What This Bill Does
This bill directs the Secretary of Defense to provide colorectal cancer screening to members of the uniformed services (military personnel in the Army, Navy, Air Force, Marines, Coast Guard and Space Force) who served in specific locations during specific time periods associated with toxic exposure. The bill requires the Department of Defense to update its preventive health care policy to include this enhanced screening standard.
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Who It Affects
- Members of the uniformed services who were deployed to specified locations during specified periods
- The Department of Defense
- Congress (receives reports from the Secretary of Defense)
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Key Provisions
- Members of the uniformed services deployed to Iraq, Southwest Asia, Afghanistan, Djibouti, Syria, Jordan, Egypt, Lebanon, Yemen and other locations determined appropriate receive colorectal cancer screening beginning five years after their first qualifying service and thereafter at intervals recommended by the United States Preventive Services Task Force (a government group that evaluates preventive health care) (Sec. 2(b)(1))
- Colorectal cancer screening may include colonoscopy (a procedure examining the large intestine), fecal occult blood testing (a test checking for hidden blood), sigmoidoscopy (a procedure examining part of the large intestine) or other colon cancer screening (Sec. 2(b)(1))
- The Secretary of Defense must submit a report to Congress no later than two years after enactment and then at least every two years thereafter identifying other locations and time periods eligible for screening (Sec. 2(b)(3))
- The Secretary of Defense must submit a report within two years comparing colorectal cancer rates among service members deployed to specified locations versus those not deployed to those locations and versus the civilian population (Sec. 2(b)(1))
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What Changes
The Department of Defense preventive health care policy will be updated to require colorectal cancer screening for service members who served in designated locations during designated periods associated with burn pits (outdoor areas where solid waste is burned) rather than considering screening only "appropriate."
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Important Definitions
- "Burn pit": an outdoor area of land used for burning solid waste that does not contain a commercially manufactured incinerator or equipment specifically designed for burning solid waste (Sec. 2(b)(5))
- "Uniformed services": Not defined in this bill; the bill references the definition in section 101(a)(5) of title 10, United States Code
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Effective Date
Not specified in bill text
II
118TH CONGRESS
1ST SESSION
S. 302
To amend title 10, United States Code, to direct the Secretary of Defense
to provide colorectal cancer screening for members of the uniformed
services who served in locations associated with toxic exposure, and
for other purposes.
IN THE SENATE OF THE UNITED STATES
FEBRUARY 7, 2023
Ms. KLOBUCHAR introduced the following bill; which was read twice and
referred to the Committee on Armed Services
A BILL
To amend title 10, United States Code, to direct the Sec-
retary of Defense to provide colorectal cancer screening
for members of the uniformed services who served in
locations associated with toxic exposure, and for other
purposes.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘CPT Rafael Barbosa
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Enhanced Colorectal Cancer Screening Standard for Toxic
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Exposed Members of the Uniformed Services Act’’ or the
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‘‘Barbosa Act’’.
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•S 302 IS
SEC. 2. REVISION OF THE PRIMARY AND PREVENTIVE
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HEALTH CARE POLICY OF THE DEPARTMENT
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OF
DEFENSE
TO
PROVIDE
ENHANCED
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COLORECTAL CANCER SCREENING STAND-
4
ARD FOR MEMBERS OF THE UNIFORMED
5
SERVICES WHO SERVED IN LOCATIONS ASSO-
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CIATED WITH TOXIC EXPOSURE.
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(a) IN GENERAL.—Section 1074d of title 10, United
8
States Code, is amended—
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(1) in subsection (a)—
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(A) in paragraph (1), by striking ‘‘sub-
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section (b)’’ and inserting ‘‘subsection (c)’’; and
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(B) in paragraph (2), by striking ‘‘consider
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appropriate.’’ and inserting ‘‘determine meet or
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exceed national standards for preventive care
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services, including screening under subsection
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(b).’’;
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(2) by redesignating subsection (b) as sub-
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section (c); and
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(3) by inserting after subsection (a) the fol-
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lowing new subsection (b):
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‘‘(b) ENHANCED COLORECTAL CANCER SCREENING
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STANDARD FOR MEMBERS OF THE UNIFORMED SERVICES
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EXPOSED TO TOXIC SUBSTANCES.—(1) Under the policy
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developed under subsection (a)(2), any member of the uni-
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formed services who, during active service, was deployed
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•S 302 IS
in support of a contingency operation in a location and
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during a period specified in paragraph (2), is entitled to
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a colorectal cancer screening, which may include a
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colonoscopy, fecal occult blood testing, sigmoidoscopy, or
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other colon cancer screening, by a health care provider of
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the Department of Defense beginning on the date that is
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five years after the first day of qualifying service for such
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member and thereafter at a frequency as recommended
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by the United States Preventive Services Task Force.
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‘‘(2) The locations and periods specified in this para-
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graph are the following:
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‘‘(A) Iraq during following periods:
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‘‘(i) The period beginning on August 2,
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1990, and ending on February 28, 1991.
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‘‘(ii) The period beginning on March 19,
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2003, and ending on such date as the Secretary
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of Defense determines burn pits are no longer
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used in Iraq.
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‘‘(B) The Southwest Asia theater of operations,
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other than Iraq, during the period beginning on Au-
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gust 2, 1990, and ending on such date as the Sec-
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retary determines burn pits are no longer used in
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such location, including the following locations:
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‘‘(i) Kuwait.
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‘‘(ii) Saudi Arabia.
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•S 302 IS
‘‘(iii) Oman.
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‘‘(iv) Qatar.
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‘‘(C) Afghanistan during the period beginning
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on September 11, 2001, and ending on such date as
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the Secretary determines burn pits are no longer
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used in Afghanistan.
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‘‘(D) Djibouti during the period beginning on
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September 11, 2001, and ending on such date as the
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Secretary determines burn pits are no longer used in
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Djibouti.
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‘‘(E) Syria during the period beginning on Sep-
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tember 11, 2001, and ending on such date as the
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Secretary determines burn pits are no longer used in
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Syria.
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‘‘(F) Jordan during the period beginning on
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September 11, 2001, and ending on such date as the
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Secretary determines burn pits are no longer used in
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Jordan.
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‘‘(G) Egypt during the period beginning on
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September 11, 2001, and ending on such date as the
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Secretary determines burn pits are no longer used in
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Egypt.
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‘‘(H) Lebanon during the period beginning on
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September 11, 2001, and ending on such date as the
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•S 302 IS
Secretary determines burn pits are no longer used in
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Lebanon.
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‘‘(I) Yemen during the period beginning on
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September 11, 2001, and ending on such date as the
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Secretary determines burn pits are no longer used in
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Yemen.
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‘‘(J) Such other locations and corresponding pe-
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riods as set forth by the Airborne Hazards and Open
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Burn Pit Registry established under section 201 of
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the Dignified Burial and Other Veterans’ Benefits
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Improvement Act of 2012 (Public Law 112–260; 38
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U.S.C. 527 note).
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‘‘(K) Such other locations and corresponding
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periods as the Secretary may determine appropriate
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in a report submitted under paragraph (3).
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‘‘(3) Not later than two years after the date of the
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enactment of the CPT Rafael Barbosa Enhanced
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Colorectal Cancer Screening Standard for Toxic Exposed
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Members of the Uniformed Services Act, and not less fre-
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quently than once every two years thereafter, the Sec-
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retary of Defense shall submit to Congress a report speci-
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fying other locations and corresponding periods for pur-
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poses of paragraph (2)(K).
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•S 302 IS
‘‘(4) A location under this subsection shall not in-
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clude any body of water around or any airspace above such
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location.
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‘‘(5) In this subsection, the term ‘burn pit’ means an
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area of land that—
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‘‘(A) is used for disposal of solid waste by burn-
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ing in the outdoor air; and
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‘‘(B) does not contain a commercially manufac-
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tured incinerator or other equipment specifically de-
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signed and manufactured for the burning of solid
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waste.’’.
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(b) REPORT ON COLORECTAL CANCER RATES FOR
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MEMBERS OF THE UNIFORMED SERVICES DEPLOYED TO
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CERTAIN AREAS.—
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(1) IN
GENERAL.—Not later than two years
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after the date of the enactment of this Act, the Sec-
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retary of Defense shall submit to the Committee on
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Armed Services of the Senate and the Committee on
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Armed Services of the House of Representatives a
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report that compares the rates of colorectal cancer
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among members of the uniformed services deployed
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to the locations and during the periods specified in
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section 1074d(b) of title 10, United States Code, as
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added by subsection (a), as compared to members of
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the uniformed services who were not deployed to
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•S 302 IS
those locations during those periods and to the civil-
1
ian population.
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(2) UNIFORMED SERVICES DEFINED.—In this
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subsection, the term ‘‘uniformed services’’ has the
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meaning given that term in section 101(a)(5) of title
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10, United States Code.
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Æ
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