H. R. 2535

One Hundred Third Congress

of the

United States of America

AT THE FIRST SESSION

Begun and held at the City of Washington on Tuesday,

the fifth day of January, one thousand nine hundred and ninety-three

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.

Be it enacted by the Senate and House of Representatives of

the United States of America in Congress assembled,

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

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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 PHIL- IPPINES.—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

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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.

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