IIA
105TH CONGRESS
2D SESSION
H. R. 3980
IN THE SENATE OF THE UNITED STATES
AUGUST 31, 1998
Received; read twice and referred to the Committee on Veterans’ Affairs
AN ACT
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.
HR 3980 RFS
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 Vet-
erans 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 oper-
ations (as determined by the Secretary in consultation
with the Secretary 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 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)’’;
HR 3980 RFS
(3) in paragraph (3)—
(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 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
paragraph:
‘‘(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 pe-
riod 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
include in the report any recommendations of the Sec-
retary for extension of that authority.’’.
HR 3980 RFS
(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
subparagraph (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 Na-
tional Center for the Study of War-Related Illnesses (here-
inafter in this section referred to as the ‘Center’). The
Center shall, as appropriate, coordinate its activities with
those of the National Center on Post-Traumatic-Stress
Disorder established pursuant to section 110(c) of the
Veterans’ Health Care Act of 1984 (Public Law 98–528).
HR 3980 RFS
‘‘(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 Cen-
ter—
‘‘(1) promotes the training of health care and
related personnel in, and research into, the causes,
mechanisms, and treatment of war-related illnesses;
‘‘(2) serves as a resource center for, and pro-
motes and seeks to coordinate the exchange of infor-
mation 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 De-
fense and other interested Federal departments and
agencies in the conduct of research, training, and
treatment and the dissemination of information per-
taining 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
HR 3980 RFS
an interdisciplinary approach to the study and treatment
of war-related illnesses.
‘‘(e) COORDINATION BETWEEN DEPARTMENTS.—(1)
In order to ensure needed coordination between the De-
partment and the Department of Defense in carrying out
the mission of the Center, the officials identified in sub-
paragraphs (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 annual 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
chapter 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.’’.
HR 3980 RFS
(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 Octo-
ber 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 Sec-
retary of Veterans Affairs shall enter into a contract with
the National Academy of Sciences for the conduct of a
review of a methodology which could be used by the De-
partment of Veterans Affairs for determining the efficacy
of treatments furnished to, and health outcomes (to in-
clude functional status) 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 out-
comes of, Persian Gulf War veterans who suffer
from diagnosed and undiagnosed illnesses which may
HR 3980 RFS
be associated 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
report on the implementation of this subsection.
SEC. 5. CONTRACT FOR INDEPENDENT RECOMMENDA-
TIONS ON RESEARCH AND FOR DEVELOP-
MENT OF CURRICULUM ON CARE OF PER-
SIAN 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
MEDICAL EDUCATION CURRICULUM.—(1) In order to fur-
ther understanding of the health consequences of military
service in the Persian Gulf theater of operations and of
new research findings with implications for improving the
provision of care for veterans of such service, the Sec-
retary 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 Medi-
cine of the Academy would—
‘‘(A) develop a curriculum pertaining to the
care and treatment of veterans of such service who
HR 3980 RFS
have ill-defined or undiagnosed illnesses for use in
the continuing medical education of both general
and specialty 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 Per-
sian Gulf theater of operations during the Persian
Gulf War, including recommendations that the
Academy considers appropriate for additional sci-
entific studies to resolve areas of continuing sci-
entific uncertainty relating to the health con-
sequences of any aspects of such military service.
‘‘(2) Not later than 6 months after the Institute of
Medicine provides the Secretaries the curriculum devel-
oped under paragraph (1), the Secretaries shall provide
for the conduct of continuing education programs using
the curriculum developed under paragraph (1). Such pro-
grams shall include instruction which seeks to emphasize
use of appropriate protocols of diagnosis, referral, and
treatment of such veterans.’’.
HR 3980 RFS
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 inserting in lieu thereof the following:
‘‘(b) PUBLIC ADVISORY COMMITTEE.—Not later than
January 1, 1999, the head of the department or agency
designated 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 depart-
ment or agency head shall consult with such advisory com-
mittee 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 Representa-
tives a report on—
HR 3980 RFS
‘‘(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 De-
partment of Veterans Affairs entitled ‘VA National Survey
of Persian Gulf Veterans—Phase III’, the head of the de-
partment or agency designated under subsection (a) shall
submit to the congressional committees specified in para-
graph (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.
HR 3980 RFS
‘‘(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 Per-
sian Gulf theater of operations during the Persian Gulf
War (including information pertinent to improving provi-
sion of care for veterans of such service) are made avail-
able 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 Medi-
cal 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
Medical Center’’.
HR 3980 RFS
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’’.
SEC. 9. MANAGEMENT OF SPECIALIZED TREATMENT AND
REHABILITATIVE PROGRAMS.
(a) STANDARDS
OF JOB PERFORMANCE.—Section
1706(b) of title 38, United States Code, is amended—
(1) in paragraph (2), by striking out ‘‘April 1,
1997, April 1, 1998, and April 1, 1999’’, and insert-
ing in lieu thereof ‘‘April 1, 1999, April 1, 2000,
and April 1, 2001’’; and
(2) by adding at the end the following new
paragraph:
‘‘(3)(A) To ensure compliance with paragraph (1),
the Under Secretary for Health shall prescribe objective
standards of job performance for employees in positions
described in subparagraph (B) with respect to the job per-
formance of those employees in carrying out the require-
HR 3980 RFS
ments of paragraph (1). Those job performance standards
shall include measures of workload, allocation of re-
sources, and quality-of-care indicators.
‘‘(B) Positions described in this subparagraph are po-
sitions in the Veterans Health Administration that have
responsibility for allocating and managing resources appli-
cable to the requirements of paragraph (1).
‘‘(C) The Under Secretary shall develop the job per-
formance standards under subparagraph (A) in consulta-
tion with the Advisory Committee on Prosthetics and Spe-
cial Disabilities Programs and the Committee on Care of
Severely Chronically Mentally Ill Veterans.’’.
(b) EFFECTIVE DATE.—The standards of job per-
formance required by paragraph (3) of section 1706(b) of
title 38, United States Code, as added by subsection (a),
shall be prescribed not later than January 1, 1999.
SEC. 10. EXTENSION OF AUTHORITY TO COUNSEL AND
TREAT VETERANS FOR SEXUAL TRAUMA.
Section 1720D(a) of title 38, United States Code, is
amended by striking out ‘‘December 31, 1998’’ in para-
graphs (1) and (3) and inserting in lieu thereof ‘‘Decem-
ber 31, 2001’’.
HR 3980 RFS
SEC. 11. AUTHORIZATION OF CONSTRUCTION OF A SPINAL
CORD INJURY CENTER AT THE TAMPA, FLOR-
IDA, VAMC.
(a) AUTHORIZATION.—The Secretary of Veterans Af-
fairs may carry out a major medical facility project for
construction of a spinal cord injury center at the Depart-
ment of Veterans Affairs Medical Center, Tampa, Florida,
in an amount not to exceed $46,300,000.
(b) FUNDING.—There are authorized to be appro-
priated to the Secretary of Veterans Affairs for fiscal year
1999 for the Construction, Major Projects, account
$20,000,000 to be available for the project authorized in
subsection (a).
(c) SOURCE OF FUNDS.—The project authorized in
subsection (a) may be carried out using —
(A) funds appropriated pursuant to the author-
ization of appropriations in subsection (b);
(B) funds appropriated for Construction, Major
Projects, for a fiscal year before fiscal year 1999
that remain available for obligation; and
HR 3980 RFS
(C) funds appropriated for Construction, Major
Projects, for a fiscal year before fiscal year 1999 for
a category of activity not specific to a project.
Passed the House of Representatives August 3,
1998.
Attest:
ROBIN H. CARLE,
Clerk.