[House Prints 111-4]
[From the U.S. Government Publishing Office]


111th Congress 
 2nd Session          HOUSE COMMITTEE PRINT NO. 4

_______________________________________________________________________

                                     


                                 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 2011




[GRAPHIC NOT AVAILABLE IN TIFF FORMAT] 



   March 5, 2010.--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 5, 2010.
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, clause 4(f) of Rule X of the 
Rules of the House of Representatives, 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 2011. 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 obligation of our national defense. As a Congress, 
and a Nation, we must fulfill our promises to the men and women 
who have served. Working together, we can ensure 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 2011

                             March 5, 2010

                   SECTION 1--DISCRETIONARY ACCOUNTS

                     DEPARTMENT OF VETERANS AFFAIRS

    The Committee \1\ recommends $57.537 billion for the 
discretionary accounts of the Department of Veterans Affairs 
(VA) for FY 2011. This recommendation is $4.5 billion, or 8.5 
percent, above the FY 2010 level of $53.039 billion, and $571 
million above the Administration's FY 2011 request of $56.966 
billion.
---------------------------------------------------------------------------
    \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.
---------------------------------------------------------------------------
    This year marks the first budget submission after the 
enactment of P.L. 111-81, the Veterans Health Care Budget 
Reform and Transparency Act of 2009, which mandated that the 
Administration's budget request include amounts for the 
following fiscal year for VA medical care accounts. The 
Consolidated Appropriations Act of 2010, P.L. 111-117, enacted 
on December 16, 2009, for the first time included $48.2 billion 
in advance appropriations for VA medical care for FY 2011. For 
FY 2012, the Administration has requested $50.6 billion for VA 
medical care for FY 2012. This amount, along with an estimated 
$3.7 billion in collections would provide a total resource 
level of $54.3 billion for VA medical care, a $2.8 billion 
increase above amounts provided for FY 2011.
    For FY 2011, the Administration estimates that it will 
obtain $3.4 billion in medical collections, for a total VA 
medical care resource level of $51.5 billion. This is $4.3 
billion, or 9.1 percent, above FY 2010 levels. The Committee 
notes that the VA's current estimate for FY 2010 collections is 
$72 million more than the amount assumed in the FY 2010 
Consolidated Appropriations Act and is confident that the VA's 
estimate for FY 2011 can be matched or exceeded.
    The Independent Budget, co-authored by AMVETS, Disabled 
American Veterans, Paralyzed Veterans of America, and the 
Veterans of Foreign Wars has recommended a total resource level 
of $52 billion for VA medical care. The Independent Budget has 
also requested that this sum be fully appropriated and is 
silent as to how third-party collections should be utilized in 
providing resource to the VA. The Independent Budget has not 
made any recommendations regarding FY 2012 medical care 
funding.
    Although the Committee is not recommending medical care 
funding levels for FY 2012, the Committee believes that the 
Administration's request is consistent with a current services 
estimate, and plans to work closely with the Administration and 
other committees as the appropriations process moves forward to 
ensure that FY 2012 funding accurately reflects the resource 
requirements facing the VA on October 1, 2011.


                                   VA Medical Care Accounts (FY 2010-FY 2012)
----------------------------------------------------------------------------------------------------------------
                                                                                        President's Request
                        ($ in thousands)                              FY 2010    -------------------------------
                                                                                    FY 2011 \1\       FY 2012
----------------------------------------------------------------------------------------------------------------
Medical Services                                                    $34,707,500     $37,136,000     $39,649,985
----------------------------------------------------------------------------------------------------------------
Medical Support and Compliance                                       $4,930,000      $5,307,000      $5,535,000
----------------------------------------------------------------------------------------------------------------
Medical Facilities                                                   $4,859,000      $5,740,000      $5,426,000
----------------------------------------------------------------------------------------------------------------
Total, Medical Care                                                 $44,496,500     $48,183,000     $50,610,985
----------------------------------------------------------------------------------------------------------------
Medical Care Collections Fund                                        $2,954,000      $3,355,000      $3,679,000
 
  (non-add) \1\
----------------------------------------------------------------------------------------------------------------
Total, Medical Care with Collec-                                    $47,450,500     $51,538,000     $54,289,985
 
  tions (non-add)
 
----------------------------------------------------------------------------------------------------------------
\1\ On December 16, 2009, the Consolidated Appropriations Act of 2010 was signed into law. Division E of this
  Act included appropriations for the Department of Veterans Affairs (VA). This included VA funding for FY 2010,
  as well as advance appropriations for the VA medical care accounts in FY 2011. The President's Budget request
  for FY 2011 reflects the same amounts appropriated for 2011 in the Consolidated Appropriations Act of 2010.


    For medical care, the Administration's FY 2011 budget 
request, submitted on February 1, 2010, requested no additional 
funding above the amounts provided in the FY 2010 Consolidated 
Appropriations Act. The Committee recommends an additional $221 
million be added to the Medical Facilities account to support 
non-recurring maintenance requirements. The Committee also 
recommends increases for the Medical and Prosthetic Research, 
General Operating Expenses, Office of Inspector General, Minor 
Construction, Grants for Construction of State Extended Care 
Facilities, and Grants for Construction of State Veterans 
Cemeteries accounts.
    The Committee believes that the Administration's request 
and the additional resources recommended by the Committee will 
enable the VA to meet the wide-ranging health care needs of our 
veterans, begin to address the disabilities claims backlog, and 
improve the administration of non-medical benefits claims such 
as the Post-9/11 GI bill. While the Committee will tirelessly 
advocate for the resources to enable the VA to meet its 
responsibilities to our veterans, the Committee remains 
cognizant that taxpayer dollars are scarce and that we must 
ensure that VA spends resources wisely. The Committee is 
proposing increased funding levels for the Office of Inspector 
General to assist in these efforts. The Committee has 
recommended increases for the VA's construction accounts and 
remains committed to ensuring that VA infrastructure is 
sufficient to deliver the highest quality health care to 
veterans.

----------------------------------------------------------------------------------------------------------------
 
----------------------------------------------------------------------------------------------------------------
Additional Funding Requirements
 
  Should Congress consider additional stimulus, supplemental, or emergency spending, especially as relating to
our current economic crisis, the Committee will seek additional funding to address VA's long-standing
construction and facilities backlog. These projects, which have been identified, would not only improve health
care and access to veterans but bolster employment opportunities throughout the Nation. The Committee could seek
an additional $700 million to fund the following:
 
                                        Non-Recurring Maintenance (NRM)              $400 million
                                        Minor Construction                           $200 million
                                        Major Construction                           $100 million
                                       ------------------------------------------------------------------
                                        Total                                        $700 million
 
  The VA has a large portfolio of capital assets, which consists of about 5,500 buildings and almost 34,000
acres of land. The VA monitors the condition of these facilities and according to the December 2009 Facility
Condition Assessment Status Report, the VA estimates that $9.4 billion is needed to correct all of the
deficiencies and to upgrade the condition of VA facilities. The situation is particularly bleak for the VA
research infrastructure because they must compete with the facility upgrade needs of the VA medical center.
Currently, the VA is in the process of reviewing the research infrastructure needs and by the end of FY 2009, 53
sites have been surveyed with about 20 sites that are waiting to be assessed in FY 2010. To date, the estimated
funding needed to improve the research infrastructure exceeds $570 million. Of this, about 44 percent or about
$250 million are priority 1 deficiencies where corrections are needed to resume normal operations, halt
accelerated deterioration, replace items that are at or beyond their useful lifecycle, and correct life and
safety hazards. The Committee recommendation of $400 million will help the VA focus on the non-recurring
maintenance backlog.
  In addition to addressing the repairs and maintenance needs of existing capital assets, the VA requires
significant investments to fully fund the capital projects that are in development. For example, the FY 2011
budget for VA major construction identifies 21 partially funded projects from prior years. An additional $4.5
billion is needed to complete these projects, but the FY 2011 budget only requests $790 million to fund just
three of the 21 projects. This means that approximately $3.7 billion remains to be funded in the out-years. The
budget also prioritizes newly scored major construction projects submitted in the FY 2011 planning cycle. There
were 61 such projects requiring $8.4 billion. Of this, the VA only requests partial funding for two newly scored
projects amounting to $73 million. The Committee recommends $200 million and $100 million for minor and major
construction respectively, so that the VA can fund additional projects. With the additional funding, the VA can
improve access to VA health care, including funding additional Community Based Outpatient Centers (CBOCs) so
that more veterans can receive medical care closer to their homes.
----------------------------------------------------------------------------------------------------------------



                                      Veterans Health Administration (VHA)
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                                                          FY 2011
                                                          FY 2011         FY 2011        Committee     Recommen-
                                          FY 2010     Administration    Independent       Recom-      dation vs.
                                                          Request       Budget  \1\      mendation      Request
----------------------------------------------------------------------------------------------------------------
Medical Services                        $34,707,500     $37,136,000     $40,940,954     $37,136,000          $0
----------------------------------------------------------------------------------------------------------------
Medical Support                          $4,930,000      $5,307,000      $5,314,595      $5,307,000          $0
 
  & Compliance
----------------------------------------------------------------------------------------------------------------
Medical Facilities                       $4,859,000      $5,740,000      $5,706,507      $5,961,000    $221,000
----------------------------------------------------------------------------------------------------------------
Total, VA                               $44,496,500     $48,183,000     $51,962,056     $48,404,000    $221,000
 
  Medical Care
----------------------------------------------------------------------------------------------------------------
MCCF Collections                         $2,954,000      $3,355,000                      $3,355,000          $0
----------------------------------------------------------------------------------------------------------------
Total, VA                               $47,450,500     $51,538,000     $51,962,056     $51,759,000    $221,000
 
  Medical Care
  (with Collections)
----------------------------------------------------------------------------------------------------------------
Medical and                                $581,000        $590,000        $700,000        $650,000     $60,000
 
  Prosthetics
  Research
----------------------------------------------------------------------------------------------------------------
Total, Veterans                         $48,031,500     $52,128,000     $52,662,056     $52,409,000    $281,000
 
  Health Ad-
  ministration
 
----------------------------------------------------------------------------------------------------------------
\1\ The Independent Budget includes amounts attributable to medical care collections in its base funding level
  for the Medical Services Account.


    VA medical care consists of the Medical Services, Medical 
Support and Compliance, and Medical Facilities accounts. 
Funding for the Veterans Health Administration includes the 
medical care accounts, and the Medical and Prosthetic Research 
account. Other VA accounts, such as Information Technology 
Systems and the construction accounts assist the VHA in 
operating the largest integrated health care system in the 
Nation.
    The Committee recommends $48.4 billion for VA medical care, 
which is $221 million above the Administration's FY 2011 budget 
request of $48.2 billion. When medical collections are 
included, the Committee recommends $51.8 billion in total 
available resources for VA medical care. This level is $200 
million lower than the amount recommended by the Independent 
Budget.
    For VA Medical and Prosthetic Research, the Committee 
recommends an appropriated level of $650 million, $69 million 
above FY 2010 and $60 million above the Administration's 
request of $590 million.


                                                Medical Services
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request          Budget \1\        mendation        Request
----------------------------------------------------------------------------------------------------------------
$34,707,500                                      $37,136,000      $40,940,954      $37,136,000               $0
 
----------------------------------------------------------------------------------------------------------------
\1\ The Independent Budget includes amounts attributable to medical care collections in its base funding level
  for the Medical Services Account.


Description \2\
    This account provides for medical services of eligible 
veterans and beneficiaries in VA medical centers, outpatient 
clinic facilities, contract hospitals, State homes, and 
outpatient programs on a fee basis. Hospital and outpatient 
care is also provided by the private sector for certain 
dependents and survivors of veterans under the civilian health 
and medical programs for the VA.
---------------------------------------------------------------------------
    \2\ Account descriptions are adapted from H. Rept. 111-188, to 
accompany H.R. 3082, the Military Construction, Veterans Affairs, and 
Related Agencies Appropriations Bill, 2010.
---------------------------------------------------------------------------
Recommendation
    For FY 2011, the Administration requests $37.1 billion for 
the Medical Services account, an increase of $2.4 billion or 7 
percent above the FY 2010 level.
    The Committee supports the funding level requested by the 
Administration. This funding has been provided in the FY 2010 
Consolidated Appropriations Act. The Committee is confident 
that this level will provide sufficient resources to enable the 
VA to provide high quality health care to veterans and to 
address many of the priorities shared by the Committee and the 
Administration. Some of these priorities include:

          Mental Health--The Administration's budget request 
        will enable the VA to expand key programs for post-
        traumatic stress disorder (PTSD) and traumatic brain 
        injury (TBI), as well as the diagnosis and treatment of 
        depression, substance abuse and other mental health 
        problems. The Committee acknowledges the VA's robust 
        investments in mental health; however, addressing 
        mental health issues continues to be a challenge. This 
        is evidenced by the rising rates of suicide, 
        incarceration, and homelessness among our veterans. The 
        Committee believes that the VA must not only expand 
        existing efforts but also must explore new evidence-
        based initiatives with a proven track record for 
        yielding positive program results.
          Homeless Veterans--It is estimated that about one-
        third of the adult homeless population served the 
        country in the Armed Services. The current population 
        estimates suggest that over 130,000 veterans are 
        homeless on any given night and twice as many 
        experience homelessness at some point during the course 
        of the year. Homelessness is also a growing problem for 
        our veterans returning from Iraq and Afghanistan, 
        especially as they as they face higher rates of PTSD 
        and TBI.
          The Committee applauds the VA's commitment to ending 
        homelessness among our veterans. In addition to the 
        various homeless proposals in the FY 2011 budget, the 
        Committee encourages the VA to continue to increase 
        resources dedicated to homeless prevention. While it is 
        important to offer transitional housing and supportive 
        services through such existing programs, it is equally 
        important to make proper investments in preventing 
        homelessness. The Committee recommends that initiatives 
        to end homelessness not be targeted solely to the VHA, 
        but also include the Veterans Benefits Administration 
        (VBA) in coordinating the range of benefits available 
        through the VA. This may include opportunities to 
        obtain education and counseling along with other key 
        benefits which may aid in preventing homelessness among 
        our veterans.
          Women Veterans--Today, there are approximately 1.7 
        million women veterans, or 7 percent of the nearly 25 
        million veterans. Assuming current enrollment rates, 
        the number of female veterans who utilize the VA system 
        will double in the next 5 years, making female veterans 
        one of the fastest growing subgroups of veterans.
          The Committee recognizes the VA's efforts to improve 
        health care for women veterans, which includes 
        proposals to institute a new peer call center and a 
        social networking site. In addition to these efforts, 
        the Committee encourages the VA to identify and study 
        the unique challenges and barriers that women veterans 
        face when seeking health care through the VA. This 
        would assist the VA in taking the necessary steps to 
        improve health care for women veterans. The Committee 
        notes that H.R. 1211, the Women Veterans Health Care 
        Improvement Act, passed the House of Representatives 
        last year.
          Among the provisions in the bill, the VA would be 
        required to conduct a barriers study, offer child care, 
        and provide time-limited medical care for newborn 
        children of women veterans receiving maternity care.
          The Committee encourages the VA to explore new 
        innovative ways of expanding access and improving the 
        quality of medical care provided to women veterans. The 
        Committee also urges the VA to develop and follow a 
        long-term plan for ensuring that women veterans receive 
        health care that is equal to what male veterans receive 
        through the VA as the VA looks toward the future of 
        providing quality health care to all of our veterans.
          Rural Veterans--Of the almost 8 million veterans who 
        are enrolled in the VA health care system, about 3 
        million, or almost 40 percent, live in rural areas. The 
        Committee concurs with the VA's proposed investments in 
        rural outreach, which include expanded use of home-
        based primary care and mental health care along with 
        technology-based solutions, including the VA's 
        telehealth and telemedicine efforts. Additionally, the 
        Committee believes that the VA must work to strengthen 
        the role and influence of the Office of Rural Health so 
        that it can work to coordinate and improve health care 
        for enrolled rural veterans and disseminate best 
        practices.
          OEF/OIF (Operation Enduring Freedom/Operation Iraqi 
        Freedom) Veterans--In order to improve the VA's budget 
        estimation capabilities and better forecast workload 
        and demand, the Committee urges the VA to work with the 
        Department of Defense to facilitate timely information 
        exchange on the number of returning OEF/OIF 
        servicemembers. Working more closely with the 
        Department of Defense is even more crucial as 
        additional troops are sent overseas and the VA works to 
        update budget projection models to properly reflect 
        current force levels.
          The Committee recognizes the challenges of projecting 
        medical care costs for OEF/OIF veterans given the range 
        and types of health care services sought by our newest 
        veterans. Some OEF/OIF veterans may only use VA 
        occasionally for pharmacy benefits while others use VA 
        extensively for treatment of catastrophic war injuries. 
        VA's capability to accurately predict health care costs 
        and demand for our newest veterans has a direct impact 
        upon the VA's ability to provide health care to all of 
        our veterans and the Committee encourages the VA to 
        work towards more accurate per unit medical care cost 
        projections for OEF/OIF veterans by refining their 
        projection models.
          Priority Group 8 Veterans--The VA expects to enroll 
        more than 500,000 previously ineligible veterans into 
        Priority Group 8 by FY 2013. Recent estimates also show 
        that the VA will enroll about 193,000 veterans by the 
        end of FY 2010. The Committee encourages the VA to 
        improve outreach plans and work with veterans' groups 
        as the VA works to undue the ban enrollment ban put in 
        place in 2003.
          Caregivers--Because the VA does not collect data on 
        this population, the number of family members and 
        friends who provide care for veterans is unknown. 
        However, a July 2007 report released by the President's 
        Commission on Care for America's Returning Wounded 
        Warriors (the Dole-Shalala Commission) found that of 
        the 1,730 injured OEF/OIF veterans surveyed, about 21 
        percent of active duty, 15 percent of the reserve, and 
        24 percent of retired or separated servicemembers had 
        friends or family who gave up a job to be the 
        caregiver. As caregivers continue to play an important 
        role as caretakers of veterans, the VA lags in offering 
        supportive services for these caregivers.
          The Committee commends the VA for recognizing the 
        plight of caregivers by submitting several legislative 
        proposals to help caregivers in the FY 2011 budget. 
        These include providing health care, education, and 
        training for caregivers, as well as paying for the 
        travel expenses that caregivers may incur when 
        accompanying the veteran to his or her medical 
        appointments. However, these proposals lack key details 
        about the target population of individuals who will 
        receive these supportive services. We encourage the VA 
        to work with the Committee to further define this 
        target population and identify the range of supportive 
        services that the Department proposes to offer.


                                           Medical Support Compliance
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$4,930,000                                        $5,307,000       $5,314,595       $5,307,000               $0
----------------------------------------------------------------------------------------------------------------


Description
    The Medical Support and Compliance appropriation funds the 
expenses of management and administration of the VA health care 
system to include financial management, public health and 
environmental hazard, quality and performance management, 
medical inspection, human research oversight, training programs 
and continuing education, security, volunteer operations, and 
human resources.
Recommendation
    For FY 2011, the Administration requests $5.3 billion for 
the Medical Support and Compliance account, an increase of $377 
million, or 7.6 percent above the amounts provided in FY 2010.
    The Committee supports the funding level requested by the 
Administration. This funding has been provided in the FY 2010 
Consolidated Appropriations Act.


                                               Medical Facilities
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$4,859,000                                        $5,740,000       $5,706,507       $5,961,000         $221,000
----------------------------------------------------------------------------------------------------------------


Description
    The Medical Facilities appropriation provides funds for the 
operation and maintenance of the VA health care system's 
capital infrastructure. Included under this heading are 
provisions for costs associated with utilities, engineering, 
capital planning, leases, laundry, groundskeeping, garbage, 
housekeeping, facility repair, and property disposition and 
acquisition.
Recommendation
    For FY 2011, the Administration requests $5.7 billion for 
the Medical Facilities account, an increase of $881 million or 
18 percent above the FY 2010 level. Of the FY 2011 request, the 
Administration expects to obligate $1.1 billion for non-
recurring maintenance, which is a decrease of $221 million from 
the updated obligations estimate for FY 2010.
    The Committee recommends $6 billion for this account, which 
is $221 million above the Administration's request and $1.1 
billion above the FY 2010 level. The Committee recommendation 
would restore non-recurring maintenance funding to the FY 2010 
level.

          Non-Recurring Maintenance--In FY 2010, the 
        Administration estimated that they would obligate $972 
        million for non-recurring maintenance, but later 
        revised this estimate to $1.3 billion. The Committee 
        recommendation would restore the proposed funding cut 
        to non-recurring maintenance and provides additional 
        resources to address the non-recurring maintenance 
        backlog. Additionally, the Committee applauds the VA's 
        commitment to allocate at least 5 percent of the total 
        Medical Facilities appropriations for non-recurring 
        maintenance and minor construction projects of research 
        facilities. The Committee supports the VA's efforts to 
        ensure that sufficient resources are dedicated to 
        combat the deterioration of the existing VA research 
        infrastructure so that the VA may continue to promote 
        excellence in research in state of the art facilities.


                                         Medical and Prosthetic Research
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$581,000                                            $590,000         $700,000         $650,000          $60,000
----------------------------------------------------------------------------------------------------------------


Description
    This account includes medical, rehabilitative, and health 
services research. Medical research is an important aspect of 
the VA's programs, providing complete medical and hospital 
services for veterans. The prosthetic research program is also 
essential in the development and testing of prosthetic, 
orthopedic, and sensory aids for the purpose of improving the 
care and rehabilitation of eligible disabled veterans, 
including amputees, paraplegics, and the blind. The health 
services research program provides unique opportunities to 
improve the effectiveness and efficiency of the health care 
delivery system. In addition, budgetary resources from a number 
of areas including appropriations from the medical care 
accounts, reimbursements from the Department of Defense (DOD), 
grants from the National Institutes of Health (NIH), private 
proprietary sources, and voluntary organizations provide 
support for the VA's researchers.
Recommendation
    For FY 2011, the Administration requests $590 million for 
Medical and Prosthetic Research, which is $9 million or 1.5 
percent above the FY 2010 level. VA also estimates additional 
program resources of $1.3 billion from private and Federal 
grants, grants from the NIH, DOD, and Centers for Disease 
Control. The Committee notes that these estimates of additional 
program resources are never fully actualized by the VA, and has 
traditionally recommended increased appropriated funding levels 
to ensure that VA research receives the funding it needs to 
continue its world-class research efforts.
    The Committee recommends $650 million for Medical and 
Prosthetic Research, an amount $60 million above the 
Administration's request and $69 million above the FY 2010 
level.
    The Bureau of Economic Analysis in the U.S. Department of 
Commerce estimates a 3.2 percent increase in the Biomedical 
Research and Development Price Index in FY 2011. This 
translates to $19 million, which is needed to maintain the 
research efforts at the FY 2010 level. The Committee 
recommended funding for Medical and Prosthetic Research 
provides $10 million in addition to the $9 million already 
included in the Administration's request. The Committee 
recommendation would also provide an additional $50 million to 
increase funding for VA research grants.


                                           General Operating Expenses
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$2,086,707                                        $2,611,973       $2,339,364       $2,629,973          $18,000
----------------------------------------------------------------------------------------------------------------


Description
    The General Operating Expenses appropriation provides for 
the administration of non-medical veterans' benefits through 
the VBA and departmental management and support.
    With the funding provided in this account, VBA administers 
the following programs:

     LCompensation and Pension Service--VA provides 
service-connected compensation to veterans with disabilities 
incurred or aggravated during military service, dependency and 
indemnity compensation (DIC) to surviving spouses, children and 
low-income dependent parents of veterans, pension benefits to 
elderly and disabled low-income wartime veterans, death pension 
to the surviving spouses and children of wartime veterans and 
benefits to certain children of veterans who were disabled by 
spina bifida or other congenital conditions related to their 
parent's military service.
     LEducation Service--provides education assistance 
to servicemembers, veterans, and certain eligible survivors and 
dependents in exchange for military service. VA education 
assistance, including the Post-9/11 GI Bill and the Montgomery 
GI Bill, is used by the Armed Forces as a recruiting and 
retention tool, as well as a readjustment benefit for 
servicemembers seeking to achieve educational and vocational 
goals in the civilian workforce.
     LHousing (Loan Guaranty Service)--VA assists 
veterans and servicemembers to purchase and retain homes in 
recognition of their service to the Nation. VA's partial 
guarantee on loans made by private lenders enables veterans and 
servicemembers to purchase homes with little or no down 
payment, thereby making home ownership affordable to many 
veterans.
     LVocational Rehabilitation and Employment (VR&E)--
VR&E provides employment services and assistance to enable 
veterans with service-connected disabilities to obtain suitable 
employment and, to the maximum extent possible, achieve 
independence in daily living.
     LInsurance--The Insurance Program provides 
servicemembers and their families with universally available 
life insurance, as well as traumatic injury protection 
insurance. It also provides for the conversion to a renewable 
term insurance policy after a servicemember's separation from 
service and provides life insurance to veterans who have lost 
the ability to purchase commercial insurance at standard 
(healthy) rates due to lost or impaired insurability resulting 
from military service.

    This account also supports all of the staff offices with 
General Administration, including the Office of the Secretary, 
the Board of Veterans' Appeals, General Counsel, Office of 
Management, Office of Human Resources and Administration, 
Office of Policy and Planning, Office of Operations, Security 
and Preparedness, Office of Public and Intergovernmental 
Affairs, Office of Congressional and Legislative Affairs, and 
the Office of Acquisition, Logistics and Construction.
Recommendation
    For FY 2011, the Administration requests $2.612 billion for 
the General Operating Expenses (GOE) account, which is an 
increase of $525 million above the $2.087 billion provided in 
FY 2010. This request includes $2.1 billion for VBA, $463 
million for General Administration, and $24 million for the 
Administration's Acquisition Improvement Initiative.
    The Committee recommends $2.630 billion, an increase of $18 
million above the Administration's request and $543 million 
above the FY 2010 level. The Committee recommendation includes 
$15 million for 150 additional vocational rehabilitation and 
employment counselors and $3 million in additional funding for 
the Education division in order to assist with additional 
expenses, including any additional information technology 
expenses that are not covered within the Information Technology 
Systems account.
    The Secretary, in his testimony before the Committee on 
February 4, 2010, stated, in regards to the VA's GOE request, 
that the:

          [L]argest increase in our 2011 budget request, in 
        percentage terms, is directed to the Veterans Benefits 
        Administration as part of our mitigation of the 
        increased workload. The President's 2011 budget request 
        for VBA is $2.149 billion, an increase of $460 million, 
        or 27 percent, over the 2010 enacted level of $1.689 
        billion. The 2011 budget supports an increase of 4,048 
        FTEs, including maintaining temporary FTE funded 
        through American Recovery and Reinvestment Act of 2009, 
        P.L. 111-5. In addition, the budget also includes 
        $145.3 million in information technology (IT) funds in 
        2011 to support the ongoing development of a paperless 
        claims processing system.

    The Committee supports this FTE increase, especially those 
FTE involved in processing applications for Post-9/11 GI Bill 
benefits and those associated with the claims process.
    One of the biggest challenges facing the Administration is 
the veterans' compensation and pension claims backlog and the 
increasing delays veterans and survivors face in receiving 
their benefits. The Committee has taken steps to address this 
chronic problem, including supporting additional resources to 
hire more claims processors and beginning systemic reforms, 
most notably in title II of P.L. 110-389, the Veterans Benefits 
Improvement Act of 2008. The next step in the process is to 
explore more comprehensive reform, a reform effort led by VA, 
and informed by Congress, veterans and other stakeholders. In 
order for VA to reach its stated paperless claims processing 
system goal by 2012, this reform must utilize 21st Century 
technology, including electronic rules-based processing. 
Additionally, for achieving its business transformation effort 
within the VBA, which VA is coupling with the above-stated IT 
effort, VA should develop further its strategic plan with 
realistic and well-informed metrics and milestones, focus on 
the quality versus the quantity of its work product and ensure 
enhanced training of VBA's claims processing personnel.


                                         Information Technology Systems
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$3,307,000                                        $3,307,000       $3,552,884       $3,307,000               $0
----------------------------------------------------------------------------------------------------------------


Description
    The Information Technology Systems account was established 
in P.L. 109-114. The account previously encompassed the entire 
nonpay information technology portfolio for the VA, including 
all automation efforts in all administrations. Starting in FY 
2007, and reflected for the first time in the budget request 
for FY 2008, this account also includes pay and associated 
costs for information technology staff.
Recommendation
    For FY 2011, the Administration requests $3.307 billion for 
the Information Technology (IT) Systems account, which is the 
same as the amounts provided in FY 2010. This includes $1.3 
billion in Medical IT investments; $380 million for Benefits 
and Memorials IT investments; $527 million in Corporate IT 
investments for the VA's Corporate 21st Century Core 
initiative; and $158 million in Inter-agency IT investments, 
which includes funds for the Virtual Lifetime Electronic Record 
(VLER) and the Bi-directional Health Information Exchange 
(BHIE).
    The Committee recommends the amount requested by the 
Administration as the VA plots a path forward in ensuring that 
the VA's IT efforts support the missions of the VA. We intend 
to closely monitor funding committed to support the VA's 
electronic medical records and IT efforts in the benefits and 
claims processing areas.


                                        National Cemetery Administration
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$250,000                                            $250,504         $274,500         $250,504               $0
----------------------------------------------------------------------------------------------------------------


Description
    The National Cemetery Administration was established in 
accordance with P.L. 93-43, the National Cemeteries Act of 
1973. It has a fourfold mission: to provide for the interment 
of, in any national cemetery with available grave space, the 
remains of eligible deceased servicemembers and discharged 
veterans, together with their spouses and certain dependents, 
and to permanently maintain their graves; to provide headstones 
for, and to mark graves of eligible persons in national, State, 
and private cemeteries; to administer the grant program for aid 
to States in establishing, expanding, or improving State 
veterans' cemeteries; and to administer the Presidential 
Memorial Certificate Program. This appropriation will provide 
for the operation and maintenance of 164 cemeterial 
installations in 39 States, the District of Columbia, and 
Puerto Rico.
Recommendation
    For FY 2011, the Administration requests $250.5 million for 
the National Cemetery Administration, which is $504,000 or 0.2 
percent above the FY 2010 level. With the requested funding, 
the VA will determine where new national veterans cemeteries 
should be built based on a new population threshold of 80,000 
veterans (170,000 veterans under current policy) living within 
75 miles of a potential cemetery site. This reflects a 
significant decrease in the population threshold, which means 
that more veterans will have access to a veterans' cemetery 
burial option within 75 miles of their residence.
    The Committee supports the Administration's requested 
funding level.


                                           Office of Inspector General
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$109,000                                            $109,367         $112,020         $121,367         +$12,000
----------------------------------------------------------------------------------------------------------------


Description
    The Office of Inspector General was established by the 
Inspector General Act of 1978 and is responsible for the audit, 
investigation, and inspection of all VA programs and 
operations. The overall operational objective is to focus 
available resources on areas which would help improve services 
to veterans and their beneficiaries, assist managers of VA 
programs to operate economically in accomplishing program 
goals, and to prevent and deter recurring and potential fraud, 
waste, and inefficiencies.
Recommendation
    In FY 2011, the Administration requests $109.4 million for 
the Office of Inspector General (IG), which is an increase of 
$367,000 or 0.3 percent above the FY 2010 level. With this 
funding request, the Office of Inspector General will be able 
to maintain 576 FTEs, the same staffing total funded with the 
amounts provided in FY 2010.
    The Committee recommends an additional $12 million for this 
account to better match the resource requirements of the IG for 
FY 2011.
    At the Subcommittee on Oversight and Investigations budget 
hearing on the Office of Inspector General and Information 
Technology accounts, the Deputy Inspector General testified 
that a stagnant budget could limit the IG's ability to take on 
new oversight initiatives. The limited resources also would 
result in the IG conducting reactive investigations and would 
reduce their ability to conduct proactive investigations.


                                          Construction, Major Projects
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$1,194,000                                        $1,151,036       $1,295,000       $1,151,036               $0
----------------------------------------------------------------------------------------------------------------


Description
    The Construction, Major Projects appropriation provides for 
constructing, altering, extending, and improving any of the 
facilities under the jurisdiction or for the use of the VA, 
including planning, architectural and engineering services, 
assessments, and site acquisition where the estimated cost of a 
project is $10,000,000 or more.
Recommendation
    For FY 2011, the Administration requests $1.2 billion, a 
decrease of $43 million, or 3.6 percent below the FY 2010 
level. The Administration's request includes $1 billion for 
VHA-related construction and $107 million for NCA-related 
construction.
    The VHA-related construction request totaling $1.2 billion 
includes the following:


 
----------------------------------------------------------------------------------------------------------------
                                                                            Total
                 Location                           Description           Estimated      Funding        2011
                                                                            Cost      Through 2010     Request
----------------------------------------------------------------------------------------------------------------
New Orleans, LA                                  New Medical Facility   $995,000,000  $625,000,000  $310,000,000
----------------------------------------------------------------------------------------------------------------
Denver, CO                                       New Medical Facility   $800,000,000  $307,300,000  $450,700,000
----------------------------------------------------------------------------------------------------------------
Palo Alto, CA                                   Polytrauma/Ambulatory   $642,900,000  $164,877,000   $30,000,000
                                                                 Care
----------------------------------------------------------------------------------------------------------------
Alameda Point, CA                               Outpatient Clinic and   $208,600,000            $0   $17,332,000
                                                 Columbarium (Design)
----------------------------------------------------------------------------------------------------------------
Omaha, NE                                        Replacement Facility   $560,000,000            $0   $56,000,000
                                                             (Design)
----------------------------------------------------------------------------------------------------------------
Advance Planning                                     Various Stations                                $89,750,000
 
  Fund
----------------------------------------------------------------------------------------------------------------
Facility Security                                    Various Stations                                $41,390,000
 
  Projects
----------------------------------------------------------------------------------------------------------------
Judgment Fund                                        Various Stations                                 $6,000,000
----------------------------------------------------------------------------------------------------------------
BRAC Land                                            Various Stations                                $13,000,000
 
  Acquisition
----------------------------------------------------------------------------------------------------------------
Resident Engi-                                       Various Stations                                $23,964,000
 
  neers for Major Construction
----------------------------------------------------------------------------------------------------------------


    The NCA-related construction request totaling $107 million 
includes the following:


 
----------------------------------------------------------------------------------------------------------------
                                                                            Total
                 Location                           Description           Estimated      Funding        2011
                                                                            Cost      Through 2010     Request
----------------------------------------------------------------------------------------------------------------
Indianatown Gap,                                Gravesite Expansion &    $23,500,000            $0   $23,500,000
                                                    Cemetery Improve-
                                                        ments-Phase 4
 
  PA                                        ..........................
 
----------------------------------------------------------------------------------------------------------------
Los Angeles, CA                                 Columbarium Expansion    $27,600,000            $0   $27,600,000
----------------------------------------------------------------------------------------------------------------
Tahoma, WA                                      Gravesite Expansion &    $25,800,000            $0   $25,800,000
                                                    Cemetery Improve-
                                                        ments-Phase 2
----------------------------------------------------------------------------------------------------------------
Advance Planning                                     Various Stations                                $20,000,000
 
  Fund
----------------------------------------------------------------------------------------------------------------
NCA Land Acqui-                                      Various Stations                                $10,000,000
 
  sition Fund
----------------------------------------------------------------------------------------------------------------


    The Committee supports the Administration's requested 
funding level of $1.2 billion. As stated previously, the 
Committee plans on working to include additional construction 
resources when any opportunities present themselves.


                                          Construction, Minor Projects
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$703,000                                            $467,700         $785,000         $632,700        +$165,000
----------------------------------------------------------------------------------------------------------------


Description
    The Construction, Minor Projects appropriation provides for 
constructing, altering, extending, and improving any of the 
facilities under the jurisdiction or for the use of the VA, 
including planning, assessment of needs, architectural and 
engineering services, and site acquisition, where the estimated 
cost of a project is less than $10,000,000.
Recommendation
    For FY 2011, the Administration requests $467.7 million, a 
decrease of $235 million, or 33.5 percent below the level 
provided in FY 2010. This request includes $387 million for 
VHA, $43 million for NCA, $15 million for VBA, and $23 million 
for General Administration staff offices.
    The Committee recommends $632.7 million, an increase of 
$165 million above the Administration's request. The 
Committee's recommendation will bring the FY 2011 levels closer 
to the FY 2010 funding level for this account which provides 
funding for construction projects where the estimated cost is 
under $10 million. The VA faces a huge backlog in these 
projects and additional resources will help address this 
backlog while supporting VA facilities across the Nation.


                            Grants for Construction of State Extended Care Facilities
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$100,000                                             $85,000         $275,000         $175,000         +$90,000
----------------------------------------------------------------------------------------------------------------


Description
    This program provides grants to assist States to construct 
State home facilities, for furnishing domiciliary or nursing 
home care to veterans, and to expand, remodel or alter existing 
buildings for furnishing domiciliary, nursing home or hospital 
care to veterans in State homes. A grant may not exceed 65 
percent of the total cost of the project.
Recommendation
    For FY 2011, the Administration requests $85 million, a 
decrease of $15 million, or 15 percent below the level provided 
in FY 2010. The Committee recommends $175 million, an increase 
of $90 million above the Administration's request and $75 
million above the FY 2010 level.
    According to the 2000 Census, there were 9.7 million 
veterans age 65 and older in the U.S and Puerto Rico. The 
number of men age 85 and older who are veterans has increased 
drastically from 150,000 in the 1990 Census to 400,000 in the 
2000 Census, and is expected to increase drastically to 1.2 
million by the 2010 Census. With this significant growth in the 
aging veteran population, the Committee recognizes the 
important role that state homes play in the VA's long-term care 
strategy. As such, the Committee believes that the VA must 
begin to address the state home backlog. With the Committee's 
recommended funding increase, the VA can begin to reduce the 
backlog of Priority Group 1 state home projects, which are 
those projects that have state funding to begin construction 
but are waiting for funding from the VA. According to the VA's 
``FY 2010 Priority List of Pending State Home Construction 
Grant Applications,'' there are 53 Priority Group 1 projects 
with an estimated $405 million in VA grant costs.


                              Grants for Construction of State Veterans Cemeteries
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$46,000                                              $46,000          $51,000          $51,000          +$5,000
----------------------------------------------------------------------------------------------------------------


Description
    This program provides grants to assist States with the 
establishment, expansion, and improvement of State veterans' 
cemeteries which are operated and permanently maintained by the 
States. Grants under this program fund up to 100 percent of 
construction costs and the initial equipment expenses when the 
cemetery is established. The States remain responsible for 
providing the land and for paying all costs related to the 
operation and maintenance of the State cemeteries, including 
the costs for subsequent equipment purchases.
Recommendation
    For FY 2011, the Administration requests $46 million, which 
is the same as the FY 2010 enacted level.
    The Committee recommends a funding level of $51 million, an 
increase of $5 million above the Administration's request and 
$5 million above the FY 2010 level. The Committee 
recommendation would provide additional resources to match what 
the VA expects to obligate for these grants in FY 2010.

                          DEPARTMENT OF LABOR

            Veterans Employment and Training Service (VETS)

    The Assistant Secretary for VETS serves as the principal 
advisor to the Secretary of Labor on all policies and 
procedures affecting veterans' employment matters. VETS 
furnishes employment and training services to servicemembers 
and veterans through a variety of programs, including providing 
grants to States, public entities and non-profit organizations, 
including faith-based organizations, to assist veterans seeking 
employment. VETS also investigates complaints filed under 
veterans' preference and re-employment laws. Specifically, VETS 
administers the following programs: DVOP/LVER state grant 
program; Transition Assistance Program; Veterans' Preference 
and Uniformed Services Employment and Reemployment Rights Act 
(USERRA); Homeless Veterans' Reintegration Program (HVRP); 
Veterans Workforce Investment Program (VWIP); Federal 
Contractor Program; and, the National Veterans' Training 
Institute (NVTI). The Administration requested a total of 
$262.5 million in FY 2011 to support the staffing and grant-
making ability of VETS. This is a $6.4 million increase over 
amounts provided in FY 2010. The Committee recommends an 
increase of $66 million for VETS, for a total funding level of 
$328.5 million. This recommended level would provide an 
additional $31 million for State Grants in order for States to 
hire more DVOP and LVER staff to better manage the One-Stop 
Career Centers, military facilities, VR&E offices, and HVRP to 
provide better priority services to veterans. Committee 
recommends an additional $2 million to HVRP. Although accurate 
numbers are impossible to come by--no one keeps national 
records on homeless veterans--current estimates suggest that as 
many as 130,000 veterans are homeless on any given night and 
twice as many experience homelessness at some point during the 
course of the year. According to the National Survey of 
Homeless Assistance Providers and Clients (U.S. Interagency 
Council on Homelessness and the Urban Institute, 1999), 
veterans account for 23 percent of all homeless people in 
America. The Committee also recommends increasing the funding 
level for VWIP to $30 million. Not all States participate in 
VWIP grants. This is due not to a lack of eligible 
participants, but to a lack of resources. Providing an 
additional $30 million will provide assistance to more 
participants and would further enable the Administration to 
provide more green energy-related jobs for veterans and afford 
veterans with more marketable skills in a tough economy. The 
Committee also recommends an additional $3 million in funding 
for the NVTI. These additional resources will better assist 
NVTI in providing the training necessary to be a successful 
DVOP/LVER and provide sufficient resources to meet any 
expansion of the training requirement.

                             OTHER AGENCIES

                                      American Battle Monuments Commission
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$62,675                                              $64,200              N/A          $64,200               $0
----------------------------------------------------------------------------------------------------------------


Description
    The American Battle Monuments Commission is responsible for 
the administration, operation and maintenance of cemetery and 
war memorials to commemorate the achievements and sacrifices of 
the American Armed Forces where they have served since April 6, 
1917. In performing these functions, the Commission maintains 
24 permanent American military cemetery memorials and 31 
monuments, memorials, markers, and offices in 15 foreign 
countries, the Commonwealth of the Northern Mariana Islands, 
and the British dependency of Gibraltar. In addition, six 
memorials are located in the United States: the East Coast 
Memorial in New York; the West Coast Memorial, The Presidio in 
San Francisco; the Honolulu Memorial in the National Memorial 
Cemetery of the Pacific in Honolulu, Hawaii; and the American 
Expeditionary Forces Memorial, the World War II, and Korean War 
Veterans Memorials in Washington, DC.
Recommendation
    For FY 2011, the Administration is requesting a total of 
$84.8 million for the ABMC consisting of $64.2 million for 
salaries and expenses and $20.2 million for costs associated 
with foreign currency fluctuations. The Committee recommends 
that the requested level be provided in FY 2011.


                                    U.S. Court of Appeals for Veterans Claims
                                                ($ in Thousands)
----------------------------------------------------------------------------------------------------------------
                                                 FY 2011           FY 2011          FY 2011         Recommen-
                 FY 2010                     Administration      Independent    Committee Recom-    dation vs.
                                                 Request            Budget          mendation        Request
----------------------------------------------------------------------------------------------------------------
$27,115                                              $90,147              N/A          $90,147               $0
----------------------------------------------------------------------------------------------------------------


Description
    The Veterans' Judicial Review Act established the U.S. 
Court of Appeals for Veterans Claims. The Court reviews appeals 
from claimants seeking review of a benefit denial. The Court 
has the authority to overturn findings of fact, regulations, 
and interpretations of law.
    Pro bono program.--The Legal Services Corporation 
administers a grant program to provide pro bono representation 
and legal assistance to claimants who file appeals with the 
Court. The Congress funds the grant program through the Court's 
appropriation. To maintain impartiality, the Court does not 
administer the program or comment on the program's budget 
estimate.
Recommendation
    The Administration has requested a total appropriation for 
the Court of $90.1 million. This includes $62 million for the 
construction of a new courthouse that would be transferred to 
the General Services Administration. The Court's budget 
submission also includes $2.5 million for the Pro Bono 
Representation Program administered by the Legal Services 
Corporation. The Committee recommends the requested level of 
$90.1 million be provided in FY 2011.

                     SECTION 2--MANDATORY ACCOUNTS

    The Committee will look to improve veterans' benefits as 
well as address improvements to VA educational assistance 
programs. The Committee will also be facing a number of 
expiring authorities over the next few years which will need to 
be continued in order for veterans not to see a diminution in 
benefits. These efforts will require appropriate offsets or a 
commitment by Congress to improve these earned benefits.
    Congress may also need to provide the Committee with some 
flexibility in mandatory spending as the Committee begins to 
take steps to improve the claims processing system and looks to 
bring the veterans benefits system into alignment with the 
current needs of veterans in a new century.

                        SECTION 3--OTHER MATTERS

    Section 425 of S. Con. Res. 13, the FY 2010 Budget 
Resolution, states that:

          [A]ll committees are directed to conduct rigorous 
        oversight hearings to root out waste, fraud, and abuse 
        in all aspects of Federal spending and Government 
        operations, giving particular scrutiny to issues raised 
        by the Federal Office of the Inspector General or the 
        Comptroller General of the United States. Based upon 
        these oversight efforts, the committees are directed to 
        make recommendations to reduce wasteful Federal 
        spending to promote deficit reduction and long-term 
        fiscal responsibility. Such recommendations should be 
        submitted to the House Committee on the Budget in the 
        views and estimates reports prepared by committees as 
        required under 301(d) of the Congressional Budget Act 
        of 1974.

    The Committee will continue its vigorous oversight efforts 
over the VA, the benefits we provide to veterans and the 
programs in place to serve them. The Committee is committed to 
working with the Administration to assist in efforts to 
transform the VA into a 21st Century organization that puts the 
needs of veterans first. As part of that effort we have pledged 
to look at programs and benefits for veterans anew and bring 
innovative ideas to the forefront.
    The Committee will be working tirelessly to ensure that 
veterans receive the health care they deserve while we ensure 
that taxpayer dollars are used wisely and to their full extent; 
we will be looking at ways we can transform the manner in which 
VA provides benefits and services, and we will look at ways to 
make the VA more accountable for the unprecedented resources we 
have provided. The Committee has recommended funding levels 
above the Administration's request for the IG in order to 
assist the Committee in identifying instances where VA 
resources are not spent as efficiently as possible or are spent 
inappropriately.

                                                                    SECTION 4--CHART
                                        Views and Estimates--FY 2011 Budget of the Department of Veterans Affairs
                                                                      March 5, 2010
                                                                    ($ in Thousands)
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                             Committee
                                                              FY 2011         FY 2011         FY 2011       Committee   Committee Recom-      Recom-
         Discretionary Accounts               FY 2010     Administration    Independent      Committee       Recom-      mendation  vs.   mendation  vs.
                                                              Request       Budget \1\        Recom-        mendation   Administration's    Independent
                                                                                             mendation     vs. FY 2010       Request        Budget \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Medical Services \1\                        34,707,500      37,136,000      40,940,954      37,136,000    +2,428,500               0        ^3,804,954
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Medical Support and                          4,930,000       5,307,000       5,314,595       5,307,000      +377,000               0            ^7,595
 
    Compliance
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Medical Facilities                           4,859,000       5,740,000       5,706,507       5,961,000    +1,102,000        +221,000          +254,493
--------------------------------------------------------------------------------------------------------------------------------------------------------
Total, Medical Care                           44,496,500      48,183,000      51,962,056      48,404,000    +3,907,500        +221,000        ^3,558,056
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Medical Care Collections                     2,954,000       3,355,000                       3,355,000      +401,000               0        +3,355,000
 
    Fund (non-add) \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Total, Medical Care                         47,450,500      51,538,000      51,962,056      51,759,000    +4,308,500        +221,000          ^203,056
 
    with Collections
    (non-add)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Medical and Prosthetic Research                  581,000         590,000         700,000         650,000       +69,000         +60,000           ^50,000
--------------------------------------------------------------------------------------------------------------------------------------------------------
  General Operating                            2,086,707       2,611,973       2,339,364       2,629,973      +543,266         +18,000          +290,609
 
    Expenses
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Information Technology                       3,307,000       3,307,000       3,552,884       3,307,000             0               0          ^245,884
 
    Systems
--------------------------------------------------------------------------------------------------------------------------------------------------------
  National Cemetery                              250,000         250,504         274,500         250,504          +504               0           ^23,996
 
    Administration
--------------------------------------------------------------------------------------------------------------------------------------------------------
 
  Office of Inspector                            109,000         109,367         112,020         121,367       +12,367         +12,000            +9,347
 
    General
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Construction, Major                          1,194,000       1,151,036       1,295,000       1,151,036       ^42,964               0          ^143,964
 
    Projects
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Construction, Minor                            703,000         467,700         785,000         632,700       ^70,300        +165,000          ^152,300
 
    Projects
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Grants for Construction                        100,000          85,000         275,000         175,000       +75,000         +90,000          ^100,000
 
    of State Extended
    Care Facilities
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Grants for Construction                         46,000          46,000          51,000          51,000        +5,000          +5,000                 0
 
    of State Veterans
    Cemeteries
--------------------------------------------------------------------------------------------------------------------------------------------------------
Total, Departmental                            7,795,707       8,028,580       8,684,768       8,318,580      +522,873        +290,000          ^366,188
 
  Administration
--------------------------------------------------------------------------------------------------------------------------------------------------------
Other Discretionary \2\                          166,103         164,738         170,482         164,738        ^1,365               0            ^5,744
--------------------------------------------------------------------------------------------------------------------------------------------------------
Total, VA Discretionary                       53,039,310      56,966,318      61,517,306      57,537,318    +4,498,008        +571,000        ^3,979,988
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Medical Care Collec-                         2,954,000       3,355,000               0       3,355,000      +401,000               0        +3,355,000
 
    tions Fund (MCCF) \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
  Total, VA Discre-                           55,993,310      60,321,318      61,517,306      60,892,318    +4,899,008        +571,000          ^624,988
 
    tionary with MCCF
    collections
 
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The Independent Budget includes amounts attributable to medical care collections in its base funding level for the Medical Services Account.
 
\2\ Other Discretionary includes the administrative expenses for the Veterans Housing Benefit Program Fund and the Vocational Rehabilitation Loan
  Program, as well as the Native American Veterans Housing Loan Program. In addition, it includes the program fund and credit subsidy totals for the
  Vocational Rehabilitation Loan Program and the Native American Veteran Housing Loan Program.



ADDITIONAL VIEWS AND ESTIMATES, COMMITTEE ON VETERANS' AFFAIRS, FISCAL 
                               YEAR 2011

    I support many of the recommendations of the House 
Committee on Veterans' Affairs Views and Estimates of the 
Fiscal Year 2011 budget. I am proud to be part of a committee 
that continues to push for the expansion of eligibility for 
access to care for our veterans, tackle the disability claims 
backlog, and improve veterans' education benefits.
    Additionally, I would support the committee seeking 
additional major construction funds should Congress consider 
any additional supplemental, emergency, or economic recovery 
appropriations; the backlog of projects both partially funded 
and completely unfunded is too deep to fulfill the needs of our 
veterans for reasonable access to care. However, I believe the 
committee should have requested more funds for major 
construction for regular FY 2011 appropriations. In the 
administration's FY 2011 budget request, only $73 million is 
requested for a list of 61 newly scored major construction 
projects totaling well over $8 billion.
    Too often, veterans in my district--and across the 
country--are forced to drive hours and hundreds of miles to 
seek the care they were promised in return for their service 
and sacrifice to our country. But veterans and their families 
are not alone in recognizing the need for expanded healthcare 
services in north central Indiana.
    In September 2008, a Subcommittee on Health roundtable 
discussion was held in South Bend. Representatives from the 
subcommittee, the local VA, local veterans service 
organizations, and the community discussed access to care in 
the South Bend area, where the South Bend CBOC has more than 
8,000 veterans enrolled and sees approximately 200 patients 
each day. Following this discussion, the Department of Veterans 
Affairs announced in April 2009 plans for a new healthcare 
center in South Bend, raising the hopes of thousands of Hoosier 
veterans and the community that the days of hours-long travel 
for healthcare would soon be over. I was pleased to see it 
listed on the VA's major construction list but disappointed 
that the administration did not request funds for FY 2011 
construction.
    On behalf of the veterans and communities of my district, I 
recommend additional funds for the major construction accounts 
in order to accelerate the building of these projects and to 
provide veterans like those in north central Indiana with the 
access to healthcare they deserve and have spent years waiting 
for.

                                   Joe Donnelly

                    REPUBLICAN LETTER OF TRANSMITTAL

                                ------                                

                          House of Representatives,
                            Committee on Veterans' Affairs,
                                     Washington, DC, March 5, 2010.
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) 2011 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 essential to fulfilling our Nation's commitment to 
veterans. Overall, the Republican Members generally agree with 
the President's FY 2011 budget proposal but believe additional 
funds are required in critical areas.
    These areas include health care and benefits programs for 
wounded warriors, particularly for medical and prosthetic 
research programs, prosthetic services, and rehabilitation. We 
also strongly advocate a special emphasis on helping veterans 
qualify for and find meaningful employment during these 
difficult economic times, and on ensuring that veterans have 
access to VA health care regardless of where they live.
    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) 2011

                             March 5, 2009

                                OVERVIEW

    For veterans' healthcare and program costs in fiscal year 
(FY) 2011, the Administration has requested a total of $125 
billion. For discretionary spending, the Administration has 
requested $60.3 billion, and for mandatory spending, the 
Administration has requested $64.7 billion.
    For veterans' program costs in FY 2011, Republican Members 
of the Committee on Veterans' Affairs recommend $113.7 million 
above the Administration's request for discretionary spending, 
as follows: Compensation and Pension Training and Performance 
Support Systems, $5 million; Compensation and Pension Skills 
Certification, $10 million; Vocational Rehabilitation and 
Employment Service, 200 additional Full Time Equivalents (FTE), 
$20.4 million; Training of State Veterans Employment Service 
staff at the National Veterans Training Institute, $2 million; 
Veterans Training Program Veterans Employment and Training 
Service (VETS) Workforce Investment Program, $11 million; 
National Cemeteries and Related Agencies National Shrine 
Commitment, $10 million; Office of the Inspector General, 230 
additional FTE, $50 million; Department of Labor VETS program, 
50 additional FTE, $5.3 million.
    For veterans' healthcare costs in FY 2011, Republican 
Members of the Committee on Veterans' Affairs recommend $200 
million above the Administration's request for discretionary 
spending, as follows: Veterans' Court, $10 million; Medical and 
Prosthetic Research, $50 million; Prosthetic Limb Program 
Modernization, $20 million; Recreational Therapy, $30.6 
million; and Rural Health Initiative, $89.4 million. These 
increases would be funded through a fee-basis care recovery 
program within the Veterans Health Administration (VHA) 
estimated to generate recoveries of at least $200 million 
annually.
    Finally, we recommend that $2.3 billion be used from the 
Administration's $100 billion jobs creation and economic 
recovery request to fund legislative initiatives to promote job 
readiness programs for veterans and a small business loan 
guarantee program for veterans.
    In total, the Republican Members recommend an increase of 
$2.66 billion in discretionary and mandatory spending above the 
Administration's request for veterans' healthcare and program 
costs, and for legislative initiatives in FY 2011.

                     DEPARTMENT OF VETERANS AFFAIRS

                    Veterans Benefits Administration

    Compensation and Pension Service--The President's FY 2011 
budget request for Compensation and Pension Service (C&P) seeks 
$53.5 billion.
    The President has proposed a budget that provides an 
additional $460 million to fund 4,048 additional permanent FTE 
to process claims for benefits. Over 3,900 of those new 
employees are slated for the Compensation and Pension Service 
(C&P). Republican Members believe that an increase in Veterans 
Benefits Administration (VBA) personnel is in order, but 
allocating 97 percent to C&P does not meet the pressing needs 
also found in the Vocational Rehabilitation and Employment 
Service (VR&E) and the Education Service (ES). Therefore, 
Republican Members recommend an additional $20.4 million to 
fund additional permanent FTE for VR&E and $18.5 million for 
the ES.
    It is important to note that according to VA, it takes at 
least 2 years for new C&P claims processors to become 
effective. However, the VR&E program hires highly credentialed 
staff who require little training beyond understanding the VA's 
paperwork program and are effective almost immediately. 
Similarly, the training period for education claims processors 
is measured in weeks rather than years and new ES staff are 
productive relatively soon after hiring.
    Republican Members generally agree with the President's 
request for C&P, but recommend an additional $5 million for 
Training and Performance Support Systems, and an additional $10 
million for skills certification required by P.L. 110-389.
    Republican Members are deeply concerned about the growing 
size of the backlog of claims for VA disability compensation. 
The number of unresolved claims has soared over the past year. 
More than 400,000 new claims are now pending, with an 
additional 200,000 decisions being appealed. The numbers grew 
despite the nearly 4,000 additional employees VA has hired 
since 2007.
    Additionally, VA recently established new regulations to 
make it easier for Vietnam veterans who were exposed to the 
Agent Orange herbicide to receive service-connected 
compensation. VA expects a significant increase in workload as 
a result of the regulatory change.
    Republican Members believe a multifaceted approach is 
necessary for VA to overcome the challenges it faces. This 
approach includes a paradigm shift that involves placing a high 
level of priority on quality of work as well as quantity. To do 
so, VA must place greater emphasis on employee training and 
accountability.
    We have long recognized the need for technological 
improvements in VA's business process, including the 
development of a paperless adjudication system. VA is striving 
to meet the requirements of the Veterans Disability Benefits 
Claims Modernization Act of 2008, which became part of P.L. 
110-389. VA's efforts include creation of the Veterans Benefits 
Management System (VBMS) to replace its antiquated paper-driven 
process.
    Vocational Rehabilitation and Employment (VR&E)--The 
President's budget proposes to reduce the VR&E staff by nine 
FTE. During the VA's Budget hearing testimony, the Department 
described the decrease as an artifact of how personnel costs 
are allocated. The President's budget estimates a 10 percent 
increase in caseload over FY 2010 and an increase of 20 percent 
over FY 2009. With the President's budget proposal, VR&E staff 
levels would result in an average caseload of approximately 150 
per counselor. At the same time, the number of disabled 
veterans returning home from the current conflicts is 
increasing. Therefore, Republican Members believe it is 
imperative to increase the number of VR&E staff to decrease the 
average caseload and shorten the time it takes to begin 
rehabilitation.
    The VR&E program has five tracks ranging from immediate 
employment services to long term education and training. 
Regardless of the track, all veterans desiring to participate 
in the VR&E program must complete the phases that include 
application for the benefit, determination of eligibility, 
evaluation, and planning. According to VA, this process 
typically takes about 171 days to complete. During that time, a 
significant number of veterans withdraw from the program, many 
because of the need to work to support their families. By 
increasing the VR&E staff levels, the extended period of 
application and evaluation should be reduced, resulting in 
fewer dropouts and a higher rehabilitation rate.
    Therefore, we agree with the authors of the Independent 
Budget that VR&E direct service staff levels should be 
increased by 200 FTE with a cost of approximately $20.4 
million. Republican Members recommend an additional $20.4 
million above the President's request to fund the recommended 
200 additional FTE for the VR&E Service. Such an increase would 
reduce the average caseload to just over 100.
    The President's budget also proposed about $165.4 million 
for the existing state grant program to fund the Disabled 
Veterans Outreach Program Specialists (DVOPS) and Local 
Veterans Employment Representatives (LVER). DVOPS and LVER are 
state employment service staff whose mission is to provide 
intensive job placement services to disabled veterans and 
outreach to employers to promote hiring veterans in general. 
The President also proposed $8 million to fund additional DVOPS 
and LVER to support the Transition Assistance Program (TAP). 
While Republican Members are supportive of providing these 
employment services to veterans, the Members believe this 
additional $8 million should be used to provide TAP services at 
U.S. bases through contract. By using contract personnel, 
Republican Members believe the President's proposal will enable 
DVOPS and LVER to focus on providing direct employment services 
to veterans.
    Education--VA's strategic goal is 26 days to adjudicate an 
original claim for education benefits. It currently takes 47 
days.
    To meet the influx of the new Post-9/11 GI Bill claims, VA 
increased ES staffing to 1,889 FTE in FY 2010 by hiring several 
hundred short term personnel. The President's budget proposes 
to reduce ES direct FTE from 1,889 to 1,521. That decrease 
reflects shifting some of the term employees hired to augment 
the permanent claims processing staffs to permanent employees. 
Most of the remaining term employees would be released to 
reflect implementation of a new information technology system 
to automate education claims processing.
    However, Republican Members remain skeptical of the 
Department's ability to meet the proposed December 2010 
implementation date for the new IT system. Therefore, 
Republican Members recommend reallocating $18.5 million in 
General Operating Expenses funds from the President's budget to 
maintain the current mix of 1,889 permanent and term FTE 
employees for the entire FY 2011. Maintaining the current level 
of FTE should enable VA to meet the VA's strategic processing 
goals in case of a slip in IT delivery and to bridge the 
transition period from manual to automated processing.

                National Cemeteries and Related Agencies

    The President's FY 2011 budget request for the National 
Cemetery Administration (NCA) seeks $251 million.
    Republican Members generally concur with the President's 
request for NCA, but recommend an additional $10 million be 
included to continue the National Shrine Commitment at NCA. 
This additional funding would ensure the highest possible 
standards for all of our veterans' final resting places, and 
would be used for infrastructure projects such as irrigation, 
renovation of historic structures, headstone cleansing, and 
road resurfacing.
    Additionally, we recommend a comprehensive and independent 
study of the Federal veterans' cemeteries under the 
jurisdiction of the VA National Cemetery Administration, the 
American Battle Monuments Commission, the Department of the 
Army, and the Department of Interior. This study would identify 
areas for improvement to ensure a consistent, high standard is 
maintained for veterans' cemeteries. Republican Members are 
concerned that having four different agencies share this 
responsibility has led to four different standards of upkeep 
and appearance of veterans' cemeteries.

                     Veterans Health Administration

    Medical Services--Republican Members recommend $37.3 
billion for medical services, which is $200 million more than 
the Administration's request. Further, Republican Members 
recommend that VA conduct a recovery audit for outpatient 
medical services that we expect would provide additional 
resources of at least $200 million. We expect that this 
recommendation would accommodate for health care inflation, 
estimated workload, and the following initiatives:

          Rural Health Care--Republican Members are concerned 
        that VA has not implemented section 403 of Public Law 
        110-387, which establishes a 3-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. Therefore, 
        we recommend an additional $89.4 million to move 
        forward with this important initiative.
          Prosthetic Limb Program Modernization--We are 
        encouraged by VA's intent to obligate an additional 
        $148 million to modernize VA's prosthetic limb program. 
        However, Republican Members recommend an additional $20 
        million because it is vitally important that VA be 
        capable, system-wide of meeting the needs of the 
        younger and more active amputees with the latest 
        technology and providing consistent and coordinated 
        state-of-the art care regardless of where the veteran 
        amputee lives.
          Mental Health Initiatives--We are also encouraged by 
        VA's intent to obligate an additional $410 million or 
        nine percent increase to support the implementation of 
        the Mental Health Strategic Plan and the hiring of 
        additional new mental health professionals to ensure 
        all veterans have access to these vital services 
        throughout the system.
          Recreation Therapy Services--Republican Members 
        recommend an increase in obligations for recreation 
        therapy services of $30.6 million. We are concerned 
        that recreation therapy services are not consistently 
        funded system-wide. Further, the budget does not 
        identify obligations for such services. Therefore, 
        Republican Members also recommend that VA provide a 
        separate budget line item to track and account for the 
        allocation of funds for recreation therapy services at 
        each VA medical center.
          Republican Members believe this is important because 
        VA recreation therapy supports wellness programs and 
        provides the first opportunity to engage veterans in 
        sports as a part of their rehabilitation. The Congress 
        recognized the value of sports in rehabilitation with 
        the enactment of Public Law 110-389. This law requires 
        VA to award grants through the United States Olympic 
        Committee to grassroots organizations to plan, develop, 
        manage, and implement an integrated adaptive sports 
        program for disabled veterans and disabled members of 
        the Armed Forces.
          Veterans Justice Outreach (VJO) Program--Republican 
        Members wholeheartedly support the VJO program VA 
        launched in 2009 to work with local justice system 
        partners to provide outreach and alternative treatment 
        for justice-involved veterans, including Veterans' 
        courts, drug courts, and mental health courts. The 
        budget request includes plans for 40 full-time VJO 
        specialist positions. Republican Members recommend an 
        additional $10 million for funding 113 more full time 
        specialist positions to accommodate full time positions 
        in each VA medical center.
          Medical Care Collections Fund--We are pleased with 
        the progress VA has made in improving third-party 
        collections. In FY 2009, VA exceeded the projection 
        level. Additionally, Republican Members are encouraged 
        and pleased with the Secretary's decision to pursue a 
        more aggressive timeline to consolidate their 
        collection activities at seven Consolidated Patient 
        Accounting Centers (CPAC).
          Outpatient Audit and Recovery Program--The Office of 
        Inspector General (IG) reported a net cost to the 
        Department due to errors in the process VA uses for 
        paying fee basis bills of $865 million over 5 years. 
        While VA currently employs a recovery audit for 
        inpatient medical services, it has not yet used the 
        authority Congress provided to conduct a recovery audit 
        program for outpatient medical services. The current 
        inpatient program has identified about $6.8 million in 
        overpayments in 2009 and over $109 million in the 
        program to date. We recommend that VA conduct a similar 
        audit and recovery program for outpatient medical 
        services. Through such a program, we believe VA could 
        identify overpayments of at least 10 to 15 percent of 
        the total amount VA spends on the outpatient fee basis 
        program, which exceeded $2 billion in FY 2009. We 
        estimate that VA would realize at least $200 million in 
        savings from this program.

    Medical Facilities--Republican Members recommend $5.74 
billion for medical facilities consistent with the 
Administration request, which is $881 million more than the 
enacted FY 2010 amount for this account.

          Energy Initiatives--Republican Members place a high 
        premium on advancing renewable energy projects at VA 
        facilities. Savings from the use of alternative sources 
        of energy results in additional resources for medical 
        care for our veterans. We recommend at least $325 
        million of this amount be obligated to implement 
        planned energy initiatives and establish a long-term 
        strategy for energy conservation and sustainability. VA 
        has completed 29 feasibility studies to implement 
        renewable energy projects at selected VA medical 
        facilities. In FY 2010, VA expects to allocate about 
        $13 million to move forward with the procurement 
        process on these projects. We expect that with the 
        additional resources for FY 2011, VA will be able to 
        fully fund all the identified projects.

    Medical Support and Compliance--Republican Members 
recommend $5.3 billion for Medical Support and Compliance, 
consistent with the Administration's request.
    Medical and Prosthetic Research--Republican Members 
recognize the importance of medical and prosthetic research to 
ensure that our veterans are receiving the best possible in 
care, treatment, and medical practices. We recommend $640 
million in direct appropriations for medical and prosthetic 
research. This amount is $50 million above the Administration's 
FY 2011 request and an increase of $59 million more than the FY 
2010 appropriation.
    The signature injury of the War on Terror is traumatic 
brain injury (TBI). TBI can also be one of the most 
debilitating combat injuries, and every effort should be made 
to improve protective equipment such as helmets, which can 
substantially limit physiological damage sustained in combat.
    Of particular interest in this regard is a new technology 
developed for race car drivers to measure G-force impact. We 
recommend VA direct funds in collaboration with the Department 
of Defense to conduct a series of similar tests and evaluations 
to improve combat helmets for servicemembers.
    VHA Major Construction Projects--Republican Members 
recommend $1.04 billion, consistent with the Administration's 
request for major medical construction projects. However, 
Republican Members are concerned with a shift in the priority 
and scope of a major medical facility project in Omaha, NE. In 
the VA FY 2010 budget submission, Omaha, NE, was described as 
``HVAC and clinical deficiencies'' with an estimated cost of 
$256 million. In the FY 2011 Budget Submission, this project 
was elevated from the seventh to the number two priority 
without justification, and the scope of the project was changed 
to a replacement facility at a cost of $560 million. Further, 
the budget request includes $56 million for the design of the 
project. This project has been moved ahead of other FY2010 
scored projects in Lexington, KY; Columbia, SC; Reno, NV; West 
Los Angeles, CA; Lebanon, PA, and Portland, OR. Therefore, 
Republican Members recommend that $56 million be instead 
appropriated for the Lexington, KY campus realignment. Finally, 
Republican Members request $36.8 million of advance planning 
and design funds be used to carry out section 804 of Public Law 
109-461 for the design of a co-located joint-use medical 
facility in Charleston, SC.
    VHA Minor Construction Projects--For FY 2011, Republican 
Members recommend $387 million for minor construction costs to 
maintain and improve an aging VA infrastructure, consistent 
with the Administration's request.

                         Advance Appropriations

    The Administration's request includes $50.6 billion in 
advance appropriations for FY 2012, consistent with Public Law 
111-81. The purpose of the advance appropriations is to ensure 
continuity of funding in the areas of Medical Services ($39.6 
billion requested), Medical Support and Compliance ($5.5 
billion requested), and Medical Facilities ($5.4 billion 
requested).
    Republican Members are concerned that the Administration's 
request for advance appropriations for FY 2012 may not reflect 
the total resource amount projected by the Enrollee Health Care 
Projection Model. However, without having the ability to 
evaluate specific components of this advance appropriation 
request (Medical Care, long term care, CHAMPVA, Vet Centers, 
and State Home Per Diem), it is not possible to assess the 
sufficiency of the request.
    The Government Accountability Office (GAO) is required by 
law to conduct a study of the adequacy and accuracy of the 
budget projection and report on whether the Administration's 
advance appropriations request for VA health care funding is 
consistent with expenditures estimated under the Model. 
However, the GAO study will not be available prior to the 
submission of our Views and Estimates, and it remains to be 
determined if the Administration's budget request is 
transparent for GAO assessments.

                  Office of Information and Technology

    Republican Members believe that a top VA priority should be 
information technology (IT) systems that are standardized, 
integrated, and 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. We are pleased with the top down 
review of all VA IT programs utilizing the Program Management 
Accountability System, which has put 45 VA IT projects on hold 
because they have not met deadlines or have failed to be 
delivered.
    The FY 2010 appropriated amount for the Office of 
Information and Technology (OI&T) was $3.307 billion. 
Republican Members concur with the FY 2011 Administration 
request of $3.307 billion for the OI&T.
    During testimony provided at the Oversight and 
Investigations Subcommittee hearing on February 23, 2010, VA 
indicated there is a carry-over amount from the FY 2009 
appropriations of $700 million for OI&T. Republican Members 
believe the procurement and implementation of currently 
available technology applications to identify and monitor when 
previously entered clinical documentation has been copied and 
pasted into another electronic patient record document within 
VHA's computerized medical record system (CPRS) should come 
from a portion of the FY 2009 carry-over account. This 
procurement would provide mandatory monitoring of the copy and 
paste functions within the CPRS system. This issue was brought 
to the Committee's attention in a number of Inspector General 
Combined Assessment Program (CAP) reviews of VA facilities.
    Republican Members also recommend an additional amount of 
$56.2 million to fund the development of the Purchased Care 
Claims Processing System and the Patient Accounting System for 
the automation of the fee-for-service program also to be 
procured out of the FY 2009 carry-over amount.

                    Office of the Inspector General

    For FY 2010, Congress appropriated $109 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 $109 million and 
551 FTE provides resources to increase work on several 
oversight initiatives.
    The President's request for FY 2011 remains at the FY 2010 
appropriated level. While this was an increase from the 
appropriations from the FY 2009 level, Republican Members 
believe it still does not provide sufficient resources to allow 
the OIG to perform the amount of work consistent with the large 
agency for which it must provide oversight. Republican Members 
recommend adding $50 million for the VA Office of Inspector 
General to provide an additional 230 FTE. The additional 
staffing resources would permit the OIG to perform much needed 
investigative and auditing work to include reduction of the 
Regional Office review cycle; appropriate oversight on the 
claims processes; more timely review of Outpatient Clinics, 
currently on a 20-year review cycle; and strengthening the OIG 
criminal investigations unit and their audit personnel. The 
additional resources would also allow new or increased 
oversight of the VA's homeless programs, elderly care programs, 
and non-VA care provided to veterans. This additional funding 
will allow the OIG to be more pro-active than reactive such as 
in the colonoscopy investigations.
    The total funding for the OIG recommended by Republican 
Members is $159 million, $50 million above the Administration's 
request.

                          DEPARTMENT OF LABOR

               Veterans' Employment and Training Service

    The U.S. Department of Labor's Veterans' Employment and 
Training Service (VETS) manages programs intended to assist 
veterans seeking employment. For FY 2011, the President 
proposes $262.5 million for VETS, an increase of $6.4 million. 
The Homeless Veteran Reintegration Program (HVRP) will receive 
$5 million of that increase. Overall, the Republican Members 
agree with the President's proposal but believe that the 
current economic climate requires additional funds to assist 
unemployed veterans.
    Therefore, Republican Members recommend increasing funding 
for the basic infrastructure devoted to promoting veterans as 
ideal employees to businesses and providing the skills to 
qualify for good-paying jobs. To ensure that state employment 
service Disabled Veteran Outreach Program Specialists (DVOPS) 
and Local Veterans Employment Representatives (LVERs) are 
properly prepared to meet their statutory duties, Republican 
Members recommend an additional $2 million to fund the training 
operations at the National Veterans Training Institute (NVTI). 
This increase should enable NVTI to meet the training 
requirements of Public Law 109-461.
    Lastly, to improve Federal oversight of the DVOPS and 
LVERs, HVRP grantees, Veterans Workforce Investment Program 
(VWIP) grantees, and NVTI, Republican Members recommend an 
additional $5.3 million to fund 50 additional Federal staff.

                        LEGISLATIVE INITIATIVES

    The Administration's budget request for other budget 
functions included a $100 billion jobs creation and economic 
recovery package. Republican Members believe it is critical 
that veterans be explicitly targeted in any jobs creation and 
economic recovery package.
    Veterans Small Business Loan Guarantees--Veterans comprise 
about 3.5 million or 13 percent of the 27 million U.S. small 
businesses. VA previously operated a small business direct and 
guaranteed loan program that terminated in 1986. H.R. 294, the 
Veteran-Owned Small Business Promotion Act of 2009, would 
reauthorize the VA's small business loan guaranty program. 
Therefore, Republican Members recommend that not less than $1 
billion of the $100 billion be applied to this legislative 
proposal to authorize VA and Small Business Administration 
loans to veteran-owned small businesses.
    Veterans Job Readiness--On January 1, 2010, there were 
968,000 unemployed veterans. Of that number, 685,000 were 
between the ages of 35 and 64--the years when most people 
experience the largest financial burdens. Unlike younger 
veterans, this is the age group that has either passed 
eligibility for VA education and training programs and who also 
may not be able to afford to pursue a long-term degree program 
to improve their marketability. Therefore, it is vital to 
provide funds for shorter-term training to provide skills 
relevant to today's job market.
    To meet these job readiness needs, Republican Members also 
recommend $700 million from the Administration's $100 billion 
jobs creation and economic recovery request to fund the 
training proposed in H.R. 4220, the Promoting Jobs for Veterans 
Act of 2009. Of that amount, VA would receive an additional 
$470 million in mandatory funds and $210 million in 
discretionary funds. Further, of that amount the Department of 
Labor would receive $20 million.
    Further, we anticipate a legislative proposal that would 
authorize eligibility for most unemployed veterans between the 
ages of 35 and 60 eligible for up to 1 year of education or 
training under the Chapter 30 Montgomery GI Bill. The program 
would be effective from FY 2011 through FY 2013. The estimated 
cost for FY 2011 would be $645 million, also to be funded from 
the Administration's $100 billion jobs creation and economic 
recovery request.

                                 
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