To amend title 38, United States Code, to provide additional authority for the Secretary of Veterans Affairs to provide health care for veterans of the Persian Gulf War.

Summary: Makes Persian Gulf War veterans exposed to a toxic substance or environmental hazard during that war eligible for medical (including outpatient) care for any disability, notwithstanding insufficient medical evidence to conclude that such disability may be associated with such exposure, with exceptions. Directs the Secretary of Veterans Affairs, upon request, to reimburse veterans for such care furnished before this Act's enactment. Extends through:  (1) June 30, 1994, the provision of veterans' hospital and nursing home care and medical services for Vietnam era veterans exposed to toxic substances during such service; (2) December 31, 1994, the period of eligibility for sexual trauma counseling services through the Department of Veterans Affairs for veterans released from duty before December 31, 1992; (3) December 31, 1994, the authority to maintain a Department regional office in the Philippines; and (4) December 31, 1994, the Veterans' Advisory Committee on Education.  Authorizes the Secretary to enter into agreements with State veterans facilities for the sharing of healthcare resources and facilities, with certain conditions.

SECTION 1. AUTHORITY TO PROVIDE PRIORITY HEALTH CARE TO VETERANS OF THE 
              PERSIAN GULF WAR.

    (a) Inpatient Care.--(1) Section 1710(a)(1)(G) of title 38, United 
States Code, is amended by striking out ``or radiation'' and inserting 
in lieu thereof ``, radiation, or environmental hazard''.
    (2) Section 1710(e) of such title is amended--
        (A) by inserting at the end of paragraph (1) the following new 
    subparagraph:
    ``(C) Subject to paragraphs (2) and (3) of this subsection, a 
veteran who the Secretary finds may have been exposed while serving on 
active duty in the Southwest Asia theater of operations during the 
Persian Gulf War to a toxic substance or environmental hazard is 
eligible for hospital care and nursing home care under subsection 
(a)(1)(G) of this section for any disability, notwithstanding that there 
is insufficient medical evidence to conclude that such disability may be 
associated with such exposure.'';
        (B) in paragraph (2), by striking out ``subparagraph (A) or 
    (B)'' and inserting in lieu thereof ``subparagraph (A), (B), or 
    (C)''; and
        (C) in paragraph (3), by striking out the period at the end and 
    inserting in lieu thereof ``, or, in the case of care for a veteran 
    described in paragraph (1)(C), after December 31, 1994.''.
    (b) Outpatient Care.--Section 1712(a) of such title is amended--
        (1) in paragraph (1)--
            (A) by striking out ``and'' at the end of subparagraph (B);
            (B) by striking out the period at the end of subparagraph 
        (C) and inserting in lieu thereof ``; and''; and
            (C) by adding at the end the following:
        ``(D) during the period before December 31, 1994, for any 
    disability in the case of a veteran who served on active duty in the 
    Southwest Asia theater of operations during the Persian Gulf War and 
    who the Secretary finds may have been exposed to a toxic substance 
    or environmental hazard during such service, notwithstanding that 
    there is insufficient medical evidence to conclude that the 
    disability may be associated with such exposure.''; and
        (2) by adding at the end the following new paragraph:
    ``(7) Medical services may not be furnished under paragraph (1)(D) 
with respect to a disability that is found, in accordance with 
guidelines issued by the Under Secretary for Health, to have resulted 
from a cause other than an exposure described in that paragraph.''.
    (c) Effective Date.--(1) The amendments made by subsections (a) and 
(b) shall take effect as of August 2, 1990.
    (2) The Secretary of Veterans Affairs shall, upon request, reimburse 
any veteran who paid the United States an amount under section 1710(f) 
or 1712(f) of title 38, United States Code, as the case may be, for 
hospital care, nursing home care, or outpatient services furnished by 
the Secretary to the veteran before the date of the enactment of this 
Act on the basis of a finding that the veteran may have been exposed to 
a toxic substance or environmental hazard during the Persian Gulf War. 
The amount of the reimbursement shall be the amount that was paid by the 
veteran for such care or services under such section 1710(f) or 1712(f).
SEC. 2. EXTENSION OF CERTAIN HEALTH CARE AND OTHER AUTHORITIES.
    (a) Eligibility for Care for Exposure to Dioxin or Ionizing 
Radiation.--Section 1710(e)(3) of title 38, United States Code, as 
amended by section 1(a)(2)(C), is further amended by striking out 
``December 31, 1993'' and inserting in lieu thereof ``June 30, 1994''.
    (b) Eligibility for Sexual Trauma Counseling.--Section 102(b) of the 
Women Veterans Health Programs Act of 1992 (Public Law 102-585; 38 
U.S.C. 1720D note) is amended--
        (1) by striking out ``December 31, 1991,'' and inserting in lieu 
    thereof ``December 31, 1992,''; and
        (2) by striking out ``December 31, 1993'' and inserting in lieu 
    thereof ``December 31, 1994''.
    (c) Authority To Maintain Regional Office in the Philippines.--
Section 315(b) of title 38, United States Code, is amended by striking 
out ``March 31, 1994'' and inserting in lieu thereof ``December 31, 
1994''.
    (d) Authority for Advisory Committee on Education.--Section 3692(c) 
of title 38, United States Code, is amended by striking out ``December 
31, 1993'' and inserting in lieu thereof ``December 31, 1994''.

SEC. 3. SHARING OF RESOURCES WITH STATE HOMES.

    (a) Purpose.--Section 8151 of title 38, United States Code, is 
amended by adding at the end the following: ``It is further the purpose 
of this subchapter to improve the provision of care to veterans under 
this title by authorizing the Secretary to enter into agreements with 
State veterans facilities for the sharing of health-care resources.''.
    (b) Definition.--Section 8152 of such title is amended--
        (1) by redesignating paragraph (3) as paragraph (4); and
        (2) by inserting after paragraph (2) the following new paragraph 
    (3):
        ``(3) The term `health-care resource' includes hospital care, 
    medical services, and rehabilitative services, as those terms are 
    defined in paragraphs (5), (6), and (8), respectively, of section 
    1701 of this title, any other health-care service, and any health-
    care support or administrative resource.''.
    (c) Sharing of Health-Care Resources.--Section 8153(a) of such title 
is amended--
        (1) by inserting ``(1)'' after ``(a)''; and
        (2) by striking out ``other form of agreement,'' and all that 
    follows and inserting in lieu thereof the following: ``other form of 
    agreement for the mutual use, or exchange of use, of--
        ``(A) specialized medical resources between Department health-
    care facilities and other health-care facilities (including organ 
    banks, blood banks, or similar institutions), research centers, or 
    medical schools; and
        ``(B) health-care resources between Department health-care 
    facilities and State home facilities recognized under section 
    1742(a) of this title.
    ``(2) The Secretary may enter into a contract or other agreement 
under paragraph (1) only if (A) such an agreement will obviate the need 
for a similar resource to be provided in a Department health care 
facility, or (B) the Department resources which are the subject of the 
agreement and which have been justified on the basis of veterans' care 
are not used to their maximum effective capacity.''.







                                Speaker of the House of Representatives.







                             Vice President of the United States and    
                                                President of the Senate.