#aagth ,,congress  #b;d ,session  ,s4   
#ceda  ,,an ,,act  ,to improve health   
care and services for veterans exposed  
to toxic substances1 and for other      
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,health ,care for   
,burn ,pit ,veterans ,act4  #b4         
,expansion of eligibility for health    
care from ,department of ,veterans      
,affairs for certain veterans exposed to
 toxic substances  7a7 ,in general      
,section #agaj7;e77#c7 of title #ch1    
,united ,states ,code1 is amended-- 7#a7
 in subparagraph 7,a7-- 7,a7 by striking
 ,january #bg1 #bjjc and inserting      
,september #aa1 #bjja2 and  7,b7 by     
striking five-year period and inserting 
ten-year period2  7#b7 by amending      
subparagraph 7,b7 to read as follows3   
7,b7 ,with respect to a veteran         
described in paragraph 7#a77;,d7 who was
 discharged or released from the active 
military1 naval1 air1 or space service  
after ,september #aa1 #bjja1 and before 
,october #a1 #bjac1 but did not enroll  

to receive such hospital care1 medical  
services1 or nursing home care under    
such paragraph pursuant to subparagraph 
7,a7 before ,october #a1 #bjbb1 the     
one-year period beginning on ,october   
#a1 #bjbb4  2 and  7#c7 by striking     
subparagraph 7,c74  7b7 ,clarification  
of coverage ,section #agaj7;e77#a77;,d7 
of such title is amended by inserting   
after ,persian ,gulf ,war the following3
 7to include any veteran who1 in        
connection with service during such     
period1 received the ,armed ,forces     
,expeditionary ,medal1 ,service         
,specific ,expeditionary ,medal1 ,combat
 ,era ,specific ,expeditionary ,medal1  
,campaign ,specific ,medal1 or any other
 combat theater award established by a  
,federal statute or an ,executive       
,order74  7c7 ,report ,not later than   
,october #a1 #bjbd1 the ,secretary of   
,veterans ,affairs shall submit to the  
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    

,representatives a report on-- 7#a7 the 
number of veterans who enrolled in the  
system of annual patient enrollment of  
the ,department of ,veterans ,affairs   
established and operated under section  
#agje7;a7 of title #ch1 ,united ,states 
,code1 to receive care pursuant to      
eligibility under subparagraph 7,b7 of  
section #agaj7;e77#c7 of such title1 as 
amended by subsection 7a77#b72 and  7#b7
 of the veterans described in paragraph 
7#a71 the number of such veterans who   
reported a health concern related to    
exposure to a toxic substance or        
radiation4  7d7 ,outreach plan ,not     
later than ,december #a1 #bjbb1 the     
,secretary shall submit to the          
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a plan to conduct      
outreach to veterans described in       
subparagraph 7,b7 of section            
#agaj7;e77#c7 of title #ch1 ,united     
,states ,code1 as amended by subsection 

7a77#b71 to notify such veterans of     
their eligibility for hospital care1    
medical services1 or nursing home care  
under such subparagraph4  7e7 ,effective
 date ,this section and the amendments  
made by this section shall take effect  
on ,october #a1 #bjbb4  #c4             
,incorporation of toxic exposure        
screening for veterans  7a7 ,in general 
,beginning not later than #ij days after
 the date of the enactment of this ,act1
 the ,secretary of ,veterans ,affairs   
shall incorporate a screening to help   
determine potential exposures to toxic  
substances during active military1      
naval1 air1 or space service as part of 
a health care screening furnished by the
 ,department of ,veterans ,affairs to   
veterans enrolled in the system of      
annual patient enrollment of the        
,department established and operated    
under section #agje of title #ch1       
,united ,states ,code1 to improve       
understanding by the ,department of     
exposures of veterans to toxic          

substances while serving in the ,armed  
,forces4  7b7 ,timing ,the ,secretary   
shall ensure that a veteran described in
 subsection 7a7 completes the screening 
required under such subsection not less 
frequently than once every five years4  
7c7 ,determination of questions  7#a7   
,in general ,the questions included in  
the screening required under subsection 
7a7 shall be determined by the          
,secretary with input from medical      
professionals4  7#b7 ,specific questions
 ,at a minimum1 the screening required  
under subsection 7a7 shall1 with respect
 to a veteran1 include-- 7,a7 a question
 about the potential exposure of the    
veteran to an open burn pit2 and  7,b7 a
 question regarding exposures that are  
commonly associated with service in the 
,armed ,forces4  7#c7 ,open burn pit    
defined ,in this subsection1 the term   
open burn pit means an area of land     
that-- 7,a7 is designated by the        
,secretary of ,defense to be used for   
disposing solid waste by burning in the 

outdoor air2 and  7,b7 does not contain 
a commercially manufactured incinerator 
or other equipment specifically designed
 and manufactured for the burning of    
solid waste4  7d7 ,print material ,in   
developing the screening established    
under subsection 7a71 the ,secretary    
shall ensure that print materials       
complementary to such screening that    
outline related resources for veterans  
are available at each medical center of 
the ,department to veterans who may not 
have access to the internet4  7e7       
,screening updates ,the ,secretary shall
 consider updates to the content of the 
screening required under subsection 7a7 
not less frequently than biennially to  
ensure the screening contains the most  
current information4  7f7 ,active       
military1 naval1 air1 or space service  
defined ,in this section1 the term      
active military1 naval1 air1 or space   
service has the meaning given that term 
in section #aja7bd7 of title #ch1       
,united ,states ,code4  #d4 ,training   

for personnel of the ,department of     
,veterans ,affairs with respect to      
veterans exposed to toxic substances    
7a7 ,health care personnel ,the         
,secretary of ,veterans ,affairs shall  
provide to health care personnel of the 
,department of ,veterans ,affairs       
education and training to identify1     
treat1 and assess the impact on veterans
 of illnesses related to exposure to    
toxic substances and inform such        
personnel of how to ask for additional  
information from veterans regarding     
different exposures4  7b7 ,benefits     
personnel  7#a7 ,in general ,the        
,secretary shall incorporate a training 
program for processors of claims under  
the laws administered by the ,secretary 
who review claims for disability        
benefits relating to service-connected  
disabilities based on exposure to toxic 
substances4  7#b7 ,annual training      
,training provided to processors under  
paragraph 7#a7 shall be provided not    
less frequently than annually4  #e4     

,analysis and report on treatment of    
veterans for medical conditions related 
to toxic exposure  7a7 ,in general ,the 
,secretary of ,veterans ,affairs shall  
analyze1 on a continuous basis1 all     
clinical data that-- 7#a7 is obtained by
 the ,department of ,veterans ,affairs  
in connection with hospital care1       
medical services1 and nursing home care 
furnished under section                 
#agaj7;a77#b77;,f7 of title #ch1 ,united
 ,states ,code2 and  7#b7 is likely to  
be scientifically useful in determining 
the association1 if any1 between the    
medical condition of a veteran and the  
exposure of the veteran to a toxic      
substance4  7b7 ,annual report ,not     
later than one year after the date of   
the enactment of this ,act1 and annually
 thereafter1 the ,secretary shall submit
 to the ,committee on ,veterans'        
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report    
containing-- 7#a7 the aggregate data    

compiled under subsection 7a72  7#b7 an 
analysis of such data2  7#c7 a          
description of the types and incidences 
of medical conditions identified by the 
,department under such subsection2  7#d7
 the explanation of the ,secretary for  
the incidence of such medical conditions
 and other explanations for the         
incidence of such conditions as the     
,secretary considers reasonable2 and    
7#e7 the views of the ,secretary on the 
scientific validity of drawing          
conclusions from the incidence of such  
medical conditions1 as evidenced by the 
data compiled under subsection 7a71     
regarding any association between such  
conditions and exposure to a toxic      
substance4  #f4 ,analysis relating to   
mortality of veterans who served in     
,southwest ,asia  7a7 ,analysis  7#a7   
,in general ,not later than #bgj days   
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs1 in coordination with the      
,secretary of ,defense1 shall conduct an

 updated analysis of total and          
respiratory disease mortality in covered
 veterans4  7#b7 ,elements ,the analysis
 required by paragraph 7#a7 shall       
include1 to the extent practicable1 the 
following with respect to each covered  
veteran3 7,a7 ,metrics of airborne      
exposures4  7,b7 ,the location and      
timing of deployments of the veteran4   
7,c7 ,the military occupational         
specialty of the veteran4  7,d7 ,the    
,armed ,force in which the veteran      
served4  7,e7 ,pre-existing health      
status of the veteran1 including with   
respect to asthma4  7,f7 ,relevant      
personal information of the veteran1    
including cigarette and e-cigarette     
smoking history1 diet1 sex1 gender1 age1
 race1 and ethnicity4  7b7 ,covered     
veteran defined ,in this section1 the   
term covered veteran means any veteran  
who-- 7#a7 on or after ,august #b1      
#aiij1 served on active duty in-- 7,a7  
,bahrain2  7,b7 ,iraq2  7,c7 ,kuwait2   
7,d7 ,oman2  7,e7 ,qatar2  7,f7 ,saudi  

,arabia2  7,g7 ,somalia2 or  7,h7 the   
,united ,arab ,emirates2 or  7#b7 on or 
after ,september #aa1 #bjja1 served on  
active duty in-- 7,a7 ,afghanistan2     
7,b7 ,djibouti2  7,c7 ,egypt2  7,d7     
,jordan2  7,e7 ,lebanon2  7,f7 ,syria2  
or  7,g7 ,yemen4  #g4 ,study on health  
trends of post #i_/aa veterans ,the     
,secretary of ,veterans ,affairs shall  
conduct an epidemiological study on the 
health trends of veterans who served in 
the ,armed ,forces after ,september #aa1
 #bjja4  #h4 ,study on cancer rates     
among veterans  7a7 ,in general ,the    
,secretary of ,veterans ,affairs shall  
conduct a study on the incidence of     
cancer in veterans to determine trends  
in the rates of the incidence of cancer 
in veterans4  7b7 ,elements ,the study  
required by subsection 7a7 shall assess1
 with respect to each veteran included  
in the study1 the following3 7#a7 ,the  
age of the veteran4  7#b7 ,the period of
 service and length of service of the   
veteran in the ,armed ,forces4  7#c7    

,the military occupational specialty or 
specialties of the veteran4  7#d7 ,the  
gender of the veteran4  7#e7 ,the type  
or types of cancer that the veteran has4
  #i4 ,publication of list of resources 
of ,department of ,veterans ,affairs for
 veterans exposed to toxic substances   
and outreach program for such veterans  
and caregivers and survivors of such    
veterans  7a7 ,publication of list of   
resources  7#a7 ,in general ,not later  
than one year after the date of the     
enactment of this ,act1 and annually    
thereafter1 the ,secretary of ,veterans 
,affairs shall publish a list of        
resources of the ,department of         
,veterans ,affairs for-- 7,a7 veterans  
who were exposed to toxic substances2   
7,b7 families and caregivers of such    
veterans2 and  7,c7 survivors of such   
veterans who are receiving death        
benefits under the laws administered by 
the ,secretary4  7#b7 ,update ,the      
,secretary shall periodically update the
 list published under paragraph 7#a74   

7b7 ,outreach ,the ,secretary shall     
develop1 with input from the community1 
an informative outreach program for     
veterans on illnesses that may be       
related to exposure to toxic substances1
 including outreach with respect to     
benefits and support programs4  #aj4    
,report on ,individual ,longitudinal    
,exposure ,record  7a7 ,in general ,not 
later than one year after the date on   
which the ,individual ,longitudinal     
,exposure ,record achieves full         
operational capability1 the ,secretary  
of ,veterans ,affairs shall submit to   
the appropriate committees of ,congress 
a report on the data quality of the     
,individual ,longitudinal ,exposure     
,record and the usefulness of the       
,individual ,longitudinal ,exposure     
,record in supporting veterans in       
receiving health care and benefits from 
the ,department of ,veterans ,affairs4  
7b7 ,elements ,the report required by   
subsection 7a7 shall include the        
following3 7#a7 ,an identification of   

exposures to toxic substances that may  
not be fully captured by the current    
systems for environmental and           
occupational health monitoring and      
recommendations for how to improve those
 systems4  7#b7 ,an analysis of the     
quality of the location data in         
determining exposures of veterans to    
toxic substances and recommendations for
 how to improve the quality of that     
location data4  7#c7 ,recommendations on
 how to improve the usefulness of the   
,individual ,longitudinal ,exposure     
,record4  7c7 ,definitions ,in this     
section3 7#a7 ,appropriate committees of
 ,congress defined ,the term appropriate
 committees of ,congress means-- 7,a7   
the ,committee on ,armed ,services and  
the ,committee on ,veterans' ,affairs of
 the ,senate2 and  7,b7 the ,committee  
on ,armed ,services and the ,committee  
on ,veterans' ,affairs of the ,house of 
,representatives4  7#b7 ,individual     
,longitudinal ,exposure ,record ,the    
term ,individual ,longitudinal ,exposure

 ,record includes any pilot program or  
other program used by the ,department of
 ,veterans ,affairs or the ,department  
of ,defense to track how members of the 
,armed ,forces or veterans have been    
exposed to various occupational or      
environmental hazards4  ,passed the     
,senate ,february #af1 #bjbb4,secretary