Persian Gulf War Veterans' Health and Medical Research Act of 1998 - Requires the Director of the National Institutes of Health to establish and manage research activities within the Departments of Defense (DOD) and Veterans Affairs (VA) to ensure that a greater priority is given to research on: (1) effective treatment for ill Persian Gulf War veterans; and (2) exposure to all potentially hazardous substances and diseases encountered by military personnel mobilized or deployed in support of combat operations under the United States Central and Eastern European Commands during the period beginning on August 2, 1990, and ending on December 31, 1991, including chemical and biological warfare agents, pyridostigmine bromide, vaccinations, and any other manmade or naturally occurring toxic substances or diseases to which such veterans were exposed. Provides a research timetable. Requires the identification of all substances to which such veterans may have been exposed and all illnesses that such veterans are experiencing. Requires the Director to compile a list of chronic illnesses for which valid models of successful treatment are provided. Requires an interagency agreement between the Secretaries of Defense, Veterans Affairs, and Health and Human Services for the completion of requirements under this section.
(Sec. 3) Requires the Director to establish a single comprehensive database and monitoring system for the collection, storage, and analysis of medical research data covering all Gulf War veterans in order to monitor their status and clinical progress. Requires such information to be available to the public. Authorizes appropriations. Requires the Director to submit a database development plan to the House and Senate Committees on Veterans' Affairs, the Senate Committee on Armed Services, the House Committee on National Security (designated committees), the Comptroller General, and Gulf War veterans' representatives. Requires the database to become operational within six months after enactment of this Act. Requires the Director to compile and analyze on an ongoing basis all database data likely to be scientifically useful in determining the association, if any, between the illnesses suffered by Gulf War veterans and their exposure to biological, chemical, or toxic agents, pyridostigmine bromide, vaccines, or other potentially hazardous substances. Requires an annual report from the Director to the designated committees.
(Sec. 4) Requires a joint semiannual report from the Secretaries of Defense and Veterans Affairs to the designated committees on their research progress concerning the health of such veterans and the health status of veterans being tracked in the database.
(Sec. 5) Directs the Comptroller General to carry out annual assessments of the research-related activities of the Director and the Secretaries of Defense and Veterans Affairs, requiring appropriate recommendations and reports to the designated committees.
(Sec. 6) Requires the Director to review the research and database findings in order to provide new treatment protocols for individual and multiple toxic exposures. Requires a training program for DOD and VA physicians to implement such protocols.
(Sec. 7) Requires the Director to carry out an outreach program to provide Gulf War veterans with information concerning the health risks of such service and available treatments. Requires the establishment of an ombudsman program to facilitate addressing complaints of such veterans regarding treatment for such health risks. Authorizes appropriations. Requires release to the public of all research findings and treatment protocols developed under this Act.
[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3661 Introduced in House (IH)]
105th CONGRESS
2d Session
H. R. 3661
To require the Secretary of Veterans Affairs and the Secretary of
Defense to give greater priority to research on the exposure of
veterans of Operation Desert Shield and Operation Desert Storm to
biological agents or chemical weapons, other toxic agents such as
depleted uranium and organophosphates, pyridostigmine bromide,
vaccines, oil well fire pollution, and other potentially hazardous
substances, to require the Director of the National Institutes of
Health to monitor, through a comprehensive database, the resulting
effects of such exposure on those veterans' health and their clinical
progress in order to identify and provide appropriate and effective
medical treatment, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 1, 1998
Mr. Kennedy of Massachusetts (for himself, Mr. Shays, Mr. Filner, Mr.
Quinn, Mr. Moakley, Mr. Sanders, Mr. Gutierrez, Mr. Peterson of
Minnesota, Ms. Brown of Florida, Ms. Carson, Mr. Olver, Ms. Rivers, Mr.
Markey, Mr. Frank of Massachusetts, Mr. Kennedy of Rhode Island, Mr.
Neal of Massachusetts, Mr. Waxman, Mr. McGovern, Mr. Burton of Indiana,
Mr. Tierney, Mrs. Maloney of New York, Mr. Delahunt, Mr. Lantos, Mr.
Underwood, Mr. Romero-Barcelo, Mr. Clement, Mr. Frost, Ms. Slaughter,
Mr. Moran of Virginia, Mr. Hastings of Florida, Mr. McIntosh, Mr.
Meehan, Mr. Rodriguez, Mr. Davis of Illinois, and Ms. Velazquez)
introduced the following bill; which was referred to the Committee on
Veterans' Affairs, and in addition to the Committees on National
Security, and Commerce, 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 concerned
_______________________________________________________________________
A BILL
To require the Secretary of Veterans Affairs and the Secretary of
Defense to give greater priority to research on the exposure of
veterans of Operation Desert Shield and Operation Desert Storm to
biological agents or chemical weapons, other toxic agents such as
depleted uranium and organophosphates, pyridostigmine bromide,
vaccines, oil well fire pollution, and other potentially hazardous
substances, to require the Director of the National Institutes of
Health to monitor, through a comprehensive database, the resulting
effects of such exposure on those veterans' health and their clinical
progress in order to identify and provide appropriate and effective
medical treatment, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Persian Gulf War
Veterans' Health and Medical Research Act of 1998''.
(b) Table of Contents.--
Sec. 1. Short title; table of contents.
Sec. 2. Management by National Institutes of Health of research on
illnesses of Gulf War veterans.
Sec. 3. Database for tracking the health status, clinical progress, and
medical treatment of Gulf War veterans.
Sec. 4. Semiannual report on research programs.
Sec. 5. General Accounting Office annual assessment and report.
Sec. 6. Research protocol and training.
Sec. 7. Outreach.
Sec. 8. Definitions.
SEC. 2. MANAGEMENT BY NATIONAL INSTITUTES OF HEALTH OF RESEARCH ON
ILLNESSES OF GULF WAR VETERANS.
(a) National Institutes of Health.--The Director of the National
Institutes of Health shall establish and manage research activities
within the Department of Defense and Department of Veterans Affairs in
order to ensure that a greater priority is given to--
(1) research on finding effective treatment for ill Gulf
War veterans; and
(2) research on exposure to all potentially hazardous
substances and diseases encountered by members of the Armed
Forces mobilized or deployed in support of combat operations in
the areas of responsibility of the United States Central
Command and the United States European Command during the
period beginning on August 2, 1990, and ending on December 31,
1991, including (among others) chemical and biological warfare
agents, pyridostigmine bromide, vaccinations, and any other
manmade or naturally occurring toxic substances or disease
vectors to which Gulf War veterans were exposed.
(b) Research Timetable.--The Director shall develop a plan for the
research to be carried out pursuant to subsection (a). The Director
shall begin to develop the plan not later than 60 days after the date
of the enactment of this Act and shall implement the plan not later
than 60 days after the completion of the development of the plan.
(c) Identification of Substances to Which Veterans May Have Been
Exposed.--Research to be carried out pursuant to subsection (a) shall
include identification of all potentially hazardous substances, natural
or manmade (including biological or chemical agents, other toxic agents
(including, among others, depleted uranium and organophosphates),
pyridostigmine bromide, and vaccines), to which members of the Armed
Forces may have been exposed by reason of service in the areas of
responsibility of the United States Central Command and the United
States European Command during the period beginning on August 2, 1990,
and ending on December 31, 1991.
(d) Identification of Illnesses.--Research to be carried out
pursuant to subsection (a) shall include identification of all
illnesses (diagnosed and undiagnosed) that Gulf War veterans are
experiencing. The Director shall review and summarize the relevant
scientific evidence regarding the occurrence of such illnesses among
Gulf War veterans and among other populations considered appropriate
for comparison. Matters to be reviewed and compared with respect to
those illnesses include symptoms, mortality rates, and reproductive
health problems ( including birth defects).
(e) List of Chronic Illnesses That Provide Valid Models of
Successful Treatment.--As part of the management of research under this
section, the Director shall compile a list of chronic illnesses for
which valid models of successful treatment are provided, as identified
by--
(1) scientific data and literature;
(2) the views of Gulf War veterans of the efficacy of the
treatment;
(3) the views of private-sector medical specialists
involved in researching Gulf War illnesses; and
(4) the views of private-sector medical clinicians treating
Gulf War veterans.
(f) Interagency Agreements.--The Secretary of Defense and the
Secretary of Veterans Affairs shall each enter into an agreement with
the Secretary of Health and Human Services to provide for the
implementation of this section. The agreements shall ensure that the
Director of the National Institutes of Health has the authority
necessary to carry out the responsibilities of the Director under this
section.
SEC. 3. DATABASE FOR TRACKING THE HEALTH STATUS, CLINICAL PROGRESS, AND
MEDICAL TREATMENT OF GULF WAR VETERANS .
(a) Establishment of the Database.--
(1) Establishment.--The Director of the National Institutes
of Health shall establish a single comprehensive database and
monitoring system for the collection, storage, and analysis of
data covering all Gulf War veterans in order to monitor the
health status and clinical progress of those veterans for the
purpose of identifying appropriate and effective treatment
needed to improve their health.
(2) Separate tracking for veterans receiving medical
care.--In the database under paragraph (1), the Director shall
identify and track separately those Gulf War veterans who--
(A) are receiving medical care from the Secretary
of Veterans Affairs;
(B) are receiving medical care from the Secretary
of Defense; and
(C) are receiving medical care in the private
sector.
(3) Public availability of information in database.--With
the exception of information protected under section 552b of
title 5, United States Code (popularly known as the ``Privacy
Act''), information in the database shall be made available to
the public through the Internet World Wide Web and other
appropriate electronic and printed means.
(4) Required consultation.--The Director shall establish
the database in consultation with the Secretary of Veterans
Affairs and the Secretary of Defense.
(5) Authorization of appropriations.--There are authorized
to be appropriated such sums as may be necessary to establish
and carry out the database under paragraph (1).
(b) Matters To Be Included in Database.--The database shall
include--
(1) all diagnosed and undiagnosed illnesses, symptoms, and
syndromes of Gulf War veterans, including fibromyalgias,
rheumatic ailments, skin ulcers, sinus diseases,
gastrointestinal or digestive diseases (especially Crohn's
colitis, ulcerative colitis, and inflammatory bowel disorders),
respiratory diseases, neurocognitive disorders, kidney stones,
reproductive illnesses, abnormalities, and birth defects;
(2) relevant medical data on illnesses reported by the
spouses and children of Gulf War veterans, including, among
other matters, reports of reproductive illnesses,
abnormalities, and birth defects since 1990; and
(3) the medical treatment provided Gulf War veterans for--
(A) any undiagnosed illness; and
(B) any illness for which the Director of the
National Institutes of Health (pursuant to section 2)
identified a valid model of treatment.
(c) Tracking Capacity.--The database shall be developed so that it
has the capacity to track and analyze--
(1) the illnesses referred to in subsection (b)(1);
(2) the treatments referred to in subsection (b)(3); and
(3) the progress of the treatments as viewed by Gulf War
veterans.
(d) Data To Be Included.--The database shall include the following:
(1) Information in the Persian Gulf War Veterans Health
Registry established under section 702 of the Persian Gulf War
Veterans' Health Status Act (title VII of Public Law 102-585;
38 U.S.C. 527 note).
(2) Information in the Comprehensive Clinical Evaluation
Program for Veterans established under section 734 of the
National Defense Authorization Act for Fiscal Years 1992 and
1993 (10 U.S.C. 1074 note).
(3) Information derived from other examinations and
treatment provided to veterans who served in the Southwest Asia
theater of operations during the period specified in section
8(1).
(4) Information derived from other examinations and
treatment provided current members of the Armed Forces
(including members on active duty and members of the reserve
components) who served in that theater of operations during
that period.
(5) Information derived from other examinations and
treatment provided to Gulf War veterans who receive medical
care in the private sector.
(6) Information derived from physicians' Current Procedure
Terminology (CPT) and the Department of Health and Human
Services-approved International Classification of Diseases with
Clinical Modification (ICD-9-CM) codes in the Persian Gulf
veterans' medical charges and medical bills, from any medical
treatments and examinations provided to Persian Gulf veterans,
even if they are not registered in the registry referred to in
paragraph (1) and are not covered by the Comprehensive Clinical
Evaluation Program for Veterans referred to in paragraph (2).
(7) Information pertaining to causes of death, health
claims, and diagnoses of Gulf War veterans contained in the
Department of Veterans Affairs' Beneficiary Identification and
Records Locator Subsystem (BIRLS).
(8) Such other information as the Secretary of Veterans
Affairs or the Secretary of Defense considers appropriate for
inclusion in the database, including information regarding
persons who underwent preparations to deploy to the Southwest
Asia theater of operations but were not deployed.
(9) Such other information as the Director of the National
Institutes of Health, based upon the advice of health
professionals, scientists, and epidemiologists, considers
appropriate for inclusion in the database, including
information regarding persons who underwent preparations to
deploy to the Southwest Asia theater of operations but were not
deployed.
(e) Implementation of Database.--(1) Not later than 90 days after
the date of the enactment of this Act, the Director of the National
Institutes of Health shall submit for comment and evaluation a plan for
the development of the database to the following:
(A) The Comptroller General.
(B) The designated congressional committees.
(C) Representatives of Gulf War veterans, including (among
others) the veterans' service organizations, with special
emphasis on those organizations formed on behalf of Persian
Gulf veterans.
(2) The Director of the National Institutes of Health shall modify
the database plan according to the evaluations received from the
entities specified in subparagraphs (A), (B), and (C) of paragraph (1)
and shall, not later than 60 days after receiving the evaluations,
implement the plan as modified.
(3) The Director shall carry out paragraphs (1) and (2) in
consultation with the Secretary of Veterans Affairs and the Secretary
of Defense.
(4) The database shall become operational no later than six months
after the date of the enactment of this Act.
(f) Compilation and Analysis of Information in Database.--The
Director of the National Institutes of Health shall compile and
analyze, on an ongoing basis, all clinical data in the database under
subsection (a) that is likely to be scientifically useful in
determining the association, if any, between the illnesses (including
diagnosed illnesses and undiagnosed illnesses) of Gulf War veterans
covered by such data and exposure to biological or chemical agents,
other toxic agents (including depleted uranium and organophosphates),
pyridostigmine bromide, vaccines, and any other potentially hazardous
substance.
(g) Annual Report.--Not later than January 31 of each year after
the database is operational, the Director of the National Institutes of
Health shall submit to the designated congressional committees a report
containing--
(1) with respect to the data compiled in accordance with
subsection (b) during the preceding year--
(A) an analysis of the data;
(B) a discussion of the types, incidence, and
prevalence of the disabilities and illnesses identified
through such data;
(C) an explanation for the incidence and prevalence
of such disabilities and illnesses;
(D) other reasonable explanations for the incidence
and prevalence of such disabilities and illnesses; and
(E) an analysis of the scientific validity of
drawing conclusions from the incidence and prevalence
of such disabilities and illnesses, as evidenced by
such data, about any association between such
disabilities and illnesses, as the case may be, and
exposure to biological or chemical agents, other toxic
agents (including depleted uranium and
organophosphates), pyridostigmine bromide, vaccines,
and any other potentially hazardous substance; and
(2) with respect to the most current information regarding
treatment models identified under section 2(e)--
(A) an analysis of the information;
(B) the results of any consultation between such
Secretaries regarding the implementation of such
treatment models in the health care systems of the
Department of Veterans Affairs and the Department of
Defense; and
(C) in the event either such Secretary determines
not to implement such treatment models, an explanation
for such determination and the views of the Director of
the National Institutes of Health regarding such
determination.
SEC. 4. SEMIANNUAL REPORT ON RESEARCH PROGRAMS.
The Secretary of Defense and Secretary of Veterans Affairs shall
submit to the designated congressional committees a semiannual joint
report on their research progress concerning the health of Gulf War
veterans and the health status of the veterans being tracked in the
database under section 3.
SEC. 5. GENERAL ACCOUNTING OFFICE ANNUAL ASSESSMENT AND REPORT.
(a) Annual Assessments.--(1) The Comptroller General shall carry
out--
(A) an assessment each year of the establishment and
management of research during the preceding calendar year by
the Director of the National Institutes of Health under section
2;
(B) an assessment each year to determine whether the
Secretary of Veterans Affairs and the Secretary of Defense are
effectively and efficiently allocating funds toward research
protocols required by the Director of the National Institutes
of Health; and
(C) an assessment each year of the establishment,
maintenance, and use during the preceding calendar year of the
database established under section 3.
(2) If the Comptroller General finds under paragraph (1)(B) that
funds are not being allocated according to the Director's guidelines,
the Comptroller General shall make recommendations to the Congress to
reappropriate funds or to take such other action as is appropriate and
necessary to ensure that the research protocols are carried out. The
recommendations of the Comptroller General shall be stated each year in
the annual report under subsection (b).
(b) Report.--Not later than March 15 each year, the Comptroller
General shall submit to the designated congressional committees a
report on the assessments under subsection (a) for the preceding
calendar year.
SEC. 6. RESEARCH PROTOCOL AND TRAINING.
(a) Treatment Protocols.--The Director of the National Institutes
of Health shall review the research findings under section 2, and the
database findings under section 3, as those findings become available
or not less often than annually. The purpose of those reviews shall be
to develop new treatment protocols for individual and multiple toxic
exposures. The Director shall provide the treatment protocols so
developed--
(1) to the Secretary of Veterans Affairs and the Secretary
of Defense, who shall ensure that those protocols are made
available to attending physicians in their respective
departments; and
(2) to attending physicians in the private sector as
provided in section 7(d)(1).
(b) Training Program.--
(1) In general.--The Director of the National Institutes of
Health shall provide a program of training for physicians of
the Department of Veterans Affairs and Department of Defense to
train those physicians in treatment protocols for persons
exposed to acute and low-level toxic substances. The Director
shall carry out the program through the Director of the
National Institute of Environmental Health Sciences.
(2) Training entity.--The training program shall be
conducted by an appropriate entity outside the Government which
is experienced in treating persons exposed to toxic substances.
(3) Content of program.--The Director shall ensure that the
training program includes training for the entire range of
medical and scientific disciplines in the course curricula as
they pertain to diagnosing and treating individual and multiple
toxic exposures, with special emphasis placed on understanding
the effects of repeated low-level exposures to single and
multiple toxic substances.
(4) Goal for training.--The Secretary of Veterans Affairs
and the Secretary of Defense shall seek to ensure that not less
than 15 percent of the attending physicians within their
respective departments participate in the training program.
(5) Timetable for program.--The training program shall be
implemented not later than one year after the date of the
enactment of this Act. Not later than 90 days after the date of
the enactment of this Act, the Director shall identify the
course content for the training program and not later than 30
days thereafter shall issue a request for proposals for a
contract for the training program. The Director shall enter
into such a contract not later than 120 days after issuing the
request for proposals.
(c) Renewal of Training Program.--Whenever the Director determines
that there have been new research results that warrant additional
training as described in subsection (b), the Director shall provide for
an additional training program to be made available in the same manner
as provided in subsection (b).
(d) Continuing Education Program.--The Director shall ensure that
the training program contains a continuing education component in order
to provide training for new attending physicians of the Department of
Veterans Affairs and the Department of Defense.
(e) Reimbursement.--A training program under this section shall be
conducted on a reimbursable basis.
SEC. 7. OUTREACH.
(a) Outreach Program by Director of National Institutes of
Health.--
(1) Required outreach program.--The Director of the
National Institutes of Health shall carry out an ongoing
program to provide Gulf War veterans the information described
in subsection (c).
(2) Required consultation.--The Director shall carry out
the outreach program in consultation with--
(A) the Secretary of Veterans Affairs and the
Secretary of Defense; and
(B) representatives of Gulf War veterans.
(b) Ombudsman.--
(1) In general.--As part of the outreach program under
subsection (a), the Director shall establish an ombudsman
program to facilitate addressing complaints of Gulf War
veterans regarding treatment for health risks described in
subsection (c)(1).
(2) Authorization of appropriations.--There are authorized
to be appropriated such sums as may be necessary to carry out
the ombudsman program under paragraph (1).
(c) Covered Information.--Information under this subsection is
information relating to--
(1) the health risks, if any, resulting from exposure to
biological or chemical agents, other toxic agents (including
depleted uranium and organophosphates), pyridostigmine bromide,
vaccines, and any other potentially hazardous substance due to
service in, or mobilization in support of, combat operations in
the areas of responsibility of the United States Central
Command and the United States European Command during the
period beginning on August 2, 1990, and ending on December 31,
1991; and
(2) any health services, medical care, or benefits that are
or become available with respect to such health risks.
(d) Public Availability of Research Findings.--
(1) Public availability.--The Director of the National
Institutes of Health shall ensure that all research findings
from research activities covered by this Act, and all treatment
protocols developed pursuant to section 6, are made available
to the public through the Internet World Wide Web, peer-
reviewed medical journals, and other appropriate medical
channels. The Director shall publish reliable, relevant, and
objective medical data regarding diseases of Gulf War veterans.
Peer review of that research shall include at least one
representative from each of the veterans' service
organizations.
(2) Required consultation.--The Director shall carry out
paragraph (1) in consultation with the Secretary of Veterans
Affairs and the Secretary of Defense.
SEC. 8. DEFINITIONS.
For the purposes of this Act:
(1) The term ``Gulf War veteran'' means a veteran or member
of the Armed Forces who during the period beginning on August
2, 1990, and ending on December 31, 1991, while serving on
active duty--
(A) served in the area of responsibility of the
United States Central Command or the United States
European Command; or
(B) while outside either such area of
responsibility--
(i) received an inoculation in anticipation
of deployment to either such area of
responsibility; or
(ii) handled equipment or supplies returned
from either such area of responsibility after
Operation Desert Storm.
(2) The term ``designated congressional committees'' means
the following:
(A) The Committee on Veterans' Affairs and the
Committee on Armed Services of the Senate.
(B) The Committee on Veterans' Affairs and the
Committee on National Security of the House of
Representatives.
<all>
Introduced in House
Introduced in House
Referred to House Veterans' Affairs
Referred to the Committee on Veterans' Affairs, and in addition to the Committees on National Security, and Commerce, 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 concerned.
Referred to House National Security
Referred to House Commerce
Referred to the Subcommittee on Health and Environment, for a period to be subsequently determined by the Chairman.
Executive Comment Requested from DOD.
Referred to the Subcommittee on Military Readiness.
Referred to the Subcommittee on Health.
Unfavorable Executive Comment Received from DOD.
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