[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on June 3, 1998]
A BILL
To amend title 38, United States Code, to extend the author-
ity for the Secretary of Veterans Affairs to treat illnesses
of Persian Gulf War veterans, to provide authority to
treat illnesses of veterans which may be attributable to
future combat service, and to revise the process for deter-
mining priorities for research relative to the health con-
sequences of service in the Persian Gulf War, and for
other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Persian Gulf War Veter-
ans Health Care and Research Act of 1998’’.
SEC. 2. HEALTH CARE FOR VETERANS OF WAR.
(a) AUTHORITY TO PROVIDE PRIORITY CARE.—Sec-
tion 1710(e) of title 38, United States Code, 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 operations (as
determined by the Secretary in consultation with the Sec-
retary of Defense) during a period of war after the Vietnam
era, 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 enactment of this subparagraph,
is eligible for hospital care, medical services, and nursing
home care under subsection (a)(2)(F) for any illness, not-
withstanding that there is insufficient medical evidence to
conclude that such condition is attributable to such serv-
ice.’’;
(2) in paragraph (2)(B), by inserting ‘‘or
(1)(D)’’ after ‘‘paragraph (1)(C)’’;
(3) in paragraph (3)—
(A) by striking out ‘‘and’’ at the end of sub-
paragraph (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 five 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 para-
graph:
‘‘(5) When the Secretary first provides care for veter-
ans using the authority provided in paragraph (1)(D), the
Secretary shall submit to Congress a report on the experi-
ence under that authority. The report shall cover the period
of the first three years during which that authority is used
and shall be submitted not later than nine months after
the end of that three-year period. The Secretary shall in-
clude in the report any recommendations of the Secretary
for extension of that authority.’’.
(b) ENROLLMENT PRIORITY.—Section 1705(a)(4) of
such title is amended—
(1) by striking out ‘‘and’’ after ‘‘permanently
housebound’’ and inserting in lieu thereof a comma;
and
(2) by inserting ‘‘, and veterans described in sub-
paragraph (F) of section 1710(a)(2) of this title’’ after
‘‘disabled’’.
SEC. 3. NATIONAL CENTER FOR THE STUDY OF WAR-RELAT-
ED ILLNESSES.
(a) IN GENERAL.—(1) Chapter 73 of title 38, United
States Code, is amended by inserting after section 7322 the
following new section:
‘‘§ 7323. National Center for the Study of War-Related
Illnesses
‘‘(a) ESTABLISHMENT.—The Secretary, acting through
the Under Secretary for Health, shall establish and operate
in the Veterans Health Administration a National Center
for the Study of War-Related Illnesses (hereinafter in this
section referred to as the ‘Center’). The Center shall, as ap-
propriate, coordinate its activities with those of the Na-
tional Center on Post-Traumatic-Stress Disorder estab-
lished pursuant to section 110(c) of the Veterans’ Health
Care Act of 1984 (Public Law 98–528).
‘‘(b) PURPOSES.—The purposes of the Center shall be
to promote improvement of clinical, research, and edu-
cational activities of the Veterans Health Administration
with respect to war-related illnesses, including medically
unexplained illnesses.
‘‘(c) FUNCTIONS.—In carrying out the purposes of the
Center, the Under Secretary shall ensure that the Center—
‘‘(1) promotes the training of health care and re-
lated personnel in, and research into, the causes,
mechanisms, and treatment of war-related illnesses;
‘‘(2) serves as a resource center for, and promotes
and seeks to coordinate the exchange of information
regarding, research and training activities carried
out by the Department, the Department of Defense,
and other Federal and non-Federal entities; and
‘‘(3) coordinates with the Department of Defense
and other interested Federal departments and agen-
cies in the conduct of research, training, and treat-
ment and the dissemination of information pertain-
ing to war-related illnesses.
‘‘(d) STAFF.—The Under Secretary shall ensure that
the staff of the Center has an appropriate range and breadth
of expertise so as to enable the Center to bring an inter-
disciplinary approach to the study and treatment of war-
related illnesses.
‘‘(e) COORDINATION BETWEEN DEPARTMENTS.—(1) In
order to ensure needed coordination between the Depart-
ment and the Department of Defense in carrying out the
mission of the Center, the officials identified in subpara-
graphs (A) and (B) of section 8111(b)(2) of this title shall—
‘‘(A) meet regularly to review pertinent policies,
procedures, and practices of their respective depart-
ments relating to such coordination and to identify
actions that could be taken to change policies, proce-
dures, and practices to improve such coordination;
and
‘‘(B) take all appropriate steps to carry out those
actions identified under paragraph (1).
‘‘(2) The Secretary and the Secretary of Defense shall
submit to the appropriate committees of Congress an an-
nual joint report, not later than April 1 each year, on the
activities under paragraph (1) during the preceding year.’’.
(2) The table of sections at the beginning of such chap-
ter is amended by inserting after the item relating to section
7322 the following new item:
‘‘7323. National Center for the Study of War-Related Illnesses.’’.
(b) EFFECTIVE DATE.—The National Center for the
Study of War-Related Illnesses required to be established
by section 7323 of title 38, United States Code, as added
by subsection (a), shall be established not later than October
1, 1999.
SEC. 4. ASSESSMENT OF EFFECTIVENESS OF CARE OF PER-
SIAN GULF WAR VETERANS.
(a) 
ASSESSMENT
BY
NATIONAL
ACADEMY
OF
SCIENCES.—Not later than November 1, 1998, the Secretary
of Veterans Affairs shall enter into a contract with the Na-
tional Academy of Sciences for the conduct of a review of
a methodology which could be used by the Department of
Veterans Affairs for determining the efficacy of treatments
furnished to, and health outcomes (to include functional sta-
tus) of, Persian Gulf War veterans who have been treated
for illnesses which may be associated with their service in
the Persian Gulf War.
(b) ACTION ON REPORT.—Not later than 180 days
after receiving the final report of the National Academy of
Sciences under subsection (a), the Secretary shall—
(1) if scientifically feasible, develop an appro-
priate mechanism to monitor and study the effective-
ness of treatments furnished to, and health outcomes
of, Persian Gulf War veterans who suffer from diag-
nosed and undiagnosed illnesses which may be associ-
ated with their service in the Persian Gulf War; and
(2) submit to the Committees on Veterans’ Af-
fairs of the Senate and House of Representatives a re-
port on the implementation of this subsection.
SEC. 5. CONTRACT FOR INDEPENDENT RECOMMENDATIONS
ON RESEARCH AND FOR DEVELOPMENT OF
CURRICULUM ON CARE OF PERSIAN GULF
WAR VETERANS.
Section 706 of the Persian Gulf War Veterans’ Health
Status Act (title VII of Public Law 102–585; 38 U.S.C. 527
note) is amended by adding at the end thereof the following
new subsection:
‘‘(d) RESEARCH REVIEW AND DEVELOPMENT OF MED-
ICAL EDUCATION CURRICULUM.—(1) In order to further
understanding of the health consequences of military service
in the Persian Gulf theater of operations and of new re-
search findings with implications for improving the provi-
sion of care for veterans of such service, the Secretary of
Veterans Affairs and the Secretary of Defense shall seek to
enter into an agreement with the National Academy of
Sciences under which the Institute of Medicine of the Acad-
emy would—
‘‘(A) develop a curriculum pertaining to the care
and treatment of veterans of such service who have ill-
defined or undiagnosed illnesses for use in the con-
tinuing medical education of both general and spe-
cialty physicians who provide care for such veterans;
and
‘‘(B) periodically review and provide rec-
ommendations regarding the research plans and re-
search strategies of the Departments relating to the
health consequences of military service in the Persian
Gulf theater of operations during the Persian Gulf
War, including recommendations that the Academy
considers appropriate for additional scientific studies
to resolve areas of continuing scientific uncertainty
relating to the health consequences of any aspects of
such military service.
‘‘(2) Not later than six months after the Institute of
Medicine provides the Secretaries the curriculum developed
under paragraph (1), the Secretaries shall provide for the
conduct of continuing education programs using the cur-
riculum developed under paragraph (1). Such programs
shall include instruction which seeks to emphasize use of
appropriate protocols of diagnosis, referral, and treatment
of such veterans.’’.
SEC. 6. REVISION TO PROCESS FOR DETERMINING PRIOR-
ITIES FOR HEALTH-RELATED RESEARCH ON
THE PERSIAN GULF WAR.
Section 707 of the Persian Gulf War Veterans’ Health
Status Act (title VII of Public Law 102–585; 38 U.S.C. 527
note) is amended by striking out subsection (b) and insert-
ing in lieu thereof the following:
‘‘(b) PUBLIC ADVISORY COMMITTEE.—Not later than
January 1, 1999, the head of the department or agency des-
ignated under subsection (a) shall establish an advisory
committee consisting of members of the general public, to
include Persian Gulf War veterans and representatives of
such veterans, to provide advice to the head of that depart-
ment or agency on proposed research studies, research
plans, or research strategies relating to the health con-
sequences of military service in the Persian Gulf theater of
operations during the Persian Gulf War. The department
or agency head shall consult with such advisory committee
on a regular basis.
‘‘(c) REPORTS.—(1) Not later than March 1 of each
year, the head of the department or agency designated under
subsection (a) shall submit to the Committees on Veterans’
Affairs of the Senate and House of Representatives a report
on—
‘‘(A) the status and results of all such research
activities undertaken by the executive branch during
the previous year;
‘‘(B) research priorities identified during that
year; and
‘‘(C) recommendations of the public advisory
committee established under subsection (b) that were
not adopted during that year and the reasons for not
adopting each such recommendation.
‘‘(2)(A) Not later than 120 days after submission of
the epidemiological research study conducted by the Depart-
ment of Veterans Affairs entitled ‘VA National Survey of
Persian Gulf Veterans—Phase III’, the head of the depart-
ment or agency designated under subsection (a) shall sub-
mit to the congressional committees specified in paragraph
(1) a report on the findings under that study.
‘‘(B) With respect to any findings of that study which
identify scientific evidence of a greater relative risk of ill-
ness or illnesses in family members of veterans who served
in the Persian Gulf War theater of operations than in fam-
ily members of veterans who did not so serve, the head of
the department or agency designated under subsection (a)
shall seek to ensure that appropriate research studies are
designed to follow up on such findings.
‘‘(d) PUBLIC AVAILABILITY
OF RESEARCH FIND-
INGS.—The head of the department or agency designated
under subsection (a) shall ensure that the findings of all
research conducted by or for the executive branch relating
to the health consequences of military service in the Persian
Gulf theater of operations during the Persian Gulf War (in-
cluding information pertinent to improving provision of
care for veterans of such service) are made available to the
public through peer-reviewed medical journals, the Internet
World Wide Web, and other appropriate media.’’.
SEC. 7. DESIGNATION OF DEPARTMENT OF VETERANS AF-
FAIRS 
MEDICAL 
CENTER 
IN 
ASPINWALL,
PENNSYLVANIA.
The Department of Veterans Affairs medical center in
Aspinwall, Pennsylvania, is hereby designated as the ‘‘H.
John Heinz III Department of Veterans Affairs Medical
Center’’. Any reference to that medical center in any law,
regulation, map, document, record, or other paper of the
United States shall be considered to be a reference to the
‘‘H. John Heinz III Department of Veterans Affairs Medi-
cal Center’’.
SEC. 8. DESIGNATION OF DEPARTMENT OF VETERANS AF-
FAIRS MEDICAL CENTER IN GAINESVILLE,
FLORIDA.
The Department of Veterans Affairs medical center in
Gainesville, Florida, is hereby designated as the ‘‘Malcom
Randall Department of Veterans Affairs Medical Center’’.
Any reference to that medical center in any law, regulation,
map, document, record, or other paper of the United States
shall be considered to be a reference to the ‘‘Malcom Randall
Department of Veterans Affairs Medical Center’’.
Union Calendar No. 350
105TH CONGRESS
2D SESSION
H. R. 3980
[Report No. 105–626]
A BILL
To amend title 38, United States Code, to extend
the authority for the Secretary of Veterans Af-
fairs to treat illnesses of Persian Gulf War veter-
ans, to provide authority to treat illnesses of vet-
erans which may be attributable to future combat
service, and to revise the process for determining
priorities for research relative to the health con-
sequences of service in the Persian Gulf War,
and for other purposes.
JULY 15, 1998
Reported with an amendment, committed to the Commit-
tee of the Whole House on the State of the Union, and
ordered to be printed