#aag? ,,congress #b;d ,session ,h4 ,r4 #cifg ,,an ,,act ,to improve heal? c>e & b5efits = vet]ans expos$ to toxic sub/ances1 & = o!r purposes4 #a4 ,%ort title2 ref]5ces to title #ch1 ,unit$ ,/ates ,code2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba or ! ,honor+ our ,,pact ,act ( #bjba4 7b7 ,matt]s relat+ to am5dm5ts to title #ch1 ,unit$ ,/ates ,code 7#a7 ,ref]5ces ,except z o!rwise expressly provid$1 :5 9 ?is ,act an am5dm5t or repeal is express$ 9 t]ms ( an am5dm5t to1 or repeal (1 a section or o!r provision1 ! ref]5ce %all be consid]$ to be made to a section or o!r provision ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,am5dm5ts to tables ( cont5ts ,except z o!rwise expressly provid$1 :5 an am5dm5t made by ?is ,act to title #ch1 ,unit$ ,/ates ,code1 adds a section or l>g] organizational unit to t title or am5ds ! designation or head+ ( a section or l>g] organizational unit 9 t title1 t am5dm5t also %all h ! effect ( am5d+ any table ( sections 9 t title to alt] ! table to con=m to ! *anges made by ! am5dm5t4 7c7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 ref]5ces to title #ch1 ,unit$ ,/ates ,code2 table ( cont5ts4 ,title ,i--,expansion ( heal? c>e eligibility ,subtitle ,a--,toxic-expos$ vet]ans ,sec4 #aja4 ,%ort title4 ,sec4 #ajb4 ,def9itions relat+ to toxic-expos$ vet]ans4 ,sec4 #ajc4 ,expansion ( heal? c>e = specific categories ( toxic-expos$ vet]ans & vet]ans support+ c]ta9 ov]seas cont+5cy op]ations4 ,sec4 #ajd4 ,assessm5ts ( implem5tation & op]ation4 ,sec4 #aje4 ,revision ( brea/ canc] mammography policy ( ,dep>tm5t ( ,vet]ans ,affairs to provide mammography scre5+ = vet]ans :o s]v$ 9 locations associat$ ) toxic exposure4 ,subtitle ,b--,c]ta9 vet]ans ( combat s]vice & o!r matt]s ,sec4 #aaa4 ,expansion ( p]iod ( eligibility = heal? c>e = c]ta9 vet]ans ( combat s]vice4 ,sec4 #aab4 ,au?orization p]iod = em]g5cy treatm5t 9 non-,dep>tm5t ( ,vet]ans ,affairs m$ical facilities4 ,title ,,ii--,toxic exposure presumption process ,sec4 #bja4 ,%ort title4 ,sec4 #bjb4 ,improvem5ts to ability ( ,dep>tm5t ( ,vet]ans ,affairs to e/abli% presumptions ( s]vice connection bas$ on toxic exposure4 ,sec4 #bjc4 ,reevaluation ( claims = comp5sation involv+ presumptions ( s]vice connection4 ,title ,,iii--,improv+ ! e/abli%m5t ( s]vice connection process = toxic-expos$ vet]ans ,sec4 #cja4 ,%ort title4 ,sec4 #cjb4 ,presumptions ( toxic exposure4 ,sec4 #cjc4 ,m$ical nexus exam9ations = toxic exposure risk activities4 ,title ,,iv--,presumptions ( s]vice connection ,sec4 #dja4 ,treatm5t ( vet]ans :o p>ticipat$ 9 cleanup ( ,enewetak ,atoll z radiation-expos$ vet]ans = purposes ( presumption ( s]vice connection ( c]ta9 disabilities by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #djb4 ,treatm5t ( vet]ans :o p>ticipat$ 9 nucle> response ne> ,palom>es1 ,spa91 or ,?ule1 ,gre5l&1 z radiation-expos$ vet]ans = purposes ( presumption ( s]vice connection ( c]ta9 disabilities by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #djc4 ,presumptions ( s]vice connection = diseases associat$ ) exposures to c]ta9 h]bicide ag5ts = vet]ans :o s]v$ 9 c]ta9 locations4 ,sec4 #djd4 ,addition ( additional diseases associat$ ) exposure to c]ta9 h]bicide ag5ts = :i* !re is a presumption ( s]vice connection = vet]ans :o s]v$ 9 c]ta9 locations4 ,sec4 #dje4 ,improv+ comp5sation = disabilities occurr+ 9 ,p]sian ,gulf ,w> vet]ans4 ,sec4 #djf4 ,presumption ( s]vice connection = c]ta9 diseases associat$ ) exposure to burn pits & o!r tox9s4 ,title ,v--,rese>* matt]s ,sec4 #eja4 ,int]ag5cy work+ gr\p on toxic exposure rese>*4 ,sec4 #ejb4 ,data collection1 analysis1 & report on treatm5t ( vet]ans = illnesses relat$ to toxic exposure4 ,sec4 #ejc4 ,/udies relat$ to vet]ans :o s]v$ 9 ,s\?we/ ,asia & c]ta9 o!r locations4 ,sec4 #ejd4 ,/udy on heal? tr5ds ( po/ #i_/aa vet]ans4 ,sec4 #eje4 ,/udy on canc] rates among vet]ans4 ,sec4 #ejf4 ,/udy on feasibility & advisability ( furni%+ hospital c>e & m$ical s]vices to dep5d5ts ( vet]ans :o p>ticipat$ 9 toxic exposure risk activities4 ,sec4 #ejg4 ,/udy on heal? effects ( wa/e relat$ to ,manhattan ,project on c]ta9 vet]ans4 ,sec4 #ejh4 ,/udy on toxic exposure & m5tal heal? outcomes4 ,sec4 #eji4 ,/udy on vet]ans 9 ,t]ritories ( ! ,unit$ ,/ates4 ,sec4 #eaj4 ,dep>tm5t ( ,vet]ans ,affairs public website = toxic exposure rese>*4 ,sec4 #eaa4 ,bi5nial report on heal? effects ( jet fuels us$ by ,arm$ ,=ces4 ,title ,,vi--,improvem5t ( res\rces & tra9+ reg>d+ toxic-expos$ vet]ans ,sec4 #fja4 ,%ort title2 def9itions4 ,sec4 #fjb4 ,publication ( li/ ( res\rces ( ,dep>tm5t ( ,vet]ans ,affairs = toxic-expos$ vet]ans & outrea* program = su* vet]ans & c>egiv]s & survivors ( su* vet]ans4 ,sec4 #fjc4 ,incorporation ( toxic exposure que/ionnaire dur+ prim>y c>e appo9tm5ts4 ,sec4 #fjd4 ,tra9+ = p]sonnel ( ! ,dep>tm5t ( ,vet]ans ,affairs ) respect to toxic-expos$ vet]ans4 ,sec4 #fje4 ,guidel9es = active duty milit>y on pot5tial risks & prev5tion ( toxic exposures4 ,title ,,vii--,regi/ries1 records1 & o!r matt]s ,sec4 #gja4 ,regi/ry ( individuals expos$ to p]- & polyfluoroalkyl sub/ances on milit>y in/allations4 ,sec4 #gjb4 ,=t ,mc,clellan ,heal? ,regi/ry4 ,sec4 #gjc4 ,indep5d5t /udy on ,individual ,longitud9al ,exposure ,record4 ,sec4 #gjd4 ,biannual report on ,individual ,longitud9al ,exposure ,record4 ,sec4 #gje4 ,correction ( exposure records by memb]s ( ! ,arm$ ,=ces & vet]ans4 ,sec4 #gjf4 ,f$]al cause ( action relat+ to wat] at ,camp ,lejeune1 ,nor? ,c>ol9a4 ,sec4 #gjg4 ,vet]ans ,toxic ,exposures ,fund4 ,sec4 #gjh4 ,au?orization ( electronic notice 9 claims "u laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs4 ,sec4 #gji4 ,au?orization ( appropriations = expansion ( claims automation4 ,sec4 #gaj4 ,non-applicability ( non-,dep>tm5t ( ,vet]ans ,affairs cov5ants n to compete to appo9tm5t ( ,vet]ans ,heal? ,adm9i/ration p]sonnel4 ,sec4 #gaa4 ,recruitm5t ( physicians on a cont+5t basis prior to completion ( tra9+ requirem5ts4 ,sec4 #gab4 ,au?ority = ,secret>y ( ,vet]ans ,affairs to aw>d grants to ,/ates to improve outrea* to vet]ans4 ,sec4 #gac4 ,/udy & report on h]bicide ag5t exposure 9 ,panama ,canal ,zone4 ,sec4 #gad4 ,budget in=mation = alt]natives to burn pits4 ,sec4 #gae4 ,au?orization ( appropriations = expansion ( claims automation4 ,sec4 #gaf4 ,burn pit regi/ry updates4 ,sec4 #gag4 ,burn pit transp>5cy4 ,i ,expansion ( heal? c>e eligibility ,a ,toxic-expos$ vet]ans #aja4 ,%ort title ,?is title may be cit$ z ! ,conc$+ ,our ,vet]ans' ,exposures ,n[ ,& ,necessitat+ ,tra9+ ,act or ! ,,cov5ant ,act4 #ajb4 ,def9itions relat+ to toxic-expos$ vet]ans 7a7 ,9 g5]al ,section #agaj7;a77#b77;,f7 is am5d$ by /rik+ :o 0 expos$ to a toxic sub/ance1 radiation1 or o!r conditions1 z provid$ 9 subsection 7e7 & ins]t+ 9 accordance ) subsection 7e71 :o is a toxic-expos$ vet]an4 7b7 ,def9itions ( toxic exposure & toxic-expos$ vet]an ,section #aja is am5d$ by add+ at ! end ! foll[+ new p>agraphs3 7#cg7 ,! t]m toxic exposure includes ! foll[+3 7,a7 ,a toxic exposure risk activity1 z def9$ 9 section #agaj7;e77#d7 ( ?is title4 7,b7 ,an exposure to a sub/ance1 *emical1 or airborne haz>d id5tifi$ 9 ! li/ "u section #aaai7;b77#b7 ( ?is title4 7#ch7 ,! t]m toxic-expos$ vet]an means a vet]an describ$ 9 section #agaj7;e77#a7 ( ?is title4 4 7c7 ,def9ition ( toxic exposure risk activity ,section #agaj7;e77#d7 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,c7 ,! t]m toxic exposure risk activity means any activity-- 7i7 t requires a correspond+ entry 9 an exposure track+ record sy/em 7z def9$ 9 section #aaai7;c7 ( ?is title7 = ! vet]an :o c>ri$ out ! activity2 or 7ii7 t ! ,secret>y det]m9es qualifies = purposes ( ?is subsection :5 tak+ into acc\nt :at is reasonably prud5t to protect ! heal? ( vet]ans4 4 #ajc4 ,expansion ( heal? c>e = specific categories ( toxic-expos$ vet]ans & vet]ans support+ c]ta9 ov]seas cont+5cy op]ations 7a7 ,9 g5]al 7#a7 ,expansion ,subsection 7e7 ( section #agaj1 z am5d$ by section #ajb7;c71 is fur!r am5d$-- 7,a7 9 p>agraph 7#a71 by add+ at ! end ! foll[+ new subp>agraphs3 7,g7 ,beg9n+ n lat] ?an ! applicable date specifi$ 9 p>agraph 7#f71 & subject to p>agraph 7#b71 a vet]an :o p>ticipat$ 9 a toxic exposure risk activity :ile s]v+ on active duty1 active duty = tra9+1 or inactive duty tra9+ is eligible = hospital c>e 7includ+ m5tal heal? s]vices & c\nsel+71 m$ical s]vices1 & nurs+ home c>e "u subsection 7a77#b77;,f7 = any illness4 7,h7 ,beg9n+ n lat] ?an ! applicable date specifi$ 9 p>agraph 7#f71 & subject to p>agraph 7#b71 a cov]$ vet]an 7z def9$ 9 section #aaai7;c7 ( ?is title7 is eligible = hospital c>e 7includ+ m5tal heal? s]vices & c\nsel+71 m$ical s]vices1 & nurs+ home c>e "u subsection 7a77#b77;,f7 = any illness4 7,i7 7i7 ,beg9n+ n lat] ?an ! applicable date specifi$ 9 p>agraph 7#f71 & subject to p>agraph 7#b71 a vet]an :o deploy$ 9 support ( a cont+5cy op]ation specifi$ 9 clause 7ii7 is eligible = hospital c>e 7includ+ m5tal heal? s]vices & c\nsel+71 m$ical s]vices1 & nurs+ home c>e "u subsection 7a77#b77;,f7 = any illness4 7ii7 ,a cont+5cy op]ation specifi$ 9 ?is clause is any ( ! foll[+3 7,i7 ,op]ation ,endur+ ,fre$om4 7,,ii7 ,op]ation ,fre$om's ,s5t9el4 7,,iii7 ,op]ation ,iraqi ,fre$om4 7,,iv7 ,op]ation ,new ,dawn4 7,v7 ,op]ation ,inh]5t ,resolve4 7,,vi7 ,resolute ,support ,mission4 2 & 7,b7 9 p>agraph 7#b77;,b7-- 7i7 by /rik+ or 7,f7 & ins]t+ 7,f71 7,g71 7,h71 or 7,i72 & 7ii7 by /rik+ s]vice or te/+ & ins]t+ s]vice1 te/+1 or activity4 7#b7 ,phase 9 ,su* subsection is fur!r am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#f7 7,a7 ,! ,secret>y %all det]m9e ! dates 9 subp>agraphs 7,g71 7,h71 & 7,i7 ( p>agraph 7#a7 z foll[s3 7i7 ,octob] #a1 #bjbd1 ) respect to a vet]an describ$ 9 su* subp>agraph 7,g7 or 7,h7 :o 0 dis*>g$ or releas$ f ! active milit>y1 naval1 air1 or space s]vice dur+ ! p]iod beg9n+ on ,augu/ #b1 #aiij1 & end+ on ,septemb] #aa1 #bjja4 7ii7 ,octob] #a1 #bjbf1 ) respect to a vet]an describ$ 9 su* subp>agraph 7,g7 or 7,h7 :o 0 dis*>g$ or releas$ f ! active milit>y1 naval1 air1 or space s]vice dur+ ! p]iod beg9n+ on ,septemb] #ab1 #bjja1 & end+ on ,decemb] #ca1 #bjjf4 7iii7 ,octob] #a1 #bjbh1 ) respect to a vet]an describ$ 9 su* subp>agraph 7,g7 or 7,h7 :o 0 dis*>g$ or releas$ f ! active milit>y1 naval1 air1 or space s]vice dur+ ! p]iod beg9n+ on ,janu>y #a1 #bjjg1 & end+ on ,decemb] #ca1 #bjab4 7iv7 ,octob] #a1 #bjcj1 ) respect to a vet]an describ$ 9 su* subp>agraph 7,g7 or 7,h7 :o 0 dis*>g$ or releas$ f ! active milit>y1 naval1 air1 or space s]vice dur+ ! p]iod beg9n+ on ,janu>y #a1 #bjac1 & end+ on ,decemb] #ca1 #bjah4 7v7 ,octob] #a1 #bjcb1 ) respect to a vet]an describ$ 9 su* subp>agraph 7,i74 7,b7 ,! ,secret>y may modify a date specifi$ 9 subp>agraph 7,a7 to an e>li] date1 z ! ,secret>y det]m9es appropriate bas$ on ! numb] ( vet]ans receiv+ hospital c>e1 m$ical s]vices1 & nurs+ home c>e "u subp>agraphs 7,g71 7,h71 & 7,i7 ( p>agraph 7#a7 & ! res\rces available to ! ,secret>y4 ,if ! ,secret>y det]m9es to s modify a date1 ! ,secret>y %all-- 7i7 notify ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate ( ! propos$ modification2 & 7ii7 publi% su* modifi$ date 9 ! ,f$]al ,regi/]4 4 7b7 ,outrea* plans ,) respect to ea* ( clauses 7i7 ?r\gh 7v7 ( section #agaj7;e77#f77;,a7 ( title #ch1 ,unit$ ,/ates ,code 7z add$ by subsection 7a77#b771 n lat] ?an #ahj days prior to ! date specifi$ 9 ! clause 7includ+ a date modifi$ pursuant to su* section71 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a plan to conduct outrea* to ! vet]ans ref]r$ to 9 ! clause to notify su* vet]ans ( _! eligibility = hospital c>e1 m$ical s]vices1 or nurs+ home c>e "u subp>agraph 7,g71 7,h71 or 7,i71 ( section #agaj7;e77#a7 ( su* title1 z ! case may be4 #ajd4 ,assessm5ts ( implem5tation & op]ation 7a7 ,initial res\rce assessm5t & report ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all-- 7#a7 complete an assessm5t to det]m9e-- 7,a7 ! p]sonnel & mat]ial res\rces necess>y to implem5t section #ajc 7includ+ ! am5dm5ts made by su* section72 & 7,b7 ! total numb] ( cov]$ vet]ans1 z su* t]m is def9$ 9 section #aaai7;c7 ( title #ch1 ,unit$ ,/ates ,code 7z add$ by section #cjb71 :o receive hospital c>e or m$ical s]vices furni%$ by ! ,secret>y "u *apt] #ag ( su* title1 disaggregat$ by priority gr\p specifi$ 9 section #agje7;a7 ( su* title2 & 7#b7 submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report conta9+ ! f9d+s ( ! assessm5t complet$ "u p>agraph 7#a71 includ+ a specific det]m9ation z to :e!r ! ,dep>tm5t has ! p]sonnel & mat]ial res\rces necess>y to implem5t section #ajc4 7b7 ,in=mation sy/ems ,n lat] ?an ,octob] #a1 #bjbd1 ! ,secret>y %all e/abli% in=mation sy/ems to assess ! implem5tation ( section #ajc1 includ+ ! am5dm5ts made by su* section1 & use ! results ( assessm5ts "u su* sy/ems to in=m ! reports "u subsection 7c74 7c7 ,annual reports 7#a7 ,reports ,n lat] ?an ,octob] #a1 #bjbe1 & on an annual basis !reaft] until ,octob] #a1 #bjcc1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report on ! foll[+3 7,a7 ,! effect ( ! implem5tation (1 & ! provision & managem5t ( c>e "u1 section #ajc1 7includ+ ! am5dm5ts made by su* section7 on ! dem& by vet]ans describ$ 9 subp>agraphs 7,g71 7,h71 & 7,i7 ( section #agaj7;e77#a7 ( title #ch1 ,unit$ ,/ates ,code 7z add$ by su* section #ajc7 = heal? c>e s]vices furni%$ by ! ,secret>y4 7,b7 ,any diff]+ patt]ns ( dem& = heal? c>e s]vices by su* vet]ans1 disaggregat$ by factors su* z ! relative di/ance ( ! vet]an f m$ical facilities ( ! ,dep>tm5t & :e!r ! vet]an _h previ\sly receiv$ hospital c>e or m$ical s]vices furni%$ by ! ,secret>y "u *apt] #ag ( su* title4 7,c7 ,! ext5t to :i* ! ,secret>y has met su* dem&4 7,d7 ,any *anges1 dur+ ! ye> cov]$ by ! report1 9 ! deliv]y patt]ns ( heal? c>e furni%$ by ! ,secret>y "u *apt] #ag ( su* title1 & ! fiscal impact ( su* *anges4 7#b7 ,matt]s ,ea* report "u p>agraph 7#a7 %all include1 ) respect to ! ye> cov]$ by ! report1 detail$ in=mation on ! foll[+3 7,a7 ,! total numb] ( vet]ans enroll$ 9 ! pati5t enrollm5t sy/em :o1 dur+ su* ye>1 receiv$ hospital c>e or m$ical s]vices furni%$ by ! ,secret>y "u *apt] #ag ( title #ch1 ,unit$ ,/ates ,code4 7,b7 ,( ! vet]ans specifi$ 9 subp>agraph 7,a71 ! numb] ( su* vet]ans :o1 dur+ ! prec$+ ?ree fiscal ye>s1 _h n receiv$ su* c>e or s]vices4 7,c7 ,) respect to ! vet]ans specifi$ 9 subp>agraph 7,b71 ! co/ ( provid+ heal? c>e to su* vet]ans dur+ ! ye> cov]$ by ! report1 %[n 9 total & disaggregat$ by-- 7i7 ! level ( c>e2 & 7ii7 :e!r ! c>e 0 provid$ ?r\gh ! ,vet]ans ,community ,c>e ,program4 7,d7 ,) respect to ! numb] ( vet]ans describ$ 9 subp>agraphs 7,g71 7,h71 & 7,i7 ( section #agaj7;e77#a7 ( title #ch1 ,unit$ ,/ates ,code 7z add$ by section #ajc71 ! foll[+ 7%[n 9 total & disaggregat$ by m$ical facility ( ! ,dep>tm5t1 z applicable73 7i7 ,! numb] ( su* vet]ans :o1 dur+ ! ye> cov]$ by ! report1 enroll$ 9 ! pati5t enrollm5t sy/em4 7ii7 ,! numb] ( su* vet]ans :o appli$ =1 b 7 d5i$1 su* enrollm5t4 7iii7 ,! numb] ( su* vet]ans :o 7 d5i$ hospital c>e or a m$ical s]vice furni%$ by ! ,secret>y t 0 consid]$ to be m$ically necess>y b n ( an em]g5cy nature4 7,e7 ,! numb]s & *>act]i/ics (1 & ! type & ext5t ( heal? c>e furni%$ by ! ,secret>y to1 vet]ans enroll$ 9 ! pati5t enrollm5t sy/em 7%[n 9 total & disaggregat$ by m$ical facility ( ! ,dep>tm5t74 7,f7 ,! numb]s & *>act]i/ics (1 & ! type & ext5t ( heal? c>e furni%$ by ! ,secret>y to1 vet]ans n enroll$ 9 ! pati5t enrollm5t sy/em 7disaggregat$ by ea* class ( eligibility = c>e "u section #agaj ( title #ch1 ,unit$ ,/ates ,code1 & fur!r %[n z a total p] class & disaggregat$ by m$ical facility ( ! ,dep>tm5t74 7,g7 ,! specific fiscal impact 7%[n 9 total & disaggregat$ by geographic heal? c>e deliv]y areas7 ( *anges 9 ! deliv]y patt]ns ( heal? c>e furni%$ by ! ,secret>y "u *apt] #ag ( su* title z a result ( ! implem5tation ( section #ajc 7includ+ ! am5dm5ts made by su* section74 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]m pati5t enrollm5t sy/em means ! pati5t enrollm5t sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,! t]m ,vet]ans ,community ,c>e ,program means ! program e/abli%$ "u section #agjc ( title #ch1 ,unit$ ,/ates ,code4 #aje4 ,revision ( brea/ canc] mammography policy ( ,dep>tm5t ( ,vet]ans ,affairs to provide mammography scre5+ = vet]ans :o s]v$ 9 locations associat$ ) toxic exposure 7a7 ,9 g5]al ,section #gcbb ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7a71 by /rik+ ,! & ins]t+ ,9 g5]al4--,!2 7#b7 9 subsection 7b7-- 7,a7 by /rik+ ,! & ins]t+ ,/&>ds = scre5+4--,!2 & 7,b7 9 p>agraph 7#b77;,b71 by ins]t+ a record ( s]vice 9 a location & dur+ a p]iod specifi$ 9 subsection 7d71 aft] risk factors12 & 7#c7 by add+ at ! end ! foll[+ new subsections3 7c7 ,eligibility = scre5+ = vet]ans expos$ to toxic sub/ances ,! ,"u ,secret>y = ,heal? %all ensure t1 "u ! policy develop$ "u subsection 7a71 any vet]an :o1 dur+ active milit>y1 naval1 or air s]vice1 0 deploy$ 9 support ( a cont+5cy op]ation 9 a location & dur+ a p]iod specifi$ 9 subsection 7d71 is eligible = a mammography scre5+ by a heal? c>e provid] ( ! ,dep>tm5t4 7d7 ,locations & p]iods specifi$ 7#a7 ,! locations & p]iods specifi$ 9 ?is subsection are ! foll[+3 7,a7 ,iraq dur+ foll[+ p]iods3 7i7 ,! p]iod beg9n+ on ,augu/ #b1 #aiij1 & end+ on ,febru>y #bh1 #aiia4 7ii7 ,! p]iod beg9n+ on ,m>* #ai1 #bjjc1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,iraq4 7,b7 ,! ,s\?we/ ,asia !at] ( op]ations1 o!r ?an ,iraq1 dur+ ! p]iod beg9n+ on ,augu/ #b1 #aiij1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 su* location1 includ+ ! foll[+ locations3 7i7 ,kuwait4 7ii7 ,saudi ,arabia4 7iii7 ,oman4 7iv7 ,qat>4 7,c7 ,afghani/an dur+ ! p]iod beg9n+ on ,septemb] #aa1 #bjja1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,afghani/an4 7,d7 ,djib\ti dur+ ! p]iod beg9n+ on ,septemb] #aa1 #bjja1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,djib\ti4 7,e7 ,syria dur+ ! p]iod beg9n+ on ,septemb] #aa1 #bjja1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,syria4 7,f7 ,jordan dur+ ! p]iod beg9n+ on ,septemb] #aa1 #bjja1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,jordan4 7,g7 ,egypt dur+ ! p]iod beg9n+ on ,septemb] #aa1 #bjja1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,egypt4 7,h7 ,lebanon dur+ ! p]iod beg9n+ on ,septemb] #aa1 #bjja1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,lebanon4 7,i7 ,yem5 dur+ ! p]iod beg9n+ on ,septemb] #aa1 #bjja1 & end+ on su* date z ! ,secret>y det]m9es burn pits are no long] us$ 9 ,yem54 7,j7 ,su* o!r locations & correspond+ p]iods z set =? by ! ,airborne ,haz>ds & ,op5 ,burn ,pit ,regi/ry e/abli%$ "u section #bja ( ! ,dignifi$ ,burial & ,o!r ,vet]ans' ,b5efits ,improvem5t ,act ( #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note74 7,k7 ,su* o!r locations & correspond+ p]iods z ! ,secret>y1 9 collaboration ) ! ,secret>y ( ,def5se1 may det]m9e appropriate 9 a report submitt$ "u p>agraph 7#b74 7#b7 ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,support+ ,exp&$ ,review = ,vet]ans ,9 ,combat ,environm5ts ,act ( #bjba1 & n less frequ5tly ?an once e two ye>s !reaft]1 ! ,secret>y ( ,vet]ans ,affairs1 9 collaboration ) ! ,secret>y ( ,def5se1 %all submit to ,congress a report specify+ o!r locations & correspond+ p]iods = purposes ( p>agraph 7#a77,k74 7#c7 ,a location "u ?is subsection %all n include any body ( wat] ar\nd or any airspace above su* location4 7#d7 ,9 ?is subsection1 ! t]m burn pit means an area ( l& t is us$ = disposal ( solid wa/e by burn+ 9 ! outdoor air4 4 7b7 ,report on brea/ canc] rates = vet]ans deploy$ to c]ta9 areas ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report t comp>es ! rates ( brea/ canc] among memb]s ( ! ,arm$ ,=ces deploy$ to ! locations & dur+ ! p]iods specifi$ 9 section #gcbb7;d7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 z comp>$ to memb]s ( ! ,arm$ ,=ces :o 7 n deploy$ to ^? locations dur+ ^? p]iods & to ! civilian population4 ,b ,c]ta9 vet]ans ( combat s]vice & o!r matt]s #aaa4 ,expansion ( p]iod ( eligibility = heal? c>e = c]ta9 vet]ans ( combat s]vice 7a7 ,exp&$ p]iod ,section #agaj7;e77#c7 is am5d$-- 7#a7 9 subp>agraph 7,a7-- 7,a7 by /rik+ ,janu>y #bg1 #bjjc & ins]t+ ,septemb] #aa1 #bjja2 & 7,b7 by /rik+ five-ye> p]iod & ins]t+ #aj-ye> p]iod2 7#b7 by am5d+ subp>agraph 7,b7 to read z foll[s3 7,b7 ,) respect to a vet]an describ$ 9 p>agraph 7#a77;,d7 :o 0 dis*>g$ or releas$ f ! active milit>y1 naval1 air1 or space s]vice aft] ,septemb] #aa1 #bjja1 & be=e ,octob] #a1 #bjac1 b did n enroll to receive su* hospital c>e1 m$ical s]vices1 or nurs+ home c>e "u su* p>agraph pursuant to subp>agraph 7,a7 be=e ,octob] #a1 #bjbb1 ! "o-ye> p]iod beg9n+ on ,octob] #a1 #bjbb4 2 & 7#c7 by /rik+ subp>agraph 7,c74 7b7 ,cl>ification ( cov]age ,section #agaj7;e77#a77;,d7 is am5d$ by ins]t+ aft] ,p]sian ,gulf ,w> ! foll[+3 7includ+ any vet]an :o1 9 connection ) s]vice dur+ su* p]iod1 receiv$ ! ,arm$ ,=ces ,exp$ition>y ,m$al1 ,s]vice ,specific ,exp$ition>y ,m$al1 ,combat ,era ,specific ,exp$ition>y ,m$al1 ,campaign ,specific ,m$al1 or any o!r combat !at] aw>d e/abli%$ by a ,f$]al /atute or an ,executive ord]74 7c7 ,outrea* plan ,n lat] ?an ,decemb] #a1 #bjbb1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a plan to conduct outrea* to vet]ans describ$ 9 subp>agraph 7,b7 ( section #agaj7;e77#c7 ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by subsection 7a77#b71 to notify su* vet]ans ( _! eligibility = hospital c>e1 m$ical s]vices1 or nurs+ home c>e pursuant to su* subp>agraph4 7d7 ,report on enrollm5ts ,n lat] ?an ,janu>y #cj1 #bjbd1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report id5tify+1 ) respect to ! "o-ye> p]iod beg9n+ on ,octob] #a1 #bjbb1 ! numb] ( vet]ans describ$ 9 section #agaj7;e77#c77;,b7 ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by subsection 7a77#b71 :o1 dur+ su* p]iod1 enroll$ 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje ( su* title4 7e7 ,effective date ,?is section & ! am5dm5ts made by ?is section %all take effect on ,octob] #a1 #bjbb4 #aab4 ,au?orization p]iod = em]g5cy treatm5t 9 non-,dep>tm5t ( ,vet]ans ,affairs m$ical facilities ,section #agjc7;a77#c7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by /rik+ ,a cov]$ vet]an & ins]t+ 7,a7 ,except z provid$ by subp>agraph 7,b71 a cov]$ vet]an2 & 7#b7 by add+ at ! end ! foll[+ new subp>agraph3 7,b7 ,9 ! case ( an em]g5cy :i* exi/$ at ! "t ( admission ( a cov]$ vet]an to a heal? c>e provid]1 ! ,secret>y %all deem ! c>e or s]vices receiv$ by ! vet]an dur+ su* admission to be au?oriz$ "u subp>agraph 7,a7 if ! cov]$ vet]an 7or an individual act+ on behalf ( ! cov]$ vet]an7 makes an application = su* au?orization dur+ ! p]iod foll[+ su* admission t ! ,secret>y det]m9es appropriate = purposes ( ?is p>agraph1 except su* p]iod may n be less ?an #if h\rs4 4 ,,ii ,toxic exposure presumption process #bja4 ,%ort title ,?is subtitle may be cit$ z ! ,fairly ,assess+ ,s]vice-relat$ ,toxic ,exposure ,residuals ,presumptions ,act or ! ,,fa/] ,presumptions ,act4 #bjb4 ,improvem5ts to ability ( ,dep>tm5t ( ,vet]ans ,affairs to e/abli% presumptions ( s]vice connection bas$ on toxic exposure 7a7 ,advisory committees1 panels1 & bo>ds ,*apt] #aa is am5d$ by add+ at ! end ! foll[+ new sub*apt]3 ,,vii ,det]m9ations relat+ to presumptions ( s]vice connection bas$ on toxic exposure #aaga4 ,proc$ures to det]m9e presumptions ( s]vice connection bas$ on toxic exposure2 def9itions 7a7 ,proc$ures ,! ,secret>y %all det]m9e :e!r to e/abli%1 or to remove1 presumptions ( s]vice connection bas$ on toxic exposure pursuant to ?is sub*apt]1 :]eby-- 7#a7 ! ,=mal ,advisory ,committee on ,toxic ,exposure "u section #aagb ( ?is title-- 7,a7 provides advice to ! ,secret>y on toxic-expos$ vet]ans & cases 9 :i* vet]ans :o1 dur+ active milit>y1 naval1 air1 or space s]vice1 may h exp]i5c$ a toxic exposure or _! dep5d5ts may h exp]i5c$ a toxic exposure :ile ! vet]ans 7 s]v+ 9 ! active milit>y1 naval1 air1 or space s]vice2 7,b7 provides to ! ,secret>y recomm5dations on corrections ne$$ 9 ! ,individual ,longitud9al ,exposure ,record1 or successor sy/em1 to bett] reflect vet]ans & dep5d5ts describ$ 9 subp>agraph 7,a72 & 7,c7 provides to ! ,secret>y recomm5dations reg>d+ :i* cases ( possible toxic exposure %\ld be review$2 & 7#b7 ! ,secret>y provides = =mal evaluations ( su* recomm5dations "u section #aagc ( ?is title2 & 7#c7 ! ,secret>y issues regulations "u section #aagd ( ?is title4 7b7 ,illness def9$ ,9 ?is sub*apt]1 ! t]m illness includes a disease or o!r condition affect+ ! heal? ( an individual1 includ+ m5tal & physical heal?4 #aagb4 ,=mal ,advisory ,committee on ,toxic ,exposure 7a7 ,e/abli%m5t 7#a7 ,!re is 9 ! ,vet]ans ,heal? ,adm9i/ration ( ! ,dep>tm5t ! ,=mal ,advisory ,committee on ,toxic ,exposure 79 ?is section ref]r$ to z ! ,committee74 7#b7 7,a7 ,! ,committee %all be compos$ ( n9e memb]s appo9t$ z foll[s3 7i7 ,five memb]s %all be appo9t$ by ! ,secret>y4 7ii7 ,"o memb] %all be appo9t$ by ! ,speak] ( ! ,h\se ( ,repres5tatives4 7iii7 ,"o memb] %all be appo9t$ by ! m9ority lead] ( ! ,h\se ( ,repres5tatives4 7iv7 ,"o memb] %all be appo9t$ by ! majority lead] ( ! ,s5ate4 7v7 ,"o memb] %all be appo9t$ by ! m9ority lead] ( ! ,s5ate4 7,b7 ,! memb]s appo9t$ "u subp>agraph 7,a7 %all meet ! foll[+ crit]ia3 7i7 ,n m ?an ?ree memb]s %all be appo9t$ f among individuals :o are (ficials or employees ( ! ,vet]ans ,b5efits ,adm9i/ration or ! ,vet]ans ,heal? ,adm9i/ration4 7ii7 ,at lea/ "o memb] %all be appo9t$ f among individuals :o are (ficials or employees ( o!r dep>tm5ts or ag5cies ( ! ,f$]al ,gov]nm5t1 includ+ ! ,dep>tm5t ( ,def5se & ! ,ag5cy ( ,toxic ,sub/ances & ,disease ,regi/ry ( ! ,c5t]s = ,disease ,control & ,prev5tion4 7iii7 ,at lea/ two memb]s %all repres5t an organization recogniz$ by ! ,secret>y = ! repres5tation ( vet]ans "u section #eijb ( ?is title4 7iv7 ,at lea/ "o memb] %all be appo9t$ f among individuals 9 ! private sector1 ,/ate or local gov]nm5t1 or academia1 :o are exp]ts 9 toxicology & epidemiology4 7#c7 ,! ,secret>y %all det]m9e ! pay & all[ances ( ! memb]s ( ! ,committee1 includ+ ) respect to any additional pay & all[ances = memb]s :o are (ficials or employees ( ! ,f$]al ,gov]nm5t4 7#d7 7,a7 ,except z provid$ by subp>agraph 7,b71 ea* memb] ( ! ,committee %all be appo9t$ = a two-ye> t]m1 & may s]ve n m ?an ?ree successive t]ms4 7,b7 ,) respect to ! five memb]s :o are initially appo9t$ by ! ,secret>y "u subp>agraph 7,a77i71 ! ,secret>y %all det]m9e ! l5g? ( ! t]m ( ea* su* memb] 9 a mann] t ensures ! expiration ( ! t]ms on a /agg]$ basis4 7#e7 ,a vacancy 9 ! ,committee %all be fill$ 9 ! mann] 9 :i* ! orig9al appo9tm5t 0 made4 7b7 ,consultation ,! ,secret>y may consult )1 & seek ! advice (1 ! ,committee ) respect to cases 9 :i* vet]ans :o1 dur+ active milit>y1 naval1 air1 or space s]vice1 are suspect$ ( hav+ exp]i5c$ a toxic exposure or dep5d5ts ( vet]ans :o may h exp]i5c$ a toxic exposure dur+ su* s]vice4 7c7 ,assessm5ts 7#a7 ,! ,committee %all assess cases ( ! toxic exposure ( vet]ans & _! dep5d5ts t occurr$ dur+ active milit>y1 naval1 air1 or space s]vice1 includ+ by conduct+ ongo+ surveillance & review+ su* exposure describ$ 9 sci5tific lit]ature1 m$ia reports1 in=mation f vet]ans1 & in=mation f ,congress4 7#b7 ,! assessm5ts "u p>agraph 7#a7 %all cov] suspect$ & kn[n toxic exposures occurr+ dur+ active milit>y1 naval1 air1 or space s]vice1 includ+ by id5tify+ & evaluat+ new & em]g+ toxic exposures t are n recogniz$ "u exi/+ presumptions ( s]vice connection4 7#c7 ,! ,committee may conduct an assessm5t "u p>agraph 7#a7 9 response to comm5ts by a p]son describ$ 9 subsection 7e77#b71 by a majority vote ( ! memb]s ( ! ,committee4 7#d7 ,! ,committee %all on a p]iodic basis assess ! ,individual ,longitud9al ,exposure ,record1 or successor sy/em1 to ensure ! accuracy ( data collect$4 7d7 ,rese>* recomm5dations 7#a7 ,foll[+ an assessm5t ( a case ( ! toxic exposure ( vet]ans or _! dep5d5ts t occurr$ dur+ active milit>y1 naval1 air1 or space s]vice "u subsection 7c71 ! ,committee may develop a recomm5dation = =mal evaluation "u section #aagc ( ?is title to conduct a review ( ! heal? effects relat$ to ! case ( exposure if ! ,committee det]m9es t ! rese>* may *ange ! curr5t und]/&+ ( ! relation%ip betwe5 an exposure to an environm5tal haz>d & adv]se heal? outcomes 9 humans4 7#b7 ,^u receipt ( evid5ce sugge/+ t previ\s f9d+s reg>d+ ! p]iods & locations ( exposure cov]$ by an exi/+ presumption ( s]vice connection are no long] support$1 ! ,committee may nom9ate su* evid5ce = =mal evaluation "u section #aagc ( ?is title to modify ! p]iods & locations4 7e7 ,input 7#a7 ,n less ?an qu>t]ly1 ! ,committee %all provide an opportunity = p]sons describ$ 9 p>agraph 7#b7 to pres5t writt5 or oral comm5ts to ! ,committee4 7#b7 ,! p]sons describ$ 9 ?is p>agraph are p]sons :o may be affect$ by ! actions ( ! ,committee1 includ+-- 7,a7 vet]ans1 ! families ( vet]ans1 vet]ans s]vice organizations & repres5tatives1 rese>*]s1 & o!r memb]s ( ! g5]al public2 & 7,b7 dep>tm5ts & ag5cies ( ! ,f$]al ,gov]nm5t4 7f7 ,reports by ! ,committee ,n less frequ5tly ?an once ea* ye>1 ! ,committee %all submit to ! ,secret>y & ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives1 & make publicly available1 a report on-- 7#a7 recomm5dations = rese>* "u subsection 7d71 if any2 & 7#b7 recomm5dations = su* legislative or adm9i/rative action z ! ,committee consid]s necess>y = ! ,committee to be m effective 9 c>ry+ out ! requirem5ts ( ?is section4 7g7 ,responses by ,secret>y ,9 response to ea* report submitt$ "u subsection 7f71 ! ,secret>y %all submit to ! ,secret>y & ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives1 & make publicly available1 a report on-- 7#a7 ! f9d+s & op9ions ( ! ,secret>y ) respect to ! report mo/ rec5tly submitt$ "u subsection 7f72 & 7#b7 :e!r ! ,secret>y w conduct rese>* recomm5d$ "u subsection 7f7 includ$ 9 ! report1 & if n1 an explanation ( :y1 includ+ citations & s\rces4 7h7 ,nonapplication ( sunset requirem5ts ,section #ad ( ! ,f$]al ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 %all n apply to ! ,committee4 #aagc4 ,=mal evaluation ( recomm5dations 7a7 ,=mal evaluation ,! ,secret>y %all e/abli% a process to conduct a =mal evaluation ) respect to ea* recomm5dation made by ! ,=mal ,advisory ,committee on ,toxic ,exposure "u section #aagb ( ?is title-- 7#a7 to conduct rese>* reg>d+ ! heal? effects relat$ to a case ( toxic exposure2 or 7#b7 to evaluate evid5ce reg>d+ ! p]iods & locations ( exposure cov]$ by an exi/+ presumption ( s]vice connection4 7b7 ,evid5ce1 data1 & factors ,! ,secret>y %all ensure t ea* =mal evaluation "u p>agraph 7#a7 cov]s ! foll[+3 7#a7 ,sci5tific evid5ce1 bas$ on ! review ( available sci5tific lit]ature1 includ+ human1 toxicological1 animal1 & me?odological /udies1 & o!r factors4 7#b7 ,claims data1 bas$ on ! review ( claim rate1 grant rate1 & s]vice connection preval5ce1 & o!r factors4 7#c7 ,o!r factors ! ,secret>y det]m9es appropriate1 su* z-- 7,a7 ! level ( disability & mortality caus$ by ! heal? effects relat$ to ! case ( toxic exposure be+ evaluat$2 7,b7 ! level ( assi/ance requir$ to rema9 9 ! community because ( su* heal? effects2 7,c7 ! quantity & quality ( ! in=mation available & review$2 7,d7 ! feasibility ( & p]iod = g5]at+ relevant in=mation & evid5ce2 7,e7 :e!r su* heal? effects are combat- or deploym5t-relat$2 & 7,f7 ! ubiquity or r>ity ( ! heal? effects4 7c7 ,conduct ( evaluations 7#a7 ,! ,secret>y %all ensure t ea* =mal evaluation "u subsection 7a7-- 7,a7 reviews sci5tific evid5ce 9 a mann] t-- 7i7 con=ms to pr9ciples ( sci5tific & data integrity2 7ii7 is free f suppression or di/ortion ( sci5tific or te*nological f9d+s1 data1 in=mation1 conclusions1 or te*nical results2 & 7,b7 7i7 evaluates ! likelihood t a positive association exi/s betwe5 an illness & a toxic exposure :ile s]v+ 9 ! active milit>y1 naval1 air1 or space s]vice2 & 7ii7 assesses ! toxic exposures & illnesses & det]m9es :e!r ! evid5ce supports a f9d+ ( a positive association betwe5 ! toxic exposure & ! illness4 7#b7 ,9 c>ry+ out p>agraph 7#a77;,b77ii71 a =mal evaluation "u subsection 7a7 %all include review+ all relevant data to det]m9e ! /r5g? ( evid5ce = a positive association bas$ on ! foll[+ f\r categories3 7,a7 ,! suffici5t category1 :]e ! evid5ce is suffici5t to conclude t a positive association exi/s4 7,b7 ,! equipoise & above category1 :]e ! evid5ce is suffici5t to conclude t a positive association is at lea/ z likely z n1 b n suffici5t to conclude t a positive association exi/s4 7,c7 ,! bel[ equipoise category1 :]e ! evid5ce is n suffici5t to conclude t a positive association is at lea/ z likely z n1 or is n suffici5t to make a sci5tifically in=m$ judgm5t4 7,d7 ,! aga9/ category1 :]e ! evid5ce sugge/s ! lack ( a positive association4 7d7 ,recomm5dation = rulemak+ ,n lat] ?an #abj days aft] ! date on :i* a =mal evaluation is comm5c$1 ! elem5t ( ! ,dep>tm5t t conducts ! evaluation %all submit to ! ,secret>y a recomm5dation ) respect to e/abli%+ a presumption ( s]vice connection = ! toxic exposure & illness1 or modify+ an exi/+ presumption ( s]vice connection1 cov]$ by ! evaluation4 #aagd4 ,regulations reg>d+ presumptions ( s]vice connection bas$ on toxic exposure 7a7 ,action ^u recomm5dation ,n lat] ?an #afj days aft] ! date on :i* ! ,secret>y receives a recomm5dation to e/abli% or modify a presumption ( s]vice connection "u section #aagc ( ?is title-- 7#a7 if ! ,secret>y det]m9es t ! presumption1 or modification1 is w>rant$1 ! ,secret>y %all comm5ce issu+ regulations 9 accordance ) ! provisions ( sub*apt] ,,ii ( *apt] #e ( title #e 7commonly ref]r$ to z ! ,adm9i/rative ,proc$ures ,act7 sett+ =? ! presumption or comm5ce revis+ regulations to c>ry out su* modification2 or 7#b7 if ! ,secret>y det]m9es t ! presumption1 or modification1 is n w>rant$1 ! ,secret>y %all publi% 9 ! ,f$]al ,regi/] a notice ( ! det]m9ation1 includ+ ! reasons support+ ! det]m9ation4 7b7 ,removal ( presumption 7#a7 ,! ,secret>y may issue regulations to remove an illness f a presumption ( s]vice connection previ\sly e/abli%$ pursuant to a regulation issu$ "u subsection 7a74 7#b7 ,:5ev] an illness is remov$ f regulations pursuant to p>agraph 7#a71 or ! p]iods & locations ( exposure cov]$ by a presumption ( s]vice connection are modifi$ "u subsection 7a7-- 7,a7 a vet]an :o 0 aw>d$ comp5sation = su* illness on ! basis ( ! presumption provid$ "u su* regulations be=e ! effective date ( ! removal or modification %all cont9ue to be entitl$ to receive comp5sation on t basis2 & 7,b7 a survivor ( a vet]an :o 0 aw>d$ dep5d5cy & indemnity comp5sation = ! dea? ( a vet]an result+ f su* illness on ! basis ( su* presumption %all cont9ue to be entitl$ to receive dep5d5cy & indemnity comp5sation on su* basis4 #aage4 ,au?ority to modify process2 congressional ov]sight 7a7 ,au?ority 7#a7 ,! ,secret>y may modify ! process "u :i* ! ,secret>y conducts =mal evaluations "u section #aagc ( ?is title & issues regulations "u section #aagd if-- 7,a7 su* evaluations cov] ! evid5ce1 data1 & factors requir$ by subsection 7b7 ( su* section #aagc2 & 7,b7 a p]iod ( #ahj days has elaps$ foll[+ ! date on :i* ! ,secret>y submits ! notice "u p>agraph 7#b7 reg>d+ ! modification4 7#b7 ,if ! ,secret>y proposes to modify ! process "u :i* ! ,secret>y conducts =mal evaluations "u section #aagc ( ?is title or issues regulations "u section #aagd1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a notice ( ! propos$ modifications conta9+ ! foll[+3 7,a7 ,a description ( ! propos$ modifications4 7,b7 ,a description ( any exceptions to ! requirem5ts ( su* sections t are propos$ because ( limit$ available sci5tific evid5ce1 & a description ( h[ su* evaluations w be conduct$4 7b7 ,reports & brief+s 7#a7 7,a7 ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report on ! implem5tation (1 & recomm5dations =1 ?is sub*apt]4 7,b7 ,! ,secret>y %all develop ! report "u subp>agraph 7,a7 9 consultation ) organizations recogniz$ by ! ,secret>y = ! repres5tation ( vet]ans "u section #eijb ( ?is title & any o!r entity ! ,secret>y det]m9es appropriate4 7#b7 ,on a qu>t]ly basis dur+ ! two-ye> p]iod beg9n+ on ! date ( ! enactm5t ( ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba1 ! ,secret>y %all provide to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a brief+ on ! implem5tation ( ?is sub*apt]4 7c7 ,indep5d5t review ,! ,secret>y %all seek to ent] into an agreem5t ) a nongov]nm5tal entity or a f$]ally fund$ rese>* & developm5t c5t] to conduct a review ( ! implem5tation ( ?is sub*apt]4 ,n lat] ?an #edj days aft] ! date ( ! enactm5t ( ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report conta9+ su* review4 4 7b7 ,con=m+ am5dm5ts ,*apt] #aa is am5d$-- 7#a7 9 section #aaaf-- 7,a7 by /rik+ subsections 7b71 7c71 7d71 & 7e72 7,b7 by ins]t+ aft] subsection 7a7 ! foll[+ new subsection 7b73 7b7 ,! ,secret>y %all ensure t any det]m9ation made on or aft] ! date ( ! enactm5t ( ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba reg>d+ a presumption ( s]vice connection bas$ on exposure to an h]bicide ag5t "u ?is section is made pursuant to sub*apt] ,,vii ( ?is *apt]1 includ+ ) respect to assess+ reports receiv$ by ! ,secret>y f ! ,national ,academy ( ,sci5ces "u section #c ( ! ,ag5t ,orange ,act ( #aiia 7,public ,law #ajb-d74 2 & 7,c7 by r$esignat+ subsection 7f7 z subsection 7c72 7#b7 9 section #aaaf;,b7b77#b77;,a71 by ins]t+ pursuant to sub*apt] ,,vii ( ?is *apt]1 be=e ! ,secret>y det]m9es2 & 7#c7 9 section #aaah-- 7,a7 by /rik+ subsections 7b7 ?r\gh 7e72 & 7,b7 by ins]t+ aft] subsection 7a7 ! foll[+ new subsection 7b73 7b7 ,! ,secret>y %all ensure t any det]m9ation made on or aft] ! date ( ! enactm5t ( ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba reg>d+ a presumption ( s]vice connection bas$ on a toxic exposure "u ?is section is made pursuant to sub*apt] ,,vii ( ?is *apt]4 4 7c7 ,rule ( con/ruction ,no?+ 9 section #aagb7;a77#b77;,a7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 %all be con/ru$ s z to require ! advice & cons5t ( ! ,s5ate 9 ! appo9tm5t ( memb]s ( ! ,=mal ,advisory ,committee on ,toxic ,exposure4 #bjc4 ,reevaluation ( claims = comp5sation involv+ presumptions ( s]vice connection 7a7 ,9 g5]al ,sub*apt] ,,vi ( *apt] #aa is am5d$ by add+ at ! end ! foll[+ new section3 #aafg4 ,reevaluation ( comp5sation det]m9ations pursuant to *anges 9 presumptions ( s]vice connection 7a7 ,reevaluation ,:5ev] a law1 includ+ ?r\gh a regulation or ,f$]al c\rt decision1 e/abli%es or modifies a presumption ( s]vice connection1 ! ,secret>y %all-- 7#a7 id5tify all claims = comp5sation "u ?is *apt] t-- 7,a7 7 submitt$ to ! ,secret>y2 7,b7 7 evaluat$ & d5i$ by ! ,secret>y be=e ! date on :i* su* provision ( law w5t into effect2 & 7,c7 might h be5 evaluat$ diff]5tly _h ! e/abli%m5t or modification be5 applicable to ! claim2 7#b7 all[ = ! reevaluation ( su* claims at ! election ( ! vet]an2 & 7#c7 not)/&+ section #eaaj ( ?is title1 ) respect to claims approv$ pursuant to su* reevaluation1 provide comp5sation "u ?is *apt] effective z if ! e/abli%m5t or modification ( ! presumption ( s]vice connection _h be5 9 effect on ! date ( ! submission ( ! orig9al claim describ$ 9 p>agraph 7#a74 7b7 ,outrea* ,! ,secret>y %all conduct outrea* to in=m relevant vet]ans t !y may elect to h a claim be reevaluat$ 9 light ( ! e/abli%m5t or modification ( a presumption ( s]vice connection describ$ 9 subsection 7a74 ,su* outrea* %all include ! foll[+3 7#a7 ,! ,secret>y %all publi% on ! int]net website ( ! ,dep>tm5t a notice t su* vet]ans may elect to h a claim s reevaluat$4 7#b7 ,! ,secret>y %all notify1 9 writ+ or by electronic means1 vet]ans s]vice organizations ( ! ability ( su* vet]ans to elect to h a claim s reevaluat$4 4 7b7 ,application ,section #aafg ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 %all apply ) respect to presumptions ( s]vice connection e/abli%$ or modifi$ on or aft] ! date ( ! enactm5t ( ?is ,act1 includ+ pursuant to am5dm5ts made by ?is ,act4 ,,iii ,improv+ ! e/abli%m5t ( s]vice connection process = toxic-expos$ vet]ans #cja4 ,%ort title ,?is title may be cit$ z ! ,vet]ans ,burn ,pits ,exposure ,recognition ,act4 #cjb4 ,presumptions ( toxic exposure ,sub*apt] ,,ii ( *apt] #aa is am5d$ by add+ at ! end ! foll[+ new section3 #aaai4 ,presumptions ( toxic exposure 7a7 ,consid]ation ( records ,if a vet]an submits to ! ,secret>y a claim = comp5sation = a s]vice-connect$ disability "u section #aaaj ( ?is title ) evid5ce ( a disability & a toxic exposure t occurr$ dur+ active milit>y1 naval1 air1 or space s]vice1 ! ,secret>y may1 9 adjudicat+ su* claim1 consid]-- 7#a7 any record ( ! vet]an 9 an exposure track+ record sy/em2 & 7#b7 if no record ( ! vet]an 9 an exposure track+ record sy/em indicates t ! vet]an 0 subject to a toxic exposure dur+ active milit>y1 naval1 air1 or space s]vice1 ! totality ( ! circum/ances ( ! s]vice ( ! vet]an4 7b7 ,presumption ( specific toxic exposure = memb]s :o s]v$ 9 c]ta9 locations 7#a7 ,! ,secret>y %all1 = purposes ( section #aaaj & *apt] #ag ( ?is title1 presume t any cov]$ vet]an 0 expos$ to ! sub/ances1 *emicals1 & airborne haz>ds id5tifi$ 9 ! li/ "u p>agraph 7#b7 dur+ ! s]vice ( ! cov]$ vet]an specifi$ 9 subsection 7c77#a71 unless !re is affirmative evid5ce to e/abli% t ! cov]$ vet]an 0 n expos$ to any su* sub/ances1 *emicals1 or haz>ds 9 connection ) su* s]vice4 7#b7 ,! ,secret>y %all e/abli% & ma9ta9 a li/ t conta9s an id5tification ( "o or m su* sub/ances1 *emicals1 & airborne haz>ds z ! ,secret>y1 9 collaboration ) ! ,secret>y ( ,def5se1 may det]m9e appropriate = purposes ( ?is section4 7#c7 ,beg9n+ n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba1 & n less frequ5tly ?an once e two ye>s !reaft]1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report id5tify+ any additions or removals to ! li/ "u p>agraph 7#b7 dur+ ! p]iod cov]$ by ! report4 7c7 ,def9itions ,9 ?is section3 7#a7 ,! t]m cov]$ vet]an means any vet]an :o-- 7,a7 on or aft] ,augu/ #b1 #aiij1 p]=m$ active milit>y1 naval1 air1 or space s]vice :ile assign$ to a duty /ation 9-- 7i7 ,bahra92 7ii7 ,iraq2 7iii7 ,kuwait2 7iv7 ,oman2 7v7 ,qat>2 7vi7 ,saudi ,arabia2 7vii7 ,somalia2 or 7viii7 ,unit$ ,arab ,emirates2 or 7,b7 on or aft] ,septemb] #aa1 #bjja1 p]=m$ active milit>y1 naval1 air1 or space s]vice :ile assign$ to a duty /ation 9-- 7i7 ,afghani/an2 7ii7 ,djib\ti2 7iii7 ,egypt2 7iv7 ,jordan2 7v7 ,lebanon2 7vi7 ,syria2 7vii7 ,yem52 7viii7 ,uzbeki/an2 7ix7 ! ,philipp9es2 or 7x7 any o!r c\ntry det]m9$ relevant by ! ,secret>y4 7#b7 ,! t]m exposure track+ record sy/em-- 7,a7 means any sy/em1 program1 or pilot program us$ by ! ,secret>y ( ,vet]ans ,affairs or ! ,secret>y ( ,def5se to track h[ vet]ans or memb]s ( ! ,arm$ ,=ces h be5 expos$ to v>i\s occupational or environm5tal haz>ds2 & 7,b7 includes ! ,individual ,longitud9al ,exposure ,record1 or successor sy/em4 7#c7 ,! t]m toxic exposure risk activity has ! mean+ giv5 su* t]m 9 section #agaj7;e77#d7 ( ?is title4 4 #cjc4 ,m$ical nexus exam9ations = toxic exposure risk activities ,sub*apt] ,,vi ( *apt] #aa1 z am5d$ by section #bjc1 is fur!r am5d$ by add+ at ! end ! foll[+ new section3 #aafh4 ,m$ical nexus exam9ations = toxic exposure risk activities 7a7 ,m$ical exam9ations & m$ical op9ions 7#a7 ,except z provid$ 9 subsection 7b71 if a vet]an submits to ! ,secret>y a claim = comp5sation = a s]vice-connect$ disability "u section #aaaj ( ?is title ) evid5ce ( a disability & evid5ce ( p>ticipation 9 a toxic exposure risk activity dur+ active milit>y1 naval1 air1 or space s]vice1 & su* evid5ce is n suffici5t to e/abli% a s]vice connection = ! disability1 ! ,secret>y %all-- 7,a7 provide ! vet]an ) a m$ical exam9ation "u section #eajc;,a7d7 ( ?is title2 & 7,b7 obta9 a m$ical op9ion 7to be reque/$ by ! ,secret>y 9 connection ) ! m$ical exam9ation "u subp>agraph 7,a77 z to :e!r x is at lea/ z likely z n t !re is a nexus betwe5 ! disability & ! toxic exposure risk activity4 7#b7 ,:5 provid+ ! ,secret>y ) a m$ical op9ion "u p>agraph 7#a77;,b7 = a vet]an1 ! heal? c>e provid] %all consid]-- 7,a7 ! total pot5tial exposure ?r\gh all applicable milit>y deploym5ts ( ! vet]an2 & 7,b7 ! syn]gi/ic1 comb9$ effect ( all toxic exposure risk activities ( ! vet]an4 7#c7 ,! requirem5t "u p>agraph 7#b77;,b7 %all n be con/ru$ z requir+ a heal? c>e provid] to consid] ! syn]gi/ic1 comb9$ effect ( ea* ( ! sub/ances1 *emicals1 & airborne haz>ds id5tifi$ 9 ! li/ "u section #aaai7;b77#b7 ( ?is title4 7b7 ,exception ,subsection 7a7 %all n apply if ! ,secret>y det]m9es !re is no indication ( an association betwe5 ! disability claim$ by ! vet]an & ! toxic exposure risk activity = :i* ! vet]an submitt$ evid5ce4 7c7 ,toxic exposure risk activity def9$ ,9 ?is section1 ! t]m toxic exposure risk activity has ! mean+ giv5 t t]m 9 section #agaj7;e77#d7 ( ?is title4 4 ,,iv ,presumptions ( s]vice connection #dja4 ,treatm5t ( vet]ans :o p>ticipat$ 9 cleanup ( ,enewetak ,atoll z radiation-expos$ vet]ans = purposes ( presumption ( s]vice connection ( c]ta9 disabilities by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,%ort title ,?is section may be cit$ z ! ,m>k ,takai ,atomic ,vet]ans ,heal?c>e ,p>ity ,act4 7b7 ,enewetak ,atoll ,section #aaab7;c77#c77;,b7 is am5d$ by add+ at ! end ! foll[+ new clause3 7v7 ,cleanup ( ,enewetak ,atoll dur+ ! p]iod beg9n+ on ,janu>y #a1 #aigg1 & end+ on ,decemb] #ca1 #aihj4 4 #djb4 ,treatm5t ( vet]ans :o p>ticipat$ 9 nucle> response ne> ,palom>es1 ,spa91 or ,?ule1 ,gre5l&1 z radiation-expos$ vet]ans = purposes ( presumption ( s]vice connection ( c]ta9 disabilities by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,%ort title ,?is section may be cit$ z ! ,palom>es or ,?ule ,vet]ans ,act 7b7 ,palom>es or ,?ule ,section #aaab7;c77#c77;,b71 z am5d$ by section #dja1 is fur!r am5d$ by add+ at ! end ! foll[+ new clauses3 7vi7 ,onsite p>ticipation 9 ! response ef=t foll[+ ! collision ( a ,unit$ ,/ates ,air ,=ce ,b-#eb bomb] & refuel+ plane t caus$ ! release ( f\r !rmonucle> weapons 9 ! vic9ity ( ,palom>es1 ,spa91 dur+ ! p]iod beg9n+ ,janu>y #ag1 #aiff1 & end+ ,m>* #ca1 #aifg4 7vii7 ,onsite p>ticipation 9 ! response ef=t foll[+ ! on-bo>d fire & cra% ( a ,unit$ ,/ates ,air ,=ce ,b-#eb bomb] t caus$ ! release ( f\r !rmonucle> weapons 9 ! vic9ity ( ,?ule ,air ,=ce ,base1 ,gre5l&1 dur+ ! p]iod beg9n+ ,janu>y #ba1 #aifh1 & end+ ,septemb] #be1 #aifh4 4 #djc4 ,presumptions ( s]vice connection = diseases associat$ ) exposures to c]ta9 h]bicide ag5ts = vet]ans :o s]v$ 9 c]ta9 locations 7a7 ,%ort title ,?is section may be cit$ z ! ,vet]ans ,ag5t ,orange ,exposure ,equity ,act4 7b7 ,9 g5]al ,section #aaaf1 z am5d$ by section #bjb1 is fur!r am5d$-- 7#a7 by /rik+ 1 dur+ active milit>y1 naval1 air1 or space s]vice1 s]v$ 9 ! ,republic ( ,vietnam dur+ ! p]iod beg9n+ on ,janu>y #i1 #aifb1 & end+ on ,may #g1 #aige ea* place x appe>s & ins]t+ p]=m$ cov]$ s]vice2 7#b7 by /rik+ p]=m$ active milit>y1 naval1 air1 or space s]vice 9 ! ,republic ( ,vietnam dur+ ! p]iod beg9n+ on ,janu>y #i1 #aifb1 & end+ on ,may #g1 #aige ea* place x appe>s & ins]t+ p]=m$ cov]$ s]vice2 & 7#c7 by add+ at ! end ! foll[+ new subsection3 7d7 ,9 ?is section1 ! t]m cov]$ s]vice means active milit>y1 naval1 air1 or space s]vice-- 7#a7 p]=m$ 9 ! ,republic ( ,vietnam dur+ ! p]iod beg9n+ on ,janu>y #i1 #aifb1 & end+ on ,may #g1 #aige2 7#b7 p]=m$ 9 ,?ail& at any ,unit$ ,/ates or ,royal ,?ai base dur+ ! p]iod beg9n+ on ,janu>y #i1 #aifb1 & end+ on ,june #cj1 #aigf1 )\t reg>d to :]e on ! base ! vet]an 0 locat$ or :at milit>y job specialty ! vet]an p]=m$2 7#c7 p]=m$ 9 ,laos dur+ ! p]iod beg9n+ on ,decemb] #a1 #aife1 & end+ on ,septemb] #cj1 #aifi2 7#d7 p]=m$ 9 ,cambodia at ,mimot or ,krek1 ,kampong ,*am ,prov9ce dur+ ! p]iod beg9n+ on ,april #af1 #aifi1 & end+ on ,april #cj1 #aifi2 or 7#e7 p]=m$ on ,guam or ,am]ican ,samoa1 or 9 ! t]ritorial wat]s !re(1 dur+ ! p]iod beg9n+ on ,janu>y #i1 #aifb1 & end+ on ,july #ca1 #aihj1 or s]v$ on ,john/on ,atoll or on a %ip t call$ at ,john/on ,atoll dur+ ! p]iod beg9n+ on ,janu>y #a1 #aigb1 & end+ on ,septemb] #cj1 #aigg4 4 7c7 ,eligibility = hospital c>e & m$ical s]vices ,section #agaj7;e77#d71 z am5d$ by section #ajb7;c71 is fur!r am5d$ by /rik+ subp>agraph 7,a7 & ins]t+ ! foll[+ new subp>agraph3 7,a7 ,! t]m ,vietnam-era h]bicide-expos$ vet]an means a vet]an :o-- 7i7 p]=m$ cov]$ s]vice1 z def9$ 9 section #aaaf7;d7 ( ?is title2 or 7ii7 ! ,secret>y f9ds may h be5 expos$ dur+ su* s]vice to diox9 or 0 expos$ dur+ su* s]vice to a toxic sub/ance f\nd 9 a h]bicide or defoliant us$ = milit>y purposes dur+ su* p]iod4 4 7d7 ,con=m+ am5dm5t ,! head+ = section #aaaf is am5d$ by /rik+ ! ,republic ( ,vietnam & ins]t+ c]ta9 locations4 #djd4 ,addition ( additional diseases associat$ ) exposure to c]ta9 h]bicide ag5ts = :i* !re is a presumption ( s]vice connection = vet]ans :o s]v$ 9 c]ta9 locations 7a7 ,%ort title ,?is section may be cit$ z ! ,fair ,c>e = ,vietnam ,vet]ans ,act4 7b7 ,additional diseases ,section #aaaf7;a77#b71 z am5d$ by section #iaji ( ! ,william ,m4 7,mac7 ,?ornb]ry ,national ,def5se ,au?orization ,act = ,fiscal ,ye> #bjba 7,public ,law #aaf-bhc71 is fur!r am5d$ by add+ at ! end ! foll[+ new subp>agraphs3 7,l7 ,hyp]t5sion4 7,m7 ,monoclonal gammopa?y ( undet]m9$ significance4 4 #dje4 ,improv+ comp5sation = disabilities occurr+ 9 ,p]sian ,gulf ,w> vet]ans 7a7 ,r$uction 9 ?re%old ( eligibility ,subsection 7a77#a7 ( section #aaag is am5d$ by /rik+ became manife/-- & all t foll[s ?r\gh ! p]iod at ! end & ins]t+ became manife/ to any degree at any "t44 7b7 ,p]man5t ext5sion ( p]iod ( eligibility ,su* section is fur!r am5d$-- 7#a7 by /rik+ subsection 7b72 7#b7 by r$esignat+ subsections 7c7 & 7d7 z subsections 7b7 & 7c71 respectively2 & 7#c7 9 subsection 7a77#b77;,c71 by /rik+ "u subsection 7d7 & ins]t+ "u subsection 7c74 7c7 ,e/abli%+ s+ul> disability-bas$ que/ionnaire ,su* section is fur!r am5d$ by ins]t+ aft] subsection 7c7 7z r$esignat$ by subsection 7b77 ! foll[+ new subsection 7d73 7d7 ,if a ,p]sian ,gulf vet]an at a m$ical facility ( ! ,dep>tm5t pres5ts ) any "o symptom associat$ ) ,gulf ,w> ,illness1 ! ,secret>y %all ensure t heal? c>e p]sonnel ( ! ,dep>tm5t use a disability b5efits que/ionnaire1 or successor que/ionnaire1 design$ to id5tify ,gulf ,w> ,illness1 9 addition to any o!r diagno/ic actions ! p]sonnel det]m9e appropriate4 4 7d7 ,expansion ( def9ition ( ,p]sian ,gulf vet]an ,subsection 7f7 ( su* section is am5d$ by ins]t+ 1 ,afghani/an1 ,israel1 ,egypt1 ,turkey1 ,syria1 or ,jordan1 aft] op]ations4 7e7 ,tra9+ ,su* section is fur!r am5d$ by add+ at ! end ! foll[+ new subsection3 7i7 7#a7 ,! ,secret>y %all take su* actions z may be necess>y to ensure t heal? c>e p]sonnel ( ! ,dep>tm5t are appropriately tra9$ to effectively c>ry out ?is section4 7#b7 ,n less frequ5tly ?an once ea* ye>1 ! ,secret>y %all submit to ,congress a report on ! actions tak5 by ! ,secret>y to c>ry out p>agraph 7#a74 4 #djf4 ,presumption ( s]vice connection = c]ta9 diseases associat$ ) exposure to burn pits & o!r tox9s 7a7 ,%ort title ,?is section may be cit$ z ! ,presumptive ,b5efits = ,w> ,fight]s ,expos$ to ,burn ,pits & ,o!r ,tox9s ,act4 7b7 ,9 g5]al ,sub*apt] ,,ii ( *apt] #aa1 z am5d$ by section #cjb1 is fur!r am5d$ by ins]t+ aft] section #aaai ! foll[+ new section3 #aabj4 ,presumption ( s]vice connection = c]ta9 diseases associat$ ) exposure to burn pits & o!r tox9s 7a7 ,presumption ( s]vice connection ,= ! purposes ( section #aaaj ( ?is title1 & subject to section #aaac ( ?is title1 a disease specifi$ 9 subsection 7b7 becom+ manife/ 9 a cov]$ vet]an %all be consid]$ to h be5 incurr$ 9 or aggravat$ dur+ active milit>y1 naval1 air1 or space s]vice1 not)/&+ t !re is no record ( evid5ce ( su* disease dur+ ! p]iod ( su* s]vice4 7b7 ,diseases specifi$ ,! diseases specifi$ 9 ?is subsection are ! foll[+3 7#a7 ,a/hma t 0 diagnos$ aft] s]vice ( ! cov]$ vet]an z specifi$ 9 subsection 7c74 7#b7 ,! foll[+ types ( canc]3 7,a7 ,head canc] ( any type4 7,b7 ,neck canc] ( any type4 7,c7 ,respiratory canc] ( any type4 7,d7 ,ga/ro9te/9al canc] ( any type4 7,e7 ,reproductive canc] ( any type4 7,f7 ,lymphoma canc] ( any type4 7,g7 ,lymphomatic canc] ( any type4 7,h7 ,kidney canc]4 7,i7 ,bra9 canc]4 7,j7 ,melanoma4 7,k7 ,pancreatic canc]4 7#c7 ,*ronic bron*itis4 7#d7 ,*ronic ob/ructive pulmon>y disease4 7#e7 ,con/rictive bron*iolitis or oblit]ative bron*iolitis4 7#f7 ,emphysema4 7#g7 ,granulomat\s disease4 7#h7 ,int]/itial lung disease4 7#i7 ,pleuritis4 7#aj7 ,pulmon>y fibrosis4 7#aa7 ,s>coidosis4 7#ab7 ,*ronic s9usitis4 7#ac7 ,*ronic rh9itis4 7#ad7 ,gliobla/oma4 7#ae7 ,any o!r disease = :i* ! ,secret>y det]m9es1 pursuant to regulations prescrib$ "u sub*apt] ,,vii t a presumption ( s]vice connection is w>rant$ bas$ on a positive association ) a sub/ance1 *emical1 or airborne haz>d id5tifi$ 9 ! li/ "u section #aaai7;b77#b7 ( ?is title4 7c7 ,cov]$ vet]an def9$ ,9 ?is section1 ! t]m cov]$ vet]an has ! mean+ giv5 t t]m 9 section #aaai7;c7 ( ?is title4 4 7c7 ,con=m+ am5dm5t ,section #aaac is am5d$ by /rik+ or #aaah ea* place x appe>s & ins]t+ #aaah1 or #aabj4 ,v ,rese>* matt]s #eja4 ,int]ag5cy work+ gr\p on toxic exposure rese>* 7a7 ,9 g5]al ,sub*apt] ,,ii ( *apt] #gc ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #gccj;,d4 ,int]ag5cy work+ gr\p on toxic exposure rese>* 7a7 ,e/abli%m5t 7#a7 ,! ,secret>y %all e/abli% ! ,toxic ,exposure ,rese>* ,work+ ,gr\p 79 ?is section ref]r$ to z ! ,work+ ,gr\p74 7#b7 ,! ,work+ ,gr\p %all consi/ ( employees1 select$ by ! ,secret>y1 ( ! foll[+3 7,a7 ,! ,dep>tm5t4 7,b7 ,! ,dep>tm5t ( ,def5se4 7,c7 ,! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7,d7 ,! ,environm5tal ,protection ,ag5cy4 7,e7 ,o!r ,f$]al entities involv$ 9 rese>* activities reg>d+ ! heal? consequ5ces ( toxic exposures exp]i5c$ dur+ active milit>y1 naval1 air1 or space s]vice4 7b7 ,functions ,! ,work+ ,gr\p %all p]=m ! foll[+ functions3 7#a7 ,id5tify collaborative rese>* activities & res\rces available among entities repres5t$ by memb]s ( ! ,work+ ,gr\p to conduct su* collaborative rese>* activities4 7#b7 ,develop a #e-ye> /rategic plan = ,f$]al entities repres5t$ 9 ! ,work+ ,gr\p to c>ry out collaborative rese>* activities4 7c7 ,report+ ,! ,secret>y %all submit1 to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives1 ! foll[+3 7#a7 ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,act1 a report on ! e/abli%m5t ( ! ,work+ ,gr\p "u subsection 7a74 7#b7 ,n lat] ?an two ye>s aft] ! date ( enactm5t ( ! ,act1 a report conta9+ ! collaborative rese>* activities id5tifi$1 & ! ,/rategic ,plan develop$1 by ! ,work+ ,gr\p1 "u subsection 7b74 7#c7 ,annually dur+ ! #e-ye> p]iod cov]$ by ! /rategic plan "u subsection 7b71 a progress reports on implem5tation ( ! ,/rategic ,plan "u subsection 7b74 7d7 ,t]m9ation ,! ,work+ ,gr\p %all t]m9ate aft] submitt+ ! f9al report "u subsection 7c74 7e7 ,def9itions ,= purposes ( ?is section-- 7#a7 ,! t]m ,act means ! ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjba4 7#b7 ,! t]m collaborative rese>* activity means a rese>* activity-- 7,a7 conduct$ by an entity repres5t$ by a memb] ( ! ,work+ ,gr\p2 7,b7 fund$ by ! ,f$]al ,gov]nm5t2 & 7,c7 reg>d+ ! heal? consequ5ces ( toxic exposures exp]i5c$ dur+ active milit>y1 naval1 air1 or space s]vice4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* sub*apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gccj;,c ! foll[+ new item3 #gccj;,d4 ,int]ag5cy work+ gr\p on toxic exposure rese>*4 4 7c7 ,implem5tation ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% ! ,work+ ,gr\p "u section #gccj;,d ( su* title1 z add$ by subsection 7a71 n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act4 #ejb4 ,data collection1 analysis1 & report on treatm5t ( vet]ans = illnesses relat$ to toxic exposure 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all compile & analyze1 on a cont9u\s basis1 all cl9ical data t-- 7#a7 is obta9$ by ! ,secret>y 9 connection ) hospital c>e 7includ+ m5tal heal? s]vices & c\nsel+71 m$ical s]vices1 or nurs+ home c>e furni%$ to a vet]an = an illness "u section #agaj7;a77#b77;,f7 ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by section #ajb2 & 7#b7 is likely to be sci5tifically useful1 z det]m9$ by ! ,secret>y1 9 det]m9+ :e!r a positive association exi/s betwe5 ! illness ( ! vet]an & a toxic exposure4 7b7 ,cons5t ( pati5ts ,! ,secret>y %all ensure t ! compilation & analysis ( ! cl9ical data ( a vet]an "u subsection 7a7 %all be conduct$1 & su* data %all be us$1 9 a mann] t is consi/5t ) ! in=m$ cons5t ( ! vet]an & 9 compliance ) all applicable ,f$]al law4 7c7 ,annual report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report conta9+-- 7#a7 any data compil$ "u subsection 7a72 7#b7 an analysis ( any su* data2 7#c7 a description ( ! types & incid5ces ( illnesses id5tifi$ by ! ,secret>y pursuant to su* subsection2 7#d7 an explanation by ! ,secret>y = ! incid5ce ( su* illnesses & su* alt]nate explanations = ! incid5ce ( su* illnesses z ! ,secret>y may consid] reasonable2 & 7#e7 a description ( ! views ( ! ,secret>y reg>d+ ! sci5tific validity ( draw+ conclusions f ! incid5ce ( su* illnesses1 z evid5c$ by ! data compil$ "u subsection 7a71 reg>d+ ! exi/5ce ( a positive association betwe5 su* illness & a toxic exposure4 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]m toxic exposure has ! mean+ giv5 t t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,! t]m illness has ! mean+ giv5 t t]m 9 section #aaga ( su* title1 z add$ by section #bjb4 #ejc4 ,/udies relat$ to vet]ans :o s]v$ 9 ,s\?we/ ,asia & c]ta9 o!r locations 7a7 ,analysis on mortality 9 cov]$ vet]ans 7#a7 ,analysis ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all conduct an updat$ analysis ( total & respiratory disease mortality 9 cov]$ vet]ans4 7#b7 ,elem5ts ,! analysis "u p>agraph 7#a7 %all include1 to ! ext5t practicable1 ! foll[+3 7,a7 ,metrics ( airborne exposures4 7,b7 ,! location & tim+ ( any deploym5ts ( ! vet]an4 7,c7 ,! milit>y occupational specialty ( ! vet]an4 7,d7 ,! ,arm$ ,=ce 9 :i* ! vet]an s]v$4 7,e7 ,! preexi/+ heal? /atus ( ! vet]an1 includ+ ) respect to a/hma4 7,f7 ,su* p]sonal in=mation ( ! vet]an z ! ,secret>y may consid] relevant1 includ+ cig>ette & e-cig>ette smok+ hi/ory1 diet1 sex1 g5d]1 age1 race1 & e?nicity4 7b7 ,epidemiological /udy ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all conduct an epidemiological /udy ( cov]$ vet]ans t involves-- 7#a7 ! use ( improv$ spatio-temporal e/imates ( ambi5t air pollution exposures t lev]age advances 9 retrospective exposure assessm5t2 & 7#b7 ! collection ( detail$ in=mation on ! cov]$ vet]ans /udi$ ?r\gh m$ical records1 adm9i/rative data1 & o!r exi/+ s\rces1 includ+1 ) respect to ! cov]$ vet]ans-- 7,a7 p]sonal in=mation1 includ+ cig>ette & e-cig>ette smok+ hi/ory1 diet1 sex1 g5d]1 age1 race1 & e?nicity2 7,b7 deploym5t hi/ory1 includ+ locations1 p]iods1 & numb] ( deploym5ts2 7,c7 biospecim5 data2 & 7,d7 supplem5t>y heal? /atus & outcomes data1 includ+ imag+ & physiological p>amet]s4 7c7 ,toxicology /udy 7#a7 ,/udy ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all conduct a toxicology /udy1 to include v>iability1 to replicate toxic exposures ( heal?y1 "y memb]s ( ! ,arm$ ,=ces1 z well z pot5tially susceptible memb]s1 ) preexi/+ heal? conditions4 7#b7 ,elem5ts ,! /udy "u p>agraph 7#a7 %all include-- 7,a7 an analysis ( results = me*ani/ic m>k]s & cl9ically relevant outcomes2 & 7,b7 a validation ( any s]um1 tissue1 or o!r biom>k]s ( toxic exposure1 susceptibility1 or effect ) respect to ! subjects ( ! /udy4 7d7 ,cov]$ vet]an def9$ ,9 ?is section1 ! t]m cov]$ vet]an has ! mean+ giv5 t t]m 9 section #aaai7;c7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #cjb4 #ejd4 ,/udy on heal? tr5ds ( po/ #i_/aa vet]ans 7a7 ,/udy ,! ,secret>y ( ,vet]ans ,affairs %all conduct an epidemiological /udy on ! heal? tr5ds ( vet]ans :o s]v$ 9 ! ,arm$ ,=ces aft] ,septemb] #aa1 #bjja4 7b7 ,elem5ts ,! /udy "u subsection 7a7 %all assess1 ) respect to ea* vet]an includ$ 9 ! /udy1 ! foll[+3 7#a7 ,! race & e?nicity ( ! vet]an4 7#b7 ,! age ( ! vet]an4 7#c7 ,! p]iod ( s]vice & l5g? ( s]vice ( ! vet]an 9 ! ,arm$ ,=ces4 7#d7 ,any milit>y occupational speciality ( ! vet]an4 7#e7 ,! g5d] ( ! vet]an4 7#f7 ,! disability /atus ( ! vet]an4 7c7 ,report ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report on ! /udy "u subsection 7a74 #eje4 ,/udy on canc] rates among vet]ans 7a7 ,/udy ,! ,secret>y ( ,vet]ans ,affairs %all conduct a /udy on ! incid5ce ( canc] 9 vet]ans1 to det]m9e tr5ds 9 ! rates ( ! incid5ce ( canc] 9 vet]ans1 & on available e>ly detection diagno/ics1 to det]m9e ! feasibility & advisability ( includ+ su* diagno/ics z "p ( ! heal? c>e furni%$ to vet]ans by ! ,secret>y4 7b7 ,elem5ts ,! /udy "u subsection 7a7 %all assess1 ) respect to ea* vet]an includ$ 9 ! /udy1 ! foll[+3 7#a7 ,! race & e?nicity ( ! vet]an4 7#b7 ,! age ( ! vet]an4 7#c7 ,! p]iod ( s]vice & l5g? ( s]vice ( ! vet]an 9 ! ,arm$ ,=ces4 7#d7 ,any milit>y occupational speciality ( ! vet]an4 7#e7 ,! g5d] ( ! vet]an4 7#f7 ,any type ( canc] t ! vet]an has4 7c7 ,report ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report on ! /udy "u subsection 7a74 #ejf4 ,/udy on feasibility & advisability ( furni%+ hospital c>e & m$ical s]vices to dep5d5ts ( vet]ans :o p>ticipat$ 9 toxic exposure risk activities 7a7 ,/udy ,! ,secret>y ( ,vet]ans ,affairs %all conduct a /udy on ! feasibility & advisability ( furni%+ hospital c>e & m$ical s]vices to qualify+ dep5d5ts ( vet]ans describ$ 9 section #agaj7;e77#a77;,g7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #ajc7;a77#a71 = any illness det]m9$ by ! ,secret>y to be connect$ to a toxic exposure risk activity c>ri$ out by ! vet]an1 z det]m9$ by ! ,secret>y1 not)/&+ t !re is insuffici5t m$ical evid5ce to conclude t su* illness is attributable to su* activity4 7b7 ,elem5ts ,! /udy "u subsection 7a7 %all include-- 7#a7 an assessm5t ( ! impact ( furni%+ hospital c>e & m$ical s]vices to qualify+ dep5d5ts z describ$ 9 su* subsection on ! ability ( ! ,dep>tm5t ( ,vet]ans ,affairs to furni% hospital c>e & m$ical s]vices to vet]ans2 7#b7 an assessm5t ( ! pot5tial co/ ( furni%+ hospital c>e & m$ical s]vices to qualify+ dep5d5ts z describ$ 9 su* subsection2 7#c7 an e/imate ( ! res\rces requir$ to furni% su* c>e & s]vices2 7#d7 an assessm5t ( any /ress or o!r effect furni%+ su* c>e & s]vices w\ld h on ! claims & appeals sy/em ( ! ,dep>tm5t2 7#e7 an e/imate ( ! numb] ( qualify+ dep5d5ts :o w\ld be eligible = su* c>e & s]vices2 & 7#f7 an assessm5t ( ! feasibility ( adjudicat+ claims = su* c>e & s]vices4 7c7 ,phas$-,9 application ,9 conduct+ ! /udy "u subsection 7a71 ! ,secret>y %all assess ! feasibility & advisability ( phas+ 9 ! furni%+ ( hospital c>e & m$ical s]vices to qualify+ dep5d5ts describ$ 9 su* subsection by ! decade 9 :i* su* toxic exposure risk activity occurr$1 />t+ ) ! mo/ rec5t decade4 7d7 ,review ( toxic exposure cases reg>d+ liability ( ,dep>tm5t ( ,def5se ,9 conduct+ ! /udy "u subsection 7a71 ! ,secret>y %all-- 7#a7 review kn[n cases ( toxic exposure on milit>y in/allations ( ! ,dep>tm5t ( ,def5se2 7#b7 analyze ! liability ( ! ,dep>tm5t ( ,def5se 9 ea* su* case2 & 7#c7 assess :e!r ! ,secret>y ( ,def5se %\ld provide c>e & s]vices relat+ to su* toxic exposures "u ! ,,tric>e program4 7e7 ,report ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ,congress a report on ! /udy conduct$ "u subsection 7a74 7f7 ,def9itions ,9 ?is section3 7#a7 ,! t]ms hospital c>e & m$ical s]vices h ! mean+s giv5 ^? t]ms 9 section #agja ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,! t]m illness has ! mean+ giv5 t t]m 9 section #aaga ( su* title1 z add$ by section #bjb4 7#c7 ,! t]m qualify+ dep5d5t means-- 7,a7 a dep5d5t ( a vet]an describ$ 9 section #agaj7;e77#a77;,g7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #ajd7;a77#a71 :o resid$ ) ! vet]an dur+ ! p]iod 9 :i*1 & on ! in/allation at :i*1 ! vet]an p>ticipat$ 9 a toxic exposure risk activity2 7,b7 an individual :o 0 9 ut]o ( su* a vet]an or o!r qualify+ dep5d5t :5 ! vet]an p>ticipat$ 9 a toxic exposure risk activity2 or 7,c7 a dep5d5t ( su* a vet]an :o is n describ$ 9 subp>agraph 7,a7 or 7,b7 b :o may h an illness t is connect$ to ! toxic exposure risk activity ( ! vet]an1 z det]m9$ by ! ,secret>y4 7#d7 ,! t]m toxic exposure has ! mean+ giv5 t t]m 9 section #aja ( su* title1 z add$ by section #ajb7;b74 7#e7 ,! t]m toxic exposure risk activity has ! mean+ giv5 t t]m 9 section #agaj7;e77#d7 ( su* title1 z add$ by section #ajb7;c74 7#f7 ,! t]m ,,tric>e program has ! mean+ giv5 t t]m 9 section #ajgb ( su* title4 #ejg4 ,/udy on heal? effects ( wa/e relat$ to ,manhattan ,project on c]ta9 vet]ans 7a7 ,/udy ,! ,secret>y ( ,vet]ans ,affairs %all conduct a /udy on ! heal? tr5ds ( vet]ans :o1 :ile s]v+ 9 ! active milit>y1 naval1 air1 or space s]vice-- 7#a7 p>ticipat$ 9 activities relat+ to ! ,manhattan ,project 7includ+ activities relat+ to cov]$ wa/e7 9 connection ) su* s]vice2 or 7#b7 resid$ at or ne>1 z det]m9$ by ! ,secret>y1 ! locations describ$ 9 subsection 7b74 7b7 ,cov]$ locations ,! locations describ$ 9 ?is subsection are ! foll[+ locations 9 ! c\nty ( ,/4 ,l\is1 ,miss\ri3 7#a7 ,coldwat] ,creek4 7#b7 ,! ,/4 ,l\is ,airport ,site4 7#c7 ,! ,we/ ,lake ,l&fill4 7#d7 ,any o!r location 9 ! c\nty ( ,/4 ,l\is1 ,miss\ri t is proximate to cov]$ wa/e1 z det]m9$ by ! ,secret>y4 7c7 ,elem5ts ,! /udy "u subsection 7a7 %all assess1 ) respect to ea* vet]an includ$ 9 ! /udy1 ! foll[+3 7#a7 ,! age1 g5d]1 & race ( ! vet]an4 7#b7 ,! p]iod & location ( exposure to cov]$ wa/e4 7#c7 ,any type ( canc]1 or o!r illness associat$ ) toxic exposure1 t ! vet]an has4 7#d7 ,a comp>ison ( ! ov]all heal? condition ( ! vet]an1 includ+ any illness ( ! vet]an id5tifi$ pursuant to p>agraph 7#c71 ) ! ov]all heal? condition ( pa/ & pres5t civilian populations resid+ at ! same location ( exposure4 7d7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report on ! /udy "u subsection 7a74 7e7 ,def9itions ,9 ?is section3 7#a7 ,! t]m cov]$ wa/e means any wa/e aris+ f activities c>ri$ out 9 connection ) ! ,manhattan ,project4 7#b7 ,! t]m illness has ! mean+ giv5 t t]m 9 section #aaga ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #bjb4 7#c7 ,! t]m toxic exposure has ! mean+ giv5 t t]m 9 section #aja ( su* title1 z add$ by section #ajb7;b74 #ejh4 ,/udy on toxic exposure & m5tal heal? outcomes 7a7 ,/udy requir$ ,! ,secret>y ( ! ,dep>tm5t ( ,vet]ans ,affairs %all ent] into an agreem5t ) ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e = ! conduct ( a /udy ( vet]ans to assess possible relation%ips betwe5 toxic exposures exp]i5c$ dur+ s]vice 9 ! ,arm$ ,=ces & m5tal heal? outcomes1 includ+ *ronic multisymptom illness1 traumatic bra9 injury1 po/-traumatic /ress disord]1 depression1 psy*osis1 suicide attempts1 & suicide dea?s4 7b7 ,elem5ts ,= ea* vet]an includ$ 9 ! /udy "u subsection 7a71 ! foll[+ in=mation %all be collect$ & assess$3 7#a7 ,age4 7#b7 ,g5d]4 7#c7 ,race & e?nicity4 7#d7 ,p]iod & l5g? ( s]vice 9 ! ,arm$ ,=ces4 7#e7 ,hi/ory ( toxic exposure dur+ s]vice 9 ! ,arm$ ,=ces4 7#f7 ,any diagnosis ( *ronic multisymptom illness4 7#g7 ,any diagnosis ( a m5tal heal? or cognitive disord]4 7#h7 ,any hi/ory ( suicide attempt or suidcidality4 7#i7 ,if ! vet]an di$ by suicide4 7c7 ,report ,n lat] ?an two ye>s aft] ! date aft] ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a report conta9+ ! f9d+s ( ! /udy conduct$ "u subsection 7a74 #eji4 ,/udy on vet]ans 9 ,t]ritories ( ! ,unit$ ,/ates 7a7 ,,gao /udy 7#a7 ,9 g5]al ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a /udy on ! /ate ( access & b>ri]s to b5efits & s]vices furni%$ "u laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs to vet]ans 9 ,t]ritories ( ! ,unit$ ,/ates1 includ+ deficits 9 ! availability & accessibility ( su* b5efits & s]vices comp>$ to vet]ans else:]e 9 ! ,unit$ ,/ates4 7#b7 ,elem5ts ,! /udy "u p>agraph 7#a7 %all include-- 7,a7 ! numb] ( vet]ans 9 ea* ,t]ritory ( ! ,unit$ ,/ates2 7,b7 ! numb] ( vet]ans 9 ea* ,t]ritory :o are enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 7,c7 ! numb] ( vet]ans 9 ea* ,t]ritory :o are eligible = s]vices "u section #agaj ( su* title b :o are n enroll$ z describ$ 9 subp>agraph 7,b72 7,d7 a detail$ description ( ob/acles fac+ vet]ans 9 ea* ,t]ritory 9 access+ heal? c>e s]vices1 includ+ ^? involv+ ! availability ( su* s]vices to vet]ans 9 ! ,t]ritory 9 :i* ! vet]ans reside1 & ! di/ance requir$ ( vet]ans to j\rney to receive s]vices at a regional m$ical c5t] ( ! ,vet]ans ,heal? ,adm9i/ration1 a community-bas$ outpati5t cl9ic1 or o!r full-s]vice m$ical facility ( ! ,dep>tm5t1 or dea? c5t]1 respectively2 7,e7 a detail$ description ( ob/acles fac+ vet]ans 9 ea* ,t]ritory 9 access+ readju/m5t c\nsel+ s]vices1 includ+ ^? involv+ ! availability ( su* s]vices to vet]ans 9 ! ,t]ritory 9 :i* ! vet]ans reside1 & ! di/ance requir$ ( vet]ans to j\rney to receive s]vices at a readju/m5t c\nsel+ s]vices c5t] ( ! ,dep>tm5t2 7,f7 a detail$ description ( ob/acles fac+ vet]ans 9 ea* ,t]ritory 9 access+ o!r vet]ans b5efits1 includ+ ^? involv+ ! availability ( b5efits & s]vices to vet]ans 9 ! ,t]ritory 9 :i* ! vet]ans reside1 & ! di/ance requir$ ( ! vet]ans to j\rney to ! ne>e/ (fice ( ! ,vet]ans ,b5efits ,adm9i/ration2 7,g7 an analysis ( ! /aff+ & recordkeep+ levels & quality ( ! (fices ( ! ,dep>tm5t *>g$ ) s]v+ vet]ans 9 ! ,t]ritories1 includ+ ! availability ( ! full- & "p-"t /aff ( ea* (fice to ! vet]ans !y are *>g$ ) s]v+1 & ! cont9uity ( c>e provid$ by su* /aff to su* vet]ans2 7,h7 an analysis ( ! availability ( ! ,vet]ans ,community ,c>e ,program e/abli%$ "u section #agjc ( title #ch1 ,unit$ ,/ates ,code1 to vet]ans 9 ea* ,t]ritory2 7,i7 an analysis ( ! economic & heal? consequ5ces = vet]ans 9 ea* ,t]ritory result+ f ob/acles to access+ adequate assi/ance & heal? c>e at facilities ( ! ,dep>tm5t2 7,j7 an analysis ( ! access to assi/ance & heal? c>e provid$ to vet]ans 9 ! aft]ma? ( major disa/]s decl>$ 9 ea* ( ! ,t]ritories s9ce ,septemb] #d1 #bjag2 & 7,k7 recomm5dations = improv+ access ( vet]ans 9 ! ,t]ritories to b5efits & s]vices furni%$ by ! ,secret>y1 & r$uc+ b>ri]s & deficits 9 ! availability & accessibility ( su* b5efits & s]vices comp>$ to vet]ans else:]e 9 ! ,unit$ ,/ates4 7b7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a f9al report sett+ =? ! results ( ! /udy conduct$ "u subsection 7a71 includ+ ! recomm5dations develop$ "u p>agraph 7#b77,k7 ( su* subsection4 7c7 ,t]ritory def9$ ,9 ?is section1 ! t]m ,t]ritory includes ,am]ican ,samoa1 ! ,commonweal? ( ! ,nor!rn ,m>ianas ,isl&s1 ,guam1 ,pu]to ,rico1 & ! ,virg9 ,isl&s4 #eaj4 ,dep>tm5t ( ,vet]ans ,affairs public website = toxic exposure rese>* 7a7 ,website ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all e/abli%1 & ma9ta9 !reaft]1 a publically accessible int]net website ( ! ,dep>tm5t ( ,vet]ans ,affairs t s]ves z a cle>+h\se = ! publication ( all toxic exposure rese>* c>ri$ out or fund$ by ! executive bran* ( ! ,f$]al ,gov]nm5t4 7b7 ,relation to ,w> ,relat$ ,illness & ,injury ,/udy ,c5t] ,! website develop$ & ma9ta9$ "u subsection 7a7 %all be h\s$ "u ! website ( ! ,w> ,relat$ ,illness & ,injury ,/udy ,c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs1 or successor c5t]4 7c7 ,coord9ation ,9 c>ry+ out subsection 7a71 ! ,secret>y %all coord9ate )-- 7#a7 ! heads ( ea* ,f$]al dep>tm5t or ag5cy c>ry+ out or fund+ toxic exposure rese>*2 7#b7 ! ,w> ,relat$ ,illness & ,injury ,/udy ,c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs1 or successor c5t]2 & 7#c7 any work+ gr\p ( ! ,dep>tm5t ( ,vet]ans ,affairs or o!r simil> entity responsible = coord9at+ toxic exposure rese>*4 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]m toxic exposure has ! mean+ giv5 t t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #ajb7;b74 7#b7 ,! t]m toxic exposure rese>* means rese>* on ! heal? consequ5ces ( toxic exposures exp]i5c$ dur+ s]vice 9 ! ,arm$ ,=ces4 #eaa4 ,bi5nial report on heal? effects ( jet fuels us$ by ,arm$ ,=ces ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & bi5nially !reaft] dur+ ! subsequ5t eight-ye> p]iod1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate1 & make publicly available1 a report t includes-- 7#a7 a discussion ( ! effect ( v>i\s diff]5t types ( jet fuels us$ by ! ,arm$ ,=ces on ! heal? ( individuals by l5g? ( exposure2 7#b7 an id5tification ( ! imm$iate symptoms ( jet fuel exposure t may indicate future heal? risks2 7#c7 a *ronology ( heal? safegu>ds implem5t$ by ! ,arm$ ,=ces int5d$ to r$uce ! exposure ( memb]s ( ! ,arm$ ,foces to jet fuel2 & 7#d7 an id5tification ( any areas relat+ to jet fuel exposure ab\t :i* new rese>* ne$s to be conduct$4 ,,vi ,improvem5t ( res\rces & tra9+ reg>d+ toxic-expos$ vet]ans #fja4 ,%ort title2 def9itions 7a7 ,%ort title ,?is title may be cit$ z ! ,toxic ,exposure 9 ! ,am]ican ,milit>y ,act or ! ,,team ,act4 7b7 ,def9itions ,9 ?is title1 ! t]ms active milit>y1 naval1 air1 or space s]vice1 toxic exposure1 & toxic-expos$ vet]an h ! mean+s giv5 ^? t]ms 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 #fjb4 ,publication ( li/ ( res\rces ( ,dep>tm5t ( ,vet]ans ,affairs = toxic-expos$ vet]ans & outrea* program = su* vet]ans & c>egiv]s & survivors ( su* vet]ans 7a7 ,publication ( li/ ( res\rces 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,vet]ans ,affairs %all publi% a li/ ( res\rces ( ! ,dep>tm5t ( ,vet]ans ,affairs =-- 7,a7 toxic-expos$ vet]ans1 includ+ ) respect to-- 7i7 disability comp5sation "u *apt] #aa ( title #ch1 ,unit$ ,/ates ,code2 & 7ii7 hospital c>e1 m$ical s]vices1 & nurs+ home c>e "u section #agaj7;a77#b77;,f7 ( su* title2 7,b7 c>egiv]s ( toxic-expos$ vet]ans :o are p>ticipat+ 9 ! program ( compreh5sive assi/ance = family c>egiv]s "u section #agbj;,g7a7 ( su* title2 & 7,c7 survivors ( toxic-expos$ vet]ans :o are receiv+ dea? b5efits "u ! laws adm9i/]$ by ! ,secret>y4 7#b7 ,update ,! ,secret>y %all p]iodically update ! li/ publi%$ "u p>agraph 7#a74 7#c7 ,languages ,! ,secret>y %all publi% ! li/ "u p>agraph 7#a7 9 languages includ+ ! foll[+3 7,a7 ,engli%4 7,b7 ,spani%4 7,c7 ,*9ese4 7,d7 ,! sev5 o!r mo/ commonly spok5 languages 9 ! ,unit$ ,/ates4 7b7 ,outrea* ,! ,secret>y %all develop1 ) input f ! community1 an in=mative outrea* program = vet]ans on illnesses t may be relat$ to toxic exposure1 includ+ outrea* ) respect to b5efits & support programs4 ,in=mation di/ribut$ "u ! outrea* program %all be treat$ z a fact %eet ( ! ,dep>tm5t ( ,vet]ans ,affairs = purposes ( mak+ ! in=mation available 9 multiple languages pursuant to section #b ( ! ,vet]ans & ,family ,in=mation ,act 7,public ,law #aag-fb2 #ch ,u4,s4,c4 #fcjc note74 7c7 ,vet]ans organizations ,to ! ext5t practicable1 ! ,secret>y %all %>e ) national vet]ans s]vice organizations & o!r vet]ans gr\ps1 includ+ su* organizations & gr\ps t improve access by vet]ans to heal? c>e & b5efits1 ! li/ ( res\rces "u subsection 7a7 & ! outrea* program "u subsection 7b74 #fjc4 ,incorporation ( toxic exposure que/ionnaire dur+ prim>y c>e appo9tm5ts 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all incorporate a cl9ical que/ionnaire to help det]m9e pot5tial toxic exposures dur+ active milit>y1 naval1 air1 or space s]vice z "p ( ! initial scre5+ conduct$ = an appo9tm5t ( a vet]an ) a prim>y c>e provid] ( ! ,dep>tm5t ( ,vet]ans ,affairs to improve und]/&+ by ! ,dep>tm5t ( toxic exposures ( vet]ans :ile s]v+ 9 ! ,arm$ ,=ces4 7b7 ,det]m9ation ( que/ions ,! que/ions includ$ 9 ! que/ionnaire requir$ "u subsection 7a7 %all be det]m9$ by ! ,secret>y ) input f m$ical pr(essionals4 #fjd4 ,tra9+ = p]sonnel ( ! ,dep>tm5t ( ,vet]ans ,affairs ) respect to toxic-expos$ vet]ans 7a7 ,heal? c>e p]sonnel ,! ,secret>y ( ,vet]ans ,affairs %all provide to heal? c>e p]sonnel ( ! ,dep>tm5t ( ,vet]ans ,affairs education & tra9+ to id5tify1 treat1 & assess ! impact on toxic-expos$ vet]ans ( illnesses relat$ to toxic exposure & in=m su* p]sonnel ( h[ to ask = additional in=mation f vet]ans reg>d+ diff]5t toxic exposures4 7b7 ,b5efits p]sonnel 7#a7 ,/&>d claims processor tra9+ curriculum 7,a7 ,curriculum ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all ensure t a /&>d tra9+ curriculum exi/s = processors ( claims "u ! laws adm9i/]$ by ! ,secret>y :o review claims = disability b5efits relat+ to s]vice-connect$ disabilities bas$ on toxic exposure1 includ+ employees :o adjudicate su* claims4 7,b7 ,matt]s includ$ ,! ,secret>y %all ensure t ! tra9+ "u subp>agraph 7,a7 includes ! foll[+ explanations ) respect to claims relat+ to toxic exposure3 7i7 ,a lack ( a presumption ( s]vice connection is n by itself suffici5t to det]m9e t s]vice connection does n exi/4 7ii7 ,! claims adjudicator %all always consid] :e!r direct s]vice connection is applicable & reque/1 z ne$$1 an advisory m$ical op9ion pursuant to section #aafh ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #cjc4 7iii7 ,! claims adjudicator may review & consid] any record ( ! claimant 9 an exposure track+ record sy/em pursuant to section #aaai ( su* title1 z add$ by section #cjb1 b a lack ( su* in=mation is n by itself suffici5t to det]m9e t su* exposure did n occur or suffici5t to d5y ! claim4 7,c7 ,provision ( tra9+ ,! ,secret>y %all-- 7i7 provide tra9+ "u subp>agraph 7,a7 to ea* employee describ$ 9 su* subp>agraph n less frequ5tly ?an annually2 & 7ii7 us+ ! ,sy/ematic ,te*nical ,accuracy ,review program1 or su* successor program1 conduct a nationwide1 qu>t]ly1 r&omiz$ review ( ! quality ( adjudication ( claims relat+ to toxic exposure4 7#b7 ,/&>d m$ical exam9] tra9+ curriculum 7,a7 ,curriculum ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all ensure t a /&>d m$ical tra9+ curriculum exi/s = m$ical provid]s :o conduct exam9ations & provide op9ions pursuant to section #aafh ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #cjc1 reg>dless ( :e!r ! provid] is an employee ( ! ,dep>tm5t or a contractor4 7,b7 ,/&>diz$ approa* ,! ,secret>y %all ensure t ! curriculum e/abli%$ "u subp>agraph 7,a7-- 7i7 provides a /&>diz$ approa* to conduct+ & provid+ exam9ations & op9ions 9 accordance ) su* section #aafh2 & 7ii7 in/ructs m$ical provid]s to consid]1 :5 conduct+ an exam9ation or provid+ an op9ion-- 7,i7 relevant m$ical & sci5tific lit]ature2 7,,ii7 ! proximity1 int5sity1 & frequ5cy ( exposure ( ! individual to ! id5tifi$ toxic exposure2 7,,iii7 m$ically unexpla9$ *ronic multisymptom illnesses2 & 7,,iv7 all compet5t & cr$ible evid5ce ( record4 #fje4 ,guidel9es = active duty milit>y on pot5tial risks & prev5tion ( toxic exposures ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,def5se & ! ,secret>y ( ,vet]ans ,affairs %all jo9tly coord9ate & e/abli% guidel9es to be us$ dur+ tra9+ ( memb]s ( ! ,arm$ ,=ces s]v+ on active duty to provide ! memb]s aw>5ess ( ! pot5tial risks ( toxic exposures & ways to prev5t be+ expos$ dur+ combat4 ,,vii ,regi/ries1 records1 & o!r matt]s #gja4 ,regi/ry ( individuals expos$ to p]- & polyfluoroalkyl sub/ances on milit>y in/allations 7a7 ,e/abli%m5t ( regi/ry 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all-- 7,a7 e/abli% & ma9ta9 a regi/ry = eligible individuals :o may h be5 expos$ to p]- & polyfluoroalkyl sub/ances 79 ?is section ref]r$ to z ,,pfas7 due to ! environm5tal release ( aque\s film-=m+ foam 79 ?is section ref]r$ to z ,,afff7 on milit>y in/allations to meet ! requirem5ts ( milit>y specification ,,mil-,f-#bdche;,f2 7,b7 include any in=mation 9 su* regi/ry t ! ,secret>y det]m9es necess>y to asc]ta9 & monitor ! heal? effects ( ! exposure ( memb]s ( ! ,arm$ ,=ces to ,,pfas associat$ ) ,,afff2 7,c7 develop a public in=mation campaign to in=m eligible individuals ab\t ! regi/ry1 includ+ h[ to regi/] & ! b5efits ( regi/]+2 & 7,d7 p]iodically notify eligible individuals ( significant developm5ts 9 ! /udy & treatm5t ( conditions associat$ ) exposure to ,,pfas4 7#b7 ,coord9ation ,! ,secret>y ( ,vet]ans ,affairs %all coord9ate ) ! ,secret>y ( ,def5se 9 c>ry+ out p>agraph 7#a74 7b7 ,reports 7#a7 ,initial report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,def5se %all submit to ,congress a report reg>d+ ! foll[+3 7,a7 ,s\rces ( ,,pfas on milit>y in/allations o!r ?an ,,afff4 7,b7 ,any recomm5dation ( ! ,secret>y reg>d+ :e!r to exp& eligibility = ! regi/ry to individuals expos$ to s\rces ( ,,pfas describ$ 9 subp>agraph 7,a74 7#b7 ,int]im report ,n lat] ?an two ye>s aft] ! date on :i* ! regi/ry "u subsection 7a7 is e/abli%$1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ,congress an initial report conta9+ ! foll[+3 7,a7 ,an assessm5t ( ! effectiv5ess ( actions tak5 by ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se to collect & ma9ta9 in=mation on ! heal? effects ( exposure to ,,pfas4 7,b7 ,recomm5dations to improve ! collection & ma9t5ance ( su* in=mation4 7,c7 ,us+ e/abli%$ & previ\sly publi%$ epidemiological /udies1 recomm5dations reg>d+ ! mo/ effective & prud5t means ( address+ ! m$ical ne$s ( eligible individuals ) respect to exposure to ,,pfas4 7#c7 ,foll[up report ,n lat] ?an five ye>s aft] submitt+ ! initial report "u p>agraph 7#a71 ! ,secret>y ( ,vet]ans ,affairs %all submit to ,congress a foll[up report conta9+ ! foll[+3 7,a7 ,an update to ! initial report submitt$ "u p>agraph 7#a74 7,b7 ,an assessm5t ( :e!r & to :at degree ! cont5t ( ! regi/ry e/abli%$ "u subsection 7a7 is curr5t & sci5tifically up to date4 7#d7 ,indep5d5t sci5tific organization ,! ,secret>y ( ,vet]ans ,affairs %all ent] into an agreem5t ) an indep5d5t sci5tific organization to prep>e ! reports "u p>agraphs 7#a7 & 7#b74 7c7 ,recomm5dations = additional exposures ,to be includ$ ,n lat] ?an five ye>s aft] ! date ( ! enactm5t ( ?is ,act1 & e five ye>s !reaft]1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ,def5se & ! ,adm9i/rator ( ! ,environm5tal ,protection ,ag5cy1 %all submit to ,congress recomm5dations = additional *emicals ) respect to :i* individuals expos$ to su* *emicals %\ld be includ$ 9 ! regi/ry e/abli%$ "u subsection 7a74 7d7 ,eligible individual def9$ ,9 ?is section1 ! t]m eligible individual means any individual :o1 on or aft] a date specifi$ by ! ,secret>y ( ,vet]ans ,affairs ?r\gh regulations1 s]v$ or is s]v+ 9 ! ,arm$ ,=ces at a milit>y in/allation :]e ,,afff 0 us$ or at ano!r location ( ! ,dep>tm5t ( ,def5se :]e ,,afff 0 us$4 #gjb4 ,=t ,mc,clellan ,heal? ,regi/ry 7a7 ,e/abli%m5t ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% & ma9ta9 a special record to be kn[n z ! ,=t ,mc,clellan ,heal? ,regi/ry 79 ?is section ref]r$ to z ! ,regi/ry74 7b7 ,cont5ts ,except z provid$ 9 subsection 7c71 ! ,regi/ry %all include ! foll[+ in=mation3 7#a7 ,a li/ conta9+ ! "n ( ea* individual :o1 :ile s]v+ z a memb] ( ! ,arm$ ,=ces1 0 /ation$ at ,=t ,mc,clellan1 ,alabama1 at any "t dur+ ! p]iod beg9n+ ,janu>y #a1 #aice1 & end+ on ,may #bj1 #aiii1 & :o-- 7,a7 applies = c>e or s]vices f ! ,dep>tm5t ( ,vet]ans ,affairs "u *apt] #ag ( title #ch1 ,unit$ ,/ates ,code2 7,b7 files a claim = comp5sation "u *apt] #aa ( su* title on ! basis ( any disability :i* may be associat$ ) su* s]vice2 7,c7 dies & is surviv$ by a sp\se1 *ild1 or p>5t :o files a claim = dep5d5cy & indemnity comp5sation "u *apt] #ac ( su* title on ! basis ( su* s]vice2 7,d7 reque/s f ! ,secret>y a heal? exam9ation "u subsection 7d72 or 7,e7 receives f ! ,secret>y a heal? exam9ation simil> to ! heal? exam9ation ref]r$ to 9 subp>agraph 7,d7 & reque/s inclusion 9 ! ,regi/ry4 7#b7 ,relevant m$ical data relat+ to ! heal? /atus (1 & o!r in=mation t ! ,secret>y consid]s relevant & appropriate ) respect to1 ea* individual describ$ 9 p>agraph 7#a7 :o-- 7,a7 grants to ! ,secret>y p]mission to include su* in=mation 9 ! ,regi/ry2 or 7,b7 at ! "t ! individual is li/$ 9 ! ,regi/ry1 is deceas$4 7c7 ,individuals submitt+ claims or mak+ reque/s be=e date ( enactm5t ,if 9 ! case ( an individual describ$ 9 subsection 7b77#a7 ! application1 claim1 or reque/ ref]r$ to 9 su* subsection 0 submitt$1 fil$1 or made be=e ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all1 to ! ext5t feasible1 include 9 ! ,regi/ry su* individual's "n & ! data & in=mation1 if any1 describ$ 9 subsection 7b77#b7 relat+ to ! individual4 7d7 ,exam9ations ,^u ! reque/ ( a vet]an :o 0 /ation$ at ,=t ,mc,clellan1 ,alabama1 at any "t dur+ ! p]iod beg9n+ ,janu>y #a1 #aice1 & end+ on ,may #bj1 #aiii1 ! ,secret>y %all provide ! vet]an ) a heal? exam9ation 7includ+ any appropriate diagno/ic te/s7 & consultation & c\nsel+ ) respect to ! results ( ! exam9ation & ! te/s4 7e7 ,outrea* 7#a7 ,ongo+ outrea* to individuals li/$ 9 ,regi/ry ,! ,secret>y %all1 f "t to "t1 notify individuals li/$ 9 ! ,regi/ry ( significant developm5ts 9 rese>* on ! heal? consequ5ces ( pot5tial exposure to a toxic sub/ance or environm5tal haz>d relat$ to s]vice at ,=t ,mc,clellan4 7#b7 ,exam9ation outrea* ,! ,secret>y %all c>ry out appropriate outrea* activities ) respect to ! provision ( any heal? exam9ations 7includ+ any diagno/ic te/s7 & consultation & c\nsel+ s]vices "u subsection 7d74 7f7 ,consultation ,! ,secret>y ( ,vet]ans ,affairs %all consult ) ! ,secret>y ( ,def5se to acquire in=mation ma9ta9$ by ! ,secret>y ( ,def5se t ! ,secret>y ( ,vet]ans ,affairs consid]s necess>y to e/abli% & ma9ta9 ! ,regi/ry4 #gjc4 ,indep5d5t /udy on ,individual ,longitud9al ,exposure ,record 7a7 ,9 g5]al ,n lat] ?an #fj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,def5se %all ent] into a contract ) an indep5d5t rese>* entity describ$ 9 subsection 7b7 to c>ry out a compreh5sive /udy ( ! developm5t ( ! ,individual ,longitud9al ,exposure ,record1 or successor sy/em1 to det]m9e-- 7#a7 ! quality ( ! location data1 occupational & environm5tal exposure data1 & heal? surveillance data2 & 7#b7 :e!r a memb] ( ! ,arm$ ,=ces c be reasonably assur$ t any toxic exposure !y exp]i5ce dur+ s]vice 9 ! ,arm$ ,=ces w be accurately reflect$ 9 ! record ( ! memb] 9 su* ,individual ,longitud9al ,exposure ,record4 7b7 ,indep5d5t rese>* entity ,! entity describ$ 9 ?is subsection is an indep5d5t rese>* entity t is a n-=-pr(it entity or a f$]ally fund$ rese>* & developm5t c5t] ) appropriate exp]tise & analytical capability to c>ry out ! /udy requir$ "u subsection 7a74 7c7 ,toxic exposure def9$ ,9 ?is section1 ! t]m toxic exposure has ! mean+ giv5 t t]m 9 section #aja7cg7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #ajb7;b74 #gjd4 ,biannual report on ,individual ,longitud9al ,exposure ,record 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date on :i* ! ,individual ,longitud9al ,exposure ,record1 or successor sy/em1 a*ieves full op]ation capability1 z det]m9$ by ! ,secret>y ( ,def5se1 & e #ahj days !reaft]1 ! ,secret>y ( ,def5se1 9 consultation ) ! ,secret>y ( ,vet]ans ,affairs1 %all submit to ! appropriate committees ( ,congress a report on-- 7#a7 ! data quality ( ! databases ( ! ,dep>tm5t ( ,def5se t provide ! in=mation pres5t$ 9 su* ,individual ,longitud9al ,exposure ,record2 & 7#b7 ! usefulness ( su* ,individual ,longitud9al ,exposure ,record 9 support+ memb]s ( ! ,arm$ ,=ces & vet]ans 9 receiv+ heal? c>e & b5efits f ! ,dep>tm5t ( ,def5se & ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,elem5ts ,ea* report requir$ by subsection 7a7 %all include1 = ! p]iod cov]$ by ! report1 ! foll[+3 7#a7 ,an id5tification ( toxic exposure ev5ts t may n be fully captur$ by ! curr5t sy/ems ( ! ,dep>tm5t ( ,def5se = environm5tal1 occupational1 & heal? monitor+1 & recomm5dations = h[ to improve ^? sy/ems4 7#b7 ,an analysis ( ! quality ( ! location data us$ by ! ,dep>tm5t ( ,def5se 9 det]m9+ toxic exposures ( memb]s ( ! ,arm$ ,=ces & vet]ans1 & recomm5dations = h[ to improve ! quality ( t location data if necess>y4 7c7 ,report on ,national ,gu>d use ( ,,il] ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,def5se %all submit to ! appropriate committees ( ,congress a report on ! feasibility ( modify+ ! ,individual ,longitud9al ,exposure ,record to ensure t a memb] ( ! ,national ,gu>d :o is deploy$ 9 ! ,unit$ ,/ates 9 connection ) a natural disa/]1 )\t reg>d to duty /atus 7includ+ any duty "u title #aj or title #cb1 ,unit$ ,/ates ,code1 or ,/ate active duty71 may record in=mation reg>d+ a suspect$ exposure by ! memb] to toxic sub/ances dur+ su* deploym5t4 7d7 ,def9itions ,9 ?is section3 7#a7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,arm$ ,s]vices & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate2 & 7,b7 ! ,committee on ,arm$ ,s]vices & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7#b7 ,toxic exposure ,! t]m toxic exposure has ! mean+ giv5 t t]m 9 section #aja7cg7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #ajb7;b74 #gje4 ,correction ( exposure records by memb]s ( ! ,arm$ ,=ces & vet]ans 7a7 ,9 g5]al ,! ,secret>y ( ,def5se %all provide a means = memb]s ( ! ,arm$ ,=ces & vet]ans to update _! records z necess>y to reflect a toxic exposure by su* memb] or vet]an 9 ! ,individual ,longitud9al ,exposure ,record1 or successor sy/em4 7b7 ,evid5ce 7#a7 ,provision ( evid5ce ,to update a record "u subsection 7a71 a memb] ( ! ,arm$ ,=ces or vet]an1 z ! case may be1 %all provide su* evid5ce z ! ,secret>y ( ,def5se consid]s necess>y4 7#b7 ,b5efit ( ! d\bt ,9 review+ evid5ce provid$ "u p>agraph 7#a71 ! ,secret>y ( ,def5se %all give ! b5efit ( ! d\bt to ! memb] ( ! ,arm$ ,=ces or vet]an :o provid$ ! evid5ce1 z ! case may be1 9 a mann] t is equival5t to ! b5efit ( ! d\bt requir$ "u section #eajg7;b7 ( title #ch1 ,unit$ ,/ates ,code4 7#c7 ,regulations ,! ,secret>y ( ,def5se %all prescribe by regulation ! evid5ce consid]$ necess>y "u p>agraph 7#a74 7c7 ,toxic exposure def9$ ,9 ?is section1 ! t]m toxic exposure has ! mean+ giv5 t t]m 9 section #aja7cg7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #ajb7;b74 #gjf4 ,f$]al cause ( action relat+ to wat] at ,camp ,lejeune1 ,nor? ,c>ol9a 7a7 ,9 g5]al ,an individual1 includ+ a vet]an 7z def9$ 9 section #aja ( title #ch1 ,unit$ ,/ates ,code71 or ! legal repres5tative ( su* an individual1 :o resid$1 work$1 or 0 o!rwise expos$ 7includ+ 9 ut]o exposure7 = n less ?an #cj days dur+ ! p]iod beg9n+ on ,augu/ #a1 #aiec1 & end+ on ,decemb] #ca1 #aihg1 to wat] at ,camp ,lejeune1 ,nor? ,c>ol9a1 t 0 suppli$ by1 or on behalf (1 ! ,unit$ ,/ates may br+ an action 9 ! ,unit$ ,/ates ,di/rict ,c\rt = ! ,ea/]n ,di/rict ( ,nor? ,c>ol9a to obta9 appropriate relief = h>m t 0 caus$ by exposure to ! wat] at ,camp ,lejeune4 7b7 ,burd5s & /&>d ( pro( 7#a7 ,9 g5]al ,! burd5 ( pro( %all be on ! p>ty fil+ ! action to %[ "o or m relation%ips betwe5 ! wat] at ,camp ,lejeune & ! h>m4 7#b7 ,/&>ds ,to meet ! burd5 ( pro( describ$ 9 p>agraph 7#a71 a p>ty %all produce evid5ce %[+ t ! relation%ip betwe5 exposure to ! wat] at ,camp ,lejeune & ! h>m is-- 7,a7 suffici5t to conclude t a causal relation%ip exi/s2 or 7,b7 suffici5t to conclude t a causal relation%ip is at lea/ z likely z n4 7c7 ,exclusive jurisdiction & v5ue ,! ,unit$ ,/ates ,di/rict ,c\rt = ! ,ea/]n ,di/rict ( ,nor? ,c>ol9a %all h exclusive jurisdiction ov] any action fil$ "u subsection 7a71 & %all be ! exclusive v5ue = su* an action4 ,no?+ 9 ?is subsection %all impair ! "r ( any p>ty to a trial by jury4 7d7 ,exclusive rem$y 7#a7 ,9 g5]al ,an individual1 or legal repres5tative ( an individual1 :o br+s an action "u ?is section = a h>m describ$ 9 subsection 7a71 includ+ a lat5t disease1 may n !reaft] br+ a tort action aga9/ ! ,unit$ ,/ates = su* h>m pursuant to any o!r law4 7#b7 ,heal? & disability b5efits relat+ to wat] exposure ,any aw>d made to an individual1 or legal repres5tative ( an individual1 "u ?is section %all be (fset by ! am\nt ( any disability aw>d1 paym5t1 or b5efit provid$ to ! individual1 or legal repres5tative-- 7,a7 "u-- 7i7 any program "u ! laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs2 7ii7 ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq472 or 7iii7 ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq472 & 7,b7 9 connection ) heal? c>e or a disability relat+ to exposure to ! wat] at ,camp ,lejeune4 7e7 ,immunity limitation ,! ,unit$ ,/ates may n ass]t any claim to immunity 9 an action "u ?is section t w\ld o!rwise be available "u section #bfhj7;a7 ( title #bh1 ,unit$ ,/ates ,code4 7f7 ,no punitive damages ,punitive damages may n be aw>d$ 9 any action "u ?is section4 7g7 ,disposition by ,f$]al ag5cy requir$ ,an individual may n br+ an action "u ?is section be=e comply+ ) section #bfge ( title #bh1 ,unit$ ,/ates ,code4 7h7 ,exception = combatant activities ,?is section does n apply to any claim or action aris+ out ( ! combatant activities ( ! ,arm$ ,=ces4 7i7 ,applicability2 p]iod = fil+ 7#a7 ,applicability ,?is section %all apply only to a claim accru+ be=e ! date ( enactm5t ( ?is ,act4 7#b7 ,/atute ( limitations ,a claim 9 an action "u ?is section may n be comm5c$ aft] ! lat] (-- 7,a7 ! date t is two ye>s aft] ! date ( enactm5t ( ?is ,act2 or 7,b7 ! date t is #ahj days aft] ! date on :i* ! claim is d5i$ "u section #bfge ( title #bh1 ,unit$ ,/ates ,code4 7#c7 ,inapplicability ( o!r limitations ,any applicable /atute ( repose or /atute ( limitations1 o!r ?an "u p>agraph 7#b71 %all n apply to a claim "u ?is section4 #gjg4 ,vet]ans ,toxic ,exposures ,fund ,*apt] #c is am5d$ by add+ at ! end ! foll[+ new section3 #cbd4 ,vet]ans ,toxic ,exposures ,fund 7a7 ,e/abli%m5t ,!re is h]eby e/abli%$ 9 ! ,treasury ( ! ,unit$ ,/ates an acc\nt to be kn[n z ! 8,vet]ans ,toxic ,exposures ,fund0 7! 8,fund071 to be adm9i/]$ ?r\gh ! ,dep>tm5t ( ,vet]ans ,affairs1 to provide = inve/m5t 9 ! deliv]y ( vet]ans' heal? c>e1 rese>*1 & b5efits associat$ ) haz>d\s exposure 9 s]vice4 7b7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ! ,fund = fiscal ye> #bjbc & ea* subsequ5t fiscal ye> su* sums z are necess>y to increase fund+1 ov] ! fiscal ye> #bjba level = ! ,vet]ans ,heal? ,adm9i/ration ( ! ,dep>tm5t ( ,vet]ans ,affairs1 = any exp5ses incid5t to ! deliv]y ( vet]ans' heal? c>e & b5efits associat$ ) exposure to environm5tal haz>ds 9 s]vice1 includ+ adm9i/rative exp5ses1 su* z claims process+ & appeals1 & = m$ical rese>* relat$ to haz>d\s exposures4 ,am\nts appropriat$ to ! ,fund pursuant to ?is subsection %all be c\nt$ z direct sp5d+ "u ! ,congressional ,budget & ,imp\ndm5t ,control ,act ( #aigd & any o!r ,act4 7c7 ,e/imates = congressional consid]ation ,! ,secret>y %all include 9 docum5ts submitt$ to ,congress 9 support ( ! ,presid5t's budget submitt$ pursuant to section #aaje ( title #ca1 ,unit$ ,/ates ,code1 detail$ e/imates ( ! sums describ$ 9 subsection 7b7 = ! applicable fiscal ye>4 7d7 ,proc$ures = e/imates ,! ,secret>y1 aft] consultation ) ! ,committees on ,appropriations ( ! ,h\se ( ,repres5tatives & ! ,s5ate1 may e/abli% policies & proc$ures = develop+ ! annual detail$ e/imates requir$ 9 subsection 7c74 4 #gjh4 ,au?orization ( electronic notice 9 claims "u laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs ,title #ch1 ,unit$ ,/ates ,code1 is am5d$ z foll[s3 7#a7 ,by /rik+ section #eajj & ins]t+ ! foll[+3 #eajj4 ,def9itions ,9 ?is *apt]3 7#a7 ,! t]m claimant means any individual apply+ =1 or submitt+ a claim =1 any b5efit "u ! laws adm9i/]$ by ! ,secret>y4 7#b7 ,! t]m notice means a communication issu$ ?r\gh means 7includ+ electronic means7 prescrib$ by ! ,secret>y4 4 7#b7 ,9 section #eajd1 by add+ at ! end ! foll[+ new subsection3 7c7 ,! ,secret>y may provide notice "u subsection 7a7 electronically if a claimant 7or ! claimant's repres5tative7 elects to receive su* notice electronically4 ,a claimant 7or ! claimant's repres5tative7 may revoke su* an election at any "t1 by means prescrib$ by ! ,secret>y4 7d7 ,! ,secret>y %all annually-- 7#a7 solicit recomm5dations f /akehold]s on h[ to improve notice "u ?is section2 & 7#b7 publi% su* recomm5dations on a publicly available website ( ! ,dep>tm5t4 4 7#c7 ,9 section #eajd;,b7c71 9 ! matt] prec$+ p>agraph 7#a7 by /rik+ 9 writ+ & ins]t+ to ! claimant 7& any repres5tative ( su* claimant74 7#d7 ,9 section #gajd-- 7,a7 9 ! head+1 by add+ 2 decisions2 notice at ! end2 & 7,b7 by /rik+ subsection 7e7 & ins]t+ ! foll[+3 7e7 ,aft] rea*+ a decision on an appeal1 ! ,bo>d %all promptly issue notice 7z t t]m is def9$ 9 section #eajj ( ?is title7 ( su* decision to ! foll[+3 7#a7 ,! appellant4 7#b7 ,any o!r p>ty ) a "r to notice ( su* decision4 7#c7 ,any au?oriz$ repres5tative ( ! appellant or p>ty describ$ 9 p>agraph 7#b74 7f7 ,! ,secret>y may provide notice "u subsection 7e7 electronically if a claimant 7or ! claimant's repres5tative7 elects to receive su* notice electronically4 ,a claimant 7or ! claimant's repres5tative7 may revoke su* an election at any "t1 by means prescrib$ by ! ,secret>y4 4 7#e7 ,9 section #gaje7;b77#a77;,a71 by /rik+ mail+ & ins]t+ issuance4 7#f7 ,9 section #gaje;,a7a71 by /rik+ mail$ & ins]t+ issu$4 7#g7 ,9 section #gbff7;a71 by /rik+ mail$ & ins]t+ issu$4 #gji4 ,au?orization ( appropriations = expansion ( claims automation ,!re is au?oriz$ to be appropriat$ to ! ,secret>y ( ,vet]ans ,affairs #cj1jjj1jjj = fiscal ye> #bjbc to support expect$ increas$ claims process+ = newly eligible vet]ans pursuant to ?is ,act & ! am5dm5ts made by ?is ,act by-- 7#a7 support+ ! automation ( process+ claims by ! ,vet]ans ,b5efits ,adm9i/ration ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7#b7 add+ self-s]vice features to ! sy/em by :i* individuals file claims2 7#c7 remov+ duplicative ef=ts reg>d+ ! process+ ( claims2 & 7#d7 r$uc+ ! dep5d5cy ( ! ,dep>tm5t on ! legacy claim sy/em4 #gaj4 ,non-applicability ( non-,dep>tm5t ( ,vet]ans ,affairs cov5ants n to compete to appo9tm5t ( ,vet]ans ,heal? ,adm9i/ration p]sonnel 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #gd ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #gdad4 ,effect ( non-,dep>tm5t cov5ants n to compete 7a7 ,non-,applicability ,except z provid$ 9 subsection 7b71 9 ! case ( an individual :o is an applicant = appo9tm5t to a position 9 ! ,vet]ans ,heal? ,adm9i/ration describ$ 9 section #gdja ( ?is title1 any cov5ant n to compete into :i* ! individual has ent]$ ) a non-,dep>tm5t facility or p>ty %all h no =ce or effect ) respect to ! appo9tm5t ( ! individual to su* a position4 7b7 ,s]vice obligation 7#a7 ,any individual :o is appo9t$ to su* a position 9 ! ,vet]ans ,heal? ,adm9i/ration %all1 z a condition ( su* appo9tm5t1 agree to provide cl9ical s]vices at a ,dep>tm5t m$ical facility = ! duration ( ! p]iod describ$ 9 p>agraph 7#b74 7#b7 ,! p]iod describ$ 9 ?is p>agraph is ! p]iod t beg9s on ! date on :i* an individual is appo9t$ to su* a position & ends on ! latt] ( ! foll[+ dates3 7,a7 ,! date t is "o ye> aft] su* date ( appo9tm5t4 7,b7 ,! date ( ! t]m9ation ( any cov5ant n to compete ent]$ into betwe5 ! individual & a non-,dep>tm5t facility or p>ty4 7#c7 ,! ,secret>y may waive ! requirem5t "u p>agraph 7#a7 ) respect to an individual at ! discretion ( ! ,secret>y4 7c7 ,t]m9ation ( ,dep>tm5t employm5t ,9 ! case ( an individual :o is appo9t$ to su* a position 9 ! ,vet]ans ,heal? ,adm9i/ration :o has ent]$ into a cov5ant n to compete t is r5d]$ non-applicable pursuant to subsection 7a71 if ! individual's employm5t at ! ,vet]ans ,heal? ,adm9i/ration is t]m9at$ = any reason be=e ! specifi$ t]m9ation date ( su* cov5ant1 subsection 7a7 %all n apply ) respect to su* cov5ant aft] ! date ( ! t]m9ation ( ! individual's employm5t at ! ,vet]ans ,heal? ,adm9i/ration4 7d7 ,cov5ant n ,to compete ,9 ?is section1 ! t]m cov5ant n to compete means an agreem5t-- 7#a7 betwe5 an employee & employ] or a contractor & pr9cipal t re/ricts su* employee or contractor f p]=m+-- 7,a7 any "w = ano!r employ] = a specifi$ p]iod ( "t2 7,b7 any "w 9 a specifi$ geographical area2 or 7,c7 "w = ano!r employ] p]=m+ "w t is simil> to ! "w su* employee or contractor p]=m$ = ! employ] or pr9cipal1 includ$ z a p>ty to ! agreem5t2 & 7#b7 t is ent]$ into aft] ! date ( enactm5t ( ?is ,act4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gdac ! foll[+ new item3 #gdad4 ,effect ( non-,dep>tm5t cov5ants n to compete4 4 #gaa4 ,recruitm5t ( physicians on a cont+5t basis prior to completion ( tra9+ requirem5ts ,section #gdjb ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7b77#a7-- 7,a7 9 ! matt] prec$+ subp>agraph 7,a7 by ins]t+ or to be (f]$ an appo9tm5t to su* position on a cont+5t basis "u subsection 7h7 aft] position2 & 7,b7 by /rik+ subp>agraph 7,b7 & ins]t+ ! foll[+3 7,b7 7i7 h complet$ a resid5cy lead+ to bo>d eligibility 9 a specialty1 satisfactory to ! ,secret>y2 or 7ii7 ) respect to an (f] = an appo9tm5t on a cont+5t basis "u subsection 7h71 complete su* a resid5cy by n lat] ?an two ye>s aft] ! date ( su* (f]2 & 2 & 7#b7 by add+ at ! end ! foll[+ new subsection3 7h7 7#a7 ,! ,secret>y may appo9t an individual "u subsection 7b77#a7 on a cont+5t basis 9 accordance ) ?is subsection if ! ,secret>y reasonably anticipat$ t ! individual w h complet$ ! requirem5ts = appo9tm5t "u su* subsection 7b77#a7 by n lat] ?an two ye>s aft] ! date on :i* ! individual is s appo9t$4 7#b7 ,an individual :o is appo9t$ to a position on a cont+5t basis "u p>agraph 7#a7 %all be appo9t$ to su* position on a p]man5t basis if1 by n lat] ?an two ye>s aft] ! date ( ! cont+5t appo9tm5t1 ! individual completes all ! requirem5ts = appo9tm5t "u subsection 7b77#a74 7#c7 ,an individual :o is appo9t$ on a cont+5t basis "u p>agraph 7#a7 :o fails to complete ! requirem5ts = appo9tm5t "u subsection 7b77#a7 by n lat] ?an two ye>s aft] ! date on :i* ! individual is s appo9t$ may n be appo9t$ to su* position on a p]man5t basis4 4 #gab4 ,au?ority = ,secret>y ( ,vet]ans ,affairs to aw>d grants to ,/ates to improve outrea* to vet]ans 7a7 ,9 g5]al ,*apt] #fc ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by r$esignat+ sections #fcjg & #fcjh & sections #fcjh & #fcji1 respectively2 & 7#b7 by ins]t+ aft] section #fcjf ! foll[+ new section #fcjg3 #fcjg4 ,grants to ,/ates to improve outrea* to vet]ans 7a7 ,purpose ,x is ! purpose ( ?is section to provide = assi/ance by ! ,secret>y to ,/ates to c>ry out programs t-- 7#a7 improve outrea* & assi/ance to vet]ans & ! sp\ses1 *ildr51 & p>5ts ( vet]ans1 to ensure t su* individuals are fully in=m$ ab\t any vet]ans & vet]ans-relat$ b5efits & programs 7includ+ ,/ate vet]ans programs7 = :i* !y may be eligible2 & 7#b7 facilitate opportunities = su* individuals to receive compet5t1 qualifi$ s]vices 9 ! prep>ation1 pres5tation1 & prosecution ( vet]ans b5efits claims4 7b7 ,au?ority ,! ,secret>y may aw>d grants to ,/ates-- 7#a7 to c>ry out1 coord9ate1 improve1 or o!rwise enhance outrea* activities2 7#b7 to increase ! numb] ( c\nty or tribal vet]ans s]vice (fic]s s]v+ 9 ! ,/ate by hir+ new1 additional su* (fic]s2 or 7#c7 to exp&1 c>ry out1 coord9ate1 improve1 or o!rwise enhance exi/+ programs1 activities1 & s]vices ( ! ,/ate's exi/+ organization t has be5 recogniz$ by ! ,dep>tm5t ( ,vet]ans ,affairs pursuant to section #eijb1 9 ! prep>ation1 pres5tation1 & prosecution ( claims = vet]ans b5efits ?r\gh repres5tatives :o hold positions z c\nty or ,tribal vet]ans s]vice (fic]s4 7c7 ,application 7#a7 ,to be eligible = a grant "u ?is section1 a ,/ate %all submit to ! ,secret>y an application !re= at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7#b7 ,ea* application submitt$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a detail$ plan = ! use ( ! grant4 7,b7 ,a description ( ! programs ?r\gh :i* ! ,/ate w meet ! outcome measures develop$ by ! ,secret>y "u subsection 7i74 7,c7 ,a description ( h[ ! ,/ate w di/ribute grant am\nts equitably among c\nties 7or ,tribal l&s1 z ! case may be7 ) v>y+ levels ( urbanization4 7,d7 ,a plan = h[ ! grant w be us$ to meet ! unique ne$s ( ,am]ican ,indian or ,alaska ,native vet]ans1 eld]ly vet]ans1 wom5 vet]ans1 & vet]ans f o!r und]s]v$ communities4 7d7 ,di/ribution ,! ,secret>y %all seek to ensure t grants aw>d$ "u ?is section are equitably di/ribut$ among ,/ates ) v>y+ levels ( urbanization4 7e7 ,priority ,! ,secret>y %all prioritize aw>d+ grants "u ?is section t w s]ve ! foll[+ areas3 7#a7 ,areas ) a critical %ortage ( c\nty or tribal vet]ans s]vice (fic]s4 7#b7 ,areas ) high rates (-- 7,a7 suicide among vet]ans2 or 7,b7 ref]rals to ! ,vet]ans ,crisis ,l9e4 7f7 ,use ( c\nty or tribal vet]ans s]vice (fic]s ,a ,/ate t receives a grant "u ?is section to c>ry out an activity describ$ 9 subsection 7b77#a7 %all c>ry out ! activity ?r\gh-- 7#a7 a c\nty or ,tribal vet]ans s]vice (fic] ( ! ,/ate2 or 7#b7 if ! ,/ate does n h a c\nty or tribal vet]ans s]vice (fic]1 or if ! c\nty or ,tribal vet]ans s]vice (fic]s ( ! ,/ate cov] only a portion ( t ,/ate1 an appropriate entity ( a ,/ate1 local1 or ,tribal gov]nm5t1 or ano!r publicly fund$ entity1 z det]m9$ by ! ,secret>y4 7g7 ,requir$ activities ,any grant aw>d$ "u ?is section %all be us$-- 7#a7 to exp& exi/+ programs1 activities1 & s]vices2 7#b7 to hire & ma9ta9 new1 additional c\nty or ,tribal vet]ans s]vice (fic]s2 or 7#c7 = travel & transportation to facilitate c>ry+ out p>agraph 7#a7 or 7#b74 7h7 ,o!r p]missible activities ,a grant "u ?is section may be us$ to provide education & tra9+1 includ+ on-!-job tra9+1 = ,/ate1 c\nty1 local1 & tribal gov]nm5t employees :o provide 7or :5 tra9$ w provide7 vet]ans outrea* s]vices 9 ord] = ^? employees to obta9 & ma9ta9 accr$itation 9 accordance ) proc$ures approv$ by ! ,secret>y4 7i7 ,outcome measures 7#a7 ,! ,secret>y %all develop & provide to ea* ,/ate t receives a grant "u ?is section writt5 guidance on ! foll[+3 7,a7 ,outcome measures4 7,b7 ,policies ( ! ,dep>tm5t4 7#b7 ,9 develop+ outcome measures "u p>agraph 7#a71 ! ,secret>y %all consid] ! foll[+ goals3 7,a7 ,increas+ ! use ( vet]ans & vet]ans-relat$ b5efits1 p>ticul>ly among vuln]able populations4 7,b7 ,increas+ ! numb] ( c\nty & tribal vet]ans s]vice (fic]s recogniz$ by ! ,secret>y = ! repres5tation ( vet]ans "u *apt] #ei ( ?is title4 7j7 ,track+ requirem5ts 7#a7 ,) respect to ea* grant aw>d$ "u ?is section1 ! ,secret>y %all track ! use ( vet]ans b5efits among ! population s]v$ by ! grant1 includ+ ! av]age p]iod ( "t betwe5 ! date on :i* a vet]an or o!r eligible claimant applies = su* a b5efit & ! date on :i* ! vet]an or o!r eligible claimant receives ! b5efit1 disaggregat$ by type ( b5efit4 7#b7 ,n less frequ5tly ?an annually dur+ ! life ( ! grant program e/abli%$ "u ?is section1 ! ,secret>y %all submit to ,congress a report on-- 7,a7 ! in=mation track$ "u p>agraph 7#a72 7,b7 h[ ! grants aw>d$ "u ?is section s]ve ! unique ne$s ( ,am]ican ,indian or ,alaska ,native vet]ans1 eld]ly vet]ans1 wom5 vet]ans1 & vet]ans f o!r und]s]v$ communities2 & 7,c7 o!r in=mation provid$ by ,/ates pursuant to ! grant report+ requirem5ts4 7k7 ,p]=mance review 7#a7 ,! ,secret>y %all-- 7,a7 review ! p]=mance ( ea* ,/ate t receives a grant "u ?is section2 & 7,b7 make in=mation reg>d+ su* p]=mance publicly available4 7l7 ,rem$iation plan 7#a7 ,9 ! case ( a ,/ate t receives a grant "u ?is section & does n meet ! outcome measures develop$ by ! ,secret>y "u subsection 7i71 ! ,secret>y %all require ! ,/ate to submit a rem$iation plan "u :i* ! ,/ate %all describe h[ & :5 x plans to meet su* outcome measures4 7#b7 ,! ,secret>y may n aw>d a subsequ5t grant "u ?is section to a ,/ate describ$ 9 p>agraph 7#a7 unless ! ,secret>y approves ! rem$iation plan submitt$ by ! ,/ate4 7m7 ,maximum am\nt ,! am\nt ( a grant aw>d$ "u ?is section may n exce$ #aj p]c5t ( am\nts made available = grants "u ?is section = ! fiscal ye> 9 :i* ! grant is aw>d$4 7n7 ,supplem5t1 n supplant ,any grant aw>d$ "u ?is section %all be us$ to supplem5t & n supplant ,/ate & local fund+ t is o!rwise available4 7o7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ! ,secret>y = ea* ( fiscal ye>s #bjbc ?r\gh #bjbg1 #ej1jjj1jjj to c>ry out ?is section4 7p7 ,def9itions ,9 ?is section3 7#a7 ,! t]m c\nty or tribal vet]ans s]vice (fic] includes a local equival5t vet]ans s]vice (fic]4 7#b7 ,! t]m ,/ate includes ea* ,indian ,tribe1 ! ,di/rict ( ,columbia1 ! ,commonweal? ( ,pu]to ,rico1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 & any t]ritory or possession ( ! ,unit$ ,/ates4 7#c7 ,! t]m ,vet]ans ,crisis ,l9e means ! toll-free hotl9e = vet]ans e/abli%$ "u section #agbj;,f7h7 ( ?is title4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #fc ( su* title is am5d$ by /rik+ ! items relat+ to sections #fcjg & #fcjh & ins]t+ ! foll[+ new items3 #fcjg4 ,grants to ,/ates to improve outrea* to vet]ans4 #fcjh4 ,outrea* = eligible dep5d5ts4 #fcji4 ,bi5nial report to ,congress4 4 7c7 ,au?orization ( additional full-"t equival5t employee ,dur+ fiscal ye>s #bjbc ?r\gh #bjbg1 ! ,secret>y ( ,vet]ans ,affairs may hire an additional full-"t equival5t employee 9 ! ,(fice ( ! ,g5]al ,c\nsel ( ! ,dep>tm5t ( ,vet]ans ,affairs1 z comp>$ to ! numb] ( full-"t equival5t employees t w\ld o!rwise be au?oriz$ = su* (fice1 to c>ry out duties "u ! accr$itation1 discipl9e1 & fees program4 #gac4 ,/udy & report on h]bicide ag5t exposure 9 ,panama ,canal ,zone 7a7 ,/udy ,! ,secret>y ( ,def5se %all conduct a /udy on ! exposure ( memb]s ( ! ,arm$ ,=ces to h]bicide ag5ts1 includ+ ,ag5t ,orange & ,ag5t ,purple1 9 ! ,panama ,canal ,zone dur+ ! p]iod beg9n+ on ,janu>y #a1 #aieh1 & end+ on ,decemb] #ca1 #aiii4 7b7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ,congress a report on ! /udy conduct$ "u subsection 7a74 #gad4 ,budget in=mation = alt]natives to burn pits ,! ,secret>y ( ,def5se %all include 9 ! budget submission ( ! ,presid5t "u section #aaje7;a7 ( title #ca1 ,unit$ ,/ates ,code1 = ea* ( fiscal ye>s #bjbc ?r\gh #bjbg1 a d$icat$ budget l9e item = inc9]ators & wa/e-to-en]gy wa/e disposal alt]natives to burn pits4 #gae4 ,au?orization ( appropriations = expansion ( claims automation ,!re is au?oriz$ to be appropriat$ to ! ,secret>y ( ,vet]ans ,affairs #aej1jjj1jjj = fiscal ye> #bjbc to cont9ue ! mod]nization & expansion ( capabilities & capacity ( ! ,vet]ans ,b5efits ,managem5t ,sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs to support expect$ increas$ claims process+ = newly eligible vet]ans pursuant to ?is ,act & ! am5dm5ts made by ?is ,act4 #gaf4 ,burn pit regi/ry updates 7a7 ,individuals eligible to update 7#a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all take actions necess>y to ensure t ! burn pit regi/ry may be updat$ ) ! cause ( dea? ( a deceas$ regi/]$ individual by-- 7,a7 an individual designat$ by su* deceas$ regi/]$ individual2 or 7,b7 if no su* individual is designat$1 an imm$iate family memb] ( su* deceas$ regi/]$ individual4 7#b7 ,designation ,! ,secret>y %all provide1 ) respect to ! burn pit regi/ry1 a process by :i* a regi/]$ individual may make a designation = purposes ( p>agraph 7#a77;,a74 7b7 ,def9itions ,9 ?is section3 7#a7 ,! t]m burn pit regi/ry means ! regi/ry e/abli%$ "u section #bja ( ! ,dignifi$ ,burial & ,o!r ,vet]ans' ,b5efits ,improvem5t ,act ( #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note74 7#b7 ,! t]m imm$iate family memb]1 ) respect to a deceas$ individual1 means-- 7,a7 ! sp\se1 p>5t1 bro!r1 si/]1 or adult *ild ( ! individual2 7,b7 an adult p]son to :om ! individual /&s 9 loco p>5tis2 or 7,c7 any o!r adult p]son-- 7i7 liv+ 9 ! h\sehold ( ! individual at ! "t ( ! dea? ( ! individual2 & 7ii7 relat$ to ! individual by blood or m>riage4 7#c7 ,! t]m regi/]$ individual means an individual regi/]$ ) ! burn pit regi/ry4 #gag4 ,burn pit transp>5cy 7a7 ,%ort title ,?is section may be cit$ z ! ,,sfc ,hea? ,rob9son ,burn ,pit ,transp>5cy ,act4 7b7 ,notifications & reports reg>d+ report$ cases ( burn pit exposure 7#a7 ,qu>t]ly notifications 7,a7 ,9 g5]al ,on a qu>t]ly basis1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! appropriate congressional committees a report on ea* report$ case ( burn pit exposure by a cov]$ vet]an report$ dur+ ! previ\s qu>t]4 7,b7 ,elem5ts ,ea* report submitt$ "u subp>agraph 7,a7 %all include1 ) respect to ea* report$ case ( burn pit exposure ( a cov]$ vet]an includ$ 9 ! report1 ! foll[+3 7i7 ,notice ( ! case1 includ+ ! m$ical facility at :i* ! case 0 report$4 7ii7 ,notice (1 z available-- 7,i7 ! enrollm5t /atus ( ! cov]$ vet]an ) respect to ! pati5t enrollm5t sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 7,,ii7 a summ>y ( all heal? c>e visits by ! cov]$ vet]an at ! m$ical facility at :i* ! case 0 report$ t are relat$ to ! case2 7,,iii7 ! demographics ( ! cov]$ vet]an1 includ+ age1 sex1 & race2 7,,iv7 any non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e b5efits t ! cov]$ vet]an receives2 7,v7 ! ,arm$ ,=ce 9 :i* ! cov]$ vet]an s]v$ & ! rank ( ! cov]$ vet]an2 7,,vi7 ! p]iod 9 :i* ! cov]$ vet]an s]v$2 7,,vii7 ea* location ( an op5 burn pit f :i* ! cov]$ vet]an 0 expos$ to toxic airborne *emicals & fumes dur+ su* s]vice2 7,,viii7 ! m$ical diagnoses ( ! cov]$ vet]an & ! treatm5t provid$ to ! vet]an2 & 7,,ix7 :e!r ! cov]$ vet]an is regi/]$ 9 ! ,airborne ,haz>ds & ,op5 ,burn ,pit ,regi/ry4 7,c7 ,protection ( in=mation ,! ,secret>y %all ensure t ! reports submitt$ "u subp>agraph 7,a7 d n include ! id5tity ( cov]$ vet]ans or conta9 o!r p]sonally id5tifiable data4 7#b7 ,annual report on cases 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,vet]ans ,affairs1 9 collaboration ) ! ,secret>y ( ,def5se1 %all submit to ! appropriate congressional committees a report detail+ ! foll[+3 7i7 ,! total numb] ( cov]$ vet]ans4 7ii7 ,! total numb] ( claims = disability comp5sation "u *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 approv$ & ! total numb] d5i$ by ! ,secret>y ( ,vet]ans ,affairs ) respect to a cov]$ vet]an1 & = ea* su* d5ial1 ! rationale ( ! d5ial4 7iii7 ,a compreh5sive li/ (-- 7,i7 ! conditions = :i* cov]$ vet]ans seek treatm5t2 & 7,,ii7 ! locations ( ! op5 burn pits f :i* ! cov]$ vet]ans 7 expos$ to toxic airborne *emicals & fumes4 7iv7 ,id5tification ( any illnesses relat+ to exposure to op5 burn pits t =m$ ! basis = ! ,secret>y to aw>d b5efits1 includ+ entitlem5t to s]vice connection or an increase 9 disability rat+4 7v7 ,! total numb] ( cov]$ vet]ans :o di$ aft] seek+ c>e = an illness relat+ to exposure to an op5 burn pit4 7vi7 ,any updates or tr5ds ) respect to ! in=mation describ$ 9 clauses 7i71 7ii71 7iii71 7iv71 & 7v7 t ! ,secret>y det]m9es appropriate4 7,b7 ,matt]s includ$ 9 fir/ report ,! ,secret>y %all include 9 ! fir/ report "u p>agraph 7#a7 in=mation specifi$ 9 p>agraph 7#a77;,b7 ) respect to report$ cases ( burn pit exposure made dur+ ! p]iod beg9n+ ,janu>y #a1 #aiij1 & end+ on ! day be=e ! date ( ! enactm5t ( ?is ,act4 7#c7 ,in=mation reg>d+ ! ,airborne ,haz>ds & ,op5 ,burn ,pit ,regi/ry 7,a7 ,notice ,! ,secret>y ( ,vet]ans ,affairs %all ensure t a m$ical pr(essional ( ! ,dep>tm5t ( ,vet]ans ,affairs in=ms a vet]an ( ! ,airborne ,haz>ds & ,op5 ,burn ,pit ,regi/ry if ! vet]an pres5ts at a m$ical facility ( ! ,dep>tm5t = treatm5t t ! vet]an describes z be+ relat$ to1 or ancill>y to1 ! exposure ( ! vet]an to toxic airborne *emicals & fumes caus$ by op5 burn pits4 7,b7 ,display ,9 mak+ in=mation public reg>d+ ! numb] ( p>ticipants 9 ! ,airborne ,haz>ds & ,op5 ,burn ,pit ,regi/ry1 ! ,secret>y %all display su* numb]s by bo? ,/ate & by congressional di/rict4 7#d7 ,comptroll] ,g5]al report ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! appropriate congressional committees a report conta9+ an assessm5t ( ! effectiv5ess ( any memor&um ( und]/&+ or memor&um ( agreem5t ent]$ into by ! ,secret>y ( ,vet]ans ,affairs ) respect to-- 7,a7 ! process+ ( report$ cases ( burn pit exposure2 & 7,b7 ! coord9ation ( c>e & provision ( heal? c>e relat+ to su* cases at m$ical facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs & at non-,dep>tm5t facilities4 7#e7 ,def9itions ,9 ?is section3 7,a7 ,! t]m ,airborne ,haz>ds & ,op5 ,burn ,pit ,regi/ry means ! regi/ry e/abli%$ by ! ,secret>y ( ,vet]ans ,affairs "u section #bja ( ! ,dignifi$ ,burial & ,o!r ,vet]ans' ,b5efits ,improvem5t ,act ( #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note74 7,b7 ,! t]m appropriate congressional committees means-- 7i7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,arm$ ,s]vices ( ! ,s5ate2 & 7ii7 ,! ,committee on ,vet]ans' ,affairs & ! ,committee on ,arm$ ,s]vices ( ! ,h\se ( ,repres5tatives4 7,c7 ,! t]m cov]$ vet]an means a vet]an :o pres5ts at a m$ical facility ( ! ,dep>tm5t ( ,vet]ans ,affairs 7or 9 a non-,dep>tm5t facility pursuant to section #agjc or #agjc;,a ( title #ch1 ,unit$ ,/ates ,code7 = treatm5t t ! vet]an describes z be+ relat$ to1 or ancill>y to1 ! exposure ( ! vet]an to toxic airborne *emicals & fumes caus$ by op5 burn pits at any "t :ile s]v+ 9 ! ,arm$ ,=ces4 7,d7 ,! t]m op5 burn pit has ! mean+ giv5 t t]m 9 section #bja7;c7 ( ! ,dignifi$ ,burial & ,o!r ,vet]ans' ,b5efits ,improvem5t ,act ( #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note74 7,e7 ,! t]m report$ case ( burn pit exposure means ea* in/ance 9 :i* a vet]an pres5ts at a m$ical facility ( ! ,dep>tm5t ( ,vet]ans ,affairs 7or 9 a non-,dep>tm5t facility pursuant to section #agjc or #agjc;,a ( title #ch1 ,unit$ ,/ates ,code7 = treatm5t t ! vet]an describes z be+ relat$ to1 or ancill>y to1 ! exposure ( ! vet]an to toxic airborne *emicals & fumes caus$ by op5 burn pits at any "t :ile s]v+ 9 ! ,arm$ ,=ces4 ,pass$ ! ,h\se ( ,repres5tatives ,m>* #c1 #bjbb4;,cl]k4