1 ,tennessee4 7#c7 ,hanford1 ,washington4 7#d7 ,any other location that is proximate to covered waste1 as determined by the ,secretary4 7c7 ,elements ,the study under subsection 7a7 shall assess1 with respect to each veteran included in the study1 the following3 7#a7 ,the age1 sex1 and race of the veteran4 7#b7 ,the period and location of exposure to covered waste4 7#c7 ,any type of cancer1 or other illness associated with toxic exposure1 that the veteran has4 7#d7 ,a comparison of the overall health condition of the veteran1 including any illness of the veteran identified pursuant to paragraph 7#c71 with the overall health condition of past and present civilian populations residing at the same location of exposure1 as determined by the ,secretary4 7d7 ,report ,not later than three years after the date of the enactment of this ,act1 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 7a7 and include in such report an analysis of the data available and data reliability4 7e7 ,definitions ,in this section3 7#a7 ,active military1 naval1 air1 or space service2 toxic exposure ,the terms active military1 naval1 air1 or space service and toxic exposure have the meanings given those terms in section #aja of title #ch1 ,united ,states ,code1 as added by section #ajb7;b74 7#b7 ,covered waste ,the term covered waste means any waste arising from activities carried out in connection with the ,manhattan ,project4 7#c7 ,illness ,the term illness has the meaning given that term in section #aaga of title #ch1 ,united ,states ,code1 as added by section #bjb4 7#d7 ,toxic exposure ,the term toxic exposure has the meaning given such term in section #aja of title #ch1 ,united ,states ,code1 as amended by section #ajb7;b74 #ejg4 ,study on toxic exposure and mental health outcomes 7a7 ,study required ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 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 conditions1 including chronic multisymptom illness1 traumatic brain injury1 post-traumatic stress disorder1 depression1 episodes of psychosis1 schizophrenia1 bipolar disorder1 suicide attempts1 and suicide deaths4 7b7 ,elements ,for each veteran included in the study under subsection 7a71 the following information shall be collected and assessed3 7#a7 ,age4 7#b7 ,sex4 7#c7 ,race and ethnicity4 7#d7 ,period and length of service in the ,armed ,forces4 7#e7 ,the military occupational specialty or specialties of the veteran4 7#f7 ,history of toxic exposure during service in the ,armed ,forces4 7#g7 ,any diagnosis of chronic multisymptom illness4 7#h7 ,any diagnosis of a mental health or cognitive disorder4 7#i7 ,any history of suicide attempt or suicidality4 7#aj7 ,if the veteran died by suicide4 7#aa7 ,any confounding traumatic experiences that could affect a veteran's mental health4 7c7 ,report ,not later than three years after the date of the enactment of this ,act1 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 ,sciences1 ,engineering1 and ,medicine with respect to the study conducted under subsection 7a74 #ejh4 ,study on veterans in ,territories of the ,united ,states 7a7 ,,gao study 7#a7 ,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 ,states1 including deficits in the availability and accessibility of such benefits and services compared to veterans elsewhere in the ,united ,states4 7#b7 ,elements ,the study under paragraph 7#a7 shall include-- 7,a7 the number of veterans in each ,territory and ,freely ,associated ,state of the ,united ,states2 7,b7 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 #agje7;a7 of title #ch1 ,united ,states ,code2 7,c7 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 #agaj of such title but who are not enrolled as described in subparagraph 7,b72 7,d7 a detailed description of obstacles facing veterans in each ,territory and ,freely ,associated ,state in accessing health care services1 including those involving the availability of such services to veterans in the ,territory or ,freely ,associated ,state in which the veterans reside1 and any distance impediments to receiving services at a regional medical center of the ,veterans ,health ,administration1 a community-based outpatient clinic1 another full-service medical facility of the ,department1 or a ,vet ,center1 respectively2 7,e7 a detailed description of obstacles facing veterans in each ,territory and ,freely ,associated ,state in accessing readjustment counseling services1 including those involving the availability of such services to veterans in the ,territory in which the veterans reside1 and any distance impediments to receiving services at a readjustment counseling services center of the ,department2 7,f7 a detailed description of obstacles facing veterans in each ,territory and ,freely ,associated ,state in accessing non-health care veterans benefits1 including those involving the availability of benefits and services to veterans in the ,territory or ,freely ,associated ,state in which the veterans reside1 and any distance impediments to accessing the nearest office of the ,veterans ,benefits ,administration2 7,g7 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 ,states1 including the availability of the full- and part-time staff of each office to the veterans they are charged with serving2 7,h7 an analysis of the availability of the ,veterans ,community ,care ,program established under section #agjc of title #ch1 ,united ,states ,code1 to veterans in each ,territory and ,freely ,associated ,state2 7,i7 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 ,department2 7,j7 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 #d1 #bjag2 and 7,k7 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 ,secretary1 and reducing barriers and deficits in the availability and accessibility of such benefits and services compared to veterans elsewhere in the ,united ,states4 7b7 ,briefing ,not later than one year after the date of the enactment of this ,act1 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 7a71 including any recommendations developed under paragraph 7#b77,k7 of such subsection4 7c7 ,definitions ,in this section3 7#a7 ,freely ,associated ,state ,the term ,freely ,associated ,state includes the ,federated ,states of ,micronesia1 the ,republic of the ,marshall ,islands1 and the ,republic of ,palau4 7#b7 ,territory ,the term ,territory includes ,american ,samoa1 the ,commonwealth of the ,northern ,marianas ,islands1 ,guam1 ,puerto ,rico1 and the ,virgin ,islands4 7#c7 ,vet ,center ,the term ,vet ,center has the meaning given that term in section #agab;,a7h7 of title #ch1 ,united ,states ,code4 #eji4 ,department of ,veterans ,affairs public website for toxic exposure research 7a7 ,website ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish1 and maintain thereafter1 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 ,government4 7b7 ,coordination ,in carrying out subsection 7a71 the ,secretary shall coordinate with-- 7#a7 the heads of each ,federal agency carrying out or funding toxic exposure research2 7#b7 the ,war ,related ,illness and ,injury ,study ,center of the ,department of ,veterans ,affairs1 or successor center2 and 7#c7 any working group of the ,department of ,veterans ,affairs or other similar entity responsible for coordinating toxic exposure research4 7c7 ,definitions ,in this section3 7#a7 ,toxic exposure ,the term toxic exposure has the meaning given that term in section #aja of title #ch1 ,united ,states ,code1 as added by section #ajb7;b74 7#b7 ,toxic exposure research ,the term toxic exposure research means research on the health consequences of toxic exposures experienced during service in the ,armed ,forces4 #eaj4 ,report on health effects of jet fuels used by ,armed ,forces 7a7 ,initial report ,not later than one year after the date of the enactment of this ,act1 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 ,representatives1 and make publicly available1 a report on health effects of jet fuels used by the ,armed ,forces4 7b7 ,contents ,the report submitted under subsection 7a7 shall include the following3 7#a7 ,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 exposure4 7#b7 ,an identification of the immediate symptoms of jet fuel exposure that may indicate future health risks4 7#c7 ,a chronology of health safeguards implemented by the ,armed ,forces intended to reduce the exposure of members of the ,armed ,forces to jet fuel4 7#d7 ,an identification of any areas relating to jet fuel exposure about which new research needs to be conducted4 7c7 ,follow-up report ,not later than five years after the date of the submittal of the report under subsection 7a71 the ,secretary shall submit to the committees referred to in such subsection an update to such report4 ,,vi ,improvement of resources and training regarding toxic-exposed veterans #fja4 ,short title2 definitions 7a7 ,short title ,this title may be cited as the ,fairly ,assessing ,service-related ,toxic ,exposure ,residuals ,presumptions ,act of #bjbb or the ,,faster ,presumption ,act of #bjbb4 7b7 ,definitions ,in this title1 the terms active military1 naval1 air1 or space service1 toxic exposure1 and toxic-exposed veteran have the meanings given those terms in section #aja of title #ch1 ,united ,states ,code1 as amended by section #ajb4 #fjb4 ,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 7a7 ,publication of list of resources 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs shall publish a list of resources of the ,department of ,veterans ,affairs for-- 7,a7 toxic-exposed veterans and veterans who report toxic exposure2 7,b7 families and caregivers of such veterans2 and 7,c7 survivors of such veterans who are receiving death benefits under the laws administered by the ,secretary4 7#b7 ,update ,the ,secretary shall periodically update the list published under paragraph 7#a74 7b7 ,outreach ,the ,secretary shall develop1 with input from the community1 an informative outreach program for veterans on illnesses that may be related to toxic exposures1 including outreach with respect to benefits and support programs4 #fjc4 ,incorporation of toxic exposure screening for veterans 7a7 ,in general ,beginning not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall incorporate a screening to help determine potential toxic exposures during active military1 naval1 air1 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 #agje of title #ch1 ,united ,states ,code1 to improve understanding by the ,department of toxic exposures while serving in the ,armed ,forces4 7b7 ,timing ,the ,secretary shall ensure that a veteran described in subsection 7a7 completes the screening required under such subsection not less frequently than once every five years4 7c7 ,determination of questions 7#a7 ,in general ,the questions included in the screening required under subsection 7a7 shall be determined by the ,secretary with input from medical professionals4 7#b7 ,specific questions ,at a minimum1 the screening required under subsection 7a7 shall1 with respect to a veteran1 include-- 7,a7 a question about the potential exposure of the veteran to an open burn pit2 and 7,b7 a question regarding toxic exposures that are commonly associated with service in the ,armed ,forces4 7#c7 ,open burn pit defined ,in this subsection1 the term open burn pit means an area of land that-- 7,a7 is designated by the ,secretary of ,defense to be used for disposing solid waste by burning in the outdoor air2 and 7,b7 does not contain a commercially manufactured incinerator or other equipment specifically designed and manufactured for the burning of solid waste4 7d7 ,print material ,in developing the screening established under subsection 7a71 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 internet4 7e7 ,screening updates ,the ,secretary shall consider updates to the content of the screening required under subsection 7a7 not less frequently than biennially to ensure the screening contains the most current information4 #fjd4 ,training for personnel of the ,department of ,veterans ,affairs with respect to veterans who report toxic exposures 7a7 ,health care personnel ,the ,secretary of ,veterans ,affairs shall provide to health care personnel of the ,department of ,veterans ,affairs education and training to identify1 treat1 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 exposures4 7b7 ,benefits personnel 7#a7 ,in general ,the ,secretary shall incorporate a training program for processors of claims under the laws administered by the ,secretary who review claims for disability benefits relating to service-connected disabilities based on toxic exposures4 7#b7 ,annual training ,training provided to processors under paragraph 7#a7 shall be provided not less frequently than annually4 ,,vii ,resourcing #gja4 ,authority to use appropriations to enhance claims processing capacity and automation 7a7 ,authority ,the ,secretary of ,veterans ,affairs may use1 from amounts appropriated to the ,cost of ,war ,toxic ,exposures ,fund established by section #cbd of title #ch1 ,united ,states ,code1 as added by section #hje of this ,act1 such amounts as may be necessary to continue the modernization1 development1 and expansion of capabilities and capacity of information technology systems and infrastructure of the ,veterans ,benefits ,administration1 including for claims automation1 to support expected increased claims processing for newly eligible veterans pursuant to this ,act4 7b7 ,plan for modernization of ,veterans ,benefits ,administration information technology systems 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 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 ,administration4 ,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 following3 7,a7 ,an identification of any information system to be modernized or retired1 if applicable1 during the period covered by the plan4 7,b7 ,a description of how the ,secretary intends to incorporate the following principles into the modernization of such information systems3 7i7 ,the purpose of automation should be to increase the speed and accuracy of claims processing decisions4 7ii7 ,automation should be conducted in a manner that enhances the productivity of employees of the ,department of ,veterans ,affairs4 7iii7 ,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 files4 7iv7 ,to the greatest extent possible1 automation should be carried out by drawing from information in the possession of the ,department1 other ,government agencies1 and applicants for benefits4 7v7 ,automation of any claims analysis or determination process should not be end-to-end or lack intermediation4 7vi7 ,employees of the ,department should continue to make decisions with respect to the approval of claims and the granting of benefits4 7vii7 ,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 ,secretary2 or the duties of the ,secretary to assist and notify claimants4 7viii7 ,automation should be carried out while taking all necessary measures to protect the privacy of claimants and their personally identifiable information4 7ix7 ,automation of claims processing should not eliminate or reduce the workforce of the ,veterans ,benefits ,administration4 7,c7 ,an identification of targets1 for each fiscal year1 by which the ,secretary intends to complete the modernization of each information system or major component or functionality of such system identified under subparagraph 7,a74 7,d7 ,cost estimates for the modernization of each information system identified under paragraph 7,a7 for each fiscal year covered by the plan and in total4 7#b7 ,appropriate congressional committees ,in this section1 the term appropriate congressional committees means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,subcommittee on ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies of the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,subcommittee on ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies of the ,committee on ,appropriations of the ,house of ,representatives4 #gjb4 ,authorization of major medical facility leases of ,department of ,veterans ,affairs for fiscal year #bjbc 7a7 ,in general ,the ,secretary of ,veterans ,affairs may carry out the following major medical facility leases in fiscal year #bjbc3 7#a7 ,lease for an outpatient clinic in the vicinity of ,allentown1 ,pennsylvania1 in an estimated amount of #ca1hcb1jjj4 7#b7 ,lease for a facility for member services for the ,veterans ,health ,administration in the vicinity of ,atlanta1 ,georgia1 in an estimated amount of #bg1acd1jjj4 7#c7 ,lease for an outpatient clinic in the vicinity of ,baltimore1 ,maryland1 in an estimated amount of #dc1jda1jjj4 7#d7 ,lease for an outpatient clinic in the vicinity of ,baton ,rouge1 ,louisiana1 in an estimated amount of #bi1eej1jjj4 7#e7 ,lease for an outpatient clinic in the vicinity of ,beaufort1 ,south ,carolina1 in an estimated amount of #bd1bed1jjj4 7#f7 ,lease for an outpatient clinic in the vicinity of ,beaumont1 ,texas1 in an estimated amount of #ae1fcb1jjj4 7#g7 ,lease for an outpatient clinic in the vicinity of ,brainerd1 ,minnesota1 in an estimated amount of #ad1ffi1jjj4 7#h7 ,lease for a facility for research in the vicinity of ,buffalo1 ,new ,york1 in an estimated amount of #aa1ajf1jjj4 7#i7 ,lease for an outpatient clinic in the vicinity of ,clarksville1 ,tennessee1 in an estimated amount of #ge1ace1jjj4 7#aj7 ,lease of a facility for research in the vicinity of ,columbia1 ,missouri1 in an estimated amount of #bj1gbf1jjj4 7#aa7 ,lease for an outpatient clinic in the vicinity of ,cookeville1 ,tennessee1 in an estimated amount of #aj1ieh1jjj4 7#ab7 ,lease for a residential treatment facility in the vicinity of ,denver1 ,colorado1 in an estimated amount of #i1acc1jjj4 7#ac7 ,lease for an outpatient clinic in the vicinity of ,elizabethtown1 ,kentucky1 in an estimated amount of #af1fga1jjj4 7#ad7 ,lease for an outpatient clinic in the vicinity of ,farmington1 ,missouri1 in an estimated amount of #ag1idj1jjj4 7#ae7 ,lease for an outpatient clinic in the vicinity of ,hampton1 ,virginia1 in an estimated amount of #fc1jhe1jjj4 7#af7 ,lease for an outpatient clinic in the vicinity of ,jacksonville1 ,north ,carolina1 in an estimated amount of #fa1dej1jjj4 7#ag7 ,lease for an outpatient clinic in the vicinity of ,killeen1 ,texas1 in an estimated amount of #fa1jcj1jjj4 7#ah7 ,lease for an outpatient clinic in the vicinity of ,lawrence1 ,indiana1 in an estimated amount of #ae1haa1jjj4 7#ai7 ,lease for an outpatient clinic in the vicinity of ,lecanto1 ,florida1 in an estimated amount of #ae1cgc1jjj4 7#bj7 ,lease for an outpatient clinic in the vicinity of ,nashville1 ,tennessee1 in an estimated amount of #eh1jch1jjj4 7#ba7 ,lease for an outpatient clinic in the vicinity of ,north ,kansas ,city1 ,missouri1 in an estimated amount of #dj1jbg1jjj4 7#bb7 ,lease for an outpatient clinic in the vicinity of ,pflugerville1 ,texas1 in an estimated amount of #af1fed1jjj4 7#bc7 ,lease for an outpatient clinic in the vicinity of ,plano1 ,texas1 in an estimated amount of #cb1gif1jjj4 7#bd7 ,lease for an outpatient clinic in the vicinity of ,prince ,george's ,county1 ,maryland1 in an estimated amount of #ca1ged1jjj4 7#be7 ,lease for an outpatient clinic in the vicinity of ,rolla1 ,missouri1 in an estimated amount of #ba1ceb1jjj4 7#bf7 ,lease for an outpatient clinic in the vicinity of ,salt ,lake ,city1 ,utah1 in an estimated amount of #bi1dff1jjj4 7#bg7 ,lease for an outpatient clinic in the vicinity of ,sarasota1 ,florida1 in an estimated amount of #cf1eag1jjj4 7#bh7 ,lease for an outpatient clinic in the vicinity of ,springfield1 ,massachusetts1 in an estimated amount of #cj1iah1jjj4 7#bi7 ,lease for a community living center in the vicinity of ,tampa1 ,florida1 in an estimated amount of #ea1fhb1jjj4 7#cj7 ,lease for an outpatient clinic in the vicinity of ,the ,villages1 ,florida1 in an estimated amount of #dh1bfg1jjj4 7#ca7 ,lease for an outpatient clinic in the vicinity of ,tri-,cities1 ,washington1 in an estimated amount of #cf1acf1jjj4 7b7 ,treatment of authorizations ,the authorization of leases under subsection 7a7 shall be considered to be a specific authorization by law of the funds for such leases for purposes of section #hajd7;a77#b7 of title #ch1 ,united ,states ,code1 as in effect on the day before the date of the enactment of this ,act4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs for fiscal year #bjbc1 or the year in which funds are appropriated for the ,medical ,facilities account1 #iih1acg1jjj for the leases authorized in subsection 7a74 #gjc4 ,treatment of major medical facility leases of the ,department of ,veterans ,affairs 7a7 ,congressional approval of major medical facility leases ,paragraph 7#b7 of subsection 7a7 of section #hajd of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by striking ,no funds and inserting 7,a7 ,no funds2 7#b7 by striking or any major medical facility lease2 7#c7 by striking or lease2 and 7#d7 by adding at the end the following new subparagraph3 7,b7 ,no funds may be appropriated for any fiscal year1 and the ,secretary may not obligate or expend funds 7other than for advance planning and design71 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 lease4 4 7b7 ,modification of definition of major medical facility lease ,subparagraph 7,b7 of paragraph 7#c7 of such subsection is amended to read as follows3 7,b7 ,the term major medical facility lease-- 7i7 means a lease for space for use as a new medical facility approved through the ,general ,services ,administration under section #ccjg7;a7 of title #dj at an average annual rent equal to or greater than the appropriate dollar threshold described in such section1 which shall be subject to annual adjustment in accordance with section #ccjg7;h7 of such title2 and 7ii7 does not include a lease for space for use as a shared ,federal medical facility for which the ,department's estimated share of the lease costs does not exceed such dollar threshold4 4 7c7 ,separate prospectus requirement for major medical facility leases ,subsection 7b7 of such section is amended-- 7#a7 by striking paragraph 7#g72 7#b7 in paragraph 7#a71 by redesignating subparagraphs 7,a7 through 7,e7 as clauses 7i7 through 7v71 respectively2 7#c7 in paragraph 7#f71 by redesignating subparagraphs 7,a7 through 7,c7 as clauses 7i7 through 7iii71 respectively2 7#d7 by redesignating paragraphs 7#a7 through 7#f7 as subparagraphs 7,a7 through 7,f71 respectively2 7#e7 in the matter preceding subparagraph 7,a71 as redesignated by paragraph 7#d7-- 7,a7 by striking ,whenever the ,president and inserting 7#a7 ,whenever the ,president2 7,b7 by striking the ,congress and inserting ,congress2 and 7,c7 by striking or a major medical facility lease 7as defined in subsection 7a77#c77;b772 7#f7 in subparagraph 7,a71 as redesignated by paragraph 7#d71 by striking leased12 7#g7 in subparagraph 7,e71 as redesignated by paragraph 7#d7-- 7,a7 by striking or lease each place it appears2 and 7,b7 by striking or leases2 and 7#h7 by adding at the end the following new paragraph3 7#b7 ,whenever the ,president or the ,secretary submit to ,congress a request for the funding of a major medical facility lease 7as defined in subsection 7a77#c77;,b771 the ,secretary shall submit to each committee1 on the same day1 a prospectus of the proposed medical facility4 ,any such prospectus shall include the following3 7,a7 ,a description of the facility to be leased4 7,b7 ,an estimate of the cost to the ,federal ,government of the facility to be leased4 7,c7 ,an estimate of the energy performance of the proposed lease space1 to include a description of anticipated utilization of renewable energy1 energy efficient and climate resilient elements1 and related matters4 7,d7 ,current and projected workload and utilization data regarding the facility to be leased1 including information on projected changes in workload and utilization over a five-year period1 a ten-year period1 and a twenty-year period4 7,e7 ,a detailed analysis of how the lease is expected to comply with ,office of ,management and ,budget ,circular ,a-#aa and section #acda of title #ca 7commonly referred to as the ,anti-,deficiency ,act74 ,any such analysis shall include-- 7i7 an analysis of the classification of the lease as a lease purchase1 a capital lease1 or an operating lease as those terms are defined in ,office of ,management and ,budget ,circular ,a-#aa2 7ii7 an analysis of the obligation of budgetary resources associated with the lease2 and 7iii7 an analysis of the methodology used in determining the asset cost1 fair market value1 and cancellation costs of the lease4 4 7d7 ,interim leasing actions ,such section is further amended by adding at the end the following new subsection3 7i7 7#a7 ,notwithstanding subsection 7a77#b77;,b71 the ,secretary may carry out interim leasing actions as the ,secretary considers necessary for the following leases3 7,a7 ,major medical facility leases 7as defined in subsection 7a77#c77;,b77 approved pursuant to this section and for which a prospectus for a replacement lease has been submitted to ,congress pursuant to subsection 7b77#b74 7,b7 ,replacement leases that do not require approval under this section and for which a prospectus has been submitted to ,congress pursuant to subsection 7b77#b74 7#b7 ,in this subsection1 the term interim leasing actions has the meaning given that term by the ,administrator of the ,general ,services ,administration4 4 7e7 ,purchase ,options ,such section is further amended by adding at the end the following new subsection3 7j7 ,the ,secretary may obligate and expend funds to exercise a purchase option included in any major medical facility lease 7as defined in subsection 7a77#c77;,b774 4 7f7 ,applicability ,the amendments made by this section shall apply with respect to any lease that has not been specifically authorized by law on or before the date of the enactment of this ,act4 #gjd4 ,authority to enter into agreements with academic affiliates and other entities to acquire space for the purpose of providing health-care resources to veterans ,section #hajc of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7h7 7#a7 ,notwithstanding any other provision of law requiring the use of competitive procedures1 including section #bcjd of title #aj1 when the ,secretary determines it to be in the best interest of the ,department1 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 veterans4 7#b7 ,in this subsection3 7,a7 ,the term academic affiliate means an institution or organization described in section #gcjb7;d7 of this title4 7,b7 ,the term covered entity means a unit or subdivision of a ,state1 local1 or municipal government1 public or nonprofit agency1 institution1 or organization1 or other institution or organization as the ,secretary considers appropriate that owns property controlled by an academic affiliate to be leased under this subsection4 7,c7 ,the term health-care resource has the meaning given that term in section #haeb7a7 of this title4 7,d7 ,the term space means any room1 unit1 floor1 wing1 building1 parking facility1 or other subdivision of a building or facility owned or controlled by an academic affiliate4 4 #gje4 ,modifications to enhanced-use lease authority of ,department of ,veterans ,affairs 7a7 ,modifications to authority ,paragraph 7#b7 of section #hafb7;a7 of title #ch1 ,united ,states ,code1 is amended to read as follows3 7#b7 7,a7 ,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-- 7i7 that the lease will not be inconsistent with1 and will not adversely affect-- 7,i7 the mission of the ,department2 or 7,,ii7 the operation of facilities1 programs1 and services of the ,department in the area of the leased property2 and 7ii7 that-- 7,i7 the lease will enhance the use of the leased property by directly or indirectly benefitting veterans2 or 7,,ii7 the leased property will provide supportive housing4 7,b7 ,the ,secretary shall give priority to enhanced-use leases that1 on the leased property-- 7i7 provide supportive housing for veterans2 7ii7 provide direct services or benefits targeted to veterans2 or 7iii7 provide services or benefits that indirectly support veterans4 4 7b7 ,extension of maximum term of enhanced-use lease ,section #hafb7;b77#b7 of such title is amended by striking #ge years and inserting #ii years4 7c7 ,modification of use of proceeds ,section #hafe7;a77#a7 of such title is amended by striking shall be deposited in the ,department of ,veterans ,affairs ,medical ,care ,collections ,fund established under section #agbi;,a of this title4 and inserting 8shall1 at the discretion of the ,secretary1 be deposited in-- 7,a7 the ,department of ,veterans ,affairs ,medical ,care ,collections ,fund established under section #agbi;,a of this title2 or 7,b7 the ,medical ,facilities or ,construction1 ,minor ,projects account of the ,department to be used to defray the costs of administration1 maintenance1 repair1 and related expenses incurred by the ,department with respect to property that is owned by or under the jurisdiction or control of the ,department4 4 7d7 ,repeal of sunset ,section #hafi of such title is repealed4 7e7 ,appropriation ,in addition to amounts otherwise available1 there is appropriated for fiscal year #bjbb1 out of any funds in the ,treasury not otherwise appropriated1 #ibb1jjj1jjj for an additional amount for the ,department of ,veterans ,affairs1 to remain available until expended1 to enter into enhanced-use leases pursuant to section #hafb of title #ch1 ,united ,states ,code1 as amended by this section4 #gjf4 ,authority for joint leasing actions of ,department of ,defense and ,department of ,veterans ,affairs 7a7 ,department of ,defense ,section #aajd;,a of title #aj1 ,united ,states ,code1 is amended-- 7#a7 by inserting 1 or the leasing1 after design1 and construction each place it appears2 and 7#b7 in subsection 7c77#b71 by inserting 1 or the leasing1 after design4 7b7 ,department of ,veterans ,affairs ,section #haaa;,b of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a71 by inserting 1 or the leasing1 after design1 and construction2 7#b7 in subsection 7b71 by adding at the end the following new paragraph3 7#c7 ,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 #hajd7;a77#c77;,b7 of this title4 2 and 7#c7 in subsection 7c71 by adding at the end the following new paragraph3 7#c7 ,any amount transferred to the ,secretary of ,veterans ,affairs by the ,secretary of ,defense for the purpose of leasing space for a shared medical facility may be credited to the ,medical ,facilities account of the ,department of ,veterans ,affairs and may be used for such purpose4 4 #gjg4 ,appropriation of amounts for major medical facility leases 7a7 ,fiscal year #bjbc ,in addition to amounts otherwise available1 there is appropriated for fiscal year #bjbc1 out of any funds in the ,treasury not otherwise appropriated1 #a1hhj1jjj1jjj for an additional amount for the ,medical ,facilities account of the ,department of ,veterans ,affairs1 to remain available until expended1 for major medical facility leases authorized by section #gjb4 7b7 ,additional years ,in addition to amounts otherwise available1 there is appropriated1 out of any funds in the ,treasury not otherwise appropriated1 for an additional amount for the ,medical ,facilities account of the ,department of ,veterans ,affairs1 to remain available until expended1 for major medical facility leases authorized by section #gjb or approved pursuant to subchapter ,i of chapter #ha of title #ch1 ,united ,states ,code1 as amended by section #gjc-- 7#a7 #ajj1jjj1jjj for fiscal year #bjbd2 7#b7 #bjj1jjj1jjj for fiscal year #bjbe2 7#c7 #djj1jjj1jjj for fiscal year #bjbf2 7#d7 #dej1jjj1jjj for fiscal year #bjbg2 7#e7 #fjj1jjj1jjj for fiscal year #bjbh2 7#f7 #faj1jjj1jjj for fiscal year #bjbi2 7#g7 #fbj1jjj1jjj for fiscal year #bjcj2 and 7#h7 #fej1jjj1jjj for fiscal year #bjca4 ,,viii ,records and other matters #hja4 ,epidemiological study on ,fort ,mc,clellan veterans ,the ,secretary of ,veterans ,affairs shall conduct an epidemiological study on the health trends of veterans who served in the ,armed ,forces at ,fort ,mc,clellan at any time during the period beginning ,january #a1 #aice1 and ending on ,may #bj1 #aiii4 #hjb4 ,biennial briefing on ,individual ,longitudinal ,exposure ,record 7a7 ,in general ,not later than one year after the date on which the ,individual ,longitudinal ,exposure ,record achieves full operational capability1 as determined by the ,secretary of ,defense1 and every two years thereafter1 the ,secretary of ,defense1 in consultation with the ,secretary of ,veterans ,affairs1 shall provide the appropriate committees of ,congress a briefing on-- 7#a7 the quality of the databases of the ,department of ,defense that provide the information presented in such ,individual ,longitudinal ,exposure ,record2 and 7#b7 the usefulness of such ,individual ,longitudinal ,exposure ,record or system in supporting members of the ,armed ,forces and veterans in receiving health care and benefits from the ,department of ,defense and the ,department of ,veterans ,affairs4 7b7 ,elements ,each briefing required by subsection 7a7 shall include1 for the period covered by the report1 the following3 7#a7 ,an identification of potential exposures to occupational or environmental hazards captured by the current systems of the ,department of ,defense for environmental1 occupational1 and health monitoring1 and recommendations for how to improve those systems4 7#b7 ,an analysis of the quality and accuracy of the location data used by the ,department of ,defense in determining potential exposures to occupational or environmental hazards by members of the ,armed ,forces and veterans1 and recommendations for how to improve the quality of such data if necessary4 7c7 ,definitions ,in this section3 7#a7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,senate2 and 7,b7 the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7#b7 ,individual ,longitudinal ,exposure ,record ,the term ,individual ,longitudinal ,exposure ,record has the meaning given such term in section #aaga of title #ch1 ,united ,states ,code1 as added by section #bjb4 #hjc4 ,correction of exposure records by members of the ,armed ,forces and veterans 7a7 ,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 ,record4 7b7 ,evidence 7#a7 ,provision of evidence ,to update a record under subsection 7a71 a veteran shall provide such evidence as the ,secretary of ,veterans ,affairs considers necessary4 7#b7 ,regulations ,the ,secretary of ,veterans ,affairs shall prescribe by regulation the evidence considered necessary under paragraph 7#a74 7c7 ,definitions ,in this section3 7#a7 ,individual ,longitudinal ,exposure ,record ,the term ,individual ,longitudinal ,exposure ,record has the meaning given such term in section #aaga of title #ch1 ,united ,states ,code1 as added by section #bjb4 7#b7 ,toxic exposure ,the term toxic exposure has the meaning given such term in section #aja of title #ch1 ,united ,states ,code1 as amended by section #ajb7;b74 #hjd4 ,federal cause of action relating to water at ,camp ,lejeune1 ,north ,carolina 7a7 ,short title ,this section may be cited as the ,camp ,lejeune ,justice ,act of #bjbb4 7b7 ,in general ,an individual1 including a veteran 7as defined in section #aja of title #ch1 ,united ,states ,code71 or the legal representative of such an individual1 who resided1 worked1 or was otherwise exposed 7including in utero exposure7 for not less than #cj days during the period beginning on ,august #a1 #aiec1 and ending on ,december #ca1 #aihg1 to water at ,camp ,lejeune1 ,north ,carolina1 that was supplied by1 or on behalf of1 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 ,lejeune4 7c7 ,burdens and standard of proof 7#a7 ,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 harm4 7#b7 ,standards ,to meet the burden of proof described in paragraph 7#a71 a party shall produce evidence showing that the relationship between exposure to the water at ,camp ,lejeune and the harm is-- 7,a7 sufficient to conclude that a causal relationship exists2 or 7,b7 sufficient to conclude that a causal relationship is at least as likely as not4 7d7 ,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 7b71 and shall be the exclusive venue for such an action4 ,nothing in this subsection shall impair the right of any party to a trial by jury4 7e7 ,exclusive remedy 7#a7 ,in general ,an individual1 or legal representative of an individual1 who brings an action under this section for a harm described in subsection 7b71 including a latent disease1 may not thereafter bring a tort action against the ,united ,states for such harm pursuant to any other law4 7#b7 ,health and disability benefits relating to water exposure ,any award made to an individual1 or legal representative of an individual1 under this section shall be offset by the amount of any disability award1 payment1 or benefit provided to the individual1 or legal representative-- 7,a7 under-- 7i7 any program under the laws administered by the ,secretary of ,veterans ,affairs2 7ii7 the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq472 or 7iii7 the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq472 and 7,b7 in connection with health care or a disability relating to exposure to the water at ,camp ,lejeune4 7f7 ,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 #bfhj7;a7 of title #bh1 ,united ,states ,code4 7g7 ,no punitive damages ,punitive damages may not be awarded in any action under this section4 7h7 ,disposition by ,federal agency required ,an individual may not bring an action under this section before complying with section #bfge of title #bh1 ,united ,states ,code4 7i7 ,exception for combatant activities ,this section does not apply to any claim or action arising out of the combatant activities of the ,armed ,forces4 7j7 ,applicability2 period for filing 7#a7 ,applicability ,this section shall apply only to a claim accruing before the date of enactment of this ,act4 7#b7 ,statute of limitations ,a claim in an action under this section may not be commenced after the later of-- 7,a7 the date that is two years after the date of enactment of this ,act2 or 7,b7 the date that is #ahj days after the date on which the claim is denied under section #bfge of title #bh1 ,united ,states ,code4 7#c7 ,inapplicability of other limitations ,any applicable statute of repose or statute of limitations1 other than under paragraph 7#b71 shall not apply to a claim under this section4 #hje4 ,cost of ,war ,toxic ,exposures ,fund 7a7 ,in general ,chapter #c is amended by adding at the end the following new section3 #cbd4 ,cost of ,war ,toxic ,exposures ,fund 7a7 ,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 7the ,fund71 to be administered by the ,secretary4 7b7 ,deposits ,there shall be deposited in the ,fund such amounts as may be appropriated to the ,fund pursuant to subsection 7c74 7c7 ,authorization of appropriations ,there is authorized to be appropriated to the ,fund for fiscal year #bjbc and each subsequent fiscal year such sums as are necessary to increase funding1 over the fiscal year #bjba level1 for investment in-- 7#a7 the delivery of veterans' health care associated with exposure to environmental hazards in the active military1 naval1 air1 or space service in programs administered by the ,under ,secretary for ,health2 7#b7 any expenses incident to the delivery of veterans' health care and benefits associated with exposure to environmental hazards in the active military1 naval1 air1 or space service1 including administrative expenses1 such as information technology and claims processing and appeals1 and excluding leases as authorized or approved under section #hajd of this title2 and 7#c7 medical and other research relating to exposure to environmental hazards4 7d7 ,budget scorekeeping 7#a7 ,immediately upon enactment of the ,sergeant ,first ,class ,heath ,robinson ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjbb1 expenses authorized to be appropriated to the ,fund in subsection 7c7 shall be estimated for fiscal year #bjbc and each subsequent fiscal year and treated as budget authority that is considered to be direct spending-- 7,a7 in the baseline for purposes of section #beg of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe 7#b ,u4,s4,c4 #ijg72 7,b7 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 ,representatives1 as appropriate1 for purposes of budget enforcement in the ,senate and the ,house of ,representatives2 7,c7 under the ,congressional ,budget ,act of #aigd 7#b ,u4,s4,c4 #fba et seq471 including in the reports required by section #cjh7;b7 of such ,act 7#b ,u4,s4,c4 #fci72 and 7,d7 for purposes of the ,statutory ,pay-,as-,you-,go ,act of #bjaj 7#b ,u4,s4,c4 #ica et seq474 7#b7 ,no amount appropriated to the ,fund in fiscal year #bjbc 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 #aigd 7#b ,u4,s4,c4 #fba et seq47 and any other ,act4 7#c7 ,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 #aje-bag1 and for purposes of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe 7#b ,u4,s4,c4 #ijj et seq47 and the ,congressional ,budget ,act of #aigd 7#b ,u4,s4,c4 #fba et seq471 the ,fund shall be treated as if it were an account designated as ,appropriated ,entitlements and ,mandatories for ,fiscal ,year #aiig in the joint explanatory statement of the committee of conference accompanying ,conference ,report #aje-bag4 7e7 ,estimates for congressional consideration ,the ,secretary shall include in documents submitted to ,congress in support of the ,president's budget submitted pursuant to section #aaje of title #ca detailed estimates of the sums described in subsection 7c7 for the applicable fiscal year4 7f7 ,procedures for estimates ,the ,secretary may1 after consultation with the ,committee on ,appropriations of the ,senate and the ,committee on ,appropriations of the ,house of ,representatives1 establish policies and procedures for developing the annual detailed estimates required by subsection 7e74 4 7b7 ,sequestration ,section #bef7;h77#d7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe 7#b ,u4,s4,c4 #ijf7;h77#d77 is amended by adding at the end the following new subparagraph3 7,g7 ,cost of ,war ,toxic ,exposures ,fund4 4 #hjf4 ,appropriation for fiscal year #bjbb 7a7 ,appropriation ,in addition to amounts otherwise available1 there is appropriated for fiscal year #bjbb1 out of any funds in the ,treasury not otherwise appropriated1 #ejj1jjj1jjj for the ,cost of ,war ,toxic ,exposures ,fund1 established by section #cbd of title #ch1 ,united ,states ,code1 as added by section #hje of this ,act1 to remain available until ,september #cj1 #bjbd4 7b7 ,spend plan ,not later than #cj days after enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit a plan for expending amounts made available by subsection 7a7 by program1 project or activity to the ,committee on ,appropriations of the ,senate and the ,committee on ,appropriations of the ,house of ,representatives4 ,funds may not be obligated until such ,committees issue an approval1 or absent a response1 a period of #cj days has elapsed4 #hjg4 ,authorization of electronic notice in claims under laws administered by the ,secretary of ,veterans ,affairs 7a7 ,in general ,title #ch1 ,united ,states ,code1 is amended as follows3 7#a7 ,by striking section #eajj and inserting the following3 #eajj4 ,definitions ,in this chapter3 7#a7 ,the term claimant means any individual applying for1 or submitting a claim for1 any benefit under the laws administered by the ,secretary4 7#b7 ,the term notice means a communication issued through means 7including electronic means7 prescribed by the ,secretary4 4 7#b7 ,in section #eajd1 by adding at the end the following new subsection3 7c7 ,the ,secretary may provide notice under subsection 7a7 electronically if a claimant 7or the claimant's representative7 elects to receive such notice electronically4 ,a claimant 7or the claimant's representative7 may revoke such an election at any time1 by means prescribed by the ,secretary4 7d7 ,the ,secretary shall annually-- 7#a7 solicit recommendations from stakeholders on how to improve notice under this section2 and 7#b7 publish such recommendations on a publicly available website of the ,department4 4 7#c7 ,in section #eajd;,b7c71 in the matter preceding paragraph 7#a7 by striking in writing and inserting to the claimant 7and any representative of such claimant74 7#d7 ,in section #eaab7;b77#f71 by striking 7at the payee's last address of record74 7#e7 ,in section #gajd-- 7,a7 in the heading1 by adding 2 decisions2 notice at the end2 and 7,b7 by striking subsection 7e7 and inserting the following3 7e7 ,after reaching a decision on an appeal1 the ,board shall promptly issue notice 7as that term is defined in section #eajj of this title7 of such decision to the following3 7#a7 ,the appellant4 7#b7 ,any other party with a right to notice of such decision4 7#c7 ,any authorized representative of the appellant or party described in paragraph 7#b74 7f7 7#a7 ,the ,secretary may provide notice under subsection 7e7 electronically if a claimant 7or the claimant's representative7 elects to receive such notice electronically4 7#b7 ,a claimant 7or the claimant's representative7 may revoke such an election at any time1 by means prescribed by the ,secretary4 4 7#f7 ,in section #gaje7;b77#a77;,a71 by striking mailing and inserting issuance4 7#g7 ,in section #gaje;,a7a71 by striking mailed and inserting issued4 7#h7 ,in section #gbff7;a71 by striking mailed and inserting issued4 7b7 ,rule of construction ,none of the amendments made by this section shall be construed to apply section #eajd7;a7 of such title to decisions of the ,board of ,veterans' ,appeals under chapter #ga of such title4 #hjh4 ,burn pit transparency 7a7 ,annual report on disability claims 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs shall submit to the appropriate congressional committees a report detailing the following3 7,a7 ,the total number of covered veterans4 7,b7 ,the total number of claimed issues for disability compensation under chapter #aa of title #ch1 ,united ,states ,code1 approved and the total number denied by the ,secretary of ,veterans ,affairs with respect to a covered veteran1 and a breakdown of the reasons for the denials4 7,c7 ,a comprehensive list of the top #aj conditions from each body system for which the ,secretary awarded service connection for covered veterans4 7,d7 ,any updates or trends with respect to the information described in subparagraphs 7,a71 7,b71 and 7,c71 that the ,secretary determines appropriate4 7#b7 ,covered veteran defined ,in this subsection1 the term covered veteran means a veteran who deployed to the ,southwest ,asia theater of operations any time after ,august #aiij1 or ,afghanistan1 ,syria1 ,djibouti1 or ,uzbekistan after ,september #ai1 #bjja1 and who submits a claim for disability compensation under chapter #aa of title #ch1 ,united ,states ,code4 7b7 ,information regarding the ,airborne ,hazards and ,open ,burn ,pit ,registry 7#a7 ,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 to1 or ancillary to1 the exposure of the veteran to toxic airborne chemicals and fumes caused by open burn pits4 7#b7 ,display ,in making information public regarding the number of participants in the ,airborne ,hazards and ,open ,burn ,pit ,registry1 the ,secretary shall display such numbers by both ,state and by congressional district4 7c7 ,definitions ,in this section3 7#a7 ,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 #bja of the ,dignified ,burial and ,other ,veterans' ,benefits ,improvement ,act of #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note74 7#b7 ,appropriate congressional committees ,the term appropriate congressional committees means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,armed ,services of the ,senate2 and 7,b7 ,the ,committee on ,veterans' ,affairs and the ,committee on ,armed ,services of the ,house of ,representatives4 7#c7 ,open burn pit ,the term open burn pit has the meaning given that term in section #bja7;c7 of the ,dignified ,burial and ,other ,veterans' ,benefits ,improvement ,act of #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note74 ,,ix ,improvement of workforce of ,department of ,veterans ,affairs #ija4 ,national rural recruitment and hiring plan for ,veterans ,health ,administration 7a7 ,in general ,not later than #ah months after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in collaboration with the directors of each community-based outpatient clinic and medical center of the ,department of ,veterans ,affairs1 shall develop and implement a national rural recruitment and hiring plan for the ,veterans ,health ,administration to-- 7#a7 recruit health care professionals for rural and highly rural community-based outpatient clinics and rural and highly rural medical centers of the ,department2 7#b7 determine which such clinics or centers have a staffing shortage of health care professionals2 7#c7 develop best practices and techniques for recruiting health care professionals for such clinics and centers2 7#d7 not less frequently than annually1 provide virtually based1 on-demand training to human resources professionals of the ,veterans ,health ,administration on the best practices and techniques developed under paragraph 7#c72 and 7#e7 provide recruitment resources1 such as pamphlets and marketing material to-- 7,a7 ,veterans ,integrated ,service ,networks of the ,department2 7,b7 rural and highly rural community-based outpatient clinics of the ,department2 and 7,c7 rural and highly rural medical centers of the ,department4 7b7 ,annual report ,not later than #ah months after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report that includes-- 7#a7 the plan developed and implemented under subsection 7a72 and 7#b7 an assessment of the outcomes related to recruitment and retention of employees of the ,veterans ,health ,administration at rural and highly rural facilities of the ,department4 7c7 ,definitions ,in this section1 the terms rural and highly rural have the meanings given those terms under the rural-urban commuting areas coding system of the ,department of ,agriculture4 #ijb4 ,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 7a7 ,in general ,for any covered health care professional to whom the ,secretary of ,veterans ,affairs has offered employment with the ,department of ,veterans ,affairs1 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 7c74 7b7 ,payment of amounts 7#a7 ,in general ,payment of any amounts for a buy out of a service contract for a covered health care professional under subsection 7a7 shall be made directly to the individual or entity with respect to which the covered health care professional has a service obligation under such contract4 7#b7 ,limitation on total amount ,the total amount paid by the ,department under this section shall not exceed #dj1jjj1jjj per fiscal year4 7c7 ,obligated service ,in exchange for a contract buy out under subsection 7a71 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 ,department4 7d7 ,liability 7#a7 ,in general ,except as provided in paragraph 7#b71 if a covered health care professional fails for any reason to complete the period of obligated service of the individual under subsection 7c71 the ,united ,states shall be entitled to recover from the individual an amount equal to-- 7,a7 the total amount paid under subsection 7a7 to buy out the non-,department service contract of the individual2 multiplied by 7,b7 a fraction-- 7i7 the numerator of which is-- 7,i7 the total number of months in the period of obligated service of the individual2 minus 7,,ii7 the number of months served by the individual2 and 7ii7 the denominator of which is the total number of months in the period of obligated service of the individual4 7#b7 ,exception ,liability shall not arise under paragraph 7#a7 in the case of an individual covered by that paragraph if the individual does not obtain1 or fails to maintain1 employment as an employee of the ,department due to staffing changes approved by the ,under ,secretary for ,health4 7e7 ,not a taxable benefit ,a contract buy out for a covered health care professional under subsection 7a7 shall not be considered a taxable benefit or event for the covered health care professional4 7f7 ,annual report 7#a7 ,in general ,not later than #ah months after the date of the enactment of this ,act1 and not less frequently than annually thereafter1 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 section4 7#b7 ,elements ,each report required by paragraph 7#a7 shall include the following3 7,a7 ,the number of health care professionals for whom a service contract buyout payment was made under subsection 7a7 in the previous fiscal year1 disaggregated by occupation or specialty4 7,b7 ,the average1 highest1 and lowest amount of the service contract buyout payments made under subsection 7a7 for each occupation or specialty in the previous fiscal year4 7,c7 ,each location where contract buyout authority under subsection 7a7 was utilized and the number of covered health care professionals who agreed to be employed at such location in the previous fiscal year4 7g7 ,definitions ,in this section3 7#a7 ,covered health care professional ,the term covered health care professional means a physician1 nurse anesthetist1 physician assistant1 or nurse practitioner offered employment with the ,department regardless of the authority under which such employment is offered4 7#b7 ,rural2 highly rural ,the terms rural and highly rural have the meanings given those terms under the rural-urban commuting areas coding system of the ,department of ,agriculture4 7h7 ,sunset ,this section shall terminate on ,september #cj1 #bjbg4 #ijc4 ,qualifications for human resources positions within ,department of ,veterans ,affairs and plan to recruit and retain human resources employees 7a7 ,establishment of qualifications ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7#a7 establish qualifications for each human resources position within the ,department of ,veterans ,affairs in coordination with the ,office of ,personnel ,management2 7#b7 establish standardized performance metrics for each such position2 and 7#c7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing the qualifications and standardized performance metrics established under paragraphs 7#a7 and 7#b74 7b7 ,improvement of human resources actions ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall establish or enhance systems of the ,department to monitor the hiring and other human resources actions that occur at the local1 regional1 and national levels of the ,department to improve the performance of those actions4 7c7 ,report ,not later than one year after the establishment of the qualifications and performance metrics under subsection 7a71 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-- 7#a7 a description of the implementation of such qualifications and performance metrics2 7#b7 an assessment of the quality of such qualifications and performance metrics2 7#c7 an assessment of performance and outcomes based on such metrics2 and 7#d7 such other matters as the ,comptroller ,general considers appropriate4 7d7 ,plan to recruit and retain human resources employees ,not later than one year after the date of the enactment of this ,act1 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 ,affairs4 #ijd4 ,modification of pay cap for certain employees of ,veterans ,health ,administration 7a7 ,in general ,section #gdee7;c7 is amended-- 7#a7 in paragraph 7#a71 by striking #cj percent inserting #ej percent2 7#b7 in paragraph 7#b71 by striking level ,,iv inserting level ,,ii2 and 7#c7 by adding at the end the following new paragraph3 7#c7 7,a7 ,notwithstanding section #ecjd of title #e or any other provision of law1 but subject to the limitation under paragraph 7#b71 pursuant to an increase under subsection 7a71 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 ,schedule4 7,b7 ,if an employee is in receipt of a special rate of pay under subparagraph 7,a7 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 #ecjd of title #e1 but a pay adjustment would cause such established special rate supplement to be of lesser value1 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 appropriate4 4 7b7 ,pay for critical positions ,section #gdjd7;a77#a77;,b7 is amended by inserting #gcjf or before #gdja7d74 #ije4 ,expansion of opportunities for housekeeping aides ,section #ccaj of title #e1 ,united ,states ,code1 is amended by inserting 7other than for positions of housekeeping aides in the ,department of ,veterans ,affairs7 after competitive service4 #ijf4 ,modification of authority of the ,secretary of ,veterans ,affairs relating to hours1 conditions of employment1 and pay for certain employees of ,veterans ,health ,administration 7a7 ,expansion of eligibility of employees for certain awards ,section #gdjd7;c7 is amended-- 7#a7 by striking ,notwithstanding and inserting 7#a7 ,notwithstanding2 7#b7 by inserting or #gdja7d7 after section #gcjf2 7#c7 by striking who is not eligible for pay under subchapter ,,iii and inserting or in a covered executive position under section #gdja7a7 of this title2 7#d7 by striking sections #dejg and #echd and inserting section #dejg2 and 7#e7 by adding at the end the following new paragraph3 7#b7 ,in this subsection1 the term covered executive position means a position that the ,secretary has determined is of equivalent rank to a ,senior ,executive ,service position 7as such term is defined in section #cacb7;a7 of title #e7 and is subject to an agency performance management system4 4 7b7 ,authority for awards programs of ,department of ,veterans ,affairs 7#a7 ,in general ,subchapter ,i of chapter #gd is amended by inserting after section #gdjd the following new section3 #gdjd;,a4 ,awards 7a7 ,superior accomplishments and performance awards program ,the ,secretary may establish an awards program for personnel listed in section #gdba7;b7 of this title consistent with chapter #de of title #e1 to the extent practicable4 7b7 ,executive performance awards program ,notwithstanding section #gdbe of this title or any other provision of law1 the ,secretary may establish a performance awards program consistent with section #echd of title #e for-- 7#a7 personnel appointed under section #gdja7a7 of this title for a position that the ,secretary has determined is of equivalent rank to a ,senior ,executive ,service position 7as such term is defined in section #cacb7;a7 of title #e7 and is subject to an agency performance management system2 and 7#b7 personnel appointed under section #gcjf or #gdja7d7 of this title4 7c7 ,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 #gdca7;e77#d7 of this title4 7d7 ,not considered basic pay ,awards under this section shall not be considered basic pay for any purpose4 7e7 ,regulations ,the ,secretary may prescribe regulations for the administration of this section4 4 7#b7 ,limitation on past awards ,notwithstanding any other provision of law1 awards made by the ,secretary of ,veterans ,affairs for any period on or after ,january #a1 #bjag1 and before the date of the enactment of this ,act for an employee under section #gcjf or #gdja7d7 of title #ch1 ,united ,states ,code1 or for a position described in section #gdja7a7 of such title that the ,secretary has determined is of equivalent rank to a ,senior ,executive ,service position 7as such term is defined in section #cacb7;a7 of title #e1 ,united ,states ,code71 may be subject to section #gdjd;,a of title #ch1 ,united ,states ,code1 as added by paragraph 7#a74 7c7 ,modification of employees subject to regulation by ,secretary of ,veterans ,affairs of hours and conditions of employment and leaves of absence 7#a7 ,in general ,section #gdba is amended-- 7,a7 in subsection 7a71 by striking chapter and inserting title2 and 7,b7 in subsection 7b71 by adding at the end the following new paragraph3 7#i7 ,any position for which the employee is appointed under section #gcjf or #gdja7d7 of this title4 4 7#b7 ,administration of full-time employees ,section #gdbc is amended-- 7,a7 in subsection 7a77#b71 by adding at the end the following new subparagraph3 7,d7 ,the ,secretary may exclude from the requirements of paragraph 7#a7 employees hired under section #gcjf or #gdja7d7 of this title or for a position described in section #gdja7a7 of this title that the ,secretary has determined is of equivalent rank to a ,senior ,executive ,service position 7as such term is defined in section #cacb7;a7 of title #e74 2 and 7,b7 in subsection 7e77#a71 by striking #gdja7a7 and inserting #gdba7;b74 7#c7 ,additional pay authorities ,section #gdaj7;a7 is amended-- 7,a7 by striking ,the ,secretary and inserting 7#a7 ,the ,secretary2 7,b7 by striking the personnel described in paragraph 7#a7 of section #gdja of this title and inserting personnel appointed under section #gcjf of this title or section #gdja7d7 of this title1 or personnel described in section #gdja7a7 of this title12 and 7,c7 by striking in the same manner1 and subject to the same limitations1 as in the case of and inserting in a manner consistent with2 and 7,d7 by adding at the end the following new paragraph3 7#b7 ,payments under paragraph 7#a7 shall not be considered in calculating the limitation under section #gdca7;e77#d7 of this title4 4 7#d7 ,treatment of pay authority changes ,for the purposes of the amendments made by paragraph 7#c71 the ,secretary of ,veterans ,affairs shall treat any award or payment made by the ,secretary between ,january #a1 #bjag1 and the date of the enactment of this ,act to employees appointed under sections #gcjf1 #gdja7a71 and #gdja7d7 of title #ch1 ,united ,states ,code1 that the ,secretary has determined are of equivalent rank to a ,senior ,executive ,service position 7as such term is defined in section #cacb7;a7 of title #e1 ,united ,states ,code71 as if such amendments had been in effect at the time of such award or payment4 7#e7 ,treatment of prior leave balances ,notwithstanding any other provision of law1 the ,secretary may adjust the leave balance and carryover leave balance of any employee described in section #gdba7;b77#i7 of title #ch1 ,united ,states ,code1 as amended by paragraph 7#a77;,b71 to ensure any leave accrued or carried over before the date of the enactment of this ,act remains available to such employee4 7d7 ,treatment of certain employees as appointed under section #gcjf ,section #gcjf is amended-- 7#a7 in subsection 7a71 by redesignating the second paragraph 7#aa7 as paragraph 7#ab72 and 7#b7 by adding at the end the following new subsection3 7g7 ,for purposes of applying any provision of chapter #gd of this title1 including sections #gdjd1 #gdaj1 and #gdba1 or any other provision of law1 the ,secretary may treat any appointment for a position under this chapter to be an appointment under this section4 4 7e7 ,conforming amendment ,section #gdca7;e77#d7 is amended by striking ,in no case and inserting ,except as provided in sections #gdjd;,a7c7 and #gdaj7;a77#b7 of this title1 in no case4 #ijg4 ,waiver of pay limitation for certain employees of ,department of ,veterans ,affairs ,subchapter ,i of chapter #g is amended by inserting after section #gjc the following new section3 #gjd4 ,waiver of pay limitation for certain employees 7a7 ,employees of ,veterans ,health ,administration impacted by closure or realignment ,notwithstanding any other provision of law1 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-- 7#a7 the official duty station of the employee is closed2 or 7#b7 the office1 facility1 activity1 or organization of the employee is realigned4 7b7 ,employees providing care to veterans exposed to open burn pits 7#a7 ,in general ,notwithstanding any other provision of law1 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 pits4 7#b7 ,open burn pit defined ,in this subsection1 the term open burn pit has the meaning given that term in section #bja7;c7 of the ,dignified ,burial and ,other ,veterans' ,benefits ,improvement ,act of #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note74 7c7 ,coordination with ,office of ,personnel ,management ,in implementing this section1 the ,secretary shall coordinate with the ,director of the ,office of ,personnel ,management4 7d7 ,reports 7#a7 ,in general ,for each quarter that the ,secretary waives a limitation under this section1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate1 the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 and the ,office of ,personnel ,management a report on the waiver or waivers4 7#b7 ,contents ,each report submitted under paragraph 7#a7 with respect to a waiver or waivers shall include the following3 7,a7 ,where the waiver or waivers were used1 including in which component of the ,department and1 as the case may be1 which medical center of the ,department4 7,b7 ,for how many employees the waiver or waivers were used1 disaggregated by component of the ,department and1 if applicable1 medical center of the ,department4 7,c7 ,the average amount by which each payment exceeded the pay limitation that was waived1 disaggregated by component of the ,department and1 if applicable1 medical center of the ,department4 7e7 ,employee defined ,in this section1 the term employee means any employee regardless of the authority under which the employee was hired4 7f7 ,termination ,this section shall terminate on ,september #cj1 #bjbg4 4 #ijh4 ,elimination of limitation on awards and bonus for employees of ,department of ,veterans ,affairs 7a7 ,in general ,section #gje7;a7 of the ,veterans ,access1 ,choice1 and ,accountability ,act of #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #gjc note7 is amended by striking paragraph 7#c74 7b7 ,applicability ,subsection 7a7 shall take effect on the date of the enactment of this ,act and apply as if such subsection had been enacted on ,september #cj1 #bjba4 #iji4 ,additional authority of the ,secretary of ,veterans ,affairs relating to recruitment and retention of personnel ,subchapter ,i of chapter #g is amended by inserting after section #gje the following new section3 #gjf4 ,additional authority relating to recruitment and retention of personnel 7a7 ,recruitment and relocation bonuses ,the ,secretary may pay a recruitment or relocation bonus under section #egec7;e7 of title #e without regard to any requirements for certification or approval under that section4 7b7 ,retention bonuses 7#a7 ,the ,secretary may pay a retention bonus under section #eged7;f7 of title #e without regard to any requirement for certification or approval under that subsection4 7#b7 ,the ,secretary may pay a retention bonus as specified in subsection 7e77#b7 of section #eged of title #e and may pay the bonus as a single lump-sum payment at the beginning of the full period of service required by an agreement under subsection 7d7 of such section4 7c7 ,merit awards ,the ,secretary may grant a cash award under section #dejb7;b7 of title #e without regard to any requirement for certification or approval under that section4 7d7 ,incentives for critical skills 7#a7 ,subject to the provisions of this paragraph1 the ,secretary may provide a critical skill incentive to an employee in a case in which the ,secretary determines-- 7,a7 the employee possesses a high-demand skill or skill that is at a shortage2 7,b7 such skill is directly related to the duties and responsibilities of the employee's position2 and 7,c7 employment of an individual with such skill in such position serves a critical mission-related need of the ,department4 7#b7 ,an incentive provided to an employee under paragraph 7#a7 may not to exceed #be percent of the basic pay of the employee4 7#c7 ,provision of an incentive under paragraph 7#a7 shall be contingent on the employee entering into a written agreement to complete a period of employment with the ,department4 7#d7 ,an incentive provided under paragraph 7#a7 shall not be considered basic pay for any purpose4 7#e7 ,the ,secretary may prescribe conditions1 including with respect to eligibility1 and limitations on provision of incentive under paragraph 7#a74 7#f7 ,incentive provided under paragraph 7#a7 shall not be included in the calculation of total amount of compensation under section #gdca7;e77#d7 of this title4 7e7 ,student loan repayments 7#a7 ,subject to the provisions of this subsection1 the ,secretary may repay a student loan pursuant to section #ecgi7;b7 of title #e4 7#b7 ,paragraph 7#b7 of such section shall not apply to payment under this subsection4 7#c7 ,payment under this subsection shall be made subject to such terms1 limitations1 or conditions as may be mutually agreed to by the ,secretary and the employee concerned1 except that the amount paid by the ,secretary under this subsection may not exceed-- 7,a7 #dj1jjj for any employee in any calendar year2 or 7,b7 a total of #ajj1jjj in the case of any employee4 7f7 ,expedited hiring authority for college graduates2 competitive service 7#a7 ,subject to paragraph 7#b7 of this subsection1 the ,secretary may expedite hiring for college graduates under section #caae of title #e without regard to subsection 7e7 of such section or any regulations prescribed by the ,office of ,personnel ,management for administration of such subsection4 7#b7 ,the number of employees the ,secretary may appoint under section #caae of title #e may not exceed the number equal to #be 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 category1 at the ,,gs-#aa level1 or an equivalent level1 or below1 under a competitive examining procedure4 7g7 ,expedited hiring authority for post-secondary students2 competitive service 7#a7 ,subject to paragraph 7#b7 of this subsection1 the ,secretary may expedite hiring of post-secondary students under section #caaf of title #e1 without regard to subsection 7d7 of such section or any regulations prescribed by the ,office of ,personnel ,management for administration of such subsection4 7#b7 ,the number of employees the ,secretary may appoint under section #caaf of title #e may not exceed the number equal to #be percent of the number of students that the ,secretary appointed during the previous fiscal year to a position at the ,,gs-#aa level1 or an equivalent level1 or below4 7h7 ,pay authority for critical positions 7#a7 ,subject to the provisions of this subsection1 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 #ecgg of title #e that apply to the ,office of ,personnel ,management4 7#b7 ,the ,secretary may fix the rate of pay for a critical position under this subsection in excess of the limitation set forth by section #ecgg7;d77#b7 of such title4 7#c7 ,basic pay may not be fixed under this subsection at a rate greater than the rate payable for the ,vice ,president of the ,united ,states established under section #ajd of title #c1 except upon written approval of the ,president4 7#d7 ,notwithstanding section #ecgg7;f7 of title #e1 the ,secretary may authorize the exercise of authority under this subsection with respect to up to #bjj positions at any time4 7i7 ,rates of special pay 7#a7 ,the ,secretary may establish a rate for special pay under section #ecje7;a77#a7 of title #e4 7#b7 ,in applying such section to the ,secretary's authority under paragraph 7#a7-- 7,a7 #ej percent shall be substituted for #cj percent2 and 7,b7 level ,,ii of the ,executive ,schedule shall be substituted for level ,,iv of the ,executive ,schedule4 7j7 ,waiver of limitations on certain payments under pay comparability system ,the ,secretary may waive the limitation in section #ecjg of title #e for an employee or a payment4 7k7 ,termination ,the authorities under this section shall terminate on ,september #cj1 #bjbg4 4 ,secretary