Veterans Administration and Department of Defense Health Resources Sharing and Emergency Operations Act
PL 97-174 (S.266), enacted 05/04/1982

96 STAT. 70 
PUBLIC LAW 97-174—MAY 4, 1982 
Public Law 97-174 
97th Congress 
May 4, 1982 
[S. 266] 
Veterans' 
Administration 
and Department 
of Defense 
Health 
Resources 
Sharing and 
Emergency 
Operations Act. 
38 use 101 note. 
38 use 5011 
note. 
38 use 5011A 
note. 
An Act 
38 use 5010. 
To amend title 38, United States Code, to promote greater sharing of health-care 
resources between the Veterans' Administration and the Department of Defense 
and to direct the Secretary of Defense and the Administrator of Veterans' Affairs 
to plan for the provision of health care by the Veterans' Administration during 
periods of war or national emergency to members of the Armed Forces on active 
auty; and for other purposes. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, That this Act may 
be cited as the "Veterans' Administration and Department of 
Defense Health Resources Sharing and Emergency Operations Act". 
SEC. 2. (a) The Congress makes the following findings: 
(1) There are opportunities for greater sharing of the health-
care resources of the Veterans' Administration and the Depart-
ment of Defense which would, if achieved, be beneficial to both 
veterans and members of the Armed Forces and could result in 
reduced costs to the Grovemment by minimizing duplication 
and underuse of health-care resources. 
(2) Present incentives to encourage such sharing of health-
care resources are inadequate. 
(3) Such sharing of health-care resources can be achieved 
without a detrimental effect on the primary health-care benefi-
ciaries of the Veterans' Administration and the Department of 
Defense. 
(b) The Congress makes the following further findings: 
(1) During and immediately after a period of war or national 
emergency involving the use of the Armed Forces of the 
United States in armed conflict, the Department of Defense 
might not have adequate health-care resources to care for 
military personnel wounded in combat and other active-duty 
military personnel. 
(2) The Veterans' Administration has an extensive, compre-
hensive health-care system that could be used to assist the 
Department of Defense in caring for such personnel in such a 
situation. 
SEC. 3. (a) Section 5011 of title 38, United States Code, is 
amended— 
(1) by inserting "(a)" before "The Administrator" the first 
place it appears; 
(2) by striking out "and material" and all that follows 
through "this title," and inserting in lieu thereof "material, 
and other resources as may be needed to operate such facilities 
properly, except that the Administrator may not enter into an 
agreement that would result (1) in a permanent reduction in 
the total number of authorized Veterans' Administration hos-
pital beds and nursing home beds to a level below the mini-
mum number of such beds required by section 5010(a)(1) of this 
title to be authorized, or (2) in a permanent reduction in the 
total number of such beds operated and maintained to a level 
PUBLIC LAW 97-174—MAY 4, 1982 
96 STAT. 71 
below the minimum number of such beds required by such sec-
tion to be operated and maintained"; and 
(3) by adding at the end the following new subsections: 
"(b)(1) In order to promote the sharing of health-care resources 
between the Veterans' Administration and the Department of 
Defense (hereinafter in this section referred to as the 'agencies'), 
there is established an interagency committee to be known as the 
Veterans' Administration/Department 
of Defense 
Health-Care 
Resources Sharing Committee (hereinafter in this subsection 
referred to as the 'Committee'). 
"(2) The Committee shall be composed of— 
"(A) the Chief Medical Director and such other officers and 
employees of the Veterans' Administration as the Chief Medi-
cal Director may designate; and 
"(B) the Assistant Secretary of Defense for Health Affairs 
(hereinafter in this section referred to as the 'Assistant Secre-
tary') and such other officers and employees of the Department 
of Defense as the Assistant Secretary may designate, 
except that the size of the Committee shall be mutually determined 
by the Chief Medical Director and the Assistcmt Secretary. During 
fiscal years 1982 and 1983, the Chief Medical Director shall be the 
chairman of the Committee. During fiscal year 1984, the Assistant 
Secretary shall be the chairman of the Committee. Thereafter, the 
chairmanship of the Committee shall alternate each fiscal year 
between the Chief Medical Director and the Assistant Secretary. 
The agencies shall provide administrative support services for the 
Committee at a level sufficient for the efficient operation of the 
Committee and shall share the responsibility for the provision of 
such services on an equitable basis. 
"(3) In order to enable the (IJommittee to make recommendations 
under paragraph (4) of this subsection, the Clommittee shall on a 
continuing basis— 
"(A) review existing policies, procedures, and practices relat-
ing to the sharing of health-care resources between the 
agencies; 
"(B) identify and assess further opportunities for the sharing 
of health-care resources between the agencies that would not, 
in the judgment of the Committee, adversely affect the range 
of services, the quality of care, or the established priorities for 
care provided by either agency; 
"(C) identify changes in policies, procedures, and practices 
that would, in the judgment of the Committee, promote such 
sharing of health-care resources between the agencies; 
"(D) monitor plans of the agencies for the acquisition of addi-
tional health-care resources, including the location of new 
facilities and the acquisition of major equipment, in order to 
assess the potential impact of such plans on further opportuni-
ties for such sharing of health-care resources; and 
"(E) monitor the implementation of activities designed to 
promote the sharing of health-care resources between the 
agencies. 
"(4) Within nine months of the date of the enactment of this sub-
section and at such times thereafter as the Committee considers 
appropriate, the Committee shall make recommendations to the 
Administrator or the Secretary of Defense, or both, with respect to 
(A) changes in policies, procedures, and practices that the Commit-
tee has identified under paragraph (3)(C) of this subsection pertain-
Veterans' 
Administration/ 
Department of 
Defense Health-
Care Resources 
Sharing Com-
mittee. 
Establishment. 
Duties. 
Recommenda-
tions to VA 
Administrator or 
DOD Secretary. 
96 STAT. 72 
PUBLIC LAW 97-174—MAY 4, 1982 
Health-care 
resources 
sharing 
guidelines. 
10 u s e 1071 et 
Sharing 
agreements. 
Reimbursement. 
Agreement 
proposals, 
submittal. 
Reimbursement 
methodology 
provisions. 
ing to the sharing of health-care resources described in such para-
graph, and (B) such other matters as the Committee considers 
appropriate in order to promote such sharing of health-care 
resources. 
"(c)(1) After considering the recommendations made under sub-
section (b)(4) of this section, the Administrator and the Secretary of 
Defense shall jointly establish guidelines to promote the sharing of 
health-care resources between the agencies. Guidelines established 
under this subsection shall provide for such sharing consistent with 
the health-care responsibilities of the Veterans' Administration 
under this title and with the health-care responsibilities of the 
Department of Defense under chapter 55 of title 10 and so as not to 
adversely affect the range of services, the quality of care, or the 
established priorities for care provided by either agency. 
"(2) Guidelines established under paragraph (1) of this subsection 
shcdl authorize the heads of individual medical facilities of the 
agencies to enter into health-care resources sharing agreements in 
accordance with subsection (d) of this section and shall include 
guidelines for such agreements. 
"(d)(1) The head of each medical facility of either agency is 
authorized to enter into sharing agreements with the heads of 
medical facilities of the other agency in accordance with guidelines 
established under subsection (c) of this section. Under any such 
agreement, an individual who is a primary beneficiary of one 
agency may be provided health care at a facility of the other 
agency that is a party to the sharing agreement. 
"(2) Each such agreement shall identify the health-care resources 
to be shared. 
"(3) Each such agreement shall provide, and shall specify proce-
dures designed to ensure, that the availability of direct health care 
to individuals who are not primary beneficiaries of the providing 
agency (A) is on a referral basis from the facility of the other 
agency, and (B) does not (as determined by the head of the facility 
of the providing agency) adversely affect the range of services, the 
quality of care, or the established priorities for care provided to the 
primary beneficiaries of the providing agency. 
"(4) Each such agreement shall provide that a providing agency 
shall be reimbursed for the cost of the health-care resources pro-
vided under the agreement and that the rate for such reimburse-
ment shall be determined in accordance with the methodology 
agreed to pursuant to subsection (e) of this section. 
"(5) Each proposal for an agreement under paragraph (1) of this 
subsection shall be submitted to the Chief Medical Director and the 
Assistant Secretary and shall be effective as an agreement in 
accordance with its terms (A) on the forty-sixth day after the 
receipt of such proposal by both such officials, unless earlier disap-
proved by either such official, or (B) if earlier approved by both 
such officials, on the date of such approval. 
"(e) Reimbursement under any sharing agreement entered into 
under subsection (d) of this section shall be based upon a method-
ology that is agreed upon by the Chief Medical Director and the 
Assistant Secretary and that provides appropriate flexibility to the 
heads of the facilities concerned to take into account local condi-
tions and needs and the actual costs to the providing agency's 
facility of the health-care resources provided. Any funds received 
through such a reimbursement shall be credited to funds that have 
been allotted to the facility that provided the care or services. 
PUBLIC LAW 97-174—MAY 4, 1982 
96 STAT. 73 
"(f) At the time the President's Budget is transmitted to Con- Report to 
gress in any year pursuant to section 201(a) of the Budget and Congress. 
Accounting Act, 1921 (31 U.S.C. 11(a)), the Administrator and the 
Secretary of Defense shall submit a joint report to Congress on the 
implementation of this section during the fiscal year that ended 
during the previous calendar year. Each such report shall 
include— 
"(1) the guidelines prescribed under subsection (c) of this sec-
tion (and any revision of such guidelines); 
"(2) the assessment of further opportunities identified under 
clause (B) of subsection (b)(3) of this section for sharing of 
health-care resources between the agencies; 
"(3) any recommendation made under subsection (bX4) of this 
section during such fiscal year; 
"(4) a review of the sharing agreements entered into under 
subsection (d) of this section and a summary of activities under 
such agreements during such fiscal year; 
"(5) a summary of other planning and activities involving 
either agency in connection with promoting the coordination 
and sharing of Federal health-care resources during the pre-
ceding fisc£d year; and 
"(6) such recommendations for legislation as the Administra-
tor and the Secretary consider appropriate to facilitate the 
sharing of health-care resources between the agencies. 
"(g) For the purposes of this section: 
Definitions. 
"(1) The term 'beneficiary' means a person who is a primary 
beneficiary of the Veterans' Administration or of the Depart-
ment of Defense. 
"(2) The term 'direct health care' means health care pro-
vided to a beneficiary in a medical facility operated by the Vet-
erans' Administration or the Department of Defense. 
"(3) The term 'head of a medical facility' (A) with respect to 
a medical facility of the Veterans' Administration, means the 
director of the facility, and (B) with respect to a medical facil-
ity of the Department of Defense, means the medical or dental 
officer in charge or the contract surgeon in charge. 
"(4) 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 section 
601 of this title, any other health-care service, and any health-
care support or administrative resource. 
"(5) The term 'primary beneficiary' (A) with respect to the 
Veterans' Administration means a person who is eligible under 
this title (other than under section 611(b) or 613 or subsection 38 use 6ii, 613. 
(d) of this section) or any other provision of law for care or 
services in Veterans' Administration medical facilities, and (B) 
with respect to the Department of Defense, means a member 
or former member of the Armed Forces who is eligible for care 
under section 1074 of title 10. 
"(6) The term 'providing agency' means the Veterans' 
Administration, in the case of care or services furnished by a 
facility of the Veterans' Administration, and the Department 
of Defense, in the case of care or services furnished by a facil-
ity of the Department of Defense.". 
(bXl) The heading of such section is amended to read as follows: 38 use son. 
96 STAT. 74 
PUBLIC LAW 97-174—MAY 4, 1982 
38 use 5011 
note. 
38 use 5011 
note. 
38 use 5011A. 
Definitions. 
38 use 601, 101. 
eontracts with 
private facilities. 
38 use 612. 
"§ 5011. Sharing of Veterans' Administration and Department of 
Defense health-care resources". 
(2) The item relating to such section in the table of sections at 
the beginning of chapter 81 of such title is amended to read as 
follows: 
"5011. Sharing of Veterans' Administration and Department of Defense health-care 
resources.". 
(c) The Assistant Secretary of Defense for Health Affairs shall 
consult regularly with the Surgeons General of the Army, Navy, 
and Air Force in carrying out the duties and functions assigned to 
the Assistant Secretary in section 5011 of title 38, United States 
Code, as amended by subsection (a) of this section. 
(d) The guidelines required to be established under subsection (c) 
of section 5011 of title 38, United States Code, as added by subsec-
tion (a) of this section, shall initially be established not later than 
twelve months after the date of the enactment of this Act. 
SEC. 4. (a) Chapter 81 of title 38, United States Code, is amended 
by inserting after section 5011 the following new section: 
"§5011A. Furnishing of health-care services to members of the 
Armed Forces during a war or national emergency 
"(a)(1) During and immediately following a period of war, or a 
period of national emergency declared by the President or the Con-
gress that involves the use of the Armed Forces in armed conflict, 
the Administrator may furnish hospital care, nursing home care, 
and medical services to members of the Armed Forces on active 
duty. The Administrator may give a higher priority to the furnish-
ing of care and services under this section than to the furnishing of 
care and services to any other group of persons eligible for care 
and services in medical facilities of the Veterans' Administration 
with the exception of veterans with service-connected disabilities. 
"(2) For the purposes of this section, the terms 'hospital care', 
'nursing home care', and 'medical services' have the meanings 
given such terms by sections 601(5), 101(28), and 601(6) of this title, 
respectively. 
'(b)(1) During a period in which the Administrator is authorized 
to furnish care and services to members of the Armed Forces under 
subsection (a) of this section, the Administrator, to the extent 
authorized by the President and subject to the availability of 
appropriations or reimbursements under subsection (c) of this sec-
tion, may enter into contracts with private facilities for the provi-
sion during such period by such facilities of hospital care and 
medical services described in paragraph (2) of this subsection. 
"(2) Hospital care and medical services referred to in paragraph 
(1) of this subsection are— 
"(A) hospital care and medical services authorized under this 
title for a veteran and necessary for the care or treatment of a 
condition for which the veteran is receiving medical services at 
a Veterans' Administration facility under subsection (f) or (g) 
of section 612 of this title, in a case in which the delay 
involved in furnishing such care or services at such Veterans' 
Administration facility or at any other Veterans' Administra-
tion facility reasonably accessible to the veteran would, in the 
judgment of the Chief Medical Director, be likely to result in a 
deterioration of such condition; and 
"(B) hospited care for a veteran who— 
PUBLIC LAW 97-174—MAY 4, 1982 
96 STAT. 75 
"(i) is receiving hospital care under section 610 of this 
title; or 
"(ii) is eligible for hospital care under such section and 
requires such care in a medical emergency that poses a 
serious threat to the life or health of the veteran; 
if Veterans' Administration facilities are not capable of fur-
nishing or continuing to furnish the care required because of 
the furnishing of care and services to members of the Armed 
Forces under subsection (a) of this section. 
"(c)(1) The cost of any care or services provided by the Veterans' 
Administration under subsection (a) of this section shall be reim-
bursed to the Veterans' Administration by the Department of 
Defense at such rates as may be agreed upon by the Administrator 
and the Secretary of Defense based on the cost of the care or serv-
ices provided. 
"(2) Amounts received under this subsection shall be credited to 
funds allotted to the Veterans' Administration facility that pro-
vided the care or services. 
"(d)(1) Not later than six months after the date of the enactment 
of this section, the Administrator and the Secretary of Defense 
shall enter into an agreement to plan and establish procedures and 
guidelines for the implementation of this section. Not later than 
one year after the date of the enactment of this section, the Admin-
istrator and the Secretary shall complete plans for such implemen-
tation and shall submit such plans to the Committees on Veterans' 
Affairs and on Armed Services of the Senate and House of 
Representatives. 
"(2) The Administrator and the Secretary of Defense shall jointly 
review such plans not less often than annually thereafter and shall 
report to such committees any modification in such plans within 
thirty days after the modification is agreed to. 
"(e) The Administrator shall prescribe regulations to govern any 
exercise of the authority of the Administrator under subsections (a) 
and (b) of this section and of the Chief Medical Director under sub-
section (bX2XA) of this section. 
"(f) Within thirty days after a declaration of a period of war or 
national emergency described in subsection (a) of this section (or as 
soon after the end of such thirty-day period as is reasonably practi-
cable), the Administrator shall submit to the Committees on Veter-
ans* Affairs of the Senate and House of Representatives a report on 
the Administrator's allocation of facilities and personnel in order 
to provide priority hospital care, nursing home care, and medical 
services under this section to members of the Armed Forces. There-
after, with respect to any fiscal year in which the authority in sub-
section (b) of this section to enter into contracts with private 
facilities has been used, the Administrator shall report within 
ninety days after the end of such fiscal year to those committees 
regarding the extent of, and the circumstances under which, such 
authority was used.". 
(b) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 5011 the 
following new item: 
"501 lA. Furnishing of health-care services to members of the Armed Forces during 
a war or national emergency.". 
SEC. 5. (a) Section 1786(a) of title 38, United States Code, is 
amended by adding at the end the following new paragraph: 
38 u s e 610. 
Care or service 
costs, 
reimbursement. 
Plans 
implementation. 
Submittal to 
congressional 
committees. 
Review and 
report. 
Regulations. 
Reports to 
congressional 
committees. 
96 STAT. 76 
PUBLIC LAW 97-174—MAY 4, 1982 
Effective date. 
38 u s e 1786 
note. 
Richard L. 
Roudebush 
Veterans' 
Administration 
Medical Center, 
designation 
^'(3) Notwithstanding any other provision of law unless enacted 
in express limitation of this paragraph, funds in the Veterans' 
Administration reacUustment benefits account shall be available for 
payments under paragraph (1) of this subsection for pursuit of a 
program of education exclusively by correspondence in which the 
veteran or spouse or surviving spouse enrolls e^r September 30, 
1981.". 
(b) The amendment made by subsection (a) of this section shall 
take effect as of October 1,1981. 
SEC. 6. The Veterans' Administration medical center located at 
1481 West 10th Street, Indianapolis, Indiana, shall after the date of 
the enactment of this Act be known and designated as the "Rich-
ard L. Roudebush Veterans' Administration Medical Center". Any 
reference to such medical center in any law, regulation, document, 
map, record, or other paper of the United States shall after such 
date be deemed to be a reference to the Richard L. Roudebush Vet-
erans' Administration Medical Center. 
Approved May 4, 1982. 
LEGISLATIVE HISTORY—S. 266 (H.R. 3502): 
HOUSE REPORTS: No. 97-72, Pt. I (Comm. on Veterans' Affairs) and Ft. II (Comm. on 
Armed Services) both accompanying H.R. 3502. 
SENATE REPORTS: No. 97-137 (Comm. on Governmental Affairs) and No. 97-196 
(Comm. on Veterans' Affairs). 
CONGRESSIONAL RECORD: 
Vol. 127 (1981): Oct. 27, considered and passed Senate. 
Nov. 4, considered and passed House, amended, in lieu of 
H.R. 3502. 
Vol. 128 (1982): Apr. 1, Senate agreed to House amendments with amend-
ments. 
Apr. 20, House concurred in Senate amendments.