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Title II — Research and review regarding exposure to toxic substances

S. 4393 · 116th Congress · Jul 30, 2020 · Lineage

II Research and review regarding exposure to toxic substances

Sec. 201 Establishment of Toxic Exposure Review Commission

(a)
In general— Subchapter III of chapter 5 of title 38, United States Code, is amended by adding at the end the following new section:

“547. Toxic Exposure Review Commission

“(a) Establishment—There is established within the Department an independent commission to be known as the “Toxic Exposure Review Commission” (in this section referred to as the “Commission”).

“(b) Duties—The Commission shall carry out the following duties:

“(1) Collect any relevant public information from the Department of Defense and other sources to identify possible exposures to toxic substances pertaining to active military, naval, or air service.

“(2) Hold public meetings to gather relevant information regarding exposure to toxic substances.

“(3) Review such information to assess whether to recommend that a study be conducted under section 202(e) of the Toxic Exposure in the American Military Act of 2020.

“(4) Recommend, by majority vote, whether such a study should be conducted.

“(5) Recommend to the Secretary, by majority vote, whether new, independent studies should be conducted regarding the health outcomes of exposure to toxic substances.

“(6) Annually report to Congress on progress regarding the duties set forth in paragraphs (1) through (5).

“(c) Membership

“(1)

“(A) The Commission shall be composed of 9 members, appointed as follows:

“(i) Two members appointed by the Speaker of the House of Representatives.

“(ii) Two members appointed by the minority leader of the House of Representatives.

“(iii) Two members appointed by the majority leader of the Senate.

“(iv) Two members appointed by the minority leader of the Senate.

“(v) One member appointed by the Secretary.

“(B) The initial members of the Commission shall be appointed under subparagraph (A) not later than 180 days after the date of the enactment of the Toxic Exposure in the American Military Act of 2020.

“(2) In appointing individuals under paragraph (1)(A), the Speaker of the House of Representatives, the minority leader of the House of Representatives, the majority leader of the Senate, the minority leader of the Senate, and the Secretary shall ensure that the following fields of experience are represented on the Commission:

“(A) The field of respiratory medicine.

“(B) The field of endocrinology and metabolic medicine.

“(C) The field of hematology.

“(D) The field of oncology.

“(E) The field of public health.

“(F) The field of occupational and environmental health.

“(3) In appointing individuals under paragraph (1)(A), the Speaker of the House of Representatives, the minority leader of the House of Representatives, the majority leader of the Senate, the minority leader of the Senate, and the Secretary shall ensure that at least two members of the Commission represent an organization recognized by the Secretary for the representation of veterans under section 5902 of this title.

“(4) In appointing individuals under paragraph (1)(A), the Speaker of the House of Representatives, the minority leader of the House of Representatives, the majority leader of the Senate, the minority leader of the Senate, and the Secretary shall give consideration to including in the Commission at least one member who works with survivors of illnesses related to exposure to toxic substances and has a background in the field of study of exposure to toxic substances.

“(d) Meetings

“(1) The Commission shall meet not less frequently than twice each year.

“(2)

“(A) Each meeting of the Commission shall be open to the public.

“(B) All the proceedings, information, and deliberations of the Commission shall be available for review by the public.

“(e) Chair and Vice Chair—At the initial meeting of the Commission under subsection (d), the Commission shall select a Chair and Vice Chair from among the members of the Commission by a majority vote of the members of the Commission.

“(f) Vacancies—A vacancy in the Commission shall be filled in the same manner as the original appointment, but the individual appointed to fill the vacancy shall serve only for the unexpired portion of the term for which the individual’s predecessor was appointed.

“(g) Pay

“(1) Members of the Commission shall serve without pay.

“(2) Each member of the Commission who is an officer or employee of the United States shall serve without compensation in addition to that received for service as an officer or employee of the United States.

“(3) Members shall receive travel expenses, including per diem in lieu of subsistence, in accordance with sections 5702 and 5703 of title 5.

“(h) Director of staff

“(1) The Commission shall appoint a Director who—

“(A) has not served as an employee of the Department during the one-year period preceding the date of such appointment; and

“(B) is not otherwise barred or prohibited from serving as Director under Federal ethics laws and regulations, by reason of post-employment conflict of interest.

“(2) The Director shall be paid at the rate of basic pay payable for level IV of the Executive Schedule under section 5315 of title 5.

“(i) Staff

“(1) Subject to paragraphs (2) and (3), the Director, with the approval of the Commission, may appoint and fix the pay of additional personnel.

“(2) The Director may make such appointments without regard to the provisions of title 5 governing appointments in the competitive service, and any personnel so appointed may be paid without regard to the provisions of chapter 51 and subchapter III of chapter 53 of that title relating to classification and General Schedule pay rates, except that an individual so appointed may not receive pay in excess of the annual rate of basic pay payable for GS–15 of the General Schedule.

“(3)

“(A) Not more than two-thirds of the personnel employed by or detailed to the Commission may be on detail from the Department.

“(B) Not more than half of the professional analysts of the Commission staff may be persons detailed from the Department to the Commission.

“(4) Subject to paragraph (3), the head of any Federal agency, upon the request of the Director, may detail any of the personnel of that agency to the Commission to assist the Commission in carrying out its duties under this section.

“(5) The Commission may secure directly from any Federal agency such information as the Commission considers necessary to carry out this section. Upon request of the Chair, the head of such agency shall furnish such information to the Commission, unless such information is classified.

“(j) Other authority

“(1) The Commission may procure by contract, to the extent funds are available, the temporary or intermittent services of experts or consultants pursuant to section 3109 of title 5.

“(2) To the extent funds are available, the Commission may lease real property and acquire personal property either of its own accord or in consultation with the General Services Administration.

“(k) Communications

“(1)

“(A) Except as provided in subparagraph (B), no person may restrict an employee of the Department in communicating with the Commission.

“(B) Subparagraph (A) does not apply to a communication that is unlawful.

“(2) All ex parte communications with the Commission shall be made part of the public record.”

(b)
Clerical amendment— The table of sections at the beginning of such subchapter is amended by adding at the end the following new item:

Sec. 202 Agreement with National Academies of Sciences, Engineering, and Medicine concerning the exposure of humans to toxic substances

(a)
Purpose— The purpose of this section is to provide for the National Academies of Sciences, Engineering, and Medicine (in this section referred to as the “Academies”), an independent nonprofit scientific organization with appropriate expertise that is not part of the Federal Government, to review and evaluate the available scientific evidence regarding associations between diseases and exposure to toxic substances.
(b)
Agreement—
(1)
In general— The Secretary of Veterans Affairs shall seek to enter into an agreement with the Academies to perform the services covered by this section.
(2)
Timing— The Secretary shall seek to enter into an agreement described in paragraph (1) not later than 60 days after the date of the enactment of this Act.
(c)
Review of scientific evidence— Under an agreement between the Secretary and the Academies under this section, the Academies shall review and summarize the scientific evidence, and assess the strength thereof, concerning the association between exposure to toxic substances during active military, naval, or air service and each disease suspected to be associated with such exposure in the human population.
(d)
Scientific determinations concerning diseases— For each disease reviewed under subsection (c), the Academies shall determine, to the extent that available scientific data permit meaningful determinations—
(1)
whether an association exists between exposure to toxic substances and the occurrence of the disease, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association;
(2)
the increased risk of the disease among those exposed to toxic substances during active military, naval, or air service; and
(3)
whether there exists a plausible biological mechanism or other evidence of a causal relationship between the exposure and the occurrence of the disease.
(e)
Scientific studies—
(1)
In general— Under an agreement between the Secretary and the Academies under this section, the Academies shall conduct such scientific studies as the Toxic Exposure Review Commission recommends pursuant to section 547(b)(4) of title 38, United States Code, as added by section 201(a).
(2)
Recommendations for additional scientific studies—
(A)
In general— Under an agreement between the Secretary and the Academies under this section, the Academies shall make any recommendations for additional scientific studies to resolve areas of continuing scientific uncertainty relating to the exposure of humans to toxic substances.
(B)
Considerations— In making recommendations under subparagraph (A), the Academies shall consider—
(i)
the scientific information that is available at the time of the recommendation;
(ii)
the value and relevance of the information that could result from additional studies; and
(iii)
the cost and feasibility of carrying out such additional studies.
(f)
Subsequent reviews— Under an agreement between the Secretary and the Academies under this section, the Academies shall—
(1)
conduct as comprehensive a review as is practicable of the evidence referred to in subsection (c) that became available since the last review of such evidence under this section; and
(2)
make determinations and estimates on the basis of the results of such review and all other reviews conducted for the purposes of this section.
(g)
Reports—
(1)
Initial report—
(A)
In general— Under an agreement between the Secretary and the Academies under this section, not later than one year after the date of the enactment of this Act, the Academies shall submit to the Secretary, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives an initial report on the activities of the Academies under the agreement.
(B)
Elements— The report submitted under subparagraph (A) shall include the following:
(i)
The determinations described in subsection (d).
(ii)
A full explanation of the scientific evidence and reasoning that led to such determinations.
(iii)
Any recommendations of the Academies under subsection (e)(2).
(iv)
The recommendation described in subparagraph (C).
(C)
Recommendation for implementation of analysis of examinations and treatment of veterans for disabilities related to exposure to toxic substances—
(i)
In general— The recommendation described in this subparagraph is the recommendation of the Academies as to whether section 203 should take effect as provided in subsection (d) of such section.
(ii)
Considerations— In making a recommendation under clause (i), the Academies shall consider—
(I)
the scientific information that is available at the time of the recommendation;
(II)
the value and relevance of the information that could result from the implementation of section 203; and
(III)
the cost and feasibility of such implementation.
(iii)
Maintenance of clinical data— If the Academies recommend that section 203 should take effect, the Academies shall recommend the means by which clinical data referred to in that section could be maintained in the most scientifically useful way.
(2)
Periodic updates— Under an agreement between the Secretary and the Academies under this section, not less frequently than once every two years after the date on which the initial report is submitted under paragraph (1)(A), the Academies shall submit to the Secretary, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives an updated report on the activities of the Academies under the agreement.
(h)
Limitation on authority— The authority to enter into agreements under this section shall be effective for a fiscal year to the extent that appropriations are available for such purpose.
(i)
Alternative contract scientific organization—
(1)
In general— If the Secretary is unable within the time period prescribed in subsection (b)(2) to enter into an agreement with the Academies for the purposes of this section on terms acceptable to the Secretary, the Secretary shall seek to enter into an agreement for the purposes of this section with another appropriate scientific organization that—
(A)
is not part of the Federal Government;
(B)
operates as a not-for-profit entity; and
(C)
has expertise and objectivity comparable to that of the Academies.
(2)
Treatment— If the Secretary enters into an agreement with another organization as described in paragraph (1), any reference in this section, section 203, and section 1119 of title 38, United States Code, as added by section 102(a), to the National Academies of Sciences, Engineering, and Medicine shall be treated as a reference to the other organization.

Sec. 203 Analysis of results of consultation, testing, and treatment of veterans for disabilities related to exposure to toxic substances

(a)
In general— The Secretary of Veterans Affairs shall compile and analyze, on a continuous basis, all clinical data that—
(1)
is obtained by the Department of Veterans Affairs in connection with consultation, testing, and treatment furnished to veterans by the Department under section 1720J of title 38, United States Code, as added by section 101(a); and
(2)
is likely to be scientifically useful in determining the association, if any, between the disability of a veteran and exposure to a toxic substance.
(b)
Consent of patients— Compilation and analysis by the Secretary of clinical data of a veteran under subsection (a) shall be conducted, and such data shall be used, consistent with the informed consent of the veteran and in compliance with all applicable Federal law.
(c)
Annual report— Not later than one year after the effective date under subsection (d), and annually thereafter, 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—
(1)
the information compiled under subsection (a);
(2)
an analysis of such information;
(3)
a description of the types and incidences of disabilities identified by the Department under such subsection;
(4)
the explanation of the Secretary for the incidence of such disabilities and other explanations for the incidence of such disabilities as the Secretary considers reasonable; and
(5)
the views of the Secretary on the scientific validity of drawing conclusions from the incidence of such disabilities, as evidenced by the data compiled under subsection (a), regarding any association between such disabilities and exposure to a toxic substance.
(d)
Effective date—
(1)
In general— Except as provided in paragraph (2), this section shall take effect on the date that is 90 days after the date on which the report submitted by the National Academies of Sciences, Engineering, and Medicine under section 202(g)(1) is received by the Secretary.
(2)
Exception— This section shall not take effect if the Secretary, after receiving the report described in paragraph (1) and before the end of the 90-day period described in such paragraph—
(A)
determines that it is not feasible or cost-effective to carry out this section or that carrying out this section would not make a material contribution to the body of scientific knowledge concerning the health effects in humans of herbicide exposure; and
(B)
notifies the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives of that determination and the reasons therefor.

Sec. 204 Report to evaluate and identify groups at-risk of exposure to toxic substances

(a)
In general— Not later than one year after the date of the enactment of this Act, and every two years thereafter, the Secretary of Defense shall submit to the appropriate committees of Congress and, subject to applicable Federal privacy laws, make available to the public a report evaluating and identifying the groups of members of the Armed Forces and former members of the Armed Forces who are at-risk of exposure to toxic substances.
(b)
Existing data— The Secretary shall use data from existing record and tracking systems to develop each report under subsection (a).
(c)
Use of capabilities of National Artificial Intelligence Institute— In developing each report under subsection (a), the Secretary shall use the capabilities of the National Artificial Intelligence Institute of the Department of Veterans Affairs to interpret the veteran population data within the Individual Longitudinal Exposure Record of the Department, including data compiled under—
(1)
the Million Veteran Program of the Department;
(2)
health records of veterans; and
(3)
benefits records of veterans.
(d)
Elements of report— Each report submitted under subsection (a) shall—
(1)
identify groups at a high-risk for illnesses relating to exposure to toxic substances and recommend an outreach strategy for those groups; and
(2)
determine the viability of correlating the Individual Longitudinal Exposure Record and health records maintained by the Veterans Health Administration, including with respect to participation of a veteran in the Million Veteran Program of the Department, to provide more data to epidemiologists of the Department.
(e)
Appropriate committees of Congress defined— In this section, the term appropriate committees of Congress means—
(1)
the Committee on Armed Services and the Committee on Veterans’ Affairs of the Senate; and
(2)
the Committee on Armed Services and the Committee on Veterans’ Affairs of the House of Representatives.