In the Senate of the United States,
November 20 (legislative day, November 2), 1993.
Resolved, That the bill from the House of Representa-
tives (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:
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:
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‘‘(C) Subject to paragraphs (2) and (3) of this sub-
section, 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 dis-
ability may be associated with such exposure.’’;
(B) in paragraph (2), by striking out ‘‘subpara-
graph (A) or (B)’’ and inserting in lieu thereof ‘‘sub-
paragraph (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 sub-
paragraph (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:
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‘‘(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 serv-
ice, notwithstanding that there is insufficient medical
evidence to conclude that the disability may be associ-
ated with such exposure.’’; and
(2) by adding at the end the following new para-
graph:
‘‘(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 Sec-
retary 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 re-
quest, 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
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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 COUNSEL-
ING.—Section 102(b) of the Women Veterans Health Pro-
grams Act of 1992 (Public Law 102–585; 38 U.S.C. 1720D
note) is amended—
(1) by striking out ‘‘December 31, 1991,’’ and in-
serting in lieu thereof ‘‘December 31, 1992,’’; and
(2) by striking out ‘‘December 31, 1993’’ and in-
serting 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’’.
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(d) AUTHORITY FOR ADVISORY COMMITTEE ON EDU-
CATION.—Section 3692(c) of title 38, United States Code,
is amended by striking out ‘‘December 31, 1993’’ and in-
serting 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 pro-
vision 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 amend-
ed—
(1) by redesignating paragraph (3) as para-
graph (4); and
(2) by inserting after paragraph (2) the follow-
ing new paragraph (3):
‘‘(3) The term ‘health-care resource’ includes hos-
pital care, medical services, and rehabilitative serv-
ices, 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—
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(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 De-
partment 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 recog-
nized 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 agree-
ment will obviate the need for a similar resource to be pro-
vided in a Department health care facility, or (B) the De-
partment 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.’’.
Attest:
Secretary.