Honoring our PACT Act of 2022

In the Senate of the United States, June 16, 2022. Resolved, That the bill from the House of Representa- tives (H.R. 3967) entitled ‘‘An Act to improve health care and benefits for veterans exposed to toxic substances, and for other purposes.’’, do pass with the following AMENDMENT: Strike all after the enacting clause and insert the following: SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, 1 UNITED STATES CODE; TABLE OF CONTENTS. 2 (a) SHORT TITLE.—This Act may be cited as the ‘‘Ser- 3 geant First Class Heath Robinson Honoring our Promise 4 to Address Comprehensive Toxics Act of 2022’’ or the ‘‘Hon- 5 oring our PACT Act of 2022’’. 6 (b) MATTERS RELATING TO AMENDMENTS TO TITLE 7 38, UNITED STATES CODE.— 8 (1) REFERENCES.—Except as otherwise expressly 9 provided, when in this Act an amendment or repeal 10 2 † HR 3967 EAS is expressed in terms of an amendment to, or repeal 1 of, a section or other provision, the reference shall be 2 considered to be made to a section or other provision 3 of title 38, United States Code. 4 (2) AMENDMENTS TO TABLES OF CONTENTS.— 5 Except as otherwise expressly provided, when an 6 amendment made by this Act to title 38, United 7 States Code, adds a section or larger organizational 8 unit to that title or amends the designation or head- 9 ing of a section or larger organizational unit in that 10 title, that amendment also shall have the effect of 11 amending any table of sections in that title to alter 12 the table to conform to the changes made by the 13 amendment. 14 (c) TABLE OF CONTENTS.—The table of contents for 15 this Act is as follows: 16 Sec. 1. Short title; references to title 38, United States Code; table of contents. TITLE I—EXPANSION OF HEALTH CARE ELIGIBILITY Subtitle A—Toxic-exposed Veterans Sec. 101. Short title. Sec. 102. Definitions relating to toxic-exposed veterans. Sec. 103. Expansion of health care for specific categories of toxic-exposed veterans and veterans supporting certain overseas contingency operations. Sec. 104. Assessments of implementation and operation. Subtitle B—Certain Veterans of Combat Service and Other Matters Sec. 111. Expansion of period of eligibility for health care for certain veterans of combat service. TITLE II—TOXIC EXPOSURE PRESUMPTION PROCESS Sec. 201. Short title. Sec. 202. Improvements to ability of Department of Veterans Affairs to establish presumptions of service connection based on toxic exposure. 3 † HR 3967 EAS Sec. 203. Outreach to claimants for disability compensation pursuant to changes in presumptions of service connection. Sec. 204. Reevaluation of claims for dependency and indemnity compensation in- volving presumptions of service connection. TITLE III—IMPROVING THE ESTABLISHMENT OF SERVICE CONNECTION PROCESS FOR TOXIC-EXPOSED VETERANS Sec. 301. Short title. Sec. 302. Presumptions of toxic exposure. Sec. 303. Medical nexus examinations for toxic exposure risk activities. TITLE IV—PRESUMPTIONS OF SERVICE CONNECTION Sec. 401. Treatment of veterans who participated in cleanup of Enewetak Atoll as radiation-exposed veterans for purposes of presumption of service connection of certain disabilities by Department of Vet- erans Affairs. Sec. 402. Treatment of veterans who participated in nuclear response near Palomares, Spain, or Thule, Greenland, as radiation-exposed veterans for purposes of presumption of service connection of cer- tain disabilities by Department of Veterans Affairs. Sec. 403. Presumptions of service connection for diseases associated with expo- sures to certain herbicide agents for veterans who served in cer- tain locations. Sec. 404. Addition of additional diseases associated with exposure to certain her- bicide agents for which there is a presumption of service connec- tion for veterans who served in certain locations. Sec. 405. Improving compensation for disabilities occurring in Persian Gulf War veterans. Sec. 406. Presumption of service connection for certain diseases associated with exposure to burn pits and other toxins. Sec. 407. Rule of construction. TITLE V—RESEARCH MATTERS Sec. 501. Interagency working group on toxic exposure research. Sec. 502. Analysis and report on treatment of veterans for medical conditions re- lated to toxic exposure. Sec. 503. Analysis relating to mortality of veterans who served in Southwest Asia. Sec. 504. Study on health trends of post–9/11 veterans. Sec. 505. Study on cancer rates among veterans. Sec. 506. Study on health effects of waste related to Manhattan Project on certain veterans. Sec. 507. Study on toxic exposure and mental health outcomes. Sec. 508. Study on veterans in Territories of the United States. Sec. 509. Department of Veterans Affairs public website for toxic exposure re- search. Sec. 510. Report on health effects of jet fuels used by Armed Forces. TITLE VI—IMPROVEMENT OF RESOURCES AND TRAINING REGARDING TOXIC-EXPOSED VETERANS Sec. 601. Short title; definitions. 4 † HR 3967 EAS Sec. 602. Publication of list of resources of Department of Veterans Affairs for toxic-exposed veterans and veterans who report toxic exposures and outreach program for such veterans and caregivers and sur- vivors of such veterans. Sec. 603. Incorporation of toxic exposure screening for veterans. Sec. 604. Training for personnel of the Department of Veterans Affairs with re- spect to veterans who report toxic exposures. TITLE VII—RESOURCING Sec. 701. Authority to use appropriations to enhance claims processing capacity and automation. Sec. 702. Authorization of major medical facility leases of Department of Vet- erans Affairs for fiscal year 2023. Sec. 703. Treatment of major medical facility leases of the Department of Vet- erans Affairs. Sec. 704. Authority to enter into agreements with academic affiliates and other entities to acquire space for the purpose of providing health-care resources to veterans. Sec. 705. Modifications to enhanced-use lease authority of Department of Veterans Affairs. Sec. 706. Authority for joint leasing actions of Department of Defense and De- partment of Veterans Affairs. Sec. 707. Appropriation of amounts for major medical facility leases. TITLE VIII—RECORDS AND OTHER MATTERS Sec. 801. Epidemiological study on Fort McClellan veterans. Sec. 802. Biennial briefing on Individual Longitudinal Exposure Record. Sec. 803. Correction of exposure records by members of the Armed Forces and vet- erans. Sec. 804. Federal cause of action relating to water at Camp Lejeune, North Caro- lina. Sec. 805. Cost of War Toxic Exposures Fund. Sec. 806. Appropriation for fiscal year 2022. Sec. 807. Authorization of electronic notice in claims under laws administered by the Secretary of Veterans Affairs. Sec. 808. Burn pit transparency. TITLE IX—IMPROVEMENT OF WORKFORCE OF DEPARTMENT OF VETERANS AFFAIRS Sec. 901. National rural recruitment and hiring plan for Veterans Health Ad- ministration. Sec. 902. Authority to buy out service contracts for certain health care profes- sionals in exchange for employment at rural or highly rural fa- cilities of Department of Veterans Affairs. Sec. 903. Qualifications for human resources positions within Department of Vet- erans Affairs and plan to recruit and retain human resources employees. Sec. 904. Modification of pay cap for certain employees of Veterans Health Ad- ministration. Sec. 905. Expansion of opportunities for housekeeping aides. Sec. 906. Modification of authority of the Secretary of Veterans Affairs relating to hours, conditions of employment, and pay for certain employ- ees of Veterans Health Administration. 5 † HR 3967 EAS Sec. 907. Waiver of pay limitation for certain employees of Department of Vet- erans Affairs. Sec. 908. Elimination of limitation on awards and bonus for employees of De- partment of Veterans Affairs. Sec. 909. Additional authority of the Secretary of Veterans Affairs relating to re- cruitment and retention of personnel. TITLE I—EXPANSION OF HEALTH 1 CARE ELIGIBILITY 2 Subtitle A—Toxic-exposed Veterans 3 SEC. 101. SHORT TITLE. 4 This title may be cited as the ‘‘Conceding Our Vet- 5 erans’ Exposure Now and Necessitating Training Act of 6 2022’’ or the ‘‘COVENANT Act of 2022’’. 7 SEC. 102. DEFINITIONS RELATING TO TOXIC-EXPOSED VET- 8 ERANS. 9 (a) IN GENERAL.—Section 1710(a)(2)(F) is amended 10 by striking ‘‘who was exposed to a toxic substance, radi- 11 ation, or other conditions, as provided in subsection (e)’’ 12 and inserting ‘‘who is a toxic-exposed veteran, in accord- 13 ance with subsection (e)’’. 14 (b) DEFINITIONS OF TOXIC EXPOSURE AND TOXIC-EX- 15 POSED VETERAN.—Section 101 is amended by adding at 16 the end the following new paragraphs: 17 ‘‘(37) The term ‘toxic exposure’ includes the following: 18 ‘‘(A) A toxic exposure risk activity, as defined in 19 section 1710(e)(4) of this title. 20 6 † HR 3967 EAS ‘‘(B) An exposure to a substance, chemical, or 1 airborne hazard identified in the list under section 2 1119(b)(2) of this title. 3 ‘‘(38) The term ‘toxic-exposed veteran’ means any vet- 4 eran described in section 1710(e)(1) of this title.’’. 5 (c) DEFINITION OF TOXIC EXPOSURE RISK ACTIV- 6 ITY.—Section 1710(e)(4) is amended by adding at the end 7 the following new subparagraph: 8 ‘‘(C) The term ‘toxic exposure risk activity’ 9 means any activity— 10 ‘‘(i) that requires a corresponding entry in 11 an exposure tracking record system (as defined 12 in section 1119(c) of this title) for the veteran 13 who carried out the activity; or 14 ‘‘(ii) that the Secretary determines qualifies 15 for purposes of this subsection when taking into 16 account what is reasonably prudent to protect 17 the health of veterans.’’. 18 SEC. 103. EXPANSION OF HEALTH CARE FOR SPECIFIC CAT- 19 EGORIES OF TOXIC-EXPOSED VETERANS AND 20 VETERANS SUPPORTING CERTAIN OVERSEAS 21 CONTINGENCY OPERATIONS. 22 (a) IN GENERAL.— 23 (1) EXPANSION.—Subsection (e) of section 1710, 24 as amended by section 102(c), is further amended— 25 7 † HR 3967 EAS (A) in paragraph (1), by adding at the end 1 the following new subparagraphs: 2 ‘‘(G) Beginning not later than the applicable date 3 specified in paragraph (6), and subject to paragraph (2), 4 a veteran who participated in a toxic exposure risk activity 5 while serving on active duty, active duty for training, or 6 inactive duty training is eligible for hospital care (includ- 7 ing mental health services and counseling), medical services, 8 and nursing home care under subsection (a)(2)(F) for any 9 illness. 10 ‘‘(H) Beginning not later than the applicable date 11 specified in paragraph (6), and subject to paragraph (2), 12 a covered veteran (as defined in section 1119(c) of this title) 13 is eligible for hospital care (including mental health services 14 and counseling), medical services, and nursing home care 15 under subsection (a)(2)(F) for any illness. 16 ‘‘(I)(i) Beginning not later than the applicable date 17 specified in paragraph (6), and subject to paragraph (2), 18 a veteran who deployed in support of a contingency oper- 19 ation specified in clause (ii) is eligible for hospital care (in- 20 cluding mental health services and counseling), medical 21 services, and nursing home care under subsection (a)(2)(F) 22 for any illness. 23 ‘‘(ii) A contingency operation specified in this clause 24 is any of the following: 25 8 † HR 3967 EAS ‘‘(I) Operation Enduring Freedom. 1 ‘‘(II) Operation Freedom’s Sentinel. 2 ‘‘(III) Operation Iraqi Freedom. 3 ‘‘(IV) Operation New Dawn. 4 ‘‘(V) Operation Inherent Resolve. 5 ‘‘(VI) Resolute Support Mission.’’; and 6 (B) in paragraph (2)(B)— 7 (i) by striking ‘‘or (F)’’ and inserting 8 ‘‘(F), (G), (H), or (I)’’; and 9 (ii) by striking ‘‘service or testing’’ and 10 inserting ‘‘service, testing, or activity’’. 11 (2) PHASE IN.—Such subsection is further 12 amended by adding at the end the following new 13 paragraph: 14 ‘‘(6)(A) The Secretary shall determine the dates in sub- 15 paragraphs (G), (H), and (I) of paragraph (1) as follows: 16 ‘‘(i) October 1, 2024, with respect to a veteran 17 described in such subparagraph (G) or (H) who was 18 discharged or released from the active military, naval, 19 air, or space service during the period beginning on 20 August 2, 1990, and ending on September 11, 2001. 21 ‘‘(ii) October 1, 2026, with respect to a veteran 22 described in such subparagraph (G) or (H) who was 23 discharged or released from the active military, naval, 24 air, or space service during the period beginning on 25 9 † HR 3967 EAS September 12, 2001, and ending on December 31, 1 2006. 2 ‘‘(iii) October 1, 2028, with respect to a veteran 3 described in such subparagraph (G) or (H) who was 4 discharged or released from the active military, naval, 5 air, or space service during the period beginning on 6 January 1, 2007, and ending on December 31, 2012. 7 ‘‘(iv) October 1, 2030, with respect to a veteran 8 described in such subparagraph (G) or (H) who was 9 discharged or released from the active military, naval, 10 air, or space service during the period beginning on 11 January 1, 2013, and ending on December 31, 2018. 12 ‘‘(v) October 1, 2032, with respect to a veteran 13 described in such subparagraph (I). 14 ‘‘(B)(i) The Secretary may modify a date specified in 15 subparagraph (A) to an earlier date, as the Secretary deter- 16 mines appropriate based on the number of veterans receiv- 17 ing hospital care, medical services, and nursing home care 18 under subparagraphs (G), (H), and (I) of paragraph (1) 19 and the resources available to the Secretary. 20 ‘‘(ii) If the Secretary determines to modify a date 21 under clause (i), the Secretary shall— 22 ‘‘(I) notify the Committee on Veterans’ Affairs of 23 the Senate and the Committee on Veterans’ Affairs of 24 10 † HR 3967 EAS the House of Representatives of the proposed modi- 1 fication; and 2 ‘‘(II) publish such modified date in the Federal 3 Register.’’. 4 (b) OUTREACH PLANS.—With respect to each of clauses 5 (i) through (v) of section 1710(e)(6)(A) of title 38, United 6 States Code (as added by subsection (a)(2)), not later than 7 180 days before the date specified in the clause (including 8 a date modified pursuant to such section), the Secretary 9 shall submit to the Committee on Veterans’ Affairs of the 10 Senate and the Committee on Veterans’ Affairs of the House 11 of Representatives a plan to conduct outreach to the vet- 12 erans described in the clause to notify such veterans of their 13 eligibility for hospital care, medical services, or nursing 14 home care under subparagraph (G), (H), or (I), of section 15 1710(e)(1) of such title, as the case may be. 16 SEC. 104. ASSESSMENTS OF IMPLEMENTATION AND OPER- 17 ATION. 18 (a) INITIAL RESOURCE ASSESSMENT AND REPORT.— 19 Not later than 180 days after the date of the enactment of 20 this [Text truncated for display. Full text available on Congress.gov.]