[House Prints 111-2]
[From the U.S. Government Publishing Office]



111th Congress 
 1st Session          HOUSE COMMITTEE PRINT NO. 2
_______________________________________________________________________

                                 REPORT

                                 to the

                        COMMITTEE ON THE BUDGET

                                from the

 
                     COMMITTEE ON VETERANS' AFFAIRS

                SUBMITTED PURSUANT TO SECTION 301 OF THE

                    CONGRESSIONAL BUDGET ACT OF 1974

                                 on the

                  BUDGET PROPOSED FOR FISCAL YEAR 2010


[GRAPHIC] [TIFF OMITTED] CONGRESS.#13



  March 13, 2008.--Printed for the use of the Committee on Veterans' 
                Affairs of the House of Representatives



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                     COMMITTEE ON VETERANS' AFFAIRS

                    BOB FILNER, California, Chairman
CORRINE BROWN, Florida               STEVE BUYER, Indiana, Ranking
VIC SNYDER, Arkansas                 CLIFF STEARNS, Florida
MICHAEL H. MICHAUD, Maine            JERRY MORAN, Kansas
STEPHANIE HERSETH SANDLIN, South     HENRY E. BROWN, Jr., South 
    Dakota                               Carolina
HARRY E. MITCHELL, Arizona           JEFF MILLER, Florida
JOHN J. HALL, New York               JOHN BOOZMAN, Arkansas
DEBORAH L. HALVORSON, Illinois       BRIAN P. BILBRAY, California
THOMAS S.P. PERRIELLO, Virginia      DOUG LAMBORN, Colorado
HARRY TEAGUE, New Mexico             GUS M. BILIRAKIS, Florida
CIRO D. RODRIGUEZ, Texas             VERN BUCHANAN, Florida
JOE DONNELLY, Indiana                DAVID P. ROE, Tennessee
JERRY McNERNEY, California
ZACHARY T. SPACE, Ohio
TIMOTHY J. WALZ, Minnesota
JOHN H. ADLER, New Jersey
ANN KIRKPATRICK, Arizona
GLENN C. NYE, Virginia
                   Malcom A. Shorter, Staff Director
                     DEMOCRAT LETTER OF TRANSMITTAL

                                ------                                

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                    Washington, DC, March 13, 2009.
Hon. John Spratt,
Chairman, Committee on the Budget,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: Pursuant to Sec. 301(d) of the 
Congressional Budget Act of 1974, and House Rule X, clause 
4(f), and Rule 7 of the Rules of the Committee on Veterans' 
Affairs, the Committee on Veterans' Affairs hereby submits its 
Views and Estimates with regard to programs and matters within 
the jurisdiction of the Committee to be set forth in the 
concurrent resolution on the budget for fiscal year 2010. The 
Minority will be submitting Additional and Dissenting Views 
under separate cover.
    Caring for our veterans is an ongoing cost of war, and a 
continuing cost of our national defense. As a Congress, and a 
nation, we must fulfill our obligations to the men and women 
who have served. We hope that you will carefully consider these 
Committee views and estimates. We have a lot of work ahead of 
us if we are to keep our promises to veterans. Working 
together, we can make sure that our veterans are not forgotten, 
and that we meet our obligations to them as a nation.
            Sincerely,
                    Bob Filner, Chairman; Corrine Brown, Vic Snyder, 
                            Michael H. Michaud, Stephanie Herseth 
                            Sandlin, Harry E. Mitchell, John J. Hall, 
                            Deborah L. Halvorson, Thomas S.P. 
                            Perriello, Harry Teague, Ciro Rodriguez, 
                            Joe Donnelly, Jerry McNerney, Zachary T. 
                            Space, Timothy J. Walz, John H. Adler, Ann 
                            Kirkpatrick, Glenn C. Nye.
                     Committee on Veterans' Affairs

                     U.S. House of Representatives

                             111th Congress

                          Views and Estimates

                                FY 2010

                             March 13, 2009

                              INTRODUCTION

    On February 26, 2009, the Administration submitted its 
preliminary FY 2010 budget. This 134-page document, entitled A 
New Era of Responsibility: Renewing America's Priorities, 
provides scant detail regarding the VA's FY 2010 budget. By 
necessity, this year's Views and Estimates will not contain the 
same level of detailed analysis and individual account 
recommendations as in previous years.
    Because of the lack of details regarding non-VA programs in 
this year's preliminary budget, the Committee will not be 
making recommendations regarding the Veterans Employment and 
Training Service of the Department of Labor, the American 
Battle Monuments Commission, and the U.S. Court of Appeals for 
Veterans Claims.

                   SECTION 1--DISCRETIONARY ACCOUNTS

                     DEPARTMENT OF VETERANS AFFAIRS

    For FY 2010, the Administration is requesting $52.5 billion 
for the discretionary accounts of the Department of Veterans 
Affairs (VA). This request is $4.9 billion, or 10.3 percent, 
over FY 2009 enacted levels. The Administration is estimating a 
total resource level, including medical care collections, of 
$55.9 billion for FY 2010. This overall level is $1.3 billion 
over the recommendations of the Independent Budget, which is 
co-authored by AMVETS, Disabled American Veterans, Paralyzed 
Veterans of America, and the Veterans of Foreign Wars. This 
year marks the first time in the 23-year history of the 
Independent Budget that an administration has proposed a budget 
that exceeds its recommendations.
    For the second year, the Independent Budget has included 
amounts attributable to medical care collections in its funding 
level recommendation for the Medical Services account. The 
Independent Budget argues that amounts for discretionary 
programs of the VA should be fully appropriated and hence 
collections should not be included. The Independent Budget is 
silent regarding how resources realized through medical 
collections should be spent by the Department, or even if the 
VA should continue to collect for the provision of health care 
services for non-service-connected conditions. In order to more 
accurately compare budget numbers, amounts attributable to 
medical care collections should be added to the discretionary 
appropriations request, or conversely, the amount estimated for 
collections should be subtracted from the Independent Budget 
request.
    The Committee \1\ is recommending $53.3 billion for the 
discretionary accounts of the Department of Veterans Affairs 
(VA) for FY 2010. This recommendation is an increase of $5.7 
billion, or 12 percent over the FY 2009 enacted level of $47.6 
billion, and $800 million, or 1.5 percent, above the 
Administration's request.
---------------------------------------------------------------------------
    \1\ While the Views and Estimates reflect a consensus effort, the 
Committee wishes to note that not all Members of the Committee 
necessarily agree with every aspect of the report. Accordingly, the 
Committee reserves its flexibility to determine program needs and 
recognizes the potential for funding changes as the Committee and 
Congress work their will through the legislative process.
---------------------------------------------------------------------------
    The Administration's number for total resources for 
discretionary programs for FY 2010 indicates an appropriations 
level of $52.5 and an amount attributable to collections of 
$3.4 billion. The VA saw an 11 percent increase in collections 
from FY 2007 to FY 2008, and is estimating $2.5 billion in 
collections for FY 2009. The Administration's estimate would 
represent an increase in collections of $900 million, or 36 
percent, from FY 2009 estimated levels.
    The Committee is estimating that the VA will realize at 
least $2.8 billion in medical care collections in FY 2010. When 
this amount is added to the recommended level of appropriated 
discretionary funding the Committee is recommending an overall 
level of resources for the VA of $56.1 billion. This represents 
an increase of $200 million over the Administration's proposed 
total resource level of $55.9 billion and $1.5 billion above 
the Independent Budget recommendation of $54.6 billion.
    The Committee is concerned that the VA may find it 
difficult to realize an increase of 36 percent in collections 
using existing authorities, even with the increase in the 
number of Priority 8 veterans allowed into the system this 
fiscal year. The Committee recommends that an additional $600 
million above the Administration's request be provided in 
appropriated dollars in order to safeguard the provision of 
health care to veterans. The Committee believes this is a 
prudent step as it awaits further details regarding the 
Administration's budget request. As further details are 
provided and the Committee is assured that the VA can collect 
these additional revenues using current authorities, then the 
Committee would recommend that these additional dollars be used 
by the VA to further improve access to care and enhance 
specialty care programs, including long-term care.
    The Committee's recommended funding level for FY 2010 also 
includes an additional $200 million to augment the VA account 
that funds discretionary activities of the Veterans Benefits 
Administration and the Department's General Administration 
activities. The Committee recommends providing this increase to 
safeguard VA claims activities and to assist the Department in 
beginning its transformation into a 21st Century organization, 
a goal outlined by the new Administration.

                                     FY 2010 VA DISCRETIONARY BUDGET REQUEST
                                                 [$ in billions]
----------------------------------------------------------------------------------------------------------------
                                                                                                      Committee
                                   FY 2009      FY 2010      FY 2010        FY 2010      Committee       vs.
                                   Enacted    Independent  President's     Committee    vs. Enacted  President's
                                                 budget      request    recommendation                  request
----------------------------------------------------------------------------------------------------------------
VA Discretionary...............         47.6     54.6 \1\         52.5           53.3          +5.7         +0.8
                                                   (51.8)
Medical Care Collections.......          2.5            0          3.4            2.8          +0.3         -0.6

Total Resources Discretionary           50.1         54.6         55.9           56.1          +6.0        +0.2
 (with collections)............
----------------------------------------------------------------------------------------------------------------
\1\ To assist in the analysis of the varying budget proposals, the figure in parentheses ($51.8) represents the
  Committee's estimate as to collections subtracted from the recommended level in order to better compare
  realistic appropriations levels.

    The Committee is pleased to note that the Administration's 
budget request marks a sharp departure from Bush Administration 
budgets in assuming out-year increases for veterans' spending. 
For FY 2009, the Bush Administration submitted a budget that 
assumed a net five-year cut of $20 billion. The preliminary 
budget for FY 2010 assumes a five-year increase of $25 billion 
over baseline estimates.
    When the Administration submits a detailed budget in April, 
the Committee plans to revisit its recommended funding level, 
if warranted. The Committee believes that its recommended level 
of $53.3 billion provides the resources to enable the VA to 
meet its responsibilities in FY 2010 in all VA accounts, but 
retains an interest in ensuring that specific accounts are 
funded at sufficient levels.
    The Committee remains committed to working diligently to 
ensure that VA budgets are sufficient to meet the needs of 
veterans and are in place at the beginning of the fiscal year. 
The Committee plans on addressing innovative ideas, such as 
advanced appropriations and other budgetary reforms, to ensure 
that veterans get the dollars they need when they need them and 
the VA is better able to plan and forecast to meet the 
challenges ahead.

                            VA MEDICAL CARE

    VA medical care is considered to be comprised of three 
accounts: Medical Services, Medical Support and Compliance, and 
Medical Facilities. These three accounts, and Medical and 
Prosthetic Research, make up the funding levels for the 
Veterans Health Administration (VHA).
    Including the recommended additional funding, the Committee 
believes that the proposed FY 2010 budget provides sufficient 
resources to provide the necessary funding levels for veterans' 
medical care. When the Committee's estimated collections level 
is factored in, the Committee believes that VHA accounts should 
be funded at levels that at least match the Independent Budget 
request. The Committee expects the VA to provide a robust 
research budget that does not rely on the ability of VA 
researchers to obtain other Federal research dollars in order 
to achieve increases above FY 2009 levels.
    Consistent with the Committee's focus on improving health 
care access for rural veterans, the Committee will work to 
ensure that the VA's Office of Rural Health is sufficiently 
funded and staffed at an appropriate level to spearhead and 
coordinate VA's efforts in this area.
    The Committee applauds the Administration's efforts to end 
the enrollment ban on the enrollment of Priority 8 veterans and 
supports the VA's stated intent to accomplish this 
incrementally in order to safeguard current quality and 
timeliness standards. The Committee also looks forward to 
working with the Administration to improve mental health care 
treatment and services, as well as improve homeless programs 
and enhance outreach efforts. The Committee will also continue 
its focus on providing health care to returning servicemembers 
and veterans of past conflicts and look for ways to improve the 
VA's ability to address specific health care needs of veterans.

                      DEPARTMENTAL ADMINISTRATION

                    VETERANS BENEFITS ADMINISTRATION

                     INFORMATION TECHNOLOGY SYSTEMS

                      OFFICE OF INSPECTOR GENERAL

    The General Operating Expenses (GOE) account provides 
discretionary funding for the Veterans Benefits Administration 
(VBA) and general administrative functions of the Department, 
including funding the Office of the Secretary, the Assistant 
Secretaries, the Office of the General Counsel, and the Board 
of Veterans Appeals. For FY 2009, GOE received $1.8 billion in 
appropriated funding.
    The Committee recommendation of $53.3 billion includes an 
additional $200 million for the GOE account. The Committee 
recommends providing this additional level of funding as it 
awaits further details regarding the Administration's proposal 
to shift the funding mechanism for contract examinations for 
disability compensation eligibility from mandatory to 
discretionary. The Committee is also looking to the 
Administration to provide the funding necessary to assist the 
VA as it begins its transformation into an organization more 
aligned with the needs of veterans and to beef up its strategic 
planning capabilities.
    The Committee will also work to ensure that the VBA has the 
funding it needs in the short term to hire and train needed 
claims processors and to work to implement the reforms the VA's 
disability compensation system contained in P.L. 110-389, the 
Veterans Benefits Improvement Act of 2008. Over the long term, 
the Committee looks forward to working with the Administration 
and the VA to transform this system and utilize all available 
technologies and processes to address the claims backlog.
    The Committee will look forward to receiving detailed 
funding information regarding the VA's Information Technology 
Systems (IT) account. The Committee will work to ensure that 
the VA has the resources to continue reforming its IT operation 
and that IT functions as a tool to improve the provision of 
benefits and services to veterans.
    The Committee notes that the National Cemetery 
Administration received $50 million as part of the American 
Recovery and Investment Act, P.L. 111-5. The Committee is 
hopeful that this account will be provided the resources it 
needs to maintain current services and that additional funding 
is provided for the National Shrine Initiative.
    The Office of Inspector General will be expected to do more 
in the next fiscal year, and the committee will look to the 
Administration to provide sufficient funding for this vital 
operation.

                    CONSTRUCTION AND GRANT PROGRAMS

    For FY 2009, the VA received $1.9 billion for its 
Construction, Major Projects, Construction, minor Projects, 
Grants for Construction of State Extended Care Facilities, and 
Grants for Construction of State Veterans Cemeteries. The 
Independent Budget has recommended $2.3 billion for these 
accounts for FY 2010.
    The American Recovery and Investment Act of 2009, P.L. 111-
5, provided $1.4 billion in funding for the VA, including $150 
million for Grants for Construction of State Extended Care 
Facilities. The VA, for FY 2009, identified $434 million worth 
of Priority Group 1 projects. These projects have State 
matching funds in place. The FY 2009 appropriation of $175 
million and the $150 million provided in the Recovery Act would 
still require an additional $109 million to meet the total 
backlog in Priority Group 1 projects. A Funding level 
consistent with FY 2009 for this program would provide the $109 
million plus provide an additional $66 million for new 
projects.
    The Committee is hopeful that the Administration will 
request sufficient construction funding consistent with recent 
appropriations levels. The Committee looks forward to working 
with the Administration and the VA to better improve the VA's 
construction process and better enable the VA to provide the 
infrastructure needed to match current and future needs. The 
Committee also plans to work with the Administration and the VA 
to identify ways that VA can reduce energy consumption and 
costs and improve environmental sustainability.

                     SECTION 2--MANDATORY ACCOUNTS

    On March 10, 2009, Secretary Shinseki testified before the 
Committee to outline the Administration's request for FY 2010. 
The Secretary indicated that the VA's mandatory account 
requirements would necessitate $57 billion, an increase of $9.7 
billion, or 21 percent, over FY 2009 levels. The Committee is 
awaiting further details regarding this increase.
    The Committee believes that there are many benefits 
programs administered by the VA that are in need of 
modernization, and many that need increases in order to fulfill 
the original intent of the underlying legislation. The 
Committee will also look to work with the VA and veterans to 
consider major overhauls in the manner in which benefits claims 
are handled to make the claims process a model of fairness and 
efficiency. Many of these reforms and changes will require 
additional mandatory expenditures, at least in the short term.
    The Committee is cognizant of the need for fiscal restraint 
and the PAYGO requirements under the Rules of the House of 
Representatives to offset increases in mandatory spending, and 
plans on working with other committees, where appropriate, to 
improve benefits for veterans. The Committee encourages the 
Committee on the Budget to consider the creation of a reserve 
fund or other budgetary mechanism that may assist the Committee 
as it begins the process of examining ways in which to 
modernize the VA's disability claims system.

ADDITIONAL VIEWS AND ESTIMATES, COMMITTEE ON VETERANS' AFFAIRS, FISCAL 
                               YEAR 2010

    We agree with the Views and Estimates of the Committee on 
Veterans' Affairs Majority concerning the funding levels and 
priorities for veterans health and benefits programs and 
services for fiscal year 2010. We believe that with these 
recommendations, the President's budget will meet the needs of 
today's veterans and begin to address many of the more 
important challenges facing the Department of Veterans Affairs 
in the future.
    However, we believe there is one issue that is not 
sufficiently addressed, namely the vital need to reform the 
budget and appropriations process to ensure that veterans 
health care programs receive sufficient, timely, and 
predictable funding, not just today, but far into the future. 
While funding for veterans health care has increased 
significantly in recent years, we believe it is essential that 
the Committee remain dedicated to securing both adequate and 
timely funding for veterans health care.
    The services and operations of the Department of Veterans 
Affairs have continuously been hampered by a lack of 
predictable funding. In July 25, 2007, testimony to the Senate 
Committee on Veterans' Affairs detailed the operational 
difficulties consistently encountered by VA managers and 
officials due to the uncertainty of funding and resources.\2\ 
For too many years, the VA has had to make do with insufficient 
budgets resulting in restricted access for many veterans. We 
remain concerned that late and unpredictable funding for VA 
medical care programs will delay the provision of care, 
diminish the quality of service, and result in less efficient 
use of funds.
---------------------------------------------------------------------------
    \2\ Joseph M. Manley, VA Medical Center Director (Retired), Funding 
for VA Healthcare, Senate Committee on Veterans' Affairs, 110th 
Congress 1st Session, 25 July 2007.
    James W. Dudley, Mandated VA Funding, Senate Committee on Veterans' 
Affairs, 110th Congress 1st Session, 25 July 2007.
    Former VA Official's Perspective on VA Health Care Appropriations: 
Operational Difficulties and Political Demands, Senate Committee on 
Veterans' Affairs, 110th Congress 1st Session, 25 July 2007.
---------------------------------------------------------------------------
    The VA requires an assured source of funding in order to 
meet the demand for services and adequately maintain 
operational facilities. We conclude that the budget and 
appropriations processes for VA medical care programs can be 
significantly improved through advanced appropriations--a 
mechanism already utilized by the Committee on the Budget for 
select federal programs. Earlier this year, legislation was 
introduced, H.R. 1016, the Veterans Health Care Budget Reform 
and Transparency Act, which would authorize one-year advance 
appropriations for veterans medical care programs. An advance 
appropriation would provide the VA with up to a year in which 
to plan the most efficient and effective means to deliver care 
to an increasing number of veterans with increasingly complex 
medical conditions. The legislation would also improve the 
transparency of VA's budget forecasting process, in order to 
aid the Committee on the Budget and the Committee on 
Appropriations in future development of appropriation bills 
that provide sufficient funding to meet the best estimate of 
anticipated demand for veterans health care services.
    This legislation has been endorsed by virtually every major 
veterans and military service organization, including the four 
co-authors of The Independent Budget, the nine members of The 
Partnership for Veterans Health Care Budget Reform, and The 
Military Coalition, comprised of 35 military and veterans 
organizations. The legislation is also actively supported by 
the American Federation of Government Employees (AFGE). Advance 
appropriations have also been endorsed by two dozen former 
senior VA officials, regional and hospital directors, including 
former Secretary Anthony Principi, former Deputy Secretary 
Hershel Gober, and four prior Under Secretaries for Health, 
stretching back to 1994.
    Our recommendation is that the Committee on the Budget work 
with the Committee on Veterans' Affairs to secure advanced 
appropriations to ensure that VA budgets are not only 
sufficient, but are available when needed. We intend to 
collaborate with our colleagues on the Committee on Veterans' 
Affairs to consider and report this legislation authorizing 
advance appropriations, working toward Congressional approval 
and final enactment this year. We ask the Budget Committee to 
remove any obstacles in the budget resolution to allow advance 
appropriations for veterans medical care in FY2011. 
Specifically, Section 302 of the FY2009 Budget Resolution (S. 
Con. Res. 70) provided a general point of order against advance 
appropriations. However, the FY2009 Budget Resolution 
delineated a specific list of programs not subject to that 
point of order. We recommend that the budget resolution for 
FY2010 include language that separately exempts all three VA 
medical care accounts (Medical Services, Medical Support and 
Compliance, and Medical Facilities) from any point of order 
against advance appropriations for FY2011.

                                   Michael H. Michaud.
                                   Stephanie Herseth Sandlin.
                                   Harry E. Mitchell.
                                   John J. Hall.
                                   Harry Teague.
                                   Timothy J. Walz.

ADDITIONAL VIEWS AND ESTIMATES, COMMITTEE ON VETERANS' AFFAIRS, FISCAL 
                               YEAR 2010

    I write to submit an additional view into the record 
regarding the House Veterans Affairs Committee's Views and 
Estimates on the budget for FY 2010. The Committee's funding 
levels and priorities for veterans' health care display an 
unparalleled and long overdue commitment to the men and women 
who served our nation in uniform. However, I write to urge a 
greater commitment to mental health services, specifically in 
awarding veterans the compensation owed for the incurrence of 
Post Traumatic Stress Disorder.
    For too long we have heard the harrowing stories of 
soldiers returning for war, bearing the scars and wounds of 
battle, only to face an adversarial process in seeking 
treatment and compensation. This is especially true for 
soldiers who have Post Traumatic Stress Disorder. In the Iraq 
and Afghanistan wars alone, over 100,000 veterans have been 
diagnosed with PTSD. Tragically, however, only 42,000 have been 
granted service-connected disability for their condition.
    This is true for past conflicts as well. The disability 
claims backlog at the VA tops 800,000, a great majority of 
which are Vietnam Veterans seeking compensation for PTSD. These 
facts are a clear indication that current regulations at the VA 
are too stringent for veterans seeking disability benefits.
    Many veterans have lost faith in their government and 
elected officials because of the hoops they have to jump 
through at the VA as well as the presumption in current law 
that they are scamming the system. We must work to restore 
their trust.
    The main prohibitive factor to making the necessary changes 
is cost, which is why it is imperative that the budget allow 
for the resources to improve the system. CBO estimates that 
lowering the burdensome threshold that is currently denying 
veterans their urgently needed benefits would cost $4.7 billion 
over 10 years. While this may seem expensive, a RAND study has 
determined that the cost of untreated PTSD to our nation could 
total $6.2 billion over two years. In order to prevent this 
catastrophe, the budget needs to adequately fund the 
compensation that veterans have earned.
    There is consensus among veterans that we need to improve 
the way PTSD claims are handled; legislation to fix the problem 
has been endorsed by the American Legion, the VFW, DAV, 
Military Order of the Purple Heart, IAVA, and other VSOs.
    Addressing this issue in the budget would raise the profile 
of this need and publicly state to all those who serve their 
country that their government is indeed living up to its 
commitment to the men and women who sacrifice life and limb to 
defend it.
    Again, I want to state that the Obama Administration and 
the House Veterans Affairs Committee have both done a 
tremendous job in displaying their commitment to veterans. 
However, I recommend that the Committee on the Budget work with 
the Committee on Veterans' Affairs to secure the funding to 
address this urgent and growing need for mental health 
compensation.
            Sincerely,
                                                      John J. Hall.

                    REPUBLICAN LETTER OF TRANSMITTAL

                                ------                                

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                    Washington, DC, March 13, 2009.
Hon. John Spratt,
Chairman, Committee on the Budget,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: Pursuant to section 301(d) of the 
Congressional Budget Act of 1974, House Rule X, clause 4(f), 
and Rule 7 of the Rules of the Committee on Veterans' Affairs, 
I herewith submit to the Committee on the Budget the Views and 
Estimates of the Republican Members of the Committee on 
Veterans' Affairs regarding the Administration's fiscal year 
(FY) 2010 budget request for the Department of Veterans Affairs 
(VA) with regard to programs and matters within the 
jurisdiction of the Committee.
    The Republican Views and Estimates address the major areas 
of focus that are critical to fulfilling our nation's 
commitment to veterans. This document reflects our enduring 
priorities, which include: providing care to veterans with 
service-connected disabilities, those with special needs, and 
the indigent; ensuring a seamless transition from military 
service to VA; and providing veterans with every opportunity to 
lead full, healthy lives. As you are aware, the Administration 
is still developing the details its FY 2010 budget request. The 
budget summary it provided did not address the funding for any 
specific VA program or activity. Therefore, please note that in 
formulating the attached Views and Estimates, Republican 
Members of the Committee relied on FY 2009 appropriated amounts 
as a baseline for their recommendations.
    We look forward to working with our Committee's Majority 
Members as well as the Members of the Budget Committee to put 
forth a budget that will honor and enhance the lives of our 
nation's veterans, as well as remain fiscally responsible to 
the American taxpayer.
            Sincerely,
                    Steve Buyer, Ranking Republican Member; Cliff 
                            Stearns, Deputy Ranking Republican Member; 
                            Jerry Moran, Committee Member; Henry E. 
                            Brown, Jr., Ranking Republican Member, 
                            Subcommittee on Health; Jeff Miller, 
                            Committee Member; John Boozman, Ranking 
                            Republican Member, Subcommittee on Economic 
                            Opportunity; Brian P. Bilbray, Committee 
                            Member; Doug Lamborn, Ranking Republican 
                            Member, Subcommittee on Disability 
                            Assistance and Memorial Affairs; Gus M. 
                            Bilirakis, Committee Member; Vern Buchanan, 
                            Committee Member; David P. Roe, Ranking 
                            Republican Member, Subcommittee on 
                            Oversight and Investigations.

        REPUBLICAN VIEWS AND ESTIMATES FOR FISCAL YEAR (FY) 2010

                             March 13, 2009

                                OVERVIEW

    For veterans' healthcare and program costs in fiscal year 
(FY) 2010, the Republican Members of the Committee on Veterans' 
Affairs recommend $1.9 billion above the Administration's 
request for FY 2010. This represents a $550 million increase in 
discretionary spending and a $1.36 billion increase in direct 
spending for veterans' programs.
    The Republican Members further recommend out-year funding 
for veterans discretionary programs as follows: $58.4 billion 
for FY 2011, $63.6 billion for FY 2012, $68.7 billion for FY 
2013, and $72.8 billion for FY 2014, a total increase of $14.6 
billion over the Administration's projections. These more 
realistic estimates would adequately fund VA for the five year 
period, assuming medical inflation of 2.6% and increased 
workloads due to the restoration of health care eligibility for 
many priority 8 veterans, the drawdown in Iraq, and increased 
demand for VA health care from the economic downturn. We 
believe the Administration's out-year funding projections would 
result in serious budget shortfalls for veterans' healthcare.
    The Administration's budget submission contains only a 
request for overall levels of funding for the Department of 
Veterans Affairs (VA), and a detailed request for FY 2010 will 
not be submitted to Congress until sometime in April. 
Consequently, an in-depth analysis of the Administration's 
budget request is not possible at this time, and these views 
and estimates may be subject to revision when more information 
is available from VA. We recommended increases for the specific 
accounts use FY 2009 appropriated funding levels as a baseline.

                     DEPARTMENT OF VETERANS AFFAIRS

                    Veterans Benefits Administration

    Disability Compensation and Pension Service--The Republican 
Members are deeply concerned about the growing size of the 
backlog of claims for disability compensation. Despite large 
increases in staffing at the compensation and pension service 
(C&P), the backlog of pending claims continues to grow. There 
must be greater emphasis on training and accountability with 
new employees. Because rating specialists require an average of 
two years before becoming fully productive, comprehensive 
training is crucial. Therefore, the Republican Members 
recommend an additional $16 million for Training and 
Performance Support Systems, and an additional $4 million for 
skills certification for C&P employees as described in P.L. 
110-389. The Republican Members also recommend at least an 
additional $2.5 million to fund 30 additional FTEE for VBA's 
National Training Academy in Baltimore, Maryland.
    The Republican Members recognize that additional direct 
compensation FTEE alone will not improve the quality, accuracy, 
consistency, and timeliness in claims processing without 
corresponding increases in quality checks and business 
processing improvement. Therefore, we make the following 
recommendations to address this issue:
          Systematic Technical Accuracy Review (STAR) Reviews--
        STAR reviews are one of many ways that VBA reviews the 
        quality of their rating decisions. Despite the recent 
        increase in the number of STAR reviews, Republican 
        Members believe that too much emphasis continues to be 
        placed on just quantity rather than on both quality and 
        production. Deciding claims correctly the first time 
        should be the emphasis, even if the initial 
        adjudication period is somewhat longer. We recommend at 
        least additional $8 million to increase the number of 
        STAR reviews and the FTEE that conduct STAR training at 
        regional offices.
          Rules Based Paperless Adjudication System--Additional 
        staffing and training will not alone reduce the 
        backlog. VBA plans to enhance its use of information 
        technology to enhance claims processing abilities. They 
        have begun this by funding a paperless claims 
        processing initiative, known as Virtual VA, which will 
        reduce reliance on burdensome paper claims files. 
        Additionally, VBA must utilize rules-based technology 
        to help claims adjudicators make rating decisions in a 
        more accurate and timely manner. To replace the 
        complicated, paper-driven process that is more than 
        twenty-five years old, the Republican Members support 
        such an initiative. This reflects our long-held 
        position favoring increased use of information 
        technology, and we recommend at least an additional 
        $170 million to fund this initiative.
          Veterans Choice in Filing Pilot Program--The 
        Republican Members also recommend $5 million for a two-
        year pilot program in which veterans who live in the 
        jurisdiction of VA regional offices in New York, New 
        York; Newark, New Jersey; Atlanta, Georgia; and 
        Detroit, Michigan would be able to submit disability 
        claims to any VA regional office for adjudication. This 
        pilot program would allow veterans to have their claims 
        adjudicated at a VA regional office with a favorable 
        performance record.
          Concurrent Receipt--The Administration's budget 
        request proposes concurrent receipt for veterans who 
        are medically retired and eligible for VA disability 
        compensation. The Republican Members support 
        eligibility for concurrent receipt of disability 
        benefits from VA in addition to Department of Defense 
        retirement benefits.
    Economic Security Programs--The GI Bill and the VA 
Vocational Rehabilitation and Employment (VR&E) program are 
designed to ultimately lead to gainful employment and 
productive lives for those veterans who are able to work. The 
VA Loan Guaranty program is designed to enable veterans to be a 
part of the American ideal of home-ownership, and VA insurance 
programs provide survivors with a measure of financial 
security. The VA Specially Adapted Housing and Adapted Auto 
grants provide severely disabled veterans increased mobility in 
and out of the home and for many severely disabled veterans 
make it possible for them to continue their working careers.
    Increase in Vocational Rehabilitation Stipend--We must 
improve education and training opportunities for unemployed 
veterans to provide them with skills relevant to today's job 
market. We recommend $357 million to allow an increase in the 
basic VR&E subsistence allowance from $541 to $1,200 per month. 
H.R. 297, to increase the VR&E subsistence allowance, would 
authorize such an increase to provide an adequate allowance for 
veterans and their families during participation in the 
program.
    Re-authorize the VA Small Business Loan Program--Because 
small business creates the vast majority of jobs, we recommend 
reauthorization of VA's expired small business loan guaranty 
program with sufficient resources to guarantee $1 billion in 
new loans to veteran-owned small businesses. H.R. 294, the 
Veteran-Owned Small Business Promotion Act of 2009, would 
authorize an updated small business loan guarantee. We also 
recommend $400,000 in funding to support an additional 5 FTEE 
to manage the program, which would be operated under contract 
in a manner similar to VA's Insurance programs.
    Improve SAH Funding--To improve the lives of severely 
injured veterans, we recommend that the Specially Adapted 
Housing (SAH) grants be increased to $180,000 and $36,000 
respectively and the Adapted Auto grant should be increased to 
$33,000. H.R. 1169, to improve Specially Adapted Housing, would 
authorize the increases.
    Develop Assistive Technologies--We also recommend 
sufficient resources for the medical care account to include a 
grant program that would provide $2 million per year to 
encourage development of advanced assistive technologies for 
the SAH program proposed in H.R. 1170, to develop assistive 
technologies for specially adapted housing.
    Economic Opportunity Administration--The Republican Members 
believe that we should shift management of programs that 
promote economic security to a separate VA administration. 
Therefore, we recommend a budget with sufficient resources to 
create a fourth administration, the Veterans Economic 
Opportunity Administration, within the VA to manage the 
education, vocational rehabilitation and employment, loan 
guaranty, small business and homeless programs. Other than 
those related to the initial startup, there would not be 
significant costs to establish the new administration and it 
would not expand the federal bureaucracy.

                National Cemeteries and Related Agencies

    Four departments or agencies within the Federal Government 
maintain the final resting place of veterans and dependents. 
These are the VA's National Cemetery Administration (NCA), 
which has jurisdiction over 125 national cemeteries; the 
American Battle Monuments Commission, which has jurisdiction 
over 25 overseas military cemeteries; the Department of the 
Army, which has jurisdiction over Arlington National Cemetery 
and the United States Soldiers and Airman's National Cemetery; 
and the Department of Interior, which has jurisdiction over 
historic 14 veteran cemeteries. Republican Members are 
concerned that with four different agencies overseeing these 
cemeteries, there are four different standards of upkeep and 
appearance.
    To improve the overall upkeep and appearance at all our 
veterans' final resting places, we recommend a National Shrine 
Commitment for all veteran cemeteries. The funding from the 
commitment would be used on infrastructure projects such as 
irrigation improvements, renovation of historic structures, 
headstone cleansing, and road resurfacing. We recommend at 
least an additional $300 million to continue the National 
Shrine Commitment at NCA. Additionally, we recommend at least 
$3 million to fund a comprehensive and independent study of the 
cemeteries under the jurisdiction of other agencies besides 
NCA. This study would help identify areas that need to be 
improved to ensure the final resting place of all veterans is 
maintained in a manner that honors their sacrifices for our 
country. The Republican Members also recommend that the two 
open cemeteries under the jurisdiction of the National Parks 
Service be moved to the jurisdiction of the National Cemetery 
Administration and recommend at least $4 million for such a 
move.
          NCA Major Construction and Gravesite Expansion--The 
        Republican Members recommend at least an additional 
        $125 million to accelerate NCA's five-year strategic 
        plan to fund gravesite expansion. Republican Members 
        also recommend at least an additional $10 million for 
        land acquisition construction initiative. This program 
        provides the flexibility NCA needs to purchase land for 
        future national cemeteries when it becomes available.
          Grants for the Construction of State Cemeteries--The 
        Republican Members also recommend an additional $10 
        million for grants for the construction of state 
        cemeteries. This program provides funding to states to 
        build national cemeteries and requires that the state 
        then pay all operation and maintenance costs once the 
        cemetery is built. The program continues to have a 
        waiting list and additional funding would provide 
        better access to veterans cemeteries for veterans and 
        their families.

                     Veterans Health Administration

    Medical Services--The Republican Members recommend $35.3 
billion for medical services which is $4.3 billion above the 
enacted FY 2009 amount for this account. This increase accounts 
for healthcare inflation, estimated workload, and the following 
initiatives:
          Rural Health Care--We recommend at least a $605 
        million increase to implement section 403 of Public Law 
        110-387 which establishes a three-year pilot program in 
        five Veterans Integrated Service Networks (VISNs) for 
        veterans in highly rural areas who elect to receive 
        healthcare from non-VA healthcare providers;
          Prosthetic Limb Program Modernization--We recommend 
        at least a $100 million increase to modernize VA's 
        prosthetic limb program, especially to meet the needs 
        of the younger and more active amputees with the latest 
        technology. It is vitally important that VA is capable 
        of providing consistent and coordinated state-of-the-
        art care regardless of where the veteran amputee lives;
          Mental Health Initiatives--We recommend at least a 
        $250 million increase to support the progress being 
        made to implement the Mental Health Strategic Plan and 
        hire additional new mental health professionals to 
        ensure all veterans have access to these vital services 
        at all VA medical centers and clinics throughout the 
        system;
          Military Vision Centers of Excellence and Eye Trauma 
        Registry--We recommend at least a $9 million increase 
        for VA's participation in the establishment of these 
        joint Department of Defense/VA centers and the eye 
        trauma registry;
          Caregiver Assistance--We recommend at least a $25 
        million increase to expand current programs to support 
        family caregivers and respite services under VA's Home 
        Health Care services;
          Home Improvement Structural Alterations (HISA) 
        Grants--We recommend a $5.5 million increase for a 
        pending legislative change that would raise the maximum 
        amount of the grants to $6,800 for service-connected 
        veterans and $2,000 for non-service connected veterans;
          Health Professional Educational Assistance Program--
        We recommend a $25 million increase to provide 
        scholarships to employees pursuing degrees or training 
        in health care disciplines for which recruitment and 
        retention of qualified personnel is difficult. We 
        expect this additional funding to include support for 
        the recruitment and retention of mental health care and 
        other staff in rural settings;
          Medical Care Collections Fund--According to the 
        Congressional Research Service and VA budget data, 
        medical care collections have fallen significantly 
        under projections in four of the past five years for an 
        average shortfall of 21%. While there was a 6% 
        improvement for FY 2008, the Republican Members are 
        concerned that VA will fall considerably short of 
        meeting the ambitious 33% increase in collections 
        projected in the Administration's FY 2010 budget 
        request. Therefore, we recommend a $536 million 
        increase in medical services to ensure adequate funding 
        will be available to support quality and timely health 
        care for veterans;
          CPAC Collections Program--The Republican Members 
        recommend that the VA compress the five year timeline 
        to three years for initiating seven Consolidated 
        Patient Accounting Centers (CPAC). We appreciate VA 
        Secretary Shinseki's willingness to consider this 
        proposal. We support compressing the implementation 
        timelines and reprioritizing the order of establishing 
        the CPAC regions to three years in order to improve 
        third-party collections and to maximize collections 
        potential. We also support funding for the facilities, 
        IT equipment, and personnel necessary for the 
        consolidations.
    Possible Administration Legislative Proposal--The 
Republican Members are very concerned about a proposal the 
Administration is considering to bill third-party insurers of 
service-connected veterans for the treatment of their 
disability or injury incurred in the line of duty. We strongly 
believe that the same military values that guided these 
servicemembers in service to our country should define how our 
government provides services and assistance to them now as 
veterans. The prospect of VA collecting from third-party 
insurers for care provided for service-connected conditions is 
contrary to these military values and our obligation as a 
grateful Nation. In addition, such action could result in 
higher health care premiums and have the effect of requiring 
service-connected veterans to pay for their own care. We intend 
to protect and honor the service of our highest priority 
veterans with the investment of tax dollars adequate to provide 
for all service-connected care and we strongly oppose any 
attempt to allow VA to offset this absolute obligation with 
collections from private insurers.
    Medical Facilities--The Republican Members recommend at 
least $5.179 billion for medical facilities which is $150 
million above the enacted FY 2009 amount for this account.
          Energy Initiatives--We recommend at least a $150 
        million increase to implement planned energy 
        initiatives and establish a long-term strategy for 
        energy conservation and sustainability. This includes 
        selected energy and water conservation measures, 
        conducting renewably fueled electric/steam generation 
        feasibility studies, and installing building level 
        electric meters in medical facilities;
    Medical and Prosthetic Research--We place a high premium on 
conducting research into injuries and illnesses related to 
military service that improves the medical treatment of 
veterans. We recommend at least $51 million above the $510 
million enacted for this account in FY 2009.
    VHA Major Construction Projects--We recommend at least $1 
billion, which is $182 million above the FY 2009 level, to move 
forward with advance planning, completion of partially funded 
FY 2009 projects and to begin new projects on VA's prioritized 
list. The recommended amount for the advance planning fund is 
$178.1 million and includes $36.8 million to carry out section 
804 of Public Law 109-461 for the design of a co-located joint-
use medical facility in Charleston, South Carolina.
    VHA Minor Construction Projects--We recommend at least 
$691.3 million, which is $66.06 million above the FY 2009 
level. The increase includes funding for the installation of 
solar photovoltaic roof applications at medical facilities in 
coordination with other energy initiatives.

                  Office of Information and Technology

    The Republican Members believe that a top VA priority 
should be information technology (IT) systems that are 
standardized, integrated, secure, function properly, and should 
be funded sufficiently. We commend VA Secretary Shinseki for 
his support of continuing the consolidation of the department's 
IT infrastructure and funding. VA must increase funding to 
accelerate its migration of Veterans' Health Information System 
of Technology Architecture (VistA) into VA's new integrated 
enterprise health care system. The new system needs to 
incorporate data standards that allow data sharing with other 
federal departments and agencies and also with private and 
public sector organizations. More importantly, VA and the 
Department of Defense (DoD) must be able to exchange critical 
medical and personnel information on all patients transitioning 
from DoD to VA. This information exchange must be done securely 
in real time, bi-directionally, and interoperably.
    All VETSNET application development should be finalized and 
any further funding should be limited to final code conversion 
and operations and maintenance. VA should immediately begin to 
move beyond this 20-year old project to automate compensation 
and pension claims processing system.
    Financial and Logistics Integrated Technology Enterprise 
(FLITE) is the follow-on to the failed Core-FLS system. It is 
essential that VA has an enterprise wide system that integrates 
financial management, asset management, logistics, accounting, 
purchasing, funds control, real property and inventory 
management. Funding levels should be sufficient to continue its 
implementation timelines. This program has been plagued with 
poor program management and dysfunctional procurements which 
need to be strengthened.
    Virtual VA is a paperless delivery system that was 
conceptualized and demonstrated in 1999 as a VBA initiative to 
image all documents related to claims processing and benefits 
delivery. The serious document shredding incidents in various 
Regional Offices in 2008 reiterate the importance of 
electronically capturing all documents at the time of receipt. 
An additional $170 million has been recommended under the 
compensation and pension service section.

                    Office of the Inspector General

    For FY 2009, Congress appropriated $72.5 million for the VA 
Office of the Inspector General (OIG). The OIG is responsible 
for the audit, investigation, and inspection of all VA programs 
and operations. Funding from appropriations at $107 million and 
537 FTEE provides resources to increase work on several 
oversight initiatives. These include expansion of the 
Consolidated Financial Statement (CFS) and Federal Information 
Security Management Act (FISMA) audits as well as expansion of 
OIG oversight in two sensitive and vulnerable VA program 
areas--health care for returning Operation Enduring Freedom and 
Operation Iraqi Freedom (OEF/OIF) veterans and VA information 
technology (IT). OIG has recently begun cyclical inspections of 
VBA regional offices, all of which are in critical need of OIG 
oversight. For the 3-year cycle necessary to cover the 57 
regional offices, the Republican Members recommend an 
additional $5 million to resource a second field division of 20 
FTEE for this purpose with a special emphasis on claims 
processing. The total funding for the OIG recommended by the 
Republican Members is at least $112 million, $39.5 million 
above the FY 2009 level.

                          DEPARTMENT OF LABOR


               Veterans' Employment and Training Service

    In the past, an economic downturn or industrial evolution 
has displaced significant numbers of mid-career workers, making 
their skills irrelevant in the labor market. Such is the case 
today as the U.S. economy weakens and labor demands shift to 
new or expanding sectors. Therefore, the Republican Members 
recommend funding the Veterans Workforce Investment Program 
(VWIP) at a level of at least $20 million. H.R. 295, More 
Training for Veterans Act of 2009, would authorize this 
funding. The VWIP program focuses on employment and training 
services to veterans needing new skill sets.
    We also recommend funding a new retraining program managed 
by VETS at the level of $100 million and an additional $400,000 
to support 5 additional FTEE as proposed in H.R. 1168. The 
program would include relocation assistance to ensure 
unemployed veterans are able to move to areas where their new 
job skills are in demand.
    The number of homeless veterans has been a persistent 
national problem and reducing the number of the homeless 
veterans has been difficult. But there has been modest 
progress. Increasingly, homeless veteran community includes 
veterans with dependent children; therefore, we recommend an 
additional $10 million for HVRP grants to providers who focus 
on services to homeless veteran families including family-style 
housing. We will also seek legislation to extend the current 
HVRP authorization through FY 2014 and urge the Budget 
Committee to include funding at the full authorized $50 million 
per year.

                         DEPARTMENT OF DEFENSE


                         Department of the Army

    Improvements at Arlington National Cemetery--While 
recognizing that Arlington National Cemetery (ANC) is funded 
through the Department of the Army budget, ANC is a national 
cemetery over which the Committee on Veterans' Affairs has 
oversight. In order to ensure that this national shrine 
continues to have adequate capacity well into the future, the 
Republican Members recommend at least $60.3 million for 
gravesite and columbarium expansion and utility improvements at 
ANC.
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