K2 Veterans Toxic Exposure Accountability Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 5957 To direct the Secretary of Defense to conduct a study regarding toxic expo- sure by members of the Armed Forces deployed to Karshi Khanabad Air Base, Uzbekistan, to direct the Secretary of Veterans Affairs to establish a registry regarding such exposure, and for other purposes. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 25, 2020 Mr. GREEN of Tennessee (for himself and Mr. LYNCH) introduced the fol- lowing bill; which was referred to the Committee on Veterans’ Affairs, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee con- cerned A BILL To direct the Secretary of Defense to conduct a study regard- ing toxic exposure by members of the Armed Forces deployed to Karshi Khanabad Air Base, Uzbekistan, to direct the Secretary of Veterans Affairs to establish a registry regarding such exposure, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘K2 Veterans Toxic 4 Exposure Accountability Act of 2020’’. 5 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 5957 IH SEC. 2. STUDY ON TOXIC EXPOSURE AT KARSHI KHANABAD 1 AIR BASE, UZBEKISTAN. 2 (a) STUDY.— 3 (1) IN GENERAL.—The Secretary of Defense 4 shall conduct a study on toxic exposure by members 5 of the Armed Forces deployed to Karshi Khanabad 6 Air Base, Uzbekistan, at any time during the period 7 beginning October 1, 2001, and ending December 8 31, 2005. 9 (2) MATTERS INCLUDED.—The study under 10 paragraph (1) shall include the following: 11 (A) An assessment regarding the condi- 12 tions of Karshi Khanabad Air Base, Uzbek- 13 istan, during the period beginning October 1, 14 2001, and ending December 31, 2005, includ- 15 ing an identification of toxic substances con- 16 taminating the Air Base during such period. 17 (B) An epidemiological study of the health 18 consequences of a member of the Armed Forces 19 deployed to the Air Base during such period. 20 (C) An assessment of any association be- 21 tween exposure to toxic substances identified 22 under subparagraph (A) and the health con- 23 sequences studied under subparagraph (B). 24 (b) REPORT.—Not later than 180 days after the date 25 of the enactment of this Act, the Secretary of Defense and 26 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 5957 IH the Secretary of Veterans Affairs shall jointly submit to 1 the appropriate congressional committees a report con- 2 taining— 3 (1) the study under subsection (a); and 4 (2) a description of— 5 (A) the benefits administered by the Sec- 6 retary of Veterans Affairs that a veteran may 7 be eligible to receive by reason of being exposed 8 to toxic substances at Karshi Khanabad Air 9 Base, Uzbekistan, while serving in the Armed 10 Forces; and 11 (B) the outreach conducted by the Sec- 12 retary to inform such veterans of such benefits. 13 SEC. 3. ESTABLISHMENT OF K2 TOXIC EXPOSURE REG- 14 ISTRY. 15 (a) ESTABLISHMENT OF REGISTRY.— 16 (1) IN GENERAL.—Not later than one year 17 after the date of the enactment of this Act, the Sec- 18 retary of Veterans Affairs shall— 19 (A) establish and maintain a registry for 20 eligible individuals who may have been exposed 21 to toxic substances at Karshi Khanabad Air 22 Base, Uzbekistan, at any time during the pe- 23 riod beginning October 1, 2001, and ending De- 24 cember 31, 2005; 25 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 5957 IH (B) include any information in such reg- 1 istry that the Secretary of Veterans Affairs de- 2 termines necessary to ascertain and monitor the 3 health effects of the exposure of members to 4 such substances; 5 (C) develop a public information campaign 6 to inform eligible individuals about the registry, 7 including how to register and the benefits of 8 registering; and 9 (D) periodically notify eligible individuals 10 of significant developments in the study and 11 treatment of conditions associated with such ex- 12 posure. 13 (2) UPDATES.—The Secretary shall take ac- 14 tions necessary to ensure that the registry may be 15 updated with the cause of death of a deceased reg- 16 istered individual by— 17 (A) an individual designated by such de- 18 ceased registered individual; or 19 (B) if no such individual is designated, an 20 immediate family member of such deceased reg- 21 istered individual. 22 (3) COORDINATION.—The Secretary of Vet- 23 erans Affairs shall coordinate with the Secretary of 24 Defense in carrying out paragraph (1). 25 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 5957 IH (b) REPORT TO CONGRESS.— 1 (1) REPORTS BY INDEPENDENT SCIENTIFIC OR- 2 GANIZATION.—The Secretary of Veterans Affairs 3 shall enter into an agreement with an independent 4 scientific organization to prepare reports as follows: 5 (A) Not later than two years after the date 6 on which the registry under subsection (a) is es- 7 tablished, an initial report containing the fol- 8 lowing: 9 (i) An assessment of the effectiveness 10 of actions taken by the Secretaries to col- 11 lect and maintain information on the 12 health effects of exposure to toxic sub- 13 stances at Karshi Khanabad Air Base, Uz- 14 bekistan. 15 (ii) Recommendations to improve the 16 collection and maintenance of such infor- 17 mation. 18 (iii) Using established and previously 19 published epidemiological studies, rec- 20 ommendations regarding the most effective 21 and prudent means of addressing the med- 22 ical needs of eligible individuals with re- 23 spect to conditions that are likely to result 24 from such exposure. 25 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 5957 IH (B) Not later than five years after com- 1 pleting the initial report described in subpara- 2 graph (A), a follow-up report containing the fol- 3 lowing: 4 (i) An update to the initial report de- 5 scribed in subparagraph (A). 6 (ii) An assessment of whether and to 7 what degree the content of the registry es- 8 tablished under subsection (a) is current 9 and scientifically up-to-date. 10 (2) SUBMITTAL TO CONGRESS.— 11 (A) INITIAL REPORT.—Not later than two 12 years after the date on which the registry under 13 subsection (a) is established, the Secretary of 14 Veterans Affairs shall submit to Congress the 15 initial report prepared under paragraph (1)(A). 16 (B) FOLLOW-UP REPORT.—Not later than 17 five years after submitting the report under 18 subparagraph (A), the Secretary of Veterans 19 Affairs shall submit to Congress the follow-up 20 report prepared under paragraph (1)(B). 21 (c) DEFINITIONS.—In this section: 22 (1) The term ‘‘eligible individual’’ means any 23 individual who was deployed as a member of the 24 Armed Forces to Karshi Khanabad Air Base, Uz- 25 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 5957 IH bekistan, at any time during the period beginning 1 October 1, 2001, and ending December 31, 2005. 2 (2) The term ‘‘immediate family member’’, with 3 respect to a deceased individual, means— 4 (A) the spouse, parent, brother, sister, or 5 adult child of the individual; 6 (B) an adult person to whom the indi- 7 vidual stands in loco parentis; or 8 (C) any other adult person— 9 (i) living in the household of the indi- 10 vidual at the time of the death of the indi- 11 vidual; and 12 (ii) related to the individual by blood 13 or marriage. 14 (3) The term ‘‘registered individual’’ means an 15 individual registered with the registry under sub- 16 section (a). 17 SEC. 4. DETERMINATION OF PRESUMPTIONS OF SERVICE 18 CONNECTION FOR ILLNESSES ASSOCIATED 19 WITH K2 EXPOSURE. 20 (a) IN GENERAL.— 21 (1) DETERMINATION REQUIRED.—Not later 22 than 60 days after the date on which the Secretary 23 of Veterans Affairs receives the results of a covered 24 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 5957 IH study, the Secretary shall make a determination 1 whether a positive association exists between— 2 (A) the exposure of humans to toxic sub- 3 stances at Karshi Khanabad Air Base, Uzbek- 4 istan, at any time during the period beginning 5 October 1, 2001, and ending December 31, 6 2005; and 7 (B) the occurrence of a diagnosed illness in 8 humans. 9 (2) BASES OF DETERMINATION.—In making a 10 determination under paragraph (1), the Secretary 11 shall consider— 12 (A) whether the evidence is statistically 13 significant, capable of replication, and able to 14 withstand peer review demonstrating that there 15 is positive association between the exposure and 16 the occurrence of a diagnosed illness; 17 (B) the results of a covered study; and 18 (C) all other sound medical and scientific 19 evidence available to the Secretary. 20 (3) PRESUMPTION.—If the Secretary deter- 21 mines that a positive association exists between ex- 22 posure and a diagnosed illness pursuant to para- 23 graph (1), the Secretary shall prescribe regulations 24 providing that— 25 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 5957 IH (A) a presumption of service connection is 1 warranted for the illness covered by that deter- 2 mination if the illness first becomes manifest 3 within the period, if any, prescribed in such 4 regulations in a covered veteran; and 5 (B) such covered veteran shall be pre- 6 sumed to have been exposed to toxic substances 7 at Karshi Khanabad Air Base, Uzbekistan, at 8 any time during the period beginning October 9 1, 2001, and ending December 31, 2005, unless 10 there is conclusive evidence to establish that— 11 (i) the covered veteran was not ex- 12 posed to toxic substances in the course of 13 such service in the Armed Forces; or 14 (ii) the illness first became manifest 15 prior to the covered veteran’s exposure. 16 (4) SUBMISSION.—Upon the date on which the 17 Secretary makes the determination under paragraph 18 (1), the Secretary shall submit to the Committees on 19 Veterans’ Affairs of the House of Representatives 20 and the Senate an explanation of such determina- 21 tion. 22 (b) REGULATIONS.— 23 (1) PROPOSED REGULATIONS.— 24 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 5957 IH (A) TIMING.—If the Secretary determines 1 under subsection (a)(1) that a presumption of 2 service connection is warranted for an illness, 3 the Secretary shall, not later than 180 days 4 after making such determination— 5 (i) issue proposed regulations setting 6 forth the determination; or 7 (ii) submit the initial report under 8 subparagraph (B). 9 (B) REPORTS.—If the Secretary does not 10 issue proposed regulations by the deadline es- 11 tablished in subparagraph (A), the Secretary 12 shall submit to the Committees on Veterans’ 13 Affairs of the House of Representatives and the 14 Senate a report on the status of such proposed 15 regulations. On a quarterly basis thereafter 16 until the date on which the Secretary issues 17 such proposed regulations, the Secretary shall 18 submit to such committees an update on such 19 status. 20 (2) FINAL REGULATIONS.—Not later than 180 21 days after the date on which the Secretary issues 22 any proposed regulations under this subsection, the 23 Secretary shall prescribe final regulations. Such reg- 24 ulations shall be effective on the date of issuance. 25 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 5957 IH (3) PRESUMPTION NOT WARRANTED.— 1 (A) PUBLICATION.—If the Secretary deter- 2 mines under subsection (a) that a presumption 3 of service connection is not warranted for an ill- 4 ness, or proposes to remove a previously estab- 5 lished presumption, the Secretary shall publish 6 in the Federal Register a notice of that deter- 7 mination not later than 180 days after making 8 the determination. The notice shall include an 9 explanation of the evidence and scientific basis 10 for that determination. 11 (B) REMOVAL OF PREVIOUS PRESUMP- 12 TION.—If an illness already presumed to be 13 service connected under this section is subject 14 to a notice published under subparagraph (A), 15 the Secretary shall issue proposed regulations 16 removing the presumption for the illness not 17 later than 180 days after publication of such 18 notice. 19 (4) EFFECT OF REMOVAL.—Whenever the pre- 20 sumption of service connection for an illness under 21 this section is removed under this subsection— 22 (A) a veteran who was awarded compensa- 23 tion for the illness on the basis of the presump- 24 tion before the effective date of the removal of 25 VerDate Sep 11 2014 00:44 Feb 26, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H5957.IH H5957 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 5957 IH the presumption shall continue to be entitled to 1 receive compensation on that basis; and 2 (B) a survivor of a veteran who was 3 awarded dependency and indemnity compensa- 4 tion for the death of a veteran resulting from 5 the illness on the basis of the presumption be- 6 fore that date shall continue to be entitled to 7 receive dependency and indemnity compensation 8 on that basis. 9 (c) EFFECTIVE DATE OF BENEFIT AWARDS.—The 10 effective date of any benefit awarded by reason of this sec- 11 tion shall be determined in accordance with section 5110 12 of title 38, United States Code, but shall in no case be 13 earlier than the effective date of the final regulations pre- 14 scribed pursuant to subsection (b)(2). 15 (d) DEFINITIONS.—In this section: 16 (1) The term ‘‘covered study’’ includes— 17 (A) the study conducted under section 2; 18 and 19 (B) any subsequent study or any study 20 conducted by the National Academies of 21 Sciences, Engineering, and Medicine regarding 22 the effects of exposure of humans to toxic sub- 23 sta [Text truncated for display. 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