103D CONGRESS

1ST SESSION H. R. 2535

AMENDMENT
In the Senate of the United States,

November 20 (legislative day, November 2), 1993.

Resolved, That the bill from the House of Representatives (H.R. 2535) entitled ‘‘An Act 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’’, do pass with the following

AMENDMENT:

Strike out all after the enacting clause and insert:

1 SECTION 1. AUTHORITY TO PROVIDE PRIORITY HEALTH

2 CARE TO VETERANS OF THE PERSIAN GULF

3 WAR.

4 (a) INPATIENT CARE.—(1) Section 1710(a)(1)(G) of

5 title 38, United States Code, is amended by striking out

6 ‘‘or radiation’’ and inserting in lieu thereof ‘‘, radiation,

7 or environmental hazard’’.

8 (2) Section 1710(e) of such title is amended—

9 (A) by inserting at the end of paragraph (1) the

10 following new subparagraph:
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1 ‘‘(C) Subject to paragraphs (2) and (3) of this sub2 section, a veteran who the Secretary finds may have been

3 exposed while serving on active duty in the Southwest Asia

4 theater of operations during the Persian Gulf War to a toxic

5 substance or environmental hazard is eligible for hospital

6 care and nursing home care under subsection (a)(1)(G) of

7 this section for any disability, notwithstanding that there

8 is insufficient medical evidence to conclude that such dis9 ability may be associated with such exposure.’’;

10 (B) in paragraph (2), by striking out ‘‘subpara11 graph (A) or (B)’’ and inserting in lieu thereof ‘‘sub12 paragraph (A), (B), or (C)’’; and

13 (C) in paragraph (3), by striking out the period

14 at the end and inserting in lieu thereof ‘‘, or, in the

15 case of care for a veteran described in paragraph

16 (1)(C), after December 31, 1994.’’.

17 (b) OUTPATIENT CARE.—Section 1712(a) of such title

18 is amended—

19 (1) in paragraph (1)—

20 (A) by striking out ‘‘and’’ at the end of sub21 paragraph (B);

22 (B) by striking out the period at the end of

23 subparagraph (C) and inserting in lieu thereof ‘‘;

24 and’’; and

25 (C) by adding at the end the following:
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1 ‘‘(D) during the period before December 31,

2 1994, for any disability in the case of a veteran who

3 served on active duty in the Southwest Asia theater

4 of operations during the Persian Gulf War and who

5 the Secretary finds may have been exposed to a toxic

6 substance or environmental hazard during such serv7 ice, notwithstanding that there is insufficient medical

8 evidence to conclude that the disability may be associ9 ated with such exposure.’’; and

10 (2) by adding at the end the following new para11 graph:

12 ‘‘(7) Medical services may not be furnished under

13 paragraph (1)(D) with respect to a disability that is found,

14 in accordance with guidelines issued by the Under Sec15 retary for Health, to have resulted from a cause other than

16 an exposure described in that paragraph.’’.

17 (c) EFFECTIVE DATE.—(1) The amendments made by

18 subsections (a) and (b) shall take effect as of August 2, 1990.

19 (2) The Secretary of Veterans Affairs shall, upon re20 quest, reimburse any veteran who paid the United States

21 an amount under section 1710(f) or 1712(f) of title 38,

22 United States Code, as the case may be, for hospital care,

23 nursing home care, or outpatient services furnished by the

24 Secretary to the veteran before the date of the enactment

25 of this Act on the basis of a finding that the veteran may
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1 have been exposed to a toxic substance or environmental

2 hazard during the Persian Gulf War. The amount of the

3 reimbursement shall be the amount that was paid by the

4 veteran for such care or services under such section 1710(f)

5 or 1712(f).

6 SEC. 2. EXTENSION OF CERTAIN HEALTH CARE AND OTHER

7 AUTHORITIES.

8 (a) ELIGIBILITY FOR CARE FOR EXPOSURE TO DIOXIN

9 OR IONIZING RADIATION.—Section 1710(e)(3) of title 38,

10 United States Code, as amended by section 1(a)(2)(C), is

11 further amended by striking out ‘‘December 31, 1993’’ and

12 inserting in lieu thereof ‘‘June 30, 1994’’.

13 (b) ELIGIBILITY FOR SEXUAL TRAUMA COUNSEL14 ING.—Section 102(b) of the Women Veterans Health Pro15 grams Act of 1992 (Public Law 102–585; 38 U.S.C. 1720D

16 note) is amended—

17 (1) by striking out ‘‘December 31, 1991,’’ and in18 serting in lieu thereof ‘‘December 31, 1992,’’; and

19 (2) by striking out ‘‘December 31, 1993’’ and in20 serting in lieu thereof ‘‘December 31, 1994’’.

21 (c) AUTHORITY TO MAINTAIN REGIONAL OFFICE IN

22 THE PHILIPPINES.—Section 315(b) of title 38, United

23 States Code, is amended by striking out ‘‘March 31, 1994’’

24 and inserting in lieu thereof ‘‘December 31, 1994’’.
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1 (d) AUTHORITY FOR ADVISORY COMMITTEE ON EDU2 CATION.—Section 3692(c) of title 38, United States Code,

3 is amended by striking out ‘‘December 31, 1993’’ and in4 serting in lieu thereof ‘‘December 31, 1994’’.

5 SEC. 3. SHARING OF RESOURCES WITH STATE HOMES.

6 (a) PURPOSE.—Section 8151 of title 38, United States

7 Code, is amended by adding at the end the following: ‘‘It

8 is further the purpose of this subchapter to improve the pro9 vision of care to veterans under this title by authorizing

10 the Secretary to enter into agreements with State veterans

11 facilities for the sharing of health-care resources.’’.

12 (b) DEFINITION.—Section 8152 of such title is amend13 ed—

14 (1) by redesignating paragraph (3) as para15 graph (4); and

16 (2) by inserting after paragraph (2) the follow17 ing new paragraph (3):

18 ‘‘(3) The term ‘health-care resource’ includes hos19 pital care, medical services, and rehabilitative serv20 ices, as those terms are defined in paragraphs (5),

21 (6), and (8), respectively, of section 1701 of this title,

22 any other health-care service, and any health-care

23 support or administrative resource.’’.

24 (c) SHARING OF HEALTH-CARE RESOURCES.—Section

25 8153(a) of such title is amended—
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1 (1) by inserting ‘‘(1)’’ after ‘‘(a)’’; and

2 (2) by striking out ‘‘other form of agreement,’’

3 and all that follows and inserting in lieu thereof the

4 following: ‘‘other form of agreement for the mutual

5 use, or exchange of use, of—

6 ‘‘(A) specialized medical resources between De7 partment health-care facilities and other health-care

8 facilities (including organ banks, blood banks, or

9 similar institutions), research centers, or medical

10 schools; and

11 ‘‘(B) health-care resources between Department

12 health-care facilities and State home facilities recog13 nized under section 1742(a) of this title.

14 ‘‘(2) The Secretary may enter into a contract or other

15 agreement under paragraph (1) only if (A) such an agree16 ment will obviate the need for a similar resource to be pro17 vided in a Department health care facility, or (B) the De18 partment resources which are the subject of the agreement

19 and which have been justified on the basis of veterans’ care

20 are not used to their maximum effective capacity.’’.

Attest:

Secretary.