#aag? ,,congress  #b;d ,session  ,s4    
#ceda  ,,an ,,act  ,to improve heal? c>e
 & s]vices = vet]ans expos$ to toxic    
sub/ances1 & = o!r purposes4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,heal?  
,c>e = ,burn ,pit ,vet]ans ,act4  #b4   
,expansion ( eligibility = heal? c>e f  
,dep>tm5t ( ,vet]ans ,affairs = c]ta9   
vet]ans expos$ to toxic sub/ances  7a7  
,9 g5]al ,section #agaj7;e77#c7 ( title 
#ch1 ,unit$ ,/ates ,code1 is am5d$--    
7#a7 9 subp>agraph 7,a7-- 7,a7 by /rik+ 
,janu>y #bg1 #bjjc & ins]t+ ,septemb]   
#aa1 #bjja2 &  7,b7 by /rik+ five-ye>   
p]iod & ins]t+ t5-ye> p]iod2  7#b7 by   
am5d+ subp>agraph 7,b7 to read z foll[s3
  7,b7 ,) respect to a vet]an describ$ 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 ( su* title is am5d$ 
by ins]t+ aft] ,p]sian ,gulf ,w> !      
foll[+3 7to include 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$]al /atute or an       
,executive ,ord]74  7c7 ,report ,n lat] 
?an ,octob] #a1 #bjbd1 ! ,secret>y (    
,vet]ans ,affairs %all submit to !      
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on-- 7#a7 ! numb] ( vet]ans :o   
enroll$ 9 ! sy/em ( annual pati5t       
enrollm5t ( ! ,dep>tm5t ( ,vet]ans      
,affairs e/abli%$ & op]at$ "u section   
#agje7;a7 ( title #ch1 ,unit$ ,/ates    
,code1 to receive c>e pursuant to       

eligibility "u subp>agraph 7,b7 (       
section #agaj7;e77#c7 ( su* title1 z    
am5d$ by subsection 7a77#b72 &  7#b7 ( !
 vet]ans describ$ 9 p>agraph 7#a71 !    
numb] ( su* vet]ans :o report$ a heal?  
conc]n relat$ to exposure to a toxic    
sub/ance or radiation4  7d7 ,outrea*    
plan ,n lat] ?an ,decemb] #a1 #bjbb1 !  
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives 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  
"u su* subp>agraph4  7e7 ,effective date
 ,?is section & ! am5dm5ts made by ?is  
section %all take effect on ,octob] #a1 
#bjbb4  #c4 ,incorporation ( toxic      
exposure scre5+ = vet]ans  7a7 ,9 g5]al 
,beg9n+ n lat] ?an #ij days aft] ! date 
( ! enactm5t ( ?is ,act1 ! ,secret>y (  

,vet]ans ,affairs %all incorporate a    
scre5+ to help det]m9e pot5tial         
exposures to toxic sub/ances dur+ active
 milit>y1 naval1 air1 or space s]vice z 
"p ( a heal? c>e scre5+ furni%$ by !    
,dep>tm5t ( ,vet]ans ,affairs to vet]ans
 enroll$ 9 ! sy/em ( annual pati5t      
enrollm5t ( ! ,dep>tm5t e/abli%$ &      
op]at$ "u section #agje ( title #ch1    
,unit$ ,/ates ,code1 to improve und]/&+ 
by ! ,dep>tm5t ( exposures ( vet]ans to 
toxic sub/ances :ile s]v+ 9 ! ,arm$     
,=ces4  7b7 ,tim+ ,! ,secret>y %all     
ensure t a vet]an describ$ 9 subsection 
7a7 completes ! scre5+ requir$ "u su*   
subsection n less frequ5tly ?an once e  
five ye>s4  7c7 ,det]m9ation ( que/ions 
7#a7 ,9 g5]al ,! que/ions includ$ 9 !   
scre5+ requir$ "u subsection 7a7 %all be
 det]m9$ by ! ,secret>y ) input f m$ical
 pr(essionals4  7#b7 ,specific que/ions 
,at a m9imum1 ! scre5+ requir$ "u       
subsection 7a7 %all1 ) respect to a     
vet]an1 include-- 7,a7 a "q ab\t !      
pot5tial exposure ( ! vet]an to an op5  

burn pit2 &  7,b7 a "q reg>d+ exposures 
t are commonly associat$ ) s]vice 9 !   
,arm$ ,=ces4  7#c7 ,op5 burn pit def9$  
,9 ?is subsection1 ! t]m op5 burn pit   
means an area ( l& t-- 7,a7 is designat$
 by ! ,secret>y ( ,def5se to be us$ =   
dispos+ solid wa/e by burn+ 9 ! outdoor 
air2 &  7,b7 does n conta9 a comm]cially
 manufactur$ inc9]ator or o!r equipm5t  
specifically design$ & manufactur$ = !  
burn+ ( solid wa/e4  7d7 ,pr9t mat]ial  
,9 develop+ ! scre5+ e/abli%$ "u        
subsection 7a71 ! ,secret>y %all ensure 
t pr9t mat]ials complem5t>y to su*      
scre5+ t outl9e relat$ res\rces =       
vet]ans are available at ea* m$ical c5t]
 ( ! ,dep>tm5t to vet]ans :o may n h    
access to ! int]net4  7e7 ,scre5+       
updates ,! ,secret>y %all consid]       
updates to ! cont5t ( ! scre5+ requir$  
"u subsection 7a7 n less frequ5tly ?an  
bi5nially to ensure ! scre5+ conta9s !  
mo/ curr5t in=mation4  7f7 ,active      
milit>y1 naval1 air1 or space s]vice    
def9$ ,9 ?is section1 ! t]m active      

milit>y1 naval1 air1 or space s]vice has
 ! mean+ giv5 t t]m 9 section #aja7bd7 (
 title #ch1 ,unit$ ,/ates ,code4  #d4   
,tra9+ = p]sonnel ( ! ,dep>tm5t (       
,vet]ans ,affairs ) respect to vet]ans  
expos$ to toxic sub/ances  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 vet]ans (   
illnesses relat$ to exposure to toxic   
sub/ances & in=m su* p]sonnel ( h[ to   
ask = additional in=mation f vet]ans    
reg>d+ diff]5t exposures4  7b7 ,b5efits 
p]sonnel  7#a7 ,9 g5]al ,! ,secret>y    
%all incorporate a tra9+ program =      
processors ( claims "u ! laws adm9i/]$  
by ! ,secret>y :o review claims =       
disability b5efits relat+ to            
s]vice-connect$ disabilities bas$ on    
exposure to toxic sub/ances4  7#b7      
,annual tra9+ ,tra9+ provid$ to         
processors "u p>agraph 7#a7 %all be     
provid$ n less frequ5tly ?an annually4  

#e4 ,analysis & report on treatm5t (    
vet]ans = m$ical conditions relat$ to   
toxic exposure  7a7 ,9 g5]al ,!         
,secret>y ( ,vet]ans ,affairs %all      
analyze1 on a cont9u\s basis1 all       
cl9ical data t-- 7#a7 is obta9$ by !    
,dep>tm5t ( ,vet]ans ,affairs 9         
connection ) hospital c>e1 m$ical       
s]vices1 & nurs+ home c>e furni%$ "u    
section #agaj7;a77#b77;,f7 ( title #ch1 
,unit$ ,/ates ,code2 &  7#b7 is likely  
to be sci5tifically useful 9 det]m9+ !  
association1 if any1 betwe5 ! m$ical    
condition ( a vet]an & ! exposure ( !   
vet]an to a toxic sub/ance4  7b7 ,annual
 report ,n lat] ?an "o ye> aft] ! date (
 ! enactm5t ( ?is ,act1 & annually      
!reaft]1 ! ,secret>y %all submit to !   
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report conta9+-- 7#a7 ! aggregate data  
compil$ "u subsection 7a72  7#b7 an     
analysis ( su* data2  7#c7 a description
 ( ! types & incid5ces ( m$ical         

conditions id5tifi$ by ! ,dep>tm5t "u   
su* subsection2  7#d7 ! explanation ( ! 
,secret>y = ! incid5ce ( su* m$ical     
conditions & o!r explanations = !       
incid5ce ( su* conditions z ! ,secret>y 
consid]s reasonable2 &  7#e7 ! views ( !
 ,secret>y on ! sci5tific validity (    
draw+ conclusions f ! incid5ce ( su*    
m$ical conditions1 z evid5c$ by ! data  
compil$ "u subsection 7a71 reg>d+ any   
association betwe5 su* conditions &     
exposure to a toxic sub/ance4  #f4      
,analysis relat+ to mortality ( vet]ans 
:o s]v$ 9 ,s\?we/ ,asia  7a7 ,analysis  
7#a7 ,9 g5]al ,n lat] ?an #bgj days aft]
 ! date ( ! enactm5t ( ?is ,act1 !      
,secret>y ( ,vet]ans ,affairs1 9        
coord9ation ) ! ,secret>y ( ,def5se1    
%all conduct an updat$ analysis ( total 
& respiratory disease mortality 9 cov]$ 
vet]ans4  7#b7 ,elem5ts ,! analysis     
requir$ by p>agraph 7#a7 %all include1  
to ! ext5t practicable1 ! foll[+ )      
respect to ea* cov]$ vet]an3 7,a7       
,metrics ( airborne exposures4  7,b7 ,! 

location & tim+ ( deploym5ts ( ! vet]an4
  7,c7 ,! milit>y occupational specialty
 ( ! vet]an4  7,d7 ,! ,arm$ ,=ce 9 :i* !
 vet]an s]v$4  7,e7 ,pre-exi/+ heal?    
/atus ( ! vet]an1 includ+ ) respect to  
a/hma4  7,f7 ,relevant p]sonal in=mation
 ( ! vet]an1 includ+ cig>ette &         
e-cig>ette smok+ hi/ory1 diet1 sex1     
g5d]1 age1 race1 & e?nicity4  7b7 ,cov]$
 vet]an def9$ ,9 ?is section1 ! t]m     
cov]$ vet]an means any vet]an :o-- 7#a7 
on or aft] ,augu/ #b1 #aiij1 s]v$ on    
active duty 9-- 7,a7 ,bahra92  7,b7     
,iraq2  7,c7 ,kuwait2  7,d7 ,oman2  7,e7
 ,qat>2  7,f7 ,saudi ,arabia2  7,g7     
,somalia2 or  7,h7 ! ,unit$ ,arab       
,emirates2 or  7#b7 on or aft] ,septemb]
 #aa1 #bjja1 s]v$ on active duty 9--    
7,a7 ,afghani/an2  7,b7 ,djib\ti2  7,c7 
,egypt2  7,d7 ,jordan2  7,e7 ,lebanon2  
7,f7 ,syria2 or  7,g7 ,yem54  #g4 ,/udy 
on heal? tr5ds ( po/ #i_/aa vet]ans ,!  
,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  #h4   
,/udy on canc] rates among vet]ans  7a7 
,9 g5]al ,! ,secret>y ( ,vet]ans        
,affairs %all conduct a /udy on !       
incid5ce ( canc] 9 vet]ans to det]m9e   
tr5ds 9 ! rates ( ! incid5ce ( canc] 9  
vet]ans4  7b7 ,elem5ts ,! /udy requir$  
by subsection 7a7 %all assess1 ) respect
 to ea* vet]an includ$ 9 ! /udy1 !      
foll[+3 7#a7 ,! age ( ! vet]an4  7#b7 ,!
 p]iod ( s]vice & l5g? ( s]vice ( !     
vet]an 9 ! ,arm$ ,=ces4  7#c7 ,! milit>y
 occupational specialty or specialties (
 ! vet]an4  7#d7 ,! g5d] ( ! vet]an4    
7#e7 ,! type or types ( canc] t ! vet]an
 has4  #i4 ,publication ( li/ ( res\rces
 ( ,dep>tm5t ( ,vet]ans ,affairs =      
vet]ans expos$ to toxic sub/ances &     
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  
vet]ans :o 7 expos$ to toxic sub/ances2 
7,b7 families & c>egiv]s ( su* vet]ans2 
&  7,c7 survivors ( su* 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  7b7 ,outrea* 
,! ,secret>y %all develop1 ) input f !  
community1 an in=mative outrea* program 
= vet]ans on illnesses t may be relat$  
to exposure to toxic sub/ances1 includ+ 
outrea* ) respect to b5efits & support  
programs4  #aj4 ,report on ,individual  
,longitud9al ,exposure ,record  7a7 ,9  
g5]al ,n lat] ?an "o ye> aft] ! date on 
:i* ! ,individual ,longitud9al ,exposure
 ,record a*ieves full op]ational        
capability1 ! ,secret>y ( ,vet]ans      
,affairs %all submit to ! appropriate   
committees ( ,congress a report on !    
data quality ( ! ,individual            
,longitud9al ,exposure ,record & !      
usefulness ( ! ,individual ,longitud9al 
,exposure ,record 9 support+ vet]ans 9  

receiv+ heal? c>e & b5efits f !         
,dep>tm5t ( ,vet]ans ,affairs4  7b7     
,elem5ts ,! report requir$ by subsection
 7a7 %all include ! foll[+3 7#a7 ,an    
id5tification ( exposures to toxic      
sub/ances t may n be fully captur$ by ! 
curr5t sy/ems = environm5tal &          
occupational heal? monitor+ &           
recomm5dations = h[ to improve ^?       
sy/ems4  7#b7 ,an analysis ( ! quality (
 ! location data 9 det]m9+ exposures (  
vet]ans to toxic sub/ances &            
recomm5dations = h[ to improve ! quality
 ( t location data4  7#c7               
,recomm5dations on h[ to improve !      
usefulness ( ! ,individual ,longitud9al 
,exposure ,record4  7c7 ,def9itions ,9  
?is section3 7#a7 ,appropriate          
committees ( ,congress def9$ ,! 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          
,individual ,longitud9al ,exposure      
,record ,! t]m ,individual ,longitud9al 
,exposure ,record includes any pilot    
program or o!r program us$ by !         
,dep>tm5t ( ,vet]ans ,affairs or !      
,dep>tm5t ( ,def5se to track h[ memb]s (
 ! ,arm$ ,=ces or vet]ans h be5 expos$  
to v>i\s occupational or environm5tal   
haz>ds4  ,pass$ ! ,s5ate ,febru>y #af1  
#bjbb4,secret>y