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.
PL 103-210 (H.R.2535), enacted 12/20/1993

107 STAT. 2496 
PUBLIC LAW 103-210—DEC. 20, 1993 
Public Law 103-210 
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103d Congress 
An Act 
Dec 20 1993 
"^^ amend title 38, United States Code, to provide additional authority for the 
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Secretary of Veterans Affairs to provide health care for veterans of the Persian 
[H.R. 2535] 
Giilf 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 VET-
ERANS OF THE PERSIAN GULF WAR. 
(a) INPATIENT CARE.—(1) Section 1710(aXlXG) 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 imder 
subsection (aXlXG) of this section for any disability, notwithstand-
ing 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 (IXC), 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 subpara-
graph (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 serv-
ice, notwithstanding that there is insufficient medical evidence 
PUBLIC LAW 103-210—DEC. 20, 1993 
107 STAT. 2497 
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 
(IXD) with respect to a disability that is foimd, 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 38 use i7io 
(a) and (b) shall take effect as of August 2,1990. 
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(2) The Secretary of Veterans Affairs shall, upon request, 
reimburse any veteran who paid the United States an amount 
imder section 1710(f) or 1712(f) of title 38, United States Code, 
as the case may be, for hospital care, nursing home care, or out-
patient services furnished by the Secretary to the vetersui 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 amoimt 
of the reimbursement shall be the amoimt that was paid by the 
veteran for such care or services under such section 171(Kf) or 
1712(f). 
SEC. 2. EXTENSION OF CERTAIN HEALTH CAKE AND OTHER AUTHORI-
TIES. 
(a) ELIGIBILITY FOR CARE FOR EXPOSURE TO DIOXIN OR IONIZING 
RADIATION.—Section 1710(eX3) of title 38, United States Code, as 
amended by section l(aX2XC), is further amended by striking out 
"December 31, 1993" and inserting in lieu thereof "Jime 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 imder this title by authorizing the Secretary to enter 
into agreements with State veterans facilities for the sharing of 
health-ecu^ 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 para-
graph (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 
107 STAT. 2498 
PUBLIC LAW 103-210—DEC. 20, 1993 
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 insertmg "(ir 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, 
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"(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.". 
Approved December 20, 1993, 
LEGISLATIVE HISTORY—H.R. 2535: 
HOUSE REPORTS: No. 103-198 (Coram, on Veterans' Affairs). 
CONGRESSIONAL RECORD, Vol. 139 (1993): 
Aug. 2, considered and passed House. 
Nov. 19, considered and passed Senate, amended. 
Nov. 22, House concurfed in Senate amendment. 
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 29 (1993): 
Dec. 20, Presidential statement.