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Friday, May 16, 2014

H.R. 4261 Myth and Fact - New Guarantees of Gulf War Veterans on the RAC

Editor's note:  This article was originally posted with inadvertent citation errors in the first two paragraphs of background.  Those errors were corrected as soon as they were found by the author, the same day as the original post.

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MYTH:  H.R. 4261, the Gulf War Health Research Reform Act of 2014, would reduce the number of Gulf War veterans serving on the RAC.


BACKGROUND:

The Veterans Programs Enhancement Act of 1998 (P.L. 105-368) and the Persian Gulf War Veterans Act of 1998 (Title XVI of P.L. 105-277) created an array of laws impacting on VA healthcare, benefits, and research for veterans of the Persian Gulf theatre of operations with service from August 2, 1990 to a date as yet to be determined by the President.  Much of that law continues to apply to veterans of the Persian Gulf theatre of operations with service through to the present.

The Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC), a federal advisory committee composed of Gulf War veterans and researchers, was created under Section 104 of P.L. 105-368 in order to review and provide advice regarding Gulf War research.  Consistent with that mission, every RAC charter has limited the scope of the RAC’s purview to veterans of the 1990-91 Gulf War, including the most recent May 17, 2013 VA charter currently governing the RAC.   The RAC is now codified in law at 38 U.S.C. 527 note Section 707.  

The number of Gulf War veterans on the RAC has never been specified, either in law or in any of the VA Charters governing the RAC. 

1)  U.S. Code.  Current law governing the RAC, which was enacted as part of the Veterans Programs Enhancement Act of 1998 (P.L. 105-368, Section 104), has remains unchanged since its first enactment in 1998, at 38 U.S.C. 527 note Section 707.  This law specifies only that the RAC must include “Persian Gulf War veterans and representatives of such veterans”. The law does not specify the total number of members of the RAC.  The law does not specify how many Persian Gulf War veterans must be on the RAC.  The law does not define “representatives of such veterans”.

“(b) Public Advisory Committee.—Not later than January 1, 1999, the head of the department or agency designated under subsection (a) shall establish an advisory committee consisting of members of the general public, including Persian Gulf War veterans and representatives of such veterans, to provide advice to the head of that department or agency on proposed research studies, research plans, or research strategies relating to the health consequences of military service in the Southwest Asia theater of operations during the Persian Gulf War. ….”

2)  CFR.  There is no corresponding Code of Federal Regulations provision. 

3)  VA Charters governing the RAC.  The first three VA charters governing the RAC did not specify the total number of RAC members; the 4th charter specified “approximately fifteen (15)” total RAC members; the 5th and 6th charters specified “approximately 12” total RAC members. 

All of the VA charters governing the RAC specified that the membership will include Gulf War Veterans (or, alternately, Persian Gulf War) and “representatives of such Veterans”.  None of the charters specified how many RAC members must be Gulf War veterans.  None of the charters define “representatives of such Veterans”. 

All of the VA’s charters governing the RAC specified that RAC members shall include “members of the medical and scientific communities representing appropriate disciplines”. 

Below is the relevant language from each of the six RAC charters, including the current one.  Each is hyperlinked so the full actual charter can be viewed. 

6th VA Charter governing the RAC (currently in effect), May 17, 2013 (Sec. Eric Shinseki):

“The Committee will be composed of approximately 12 members.  Several members may be regular Government employees, but the majority of the Committee’s membership will be special Government employees.  The Committee membership will include, but is not limited to, Gulf War Veterans, representatives of such Veterans, and members of the medical and scientific communities representing appropriate disciplines such as, but not limited to, epidemiology, immunology, environmental health, neurology, and toxicology.”

5th VA Charter governing the RAC11/19/2010 (Sec. Eric Shinseki):

“The Committee membership will include, but is not limited to, Gulf War Veterans, representatives of such Veterans, and members of the medical and scientific communities representing appropriate disciplines such as, but not limited to, biomedicine, epidemiology, immunology, environmental health, neurology, and toxicology.    ….   The Committee will be composed of approximately 12 members.  Several members may be regular Government employees (RGE), but the majority of the Committee’s membership will be Special Government Employees (SGE).”

4th VA Charter governing the RAC5/8/2008 (Sec. James Peake):

“The Committee shall be comprised of members of the general public, including GulfWar veterans, representatives of such veterans, and members of the medical andscientific communities representing appropriate disciplines such as, but not limited to,biomedicine, epidemiology, immunology, environmental health, neurology, andtoxicology.  …. The Committee will be composed of approximately fifteen (15) members. Several members may be Regular Government Employees (RGE), but the majority of the Committee’s membership will be Special Government Employees (SGE).”

3rd VA Charter governing the RAC5/10/2006 (Sec. R. James Nicholoson):
 “The Committee shall be comprised of members of the general public, including GulfWar veterans, representatives of such veterans, and members of the medical andscientific communities representing appropriate disciplines such as, but not limited to,biomedicine, epidemiology, immunology, environmental health, neurology, andtoxicology. The Secretary of Veterans Affairs may appoint non-U.S. citizens asCommittee members.”

2nd VA Charter governing the RAC4/19/2004 (Sec. Anthony J. Principi):

“The Committee shall be comprised of members of the general public, including PersianGulf War veterans, representatives of such veterans, and members of the medical andscientific communities representing appropriate disciplines such as, but not limited to,biomedicine, epidemiology, immunology, environmental health, neurology, andtoxicology. The Secretary of Veterans Affairs may appoint non-U.S. citizens asCommittee members.”

1st VA Charter governing the RAC1/23/2002 (Sec. Anthony J. Principi):

“The Committee shall be comprised of members of the general public, including GulfWar veterans, the representatives of such veterans, and members of the medical andscientific communities representing appropriate disciplines such as, but not limited to,biomedicine, epidemiology, immunology, environmental health, neurology, andtoxicology. Membership of veterans and their representatives shall be based on themembers’ abilities to represent the broad health concerns of Gulf War veterans. Closeattention will be given to equitable geographic distribution and to ethnic and genderrepresentation. The Secretary of Veterans Affairs may appoint non-U.S. citizens ascommittee members to take advantage of their special experience or specialties.”

4)  Current RAC membership.  The RAC currently includes three (3) Gulf War veteran members:  Joel Graves (RAC 2002-Present); Jim Bunker (appointed 2014); and Steve Ondra (appointed 2014), who is also a physician; Bunker and Ondra were appointed to replace the two Gulf War veterans who resigned in protest in June 2013, Anthony Hardie (RAC 2006-2013) and Marguerite Knox (RAC 2002-2013).   The RAC currently has twelve (12) members.  The chair is a Vietnam War veteran.  The remaining eight (8) current RAC members are scientists and physicians. 

5)  H.R. 4261.  H.R. 4261 would set the RAC membership at twelve (12) members, which is in conformity with the current number of members.  H.R. 4261 would retain the current mix of veterans (3) and scientists (8) on the RAC. 

First, the current law provision requiring Gulf War veterans on the RAC would be retained under H.R. 4261, amended as follows [current law remains in plain text; additions to current law are underscored; deletions from current law are struck through].  The retention of this current law provision ensures the continuation of the current law requirement that Gulf War veterans be included as RAC members:

“(b) Public Advisory Committee.—Not later than
(1) Establishment.--Not later than January 1, 1999, the head of the department or agency designated under subsection (a) shall establish an advisory committee (in this subsection referred to as the `Committee') consisting of members of the general public, including Persian Gulf War Gulf War veterans and representatives of such veterans , representatives of such veterans, and individuals from the scientific and medical community to provide advice to the head of that department or agency on proposed research studies, research plans, or research strategies relating to the health consequences of military service in the Southwest Asia theater of operations during the Persian Gulf War Gulf War.”

H.R. 4261 further makes clear the composition of the RAC, consistent with the current RAC’s size, composition, and mix of veterans and scientists: at least three (3) veterans, at least eight (8) scientists or physicians, and a chairman who is either a veteran, scientist, or physician.  This also leaves open the possibility for service of individuals who are both a veteran and scientist at the same time.
 ``(i) not fewer than three members shall be veterans; ``(ii) not fewer than eight members shall be scientists or physicians who have experience in biomedicine, epidemiology, immunology, environmental health, neurology, toxicology, or other appropriate disciplines; and ``(iii) the chairman shall be a veteran or an expert described in clause (ii), or both. (b)(2)(5).  The Committee shall be composed of 12 members  …. [with eight (8) members and the chair appointed by the U.S. Senate and House Veterans’ Affairs Committee leadership, and]

``(vi) Three members appointed by the Secretary of Veterans Affairs, of whom not less than one shall be a veteran.

``(vi) Three members appointed by the Secretary of Veterans Affairs, of whom not less than one shall be a veteran.


FACT:  Not only does H.R. 4261 not reduce the number of Gulf War veterans on the RAC, but the law as amended by H.R. 4261 would finally require not only that Gulf War veterans be included on the RAC, but for the first time since the creation of the RAC require that at least three (3) RAC members be veterans.  

As noted above, the total number of RAC members has never been specified in law, and has varied over time, including in various VA charters governing the RAC.  Under H.R. 4261, the total number of RAC members would be set at twelve (12), the current size of the RAC. 

As noted above, the number of Gulf War veterans on the RAC has never to present been specified in law or in any of the VA Charters governing the RAC.  The current law provision that requires Gulf War veterans on the RAC is retained under H.R. 4261.  H.R. 4261 would further require at least three (3) of the twelve (12) total RAC members be veterans.  H.R. 4261 would require at least one (1) of the VA Secretary's three appointees to the RAC be a veteran.   

As noted above, the ratio of veterans to scientists on the RAC as specified in H.R. 4261 is consistent with the present and historical ratios of veterans to scientists on the RAC. 

H.R. 4261 would allow for the RAC chair to be either a veteran, a scientist, or both. 

The full text of H.R. 4261, wherein the number of veterans on the RAC is clearly specified, is publicly available at: 







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