IV
105TH CONGRESS
2D SESSION
H. RES. 592
Providing for the concurrence by the House with amendments in the Senate
amendment to H.R. 4110.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 10, 1998
Mr. STUMP submitted the following resolution; which was considered and
agreed to
RESOLUTION
Providing for the concurrence by the House with
amendments in the Senate amendment to H.R. 4110.
Resolved, That upon the adoption of this resolution
the House shall be considered to have taken from the
Speaker’s table the bill H.R. 4110, with the amendment
of the Senate thereto, and to have concurred in the
amendment of the Senate with the following amendments:
(1) Amend the title so as to read: ‘‘An Act to
amend title 38, United States Code, to improve ben-
efits and services provided to Persian Gulf War vet-
erans, to provide a cost-of-living adjustment in rates
of compensation paid to veterans with service-con-
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nected disabilities, to enhance programs providing
health care, compensation, education, insurance, and
other benefits for veterans, and for other purposes.
(2) In lieu of the matter proposed to be in-
serted by the amendment of the Senate, insert the
following:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Veterans Programs Enhancement Act of 1998’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States code.
TITLE I—PROVISIONS RELATING TO VETERANS OF PERSIAN
GULF WAR AND FUTURE CONFLICTS
Sec. 101. Agreement with National Academy of Sciences regarding evaluation
of health consequences of service in Southwest Asia during the
Persian Gulf War.
Sec. 102. Health care for veterans of Persian Gulf War and future conflicts.
Sec. 103. National center on war-related illnesses and post-deployment health
issues.
Sec. 104. Coordination of activities.
Sec. 105. Improving effectiveness of care of Persian Gulf War veterans.
Sec. 106. Contract for independent recommendations on research and for devel-
opment of curriculum on care of Persian Gulf War veterans.
Sec. 107. Extension and improvement of evaluation of health status of spouses
and children of Persian Gulf War veterans.
TITLE II—EDUCATION AND EMPLOYMENT
Subtitle A—Education Matters
Sec. 201. Calculation of reporting fee based on total veteran enrollment during
a calendar year.
Sec. 202. Election of advance payment of work-study allowance.
Sec. 203. Alternative to twelve semester hour equivalency requirement.
Sec. 204. Medical evidence for flight training requirements.
Sec. 205. Waiver of wage increase and minimum payment rate requirements for
government job training program approval.
Sec. 206. Expansion of education outreach services.
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Sec. 207. Information on minimum requirements for education benefits for
members of the Armed Forces discharged early from duty for
the convenience of the Government.
Subtitle B—Uniformed Services Employment and Reemployment Rights Act
Amendments
Sec. 211. Enforcement of rights with respect to a State as an employer.
Sec. 212. Protection of extraterritorial employment and reemployment rights of
members of the uniformed services.
Sec. 213. Complaints relating to reemployment of members of the uniformed
services in Federal service.
TITLE III—COMPENSATION, PENSION, AND INSURANCE
Sec. 301. Medal of Honor special pension.
Sec. 302. Accelerated death benefit for Servicemembers’ Group Life Insurance
and Veterans’ Group Life Insurance participants.
Sec. 303. Assessment of effectiveness of insurance and survivor benefits pro-
grams for survivors of veterans with service-connected disabil-
ities.
Sec. 304. National Service Life Insurance program.
TITLE IV—MEMORIAL AFFAIRS
Sec. 401. Commemoration of individuals whose remains are unavailable for in-
terment.
Sec. 402. Merchant mariner burial and cemetery benefits.
Sec. 403. Redesignation of National Cemetery System and establishment of
Under Secretary for Memorial Affairs.
Sec. 404. State cemetery grants program.
TITLE V—COURT OF VETERANS APPEALS
Subtitle A—Administrative Provisions Relating to the Court
Sec. 501. Continuation in office of judges pending confirmation for second
term.
Sec. 502. Exemption of retirement fund from sequestration orders.
Sec. 503. Adjustments for survivor annuities.
Sec. 504. Reports on retirement program modifications.
Subtitle B—Renaming of Court
Sec. 511. Renaming of the Court of Veterans Appeals.
Sec. 512. Conforming amendments.
Sec. 513. Effective date.
TITLE VI—HOUSING
Sec. 601. Loan guarantee for multifamily transitional housing for homeless vet-
erans.
Sec. 602. Veterans housing benefit program fund account consolidation.
Sec. 603. Extension of eligibility of members of Selected Reserve for veterans
housing loans.
Sec. 604. Applicability of procurement law to certain contracts of department
of veterans affairs.
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TITLE VII—CONSTRUCTION AND FACILITIES MATTERS
Sec. 701. Authorization of major medical facility projects.
Sec. 702. Authorization of major medical facility leases.
Sec. 703. Authorization of appropriations.
Sec. 704. Increase in threshold for major medical facility leases for purposes of
congressional authorization.
Sec. 705. Threshold for treatment of parking facility project as a major medical
facility project.
Sec. 706. Parking fees.
Sec. 707. Master plan regarding use of Department of Veterans Affairs lands
at West Los Angeles Medical Center, California.
Sec. 708. Designation of Department of Veterans Affairs Medical Center,
Aspinwall, Pennsylvania.
Sec. 709. Designation of Department of Veterans Affairs Medical Center,
Gainesville, Florida.
Sec. 710. Designation of Department of Veterans Affairs outpatient clinic, Co-
lumbus, Ohio.
TITLE VIII—HEALTH PROFESSIONALS EDUCATIONAL
ASSISTANCE
Sec. 801. Short title.
Sec. 802. Scholarship program for Department of Veterans Affairs employees
receiving education or training in the health professions.
Sec. 803. Education debt reduction program for Veterans Health Administra-
tion health professionals.
Sec. 804. Repeal of prohibition on payment of tuition loans.
Sec. 805. Conforming amendments.
Sec. 806. Coordination with appropriations provision.
TITLE IX—MISCELLANEOUS MEDICAL CARE AND MEDICAL
ADMINISTRATION PROVISIONS
Sec. 901. Examinations and care associated with certain radiation treatment.
Sec. 902. Extension of authority to counsel and treat veterans for sexual trau-
ma.
Sec. 903. Management of specialized treatment and rehabilitative programs.
Sec. 904. Authority to use for operating expenses of Department of Veterans
Affairs medical facilities amounts available by reason of the
limitation on pension for veterans receiving nursing home care.
Sec. 905. Report on nurse locality pay.
Sec. 906. Annual report on program and expenditures of Department of Veter-
ans Affairs for domestic response to weapons of mass destruc-
tion.
Sec. 907. Interim appointment of Under Secretary for Health.
TITLE X—OTHER MATTERS
Sec. 1001. Requirement for naming of Department property.
Sec. 1002. Members of the Board of Veterans’ Appeals.
Sec. 1003. Flexibility in docketing and hearing of appeals by Board of Veter-
ans’ Appeals.
Sec. 1004. Disabled veterans outreach program specialists.
Sec. 1005. Technical amendments.
TITLE XI—COMPENSATION COST-OF-LIVING ADJUSTMENT
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Sec. 1101. Increase in rates of disability compensation and dependency and in-
demnity compensation.
Sec. 1102. Publication of adjusted rates.
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.
Except as otherwise expressly provided, whenever in
this Act an amendment or repeal is expressed in terms
of an amendment to, or repeal of, a section or other provi-
sion, the reference shall be considered to be made to a
section or other provision of title 38, United States Code.
TITLE I—PROVISIONS RELATING
TO VETERANS OF PERSIAN
GULF WAR AND FUTURE CON-
FLICTS
SEC. 101. AGREEMENT WITH NATIONAL ACADEMY OF
SCIENCES 
REGARDING 
EVALUATION 
OF
HEALTH CONSEQUENCES OF SERVICE IN
SOUTHWEST ASIA DURING THE PERSIAN
GULF WAR.
(a) PURPOSE.—The purpose of this section is to pro-
vide for the National Academy of Sciences, an independent
nonprofit scientific organization with appropriate expertise
which is not a part of the Federal Government, to review
and evaluate the available scientific evidence regarding as-
sociations between illness and service in the Persian Gulf
War.
(b) AGREEMENT.—(1) The Secretary of Veterans Af-
fairs shall seek to enter into an agreement with the Na-
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fied under subparagraph (B) or (C) of that paragraph,
assess the latency period, if any, between service or expo-
sure to any potential risk factor (including an agent, haz-
ard, or medicine or vaccine identified under subparagraph
(A) of that paragraph) and the manifestation of such ill-
ness.
(d) SPECIFIED AGENTS.—(1) In identifying under
subsection (c)(1)(A) the agents, hazards, or preventive
medicines or vaccines to which members of the Armed
Forces may have been exposed, the National Academy of
Sciences shall consider the following:
(A) The following organophosphorous pes-
ticides:
(i) Chlorpyrifos.
(ii) Diazinon.
(iii) Dichlorvos.
(iv) Malathion.
(B) The following carbamate pesticides:
(i) Proxpur.
(ii) Carbaryl.
(iii) Methomyl.
(C) The carbamate pyridostigmine bromide
used as nerve agent prophylaxis.
(D) The following chlorinated hydrocarbons and
other pesticides and repellents:
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(i) Lindane.
(ii) Pyrethrins.
(iii) Permethrins.
(iv) Rodenticides (bait).
(v) Repellent (DEET).
(E) The following low-level nerve agents and
precursor compounds at exposure levels below those
which produce immediately apparent incapacitating
symptoms:
(i) Sarin.
(ii) Tabun.
(F) The following synthetic chemical com-
pounds:
(i) Mustard agents at levels below those
which cause immediate blistering.
(ii) Volatile organic compounds.
(iii) Hydrazine.
(iv) Red fuming nitric acid.
(v) Solvents.
(G) The following sources of radiation:
(i) Depleted uranium.
(ii) Microwave radiation.
(iii) Radio frequency radiation.
(H) The following environmental particulates
and pollutants:
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(i) Hydrogen sulfide.
(ii) Oil fire byproducts.
(iii) Diesel heater fumes.
(iv) Sand micro-particles.
(I) Diseases endemic to the region (including
the following):
(i) Leishmaniasis.
(ii) Sandfly fever.
(iii) Pathogenic escherichia coli.
(iv) Shigellosis.
(J) Time compressed administration of multiple
live, ‘attenuated’, and toxoid vaccines.
(2) The consideration of agents, hazards, and medi-
cines and vaccines under paragraph (1) shall not preclude
the Academy from identifying other agents, hazards, or
medicines or vaccines to which members of the Armed
Forces may have been exposed for purposes of any report
under subsection (h).
(3) Not later than six months after entry into the
agreement under subsection (b), the Academy shall submit
to the Committees on Veterans’ Affairs of the Senate and
the House of Representatives a report specifying the
agents, hazards, and medicines and vaccines considered
under paragraph (1).
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(e) SCIENTIFIC DETERMINATIONS CONCERNING ILL-
NESSES.—(1) For each illness identified under subpara-
graph (B) or (C) of subsection (c)(1), the National Acad-
emy of Sciences shall determine (to the extent available
scientific evidence permits) whether there is scientific evi-
dence of an association of that illness with Gulf War serv-
ice or exposure during Gulf War service to one or more
agents, hazards, or medicines or vaccines. In making those
determinations, the Academy shall consider—
(A) the strength of scientific evidence, the
replicability of results, the statistical significance of
results, and the appropriateness of the scientific
methods used to detect the association;
(B) in any case where there is evidence of an
apparent association, whether there is reasonable
confidence that that apparent association is not due
to chance, bias, or confounding;
(C) the increased risk of the illness among
human or animal populations exposed to the agent,
hazard, or medicine or vaccine;
(D) whether a plausible biological mechanism or
other evidence of a causal relationship exists between
exposure to the agent, hazard, or medicine or vac-
cine and the illness;
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(E) in any case where information about expo-
sure levels is available, whether the evidence indi-
cates that the levels of exposure of the studied popu-
lations were of the same magnitude as the estimated
likely exposures of Gulf War veterans; and
(F) whether there is an increased risk of illness
among Gulf War veterans in comparison with appro-
priate peer groups.
(2) The Academy shall include in its reports under
subsection (h) a full discussion of the scientific evidence
and reasoning that led to its conclusions under this sub-
section.
(f) RECOMMENDATIONS
FOR
ADDITIONAL
SCI-
ENTIFIC STUDIES.—(1) Under the agreement under sub-
section (b), the National Academy of Sciences shall make
any recommendations that it considers appropriate for ad-
ditional scientific studies (including studies relating to
treatment models) to resolve areas of continuing scientific
uncertainty relating to the health consequences of service
in the Persian Gulf War or exposure to toxic agents, envi-
ronmental or wartime hazards, or preventive medicines or
vaccines associated with Gulf War service.
(2) In making recommendations for additional stud-
ies, the Academy shall consider the available scientific
data, the value and relevance of the information that could
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result from such studies, and the cost and feasibility of
carrying out such studies.
(g) SUBSEQUENT REVIEWS.—(1) Under the agree-
ment under subsection (b), the National Academy of
Sciences shall conduct on a periodic and ongoing basis ad-
ditional reviews of the evidence and data relating to its
activities under this section.
(2) As part of each review under this subsection, the
Academy shall—
(A) conduct as comprehensive a review as is
practicable of the information referred to in sub-
section (c), the evidence referred to in subsection (e),
and the data referred to in subsection (f) that be-
came available since the last review of such informa-
tion, evidence, and data under this section; and
(B) make determinations under the subsections
referred to in subparagraph (A) on the basis of the
results of such review and all other reviews pre-
viously conducted for purposes of this section.
(h) REPORTS BY ACADEMY.—(1) Under the agree-
ment under subsection (b), the National Academy of
Sciences shall submit to the Committees on Veterans’ Af-
fairs of the Senate and the House of Representatives and
the Secretary of Veterans Affairs periodic written reports
regarding the Academy’s activities under the agreement.
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(2) The first report under paragraph (1) shall be sub-
mitted not later than two years after entry into the agree-
ment under subsection (b). That report shall include—
(A) the determinations and discussion referred
to in subsection (e); and
(B) any recommendations of the Academy
under subsection (f).
(3) Reports shall be submitted under this subsection
at least once every two years, as measured from the date
of the report under paragraph (2).
(4) In any report under this subsection (other than
the report under paragraph (2)), the Academy may specify
an absence of meaningful developments in the scientific
or medical community with respect to the activities of the
Academy under this section during the two-year period
ending on the date of such report.
(i) REPORTS
BY SECRETARY.—(1) The Secretary
shall review each report from the Academy under sub-
section (h). As part of such review, the Secretary shall
seek comments on, and evaluation of, the Academy’s re-
port from the heads of other affected departments and
agencies of the United States.
(2) Based upon a review under paragraph (1), the
Secretary shall submit to the Committees on Veterans’ Af-
fairs of the Senate and the House of Representatives a
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report on the available scientific and medical information
regarding the health consequences of Persian Gulf War
service and of exposures to risk factors during service in
the Persian Gulf War. The Secretary shall include in the
report the Secretary’s recommendations as to whether
there is sufficient evidence to warrant a presumption of
service-connection for the occurrence of a specified condi-
tion in Gulf War veterans. In determining whether to
make such a recommendation, the Secretary shall consider
the matters specified in subparagraphs (A) through (F)
of subsection (e)(1).
(3) The report under this subsection shall be submit-
ted not later than 120 days after the date on which the
Secretary receives the report from the Academy.
(j) SUNSET.—This section shall cease to be effective
11 years after the last day of the fiscal year in which the
National Academy of Sciences enters into an agreement
with the Secretary under subsection (b).
(k) DEFINITION.—In this section, the term ‘‘toxic
agent, environmental or wartime hazard, or preventive
medicine or vaccine associated with Gulf War service’’
means a biological, chemical, or other toxic agent, environ-
mental or wartime hazard, or preventive medicine or vac-
cine that is known or presumed to be associated with serv-
ice in the Armed Forces in the Southwest Asia theater
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of operations during the Persian Gulf War, whether such
association arises as a result of single, repeated, or sus-
tained exposure and whether such association arises
through exposure singularly or in combination.
SEC. 102. HEALTH CARE FOR VETERANS OF PERSIAN GULF
WAR AND FUTURE CONFLICTS.
(a) AUTHORITY.—Section 1710(e) is amended—
(1) by adding at the end of paragraph (1) the
following new subparagraph:
‘‘(D) Subject to paragraphs (2) and (3), a veteran
who served on active duty in a theater of combat oper-
ations (as determined by the Secretary in consultation
with the Secretary of Defense) during a period of war
after the Persian Gulf War, or in combat against a hostile
force during a period of hostilities (as defined in section
1712A(a)(2)(B) of this title) after the date of the enact-
ment of this subparagraph, is eligible for hospital care,
medical services, and nursing home care under subsection
(a)(2)(F) for any illness, notwithstanding that there is in-
sufficient medical evidence to conclude that such condition
is attributable to such service.’’;
(2) in paragraph (2)(B), by inserting ‘‘or
(1)(D)’’ after ‘‘paragraph (1)(C)’’;
(3) in paragraph (3)—
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(A) by striking out ‘‘and’’ at the end of
subparagraph (A);
(B) by striking out ‘‘December 31, 1998.’’
in subparagraph (B) and inserting in lieu there-
of ‘‘December 31, 2001; and’’; and
(C) by adding at the end the following new
subparagraph:
‘‘(C) in the case of care for a veteran described
in paragraph (1)(D), after a period of two years be-
ginning on the date of the veteran’s discharge or re-
lease from active military, naval, or air service.’’;
and
(4) by adding at the end the following new
paragraph:
‘‘(5) When the Secretary first provides care for veter-
ans using the authority provided in paragraph (1)(D), the
Secretary shall establish a system for collection and analy-
sis of information on the general health status and health
care utilization patterns of veterans receiving care under
that paragraph. Not later than 18 months after first pro-
viding care under such authority, the Secretary shall sub-
mit to Congress a report on the experience under that au-
thority. The Secretary shall include in the report any rec-
ommendations of the Secretary for extension of that au-
thority.’’.
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(b) IMPLEMENTATION REPORT.—Not later than Oc-
tober 1, 1999, the Secretary of Veterans Affairs shall sub-
mit to the Committees on Veterans’ Affairs of the Senate
and House of Representatives a report on the Secretary’s
plan for establishing and operating the system for collec-
tion and analysis of information required by paragraph (5)
of section 1710(e) of title 38, United States Code, as
added by subsection (a)(4).
SEC. 103. NATIONAL CENTER ON WAR-RELATED ILLNESSES
AND POST-DEPLOYMENT HEALTH ISSUES.
(a) ASSESSMENT.—The Secretary of Veterans Affairs
shall seek to enter into an agreement with the National
Academy of Sciences, or another appropriate independent
organization, under which such entity shall assist in devel-
oping a plan for the establishment of a national center
or national centers for the study of war-related illnesses
and post-deployment health issues. The purposes of such
a center may include—
(1) carrying out and promoting research re-
garding the etiologies, diagnosis, treatment, and pre-
vention of war-related illnesses and post-deployment
health issues; and
(2) promoting the development of appropriate
health policies, including monitoring, medical record-
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keeping, risk communication, and use of new tech-
nologies.
(b) RECOMMENDATIONS AND REPORT.—With respect
to such a center, an agreement under this section shall
provide for the Academy (or other entity) to—
(1) make recommendations regarding (A) de-
sign of an organizational structure or structures,
operational scope, staffing and resource needs, es-
tablishment of appropriate databases, the advan-
tages of single or multiple sites, mechanisms for im-
plementing recommendations on policy, and relation-
ship to academic or scientific entities, (B) the role
or roles that relevant Federal departments and
agencies should have in the establishment and oper-
ation of any such center or centers, and (C) such
other matters as it considers appropriate; and
(2) report to the Secretary, the Secretaries of
Defense and Health and Human Services, and the
Committees on Veterans’ Affairs of the Senate and
House of Representatives, not later than one year
after the date of the enactment of this Act, on its
recommendations.
(c) REPORT ON ESTABLISHMENT OF NATIONAL CEN-
TER.—Not later than 60 days after receiving the report
under subsection (b), the Secretaries specified in sub-
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‘‘(1) the form and manner in which an applica-
tion for an election under this section shall be made;
and
‘‘(2) the procedures under which any such ap-
plication shall be considered.
‘‘(f)(1) An election to receive a benefit under this sec-
tion shall be irrevocable.
‘‘(2) A person may not make more than one election
under this section, even if the election of the person is
to receive less than the maximum amount of the benefit
available to the person under this section.
‘‘(g) If a person insured under Servicemembers’
Group Life Insurance elects to receive a benefit under this
section and the person’s Servicemembers’ Group Life In-
surance is thereafter converted to Veterans’ Group Life
Insurance as provided in section 1968(b) of this title, the
amount of the benefit paid under this section shall reduce
the amount of Veterans’ Group Life Insurance available
to the person under section 1977(a) of this title.
‘‘(h) Notwithstanding any other provision of law, the
amount of the accelerated death benefit received by a per-
son under this section shall not be considered income or
resources for purposes of determining eligibility for or the
amount of benefits under any Federal or federally-assisted
program or for any other purpose.’’.