[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2535 Engrossed Amendment Senate (EAS)]

103d CONGRESS

  1st Session

                               H. R. 2535

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                               AMENDMENT
  
  
  
  
  
  
  
  
  
  

                  In the Senate of the United States,

                       November 20 (legislative day, November 2), 1993.
      Resolved, That the bill from the House of Representatives (H.R. 
2535) entitled ``An Act 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'', do pass 
with the following

                               AMENDMENT:

            Strike out all after the enacting clause and insert:

SECTION 1. AUTHORITY TO PROVIDE PRIORITY HEALTH CARE TO VETERANS OF THE 
              PERSIAN GULF WAR.

    (a) Inpatient Care.--(1) Section 1710(a)(1)(G) 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 under subsection 
(a)(1)(G) of this section for any disability, notwithstanding 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 (1)(C), 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 
                subparagraph (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 service, 
        notwithstanding that there is insufficient medical evidence 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 (1)(D) 
with respect to a disability that is found, 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 (a) and 
(b) shall take effect as of August 2, 1990.
    (2) The Secretary of Veterans Affairs shall, upon request, 
reimburse any veteran who paid the United States an amount under 
section 1710(f) or 1712(f) of title 38, United States Code, as the case 
may be, for hospital care, nursing home care, or outpatient services 
furnished by the Secretary to the veteran 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 amount of the reimbursement shall be the 
amount that was paid by the veteran for such care or services under 
such section 1710(f) or 1712(f).

SEC. 2. EXTENSION OF CERTAIN HEALTH CARE AND OTHER AUTHORITIES.

    (a) Eligibility for Care for Exposure to Dioxin or Ionizing 
Radiation.--Section 1710(e)(3) of title 38, United States Code, as 
amended by section 1(a)(2)(C), is further amended by striking out 
``December 31, 1993'' and inserting in lieu thereof ``June 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 Philippines.--
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 under 
this title by authorizing the Secretary to enter into agreements with 
State veterans facilities for the sharing of health-care 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 
        paragraph (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 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 inserting ``(1)'' 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, of--
            ``(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.''.

            Attest:






                                                             Secretary.